scholarly journals Pengaruh Pemberian Pre Emptive Ketamin 0,15 mg/kgbb iv Terhadap Intensitas Nyeri Pasca Operasi Bedah Onkologi Mayor Dengan Anestesi Umum Di RSUD Dr Saiful Anwar Malang

2015 ◽  
Vol 7 (3) ◽  
pp. 197
Author(s):  
Umi Satiyah ◽  
Djudjuk Rahmad Basuki ◽  
Ristiawan Muji Laksono

Latar Belakang : Preemptive analgesia dan multimodal analgesia mempunyai peranan penting dalam penanganan nyeri selama dan pasca operasi dengan memblok jalur nyeri yang terdiri dari tranduksi, transmisi, modulasi dan persepsi. Ketamin sebagai Anti NMDA (N metil D Aspartat) reseptor bekerja memblok  jalur transmisi dan modulasi serta sinergis dengan opioid. Ketamin dosis kecil 0,15 mg/kgbb mempunyai efek preemptive analgesia dan tidak memiliki efek samping yang berat.Tujuan : mengetahui pengaruh pemberian preemptive ketamin 0,15 mg/kgbb iv terhadap intensitas nyeri  pasca bedah onkologi mayor dengan anestesi umum pada  1,2 dan 3 jam pasca operasiMetode : Penelitian ini merupakan uji klinis acak tersamar ganda, bersifat eksperimental. Sampel penelitian adalah pasien usia 17-40 tahun, kriteria klinis ASA I-II, pendidikan minimal SMP, dan BMI antara 20-30 kg/M2 yang menjalani pembedahan elektif bedah onkologi mayor kategori nyeri sedang yang meliputi operasi struma dan mammae selain radikal mastektomi (MRM). Jumlah sampel  adalah 44 pasien yang  dibagi secara random menjadi 2 kelompok, yaitu kelompok 1 (perlakuan) yang menerima ketamin 0,15 mg/kgbb dan kelompok 2 (kontrol) tanpa menerima ketamin 0,15mg/kgbb. Semua pasien menerima  (multimodal analgesia) yaitu fentanyl (opioid), ketorolac (NSID) dan juga obat2an lain untuk  anestesi umum. Intensitas nyeri  pada semua sampel diamati pada  1, 2 dan  3 jam pasca operasi dengan menggunakan Verbal numerical rating scale (VNRS) yang setara dengan VAS (visual Analogue scale). Uji statistik normalitas menggunakan uji saphiro wilk diperoleh hasil bahwa data yang ada tidak terdistribusi normal sehingga dilakukan uji beda non parametrik mann whitney testHasil : Penelitian ini menunjukkan bahwa pemberian ketamin 0,15 mg/kgbb mengurangi nyeri akut lebih baik pada  1, 2 dan 3 jam pasca operasi.  Pada  1 jam pasca operasi  kelompok perlakuan memiliki nilai rerata VAS 0 atau lebih rendah 0,77 cm dbandingkan kelompok kontrol dengan nilai p<0,001. Pada  2 jam pasca operasi kelompok perlakuan memiliki rerata VAS 0,3 cm atau lebih rendah 1,4 cm bila dibandingkan dengan kelompok kontrol dengan nilai p<0,001. Pada  3 jam pasca operasi kelompok perlakuan memiliki rerata 0,9 cm atau lebih rendah 1,6 cm dengan nilai p<0,001.Kesimpulan : Pada penelitian ini preepmtive ketamin 0,15 mg/kgbb iv memberikan pengaruh menurunkan intensitas nyeri  pada  1 jam, 2 jam dan 3 jam pasca pembedahan onkologi mayor kategori nyeri sedang. 

2016 ◽  
Vol 22 (13) ◽  
pp. 1658-1667 ◽  
Author(s):  
Elisabet Sánchez-Rodríguez ◽  
Elena Castarlenas ◽  
Rocío de la Vega ◽  
Roman Roset ◽  
Jordi Miró

The objective of this work was to study the agreement between four pain intensity scales when administered electronically: the Numerical Rating Scale-11, the Faces Pain Scale-Revised, the Visual Analogue Scale and the Coloured Analogue Scale. In all, 180 schoolchildren between 12 and 19 years old participated in the study. They had to report the maximum intensity of their most frequent pain using the electronic versions of the four scales. Agreement was calculated using the Bland–Altman method. Results show that the electronic versions of Numerical Rating Scale-11, Coloured Analogue Scale and Visual Analogue Scale can be used interchangeably.


2018 ◽  
Vol 132 (4) ◽  
pp. 327-328 ◽  
Author(s):  
R Haye ◽  
L K Døsen ◽  
M Tarangen ◽  
O Shiryaeva

AbstractObjective:Results from telephone interviews may be needed to supplement those from mailed questionnaires when response rates are inadequate. This study assessed the correlation between visual analogue scale ratings used in mailed questionnaires and numerical rating scale scores used in telephone interviews.Methods:Patients scheduled for nasal septal surgery routinely respond to a visual analogue scale of obstruction during the day and at night. In this study, they were also asked to verbally rate their sense of obstruction using whole numbers.Results:There was no significant difference between visual analogue scale and numerical rating scale obstruction scores.Conclusion:Ratings of nasal obstruction obtained with a numerical rating scale in telephone interviews are comparable to visual analogue scale scores in mailed questionnaires.


2015 ◽  
Vol 2;18 (2;3) ◽  
pp. E195-E200
Author(s):  
Sang Sik Choi

The pain relief scale (PRS) is a method that measures the magnitude of change in pain intensity after treatment. The present study aimed to evaluate the correlation between PRS and changes in pain determined by the visual analogue scale (VAS) and numerical rating scale (NRS), to confirm the evidence supporting the use of PRS. Sixty patients with chronic spinal pain that had a VAS and NRS recorded during an initial examination were enrolled in the study. One week later, the patients received an epidural nerve block, then VAS, NRS, and PRS assessments were performed. Differences between VAS and NRS were compared to the PRS and scatter plots and correlation coefficient were generated. The differences and magnitude of decrease in the VAS and NRS raw data were converted to percentile values, and compared to the PRS. Both VAS and NRS values exhibited strong correlations (> 0.8) with PRS. Further, the differences between the VAS-PRS R (0.859) and NRS-PRS R (0.915) were statistically significant, (P = 0.0259). Compared to PRS, the VAS and NRS percentile scores exhibited higher correlation coefficients than scores based on the raw data differences. Furthermore, even when converted to a percentile, the NRS%-PRS R (0.968) was higher than the VAS%-PRS R (0.904), P = 0.0001. The results indicated that using the PRS together with NRS in pain assessment increased the objectivity of the assessment compared to using only VAS or NRS, and may have offset the limitations of VAS or NRS alone. Key words: Pain relief scale, numerical rating scale, visual analogue scale, pain measurement, pain intensity measurement, pain intensity scale


2020 ◽  
Vol 8 (1) ◽  
pp. 21-21
Author(s):  
Mani Mofidi ◽  
Ali Dashti ◽  
Mahdi Rezai ◽  
Niloufar Ghodrati ◽  
Hoorolnesa Ameli ◽  
...  

Introduction: This study was designed to compare the effectiveness of intravenous morphine with nebulized morphine in pain relief of patients referring to the emergency setting with traumatic musculoskeletal pain. Methods: This randomized, placebo-controlled and double-blind clinical study evaluated 160 patients 18 to 65 years of age with acute traumatic pain, who attended the emergency department during 2019. Subjects were assessed with Numerical Rating Scale based on inclusion and exclusion criteria and randomly divided into two groups. In one group, 80 patients received IV morphine (0.1 mg/kg+5 mL normal saline) plus an equivalent volume of IV placebo. In the second group, 80 patients received nebulized morphine (0.2 mg/kg+5 mL normal saline) plus nebulized placebo. Pain score was monitored in all patients with Numerical Rating Scale before and after intervention at baseline, 15, 30, 45, and 60-minute intervals. Patients’ vital signs and possible adverse events were evaluated in each observation time points. Finally, all participants were assessed for their satisfaction with pain management. Data were analyzed using repeated measure analysis for continuous variables and Binomial test for categorical variables Results: There was no significant difference between the demographic characteristics of patients in study groups. Pain relief between the two groups was similar during the observation (0, 15, 30, 45, 60 min) (P>0.05). There were no changes in vital signs between two groups, although the nebulized group had lower systolic blood pressure at the time-point of 15 minutes after the treatment initiation (P=0.03). Conclusion: Although Nebulized morphine has similar efficacy in comparison with IV route, nebulization might be considered as the clinically efficacious route of morphine administration with minimal side effects, providing optimal pain relief in patients.


2020 ◽  
Vol 103 (10) ◽  
pp. 1028-1035

Background: Craniotomy causes acute and chronic pain. Uncontrolled postoperative pain may lead to adverse events. Perioperative scalp nerves block is not only effective in reducing intraoperative hemodynamic response, but it also reduces postoperative pain and postoperative analgesia requirement. Objective: To compare the benefits of adding dexmedetomidine to levobupivacaine in scalp nerves block before craniotomy for the duration of analgesia in supratentorial craniotomy. Materials and Methods: After approval by the Committee for Research, 50 supratentorial craniotomy patients were randomized into two groups. The control group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000, whereas the study group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000 plus dexmedetomidine 1 mcg/kg. The primary outcome was the time to first analgesic requirement postoperatively. The secondary outcomes included intraoperative fentanyl consumption, verbal numerical rating scale, tramadol consumption, and complications during the first 24 hours postoperatively. Results: Patients in the study group had significantly increase time to the first analgesic requirement in postoperative period and reduced intraoperative fentanyl consumption. The median time to first analgesic requirement was 555 (360 to 1,035) minutes in the study group versus 405 (300 to 520) minutes in the control group (p=0.023). Intraoperative fentanyl consumption 125 (75 to 175) mcg in the study group was significantly lower than 200 (150 to 250) mcg in the control group (p=0.02). The verbal numerical rating scale at 1, 4, 8, 12 and 24 hours postoperatively, tramadol consumption, and complications during the first 24 hours postoperatively were not statistically significant different. Conclusion: Preoperative scalp nerves block with 0.25% levobupivacaine with adrenaline (1:200,000) with dexmedetomidine 1 mcg/kg significantly increased the time to first analgesic requirement and reduced intraoperative fentanyl consumption compared to 0.25% levobupivacaine with adrenaline (1:200,000) without perioperative complications. Keywords: Scalp block, Dexmedetomidine, Post-craniotomy analgesia, Supratentorial tumor, Levobupivacaine


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