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Efek Blok Transversus Abdominis Plane Teknik Landmark Terhadap Kebutuhan Analgetik Pascabedah Herniorafi

1Bagian Anestesi, Terapi Intensif, dan Manajemen Nyeri Fakultas Kedokteran Universitas Hasanuddin/RS dr. Wahidin Sudirohusodo, Indonesia

2Makassar, Indonesia

Published: 1 Jul 2015.
Open Access Copyright 2015 JAI (Jurnal Anestesiologi Indonesia)

Citation Format:
Abstract

Latar Belakang : Blok transversus abdominis plane (TAP) adalah teknik yang aman, mudah, dan efektif untuk memberikan analgesia pascabedah pada operasi yang melibatkan dinding anterior abdomen.

Obyektif : Menilai  efek blok TAP teknik landmark terhadap kebutuhan analgetik pascabedah herniorafi.

Metode : Penelitian ini merupakan uji klinik tersamar tunggal. Penelitian dilakukan pada 44 pasien laki-laki, usia 18-60 tahun, status fisik ASA I-II, dan IMT 18-24 yang menjalani operasi herniorafi elektif dengan anestesi spinal. Pasien dibagi menjadi kelompok TAP  (n=22) yang mendapatkan blok TAP dengan bupivakain 0,25% 20 ml ditambahkan epinefrin 1:200.000  setelah operasi selesai; dan kelompok kontrol (n=22) yang tidak mendapatkan blok TAP. Semua pasien diberikan  meloksikam suppositoria 15 mg dan tramadol 0,1 mg/kgBB/infus kontinyu pada akhir operasi. Penilaian skala nyeri menggunakan Numeric Rating Scale (NRS), bila NRS mencapai 4 diberikan rescue fentanil 0,5 mcg/kgBB; waktu rescue pertama dan kebutuhan total fentanil selama 24 jam pascabedah dicatat.

Hasil : Waktu rescue pertama lebih panjang pada kelompok TAP  dibandingkan dengan kelompok kontrol (17,81 ± 7,62 berbanding 9,15 ± 8,12 jam; p<0,001). Kebutuhan total fentanil dalam 24 jam lebih sedikit pada kelompok TAP  dibandingkan dengan kelompok kontrol (9,21 ± 13,59 berbanding 30,88 ± 20,39 mcg; p=0,02).

Simpulan : Sehingga dari penelitian ini disimpulkan bahwa blok TAP sebagai komponen rejimen analgesia multimodal memberikan analgesia yang efektif  dengan durasi analgesia lebih panjang dibanding kontrol dan memiliki opioid sparing effect yang tinggi.

 

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Keywords: Blok TAP; herniorafi; teknik landmark

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