Lupi Lestari, dr (2016) EFEKTIFITAS KETOPROFEN SUPPOSITORIA SEBAGAI PREEMPTIVE ANALGESIA TERHADAP NYERI POSTOPERATIF PADA PASIEN YANG MENJALANI OPERASI ELEKTIF DENGAN GENERAL ANESTESI. Thesis thesis, Universitas Airlangga.

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Abstract

Background : Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac compilcations, reduced risk deep vein thrombosis, faster recovery , and reduced cost of care. Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period has the potential to be more effective than a similar analgesic treatment initiated after surgery. As a part of the multimodal analgesia, the use of NSAIDs should always be considered for acut postoperative pain management. NSAIDs can be used preoperatively as a part of preemptive regimen and for postoperative pain control to increase the efficacy of opioids and reduce its side effect. Objective : To compare the effect of preemptive analgesia with postoperative analgesia using ketoprofen suppositoria in patients undergoing operations with general anesthesia (with postoperative expected pain moderate to severe) Methods : In this randomized, following surgery with general anesthesia, 60 patients, aging 18-65 years, were assigned to receive either morphine 0,1 mg/ kg with ketoprofen suppositoria 100mg (BW ≤ 50kg) and 200 mg (BW > 50 kg) after induction (n=30) and morphine 0,1 mg/kg without any preemptive analgesia (n=30). Intensity of pain, measured with Numeric Rating Scale (NRS) or Wong Baker Faces Pain Scale, was the variable studied at different postoperative times (30 min, 60 min, 120 min, 2-6 h, 6- 12 h). The total amount of rescue analgetics (fentanyl) and side effect were another variable of the study. Results : It was found that ketoprofen suppositoria as preemptive analgesia administrations can reduce postoperative pain. Numeric Rating Scale was significant lower in ketoprofen group compared to control group (p < 0,05) at 30 min, 60 min, 120 min , 2-6 h, 6- 12 h. The amount of postoperative analgesics needed in recovery room was significant different among both of groups (p< 0,05). Conclusion : Preemptive analgesia in patients who underwent operations with general anesthesia with ketoprofen suppositoria was effective in blocking noxious stimuli and central sensitization, with subsequent prevention of acute postoperative pain Keywords : Postoperative analgesia, general anesthesia, ketoprofen suppositoria, preemptive analgesia

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