Kadar Serum Substansi P Pada Pemberian Klonidin Sebagai Ajuvan Analgesia Epidural
ABSTRACT

Background : Clonidine, when used in conjunction with a local anesthetic drug as a regional anesthetic techniques, could reduce the incidence of chronic postoperative pain. Peripheral and central sensitization is one of the mechanisms of transition of acute pain into chronic pain. Initial cascade that causes peripheral sensitization and central sensitization triggered by the presynaptic and post-synaptic release of excitatory neurotransmitters such as glutamate and substance P.

Objective: To compare serum levels of substance P and the value of visual analogue scores at 0 and 12 hours post- operation between epidural analgesia with bupivacaine solely and bupivacaine with adjuvant clonidine

Methods : This study is a randomized double-blind study. Samples of 40 people divided into 2 groups, control group received epidural analgesia with bupivacaine solely and the treatment group received epidural analgesia bupivacaine with clonidine as adjuvant, analgesic was administered pre incisional continued for post-surgery. Serum levels of substance P assessed preoperatively and 12 hours postoperatively in each group. While the VAS value was measured at 0 and 12 hours post- surgery

Results: There were significant differences in serum levels of substance P in the form of a significant reduction at 12 hours postoperatively both the control and treatment groups. There was no significant difference serum levels of substance P between the control and treatment groups at 12 hours post-surgery. There was significant different of VAS values ​​ at 0 and 12 hours post-operation between the control and treatment groups

Conclusion : Epidural analgesia with bupivacaine and bupivacaine with adjuvant clonidine pre incision continued post operatively equally effective in lowering the levels of substance P at 12 hours after surgery

Keywords : epidural analgesia , clonidine , bupivacaine, substance P
ABSTRAK

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.

 

Kata kunci : analgesia epidural, klonidin, bupivakain, substansi P
Artikel Sekarang
Dipublikasi pada 01 November 2014
Penulis :
» Karyadi
» Yulia Wahyu Villyastuti
Kategori : Penelitian
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Volume VI Nomor 3, November 2014 Cover JAI
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