Kadar Serum Substansi P Pada Pemberian Klonidin Sebagai Ajuvan Analgesia Epidural

*Karyadi Karyadi  -  RSUD Tarakan, Indonesia
Yulia Wahyu Villyastuti  -  Bagian Anestesi dan Terapi Intensif, Fakultas Kedokteran, Universitas Diponegoro/ RSUP Dr. Kariadi, Indonesia
Published: 1 Nov 2014.
Open Access
Citation Format:
Abstract

Latar belakang : Klonidin ketika digunakan bersamaan dengan obat lokal anestesi sebagai teknik regional anestesi, bisa mengurangi kejadian nyeri kronik pasca operasi. Sensitisasi perifer dan  sensitisasi sentral merupakan salah satu mekanisme terjadinya transisi nyeri akut menjadi nyeri kronik. Kaskade awal yang menyebabkan sensitisasi perifer dan sensitisasi sentral di picu oleh pelepasan neurotransmitter eksitatorik presinaptik dan pasca sinaptik seperti glutamat dan substansi P.

Tujuan : Membandingkan peningkatan  kadar serum substansi P pada 12 jam pasca operasi  dan nilai visual analog skor pada 0 dan 12 jam pasca operasi antara  analgesia epidural  dengan bupivakain murni dan bupivakain dengan ajuvan klonidin

Metode : penelitian ini merupakan penelitian acak tersamar ganda. Sampel 40 orang dibagi 2 kelompok, yaitu kelompok kontrol mendapat epidural analgesia dengan bupivacain murni dan kelompok kontrol mendapat epidural analgesia bupivakain ditambah ajuvan klonidin dimana pemberian analgesia dilakukan pra insisi dan dilanjutkan samapai pasca operasi. Kadar serum substansi P dinilai pra operasi dan 12 jam pasca operasi pada masing-masing kelompok perlakuan. Sedangkan nilai VAS diukur pada 0 dan 12 jam pasca operasi

Hasil : Terdapat perbedaan kadar serum substansi P berupa penurunan secara bermakna pada 12 jam pasca operasi baik pada kelompok kontrol dan perlakuan. Tidak terdapat perbedaan yang bermakna antara rerata kadar serum substansi P antara kelompok kontrol dan perlakuan pada 12 jam pasca operasi. Terdapat perbedan nilai VAS secara bermakna pada 0 dan 12 jam pasca operasi antara kelompok kontrol dan perlakuan

Simpulan : epidural analgesia dengan bupivacain maupun dengan ajuvan klonidin yang diberikan pra insisi yang dilanjutkan pasca operasi sama-sama efektif menurunkan kadar substansi P pada 12 jam pasca operasi.

Keywords: analgesia epidural; klonidin; bupivakain; substansi P

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