scholarly journals Penurunan intensitas nyeri luka post-sectio caesarea menggunakan mobilisasi dini

Ners Muda ◽  
2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Suastini Suastini ◽  
Pawestri Pawestri

Nyeri merupakan respon sensori tidak menyenangkan yang dialami oleh individu secara unik yang diekspresikan secara berbeda oleh tiap individu serta dapat berdampak terhadap kondisi fisik dan psikis seseorang. Nyeri akibat luka post sectio caesarea dalam rentang ringan hingga berat dapat mengganggu mobilitas fisik, pemenuhan kebutuhan dasar, bahkan sampai mengakibatkan syok neurogenik pada pasien. Studi kasus ini bertujuan untuk mengaplikasikan mobilisasi dini secara bertahap pada pasien post sectio caesarea yang mengalami nyeri akibat luka post sectio caesarea. Penelitian ini menggunakan metode deskriptif dengan pendekatan asuhan keperawatan yang dilakukan pada tiga pasien yang mengalami nyeri intensitas sedang-berat akibat luka post sectio caesarea. Pengukuran intensitas nyeri dilakukan pre dan post mobilisasi dini secara bertahap dengan menggunakan alat ukur Numeric Rating Scale (NRS). Terdapat penurunan intensitas nyeri paska dilakukan mobilisasi dini secara bertahap rata-rata menurun 5 skala. Penurunan intensitas nyeri ini terjadi karena mobilisasi akan menjadikan konsentrasi pasien pada lokasi nyeri berkurang serta dapat meminimalkan transmisi saraf nyeri menuju syaraf pusat. Mobilisasi akan melancarkan sirkulasi darah termasuk sirkulasi yang menuju area luka post sectio caesarea sehingga mampu mengurangi aktivasi mediator kimiawi pada proses peradangan, sehingga intensitas nyeri berkurang. Mobilisasi dini merupakan intervensi yang dapat dilakukan untuk menurunkan intensitas nyeri luka post sectio caesarea pada pasien. 

2020 ◽  
Vol 6 (2) ◽  
pp. 164-170
Author(s):  
Dewi Nurlaela Sari ◽  
Aay Rumhaeni

ABSTRAK Sectio caesarea merupakan tindakan alternatif dalam proses persalinan untuk menyelamatkan ibu dan janin. Ibu Bersalin dengan operasi sectio caesarea dilakukan pembedahan pada dinding abdomen dan dinding rahim. Dampak yang paling sering muncul dirasakan oleh postpartum dengan post operasi sectio caesarea adalah  nyeri. Nyeri akan berdampak pada bounding attachment terganggu, mobilisasi terbatas, Activity Daily Living (ADL) terganggu serta berpengaruh  terhadap Inisiasi Menyusui Dini (IMD). Asuhan yang diberikan terbatas pada terapi farmakologi dibandingkan  non farmakologi. Foot massage adalah salah satu terapi non farmakologi yang dapat membantu menutup gerbang di posterior horns dari sumsum tulang belakang dan memblokir bagian dari nyeri ke sistem saraf pusat. Tujuan penelitian ini untuk mengetahui pengaruh foot massage terhadap skala nyeri pada klien post operasi sectio caesarea di RS AMC. Penelitian ini merupakan penelitian pre eksperimen dengan pendekatan one group pre test post test design. Jumlah sampel yang digunakan berjumlah 27 orang dengan menggunakan teknik purposive sampling. Instrumen yang digunakan adalah Numeric Rating Scale (NRS) dan prosedur kerja foot massage. Responden dilakukan foot massage selama 20 menit selama 2 hari. Data di analisis dengan menggunakan uji wilcoxon. Hasil penelitian menunjukkan lebih dari setengah klien post operasi sectio caesarea berada di skala nyeri 6 sebelum dilakukan foot massage dan hampir setengah memiliki skala nyeri 3 sesudah dilakukan foot massage dan didapatkan nilai p value = 0.000, sehingga disimpulkan ada pengaruh foot massage terhadap skala nyeri pada klien post operasi sectio caesarea. Diharapkan rumah sakit dapat menjadikan foot massage sebagai salah satu alternatif manajemen non farmakologi dalam penanganan nyeri.   Kata kunci: Foot Massage; Post Partum; Nyeri; Sectio Caesarea      


2018 ◽  
Vol 14 (1) ◽  
pp. 91
Author(s):  
Khairun Nuhan ◽  
Titi Astuti ◽  
Al Murhan

<p>Prevalensi persalinan <em>sectio caesarea </em>di Indonesia menurut WHO pada tahun 2015 adalah 15,3%. Pada pasien post operasi <em>sectio caesarea</em>setelah anestesi menghilang pasien akan merasakan nyeri, sehingga diperlukan terapi yang efektif dan aman dari efek samping. Terapi Al-Qur’an salah satu bentuk teknik distraksi (pengalihan) secara non farmakologi untuk menurunkan intensitas nyeri yang dirasakan.Keberhasilan menggunakan murrotal 70 % dari penelitian terkait.Penelitian ini menggunakan desain<em>quasi exsperiment</em> dengan pendekatan <em>nonrandomized control grup pretest postests design</em>.Teknik pengambilan sampel dengan menggunakan teknik <em>accidental sampling</em> sebanyak 22 responden (11 responden kelompok perlakuan dan 11 responden kelompok kontrol).Pengumpulan data nyeri menggunakan instrumen <em>Numeric Rating Scale</em> (NRS).Uji statistik menggunakan Wilcoxon dan Mann-Withney. Hasil penelitian terdapat  perbedaan pengaruh terapi murottal Al-Qur’an terhadap penurunan intensitas nyeri pada pasien post operasi SC pada kelompok perlakuan dan kelompok kontrol p-value 0.001. Peneliti menyarankan agar pihak RS mempertimbangkan menggunakan terapi komplementer murottal Al-Qur’an untuk mempersiapkan ibu menghadapi operasi SC menggunakan SOP yang ada.</p>


2018 ◽  
Vol 12 (2) ◽  
pp. 184-191
Author(s):  
Maya Indriati ◽  
Dyah Triwidiyantari ◽  
Krisnasari Nur Apriyanti

Nyeri merupakan gejala yang tidak menyenangkan yang dialam oleh pasien post operasi section caesarea. Salah satu terapi yang dapat diberikan untuk mengurangi nyeri adalah teknik relaksasi nafas dalam. Tujuan penelitian adalah untuk mengetahui pengaruh teknik relaksasi nafas dalam terhadap penurunan intensits nyeri post sectio caesarea di RSUD Cianjur. Penelitan ini adalah penelitian kuantitatif dengan Quasy-Exsperimental with pretest and posttest without control group. Teknik pengambilan data dengan purposive sampling. Sampel penelitian berjumlah 45 ibu post sectio caesarea pengumpulan data menggunakan Numeric Rating Scale (NRS). Analisis data dilakukan dengan uji wilcoxson. Hasil penelitian menunjukan perbedaan rata-rata rasa nyeri sebelum dilakukan teknik relaksasi nafas dalam yaitu 3,31 dan rata-rata rasa nyeri sesudah dilakukan teknik relaksasi nafas dalam yaitu 2,22. Hasil analisis didapatkan bahwa terdapat pengaruh teknik relaksasi nafas dalam terhadap penurunan intensitas nyeri post section caesarea di RSUD Cianjur (p=0.000).


MEDISAINS ◽  
2018 ◽  
Vol 16 (2) ◽  
pp. 83
Author(s):  
Susilo Rini ◽  
Indri Heri Susanti

Latar Belakang: Tindakan sectio caesarea (SC) menyebabkan nyeri yang menimbulkan berbagai masalah, salah satunya masalah laktasi. Sebanyak 68% ibu post sectio caesarea mengalami kesulitan dengan perawatan bayi, bergerak naik turun dari tempat tidur dan mengatur posisi yang nyaman selama menyusui akibat adanya nyeri. Akibat rasa nyeri tersebut menyebabkan pasien menunda pemberian ASI sejak awal pada bayinya. Posisi biologic nurturing baby led feeding merupakan salah satu posisi menyusui yang direkomendasikan bagi ibu nifas post SC karena lebih rileks. Selama ini penanganan ibu nifas dengan nyeri masing dengan pemberian analgetik peroral, sedangkan posisi menyusui biologic nurturing baby led feeding belum diterapkan.Tujuan: Penelitian ini untuk menganalisis adanya penurunan nyeri pada ibu post sectio caesaria pasca intervensi biologic nurturing baby led feedingMetode: Penelitian ini merupakan penelitian Quasi-eksperiment, dengan rancangan one group pretest-postest design. Penelitian dilakukan di RSUD Goeteng Taruna Dibrata Purbalingga. Populasi penelitian adalah seluruh ibu yang melahirkan secara SC, sampel yang digunakan sebanyak 41 responden yang diambil secara purposive sampling. Instrument untuk menilai nyeri menggunakan Numeric Rating Scale (NRS). Data dianalilis dengan menggunakan uji WilcoxonHasil: Hasil penelitian menunjukan sebanyak 28 dari 41 responden (68,3%) mengalami penurunan skala nyeri pasca intervensi biologic nurturing baby led feeding. Hasil analysis menunjukkan terdapat penurunan nyeri yang bermakna pada ibu post SC sebelum dan sesudah intervensi biologic nurturing baby led feeding (p<0,01)Kesimpulan: Intervensi biologic nurturing baby led feeding dapat menurunkan nyeri pada ibu post sectio caesarea


2019 ◽  
Vol 8 (2) ◽  
pp. 152
Author(s):  
Adi Antoni ◽  
Yanna Wari Harahap

Abstrak   Latar belakang: Diabetes mellitus (DM) merupakan penyakit kronik dan menjadi masalah global. Salah satu komplikasi yang ditimbulkan dari DM adalah luka kaki diabetic. Langkah awal dalam perawatan luka kaki diabetic adalah mencuci luka. Tujuan penelitian ini adalah mengetahui keefektifan dari rebusan daun jambu biji sebagai cairan pencuci luka terhadap tingkat malodor pada luka kaki diabetic. Metode: Desain penelitian yang digunakan adalah quasy experiment dengan rancangan one group pretests-posttest only. Teknik sampling yang digunakan adalah consecutive sampling dengan jumlah sampel 16 orang. Kriteria sampel yang digunakan adalah klien luka kaki diabetic, tingkat malodor 1-10 dengan NRS. Alat ukur yang digunakan adalah Numeric Rating Scale (NRS). Analisa data yang digunakan dalam penelitian ini menggunakan uji paired t test. Hasil: tingkat malodor sebelum intervensi pencucuan luka menggunakan rebusan daun jambu biji rata-rata sebesar 4.40 dan sesudah intervensi sebesart 2.44 dengan p value < 0.001. Selisih tingkat malodor antara sebelum dan sesudah intervensi sebesar 1.96. Hasil penelitian ini menunjukkan bahwa daun jambu dapat digunakan sebagai cairan pencuci luka dalam mengatasi tingkat malodor pada luka kaki diabetik. Kesimpulan : daun jambu biji dapat digunakan sebagai cairan pencuci luka pada luka kaki diabetic. Perawat diharapkan dapat memanfaatkan daun jambu biji sebagai salah satu alternatif dalam pencucian luka kronik khususnya luka kaki diabetik.   Kata kunci: Daun Jambu Biji, Tingkat Malodor, Luka Kaki Diabetik   Abstract   Background: Diabetes mellitus (DM) is a chronic disease and a global problem. One of the complications that arise from DM is diabetic foot ulcer. The first step in treating diabetic foot ulcer is washing the wound. The purpose of this study was to determine the effectiveness of guava leaf decoction as a washing fluid for malodor levels in diabetic foot ulcer. Method: The research design used was quasy experiment with one group pretests-posttest only design. The sampling technique used was consecutive sampling with a sample of 16 people. Sample criteria used were diabetic foot ulcer clients, malodor level 1-10 with NRS. The measuring instrument used is the Numeric Rating Scale (NRS). Analysis of the data used in this study used paired t test. Results: the level of malodor before intervening in wound washing using guava leaf decoctions on average was 4.40 and after the intervention was 2.44 with p value <0.001. The difference in the level of malodor between before and after the intervention was 1.96. The results of this study indicate that guava leaves can be used as a washing fluid in dealing with malodor levels in diabetic foot ulcer. Conclusion: Guava leaves can be used as a washing fluid for diabetic foot wounds. Nurses are expected to be able to use guava leaves as an alternative in washing chronic wounds, especially diabetic foot injuries.   Key words: Guava Leaf, Malodor Level, Diabetic foot ulcer.


Author(s):  
Bahaa R. Youssef ◽  
Andreas Söhnel ◽  
Alexander Welk ◽  
Mohamed H. Abudrya ◽  
Mohamed Baider ◽  
...  

Abstract Objective To compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth. Materials and methods In this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes. Results Patients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations. Conclusion This study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed. Clinical relevance ILA could be considered as an effective alternative for routine dental treatment. Trial registration NCT04563351


Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 566
Author(s):  
Masato Ise ◽  
Eiji Nakata ◽  
Yoshimi Katayama ◽  
Masanori Hamada ◽  
Toshiyuki Kunisada ◽  
...  

Psychological distress is common in patients with soft tissue and bone tumors. We first investigated its frequency and the associated risk factors in patients with pre-operative bone and soft tissue tumors. Participants included 298 patients with bone and soft tissue tumors who underwent surgery in our institution between 2015 and 2020. Psychological distress was evaluated by the Distress and Impact Thermometer (DIT) that consists of two types of questions (questions about the severity of the patient’s distress (DIT-D) and its impact (DIT-I)). We used a cut-off point of 4 on the DIT-D and 3 on the DIT-I for screening patients with psychological distress. We therefore investigated: (1) the prevalence of psychological distress as assessed with DIT or distress thermometer (DT), which can be decided by DIT-D ≥ 4, (2) what are the risk factors for the prevalence of psychological distress, and (3) what is the number of patients who consulted a psychiatrist for psychological distress in patients with pre-operative bone and soft tissue tumors. With DIT and DT, we identified 64 patients (21%) and 95 patients (32%), respectively, with psychological distress. Multivariate logistic regression revealed that older age, sex (female), malignancy (malignant or intermediate tumor), a lower Barthel Index, and higher numeric rating scale were risk factors for psychological distress. Two patients (3%) consulted a psychiatrist after surgery. In conclusion, careful attention to psychological distress is needed, especially for female patients, older patients, and those with malignant soft or bone tissue tumors who have more than moderate pain.


2021 ◽  
pp. 030089162199043
Author(s):  
Silvia Gonella ◽  
Dino S. Di Massimo ◽  
Marinella Mistrangelo ◽  
Gianmauro Numico ◽  
Paola Berchialla ◽  
...  

Introduction: Chemotherapy-induced nausea, vomiting, and retching (CINVR) remains a common side effect of treatment. Most previous studies have focused on vomiting control; nausea and retching have been less explored. This study aimed at describing the incidence, severity, and impact on daily life (IDL) of CINVR in the acute (0–24 hours), delayed (>24–120 hours), and overall (0–120 hours) postchemotherapy periods and beyond 120 hours (until next chemotherapy administration); and the pharmacologic and nonpharmacologic strategies adopted by patients to relieve symptoms. Methods: This was a single-center, cross-sectional study of 60 patients undergoing chemotherapy. Participants reported the frequency, severity, and IDL of CINVR from the day of chemotherapy administration up to 120 hours thereafter and nausea and vomiting that occurred beyond 120 hours, as well as pharmacologic and nonpharmacologic remedies used. Results: Forty-seven (78.3%, 95% confidence interval [CI] 66.4–86.9), 37 (61.7%, 95% CI 49.0–72.9), and 35 (58.3%, 95% CI 45.7–69.9) patients reported no nausea (Numeric Rating Scale ⩽1), vomiting, or retching in the acute, delayed, and overall periods, respectively. Nausea was more frequent, more severe, and had a greater IDL than did vomiting and retching across the overall observation period; beyond 120 hours, 11 (18.3%, 95% CI 10.6–29.9) patients reported nausea and none reported vomiting, with a median IDL of 1/10 (interquartile range: 0.75–5.00; 95% CI 0–7.6). Metoclopramide (n = 57 administrations), dexamethasone (n = 28), eating small servings of food (n = 13), and aloe (n = 11) were the most commonly used rescue therapies. Conclusions: Future studies should set hard outcomes, such as the absence of any symptoms, as a primary end point, and these should be assessed across and beyond the 120-hour period.


2020 ◽  
Vol 163 (3) ◽  
pp. 428-443
Author(s):  
Usman Khan ◽  
Jake MacPherson ◽  
Michael Bezuhly ◽  
Paul Hong

Objective To compare the effectiveness of conventional (CF), laser (LF), and Z-plasty (ZF) frenotomies for the treatment of ankyloglossia in the pediatric population. Data Sources A comprehensive search of PUBMED, EMBASE, and COCHRANE databases was performed. Review Methods Relevant articles were independently assessed by 2 reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results Thirty-five articles assessing CF (27 articles), LF (4 articles), ZF (3 articles), and/or rhomboid plasty frenotomy (1 article) were included. A high level of outcome heterogeneity prevented pooling of data. All 7 randomized controlled trials (RCTs) were of low quality. Both CF (5 articles with 589 patients) and LF (2 articles with 78 patients) were independently shown to reduce maternal nipple pain on a visual analog or numeric rating scale. There were reports of improvement with breastfeeding outcomes as assessed on validated assessment tools for 88% (7/8) of CF articles (588 patients) and 2 LF articles (78 patients). ZF improved breastfeeding outcomes on subjective maternal reports (1 article with 18 infants) only. One RCT with a high risk of bias concluded greater speech articulation improvements with ZF compared to CF. Only minor adverse events were reported for all frenotomy techniques. Conclusions Current literature does not demonstrate a clear advantage for one frenotomy technique when managing children with ankyloglossia. Recommendations for future research are provided to overcome the methodological shortcomings in the literature. We conclude that all frenotomy techniques are safe and effective for treating symptomatic ankyloglossia.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nina Graf ◽  
Katharina Geißler ◽  
Winfried Meißner ◽  
Orlando Guntinas-Lichius

AbstractData on chronic postsurgical pain (CPSP) after otorhinolaryngological surgery are sparse. Adult in-patients treated in 2017 were included into the prospective PAIN OUT registry. Patients’ pain on the first postoperative day (D1), after six months (M6) and 12 months (M12) were evaluated. Determining factor for CPSP was an average pain intensity ≥ 3 (numeric rating scale 0–10) at M6. Risk factors associated with CPSP were evaluated by univariate and multivariate analyses. 10% of 191 included patients (60% male, median age: 52 years; maximal pain at D1: 3.5 ± 2.7), had CPSP. Average pain at M6 was 0.1 ± 0.5 for patients without CPSP and 4.2 ± 1.2 with CPSP. Average pain with CPSP still was 3.7 ± 1.1 at M12. Higher ASA status (Odds ratio [OR] = 4.052; 95% confidence interval [CI] = 1.453–11.189; p = 0.007), and higher minimal pain at D1 (OR = 1.721; CI = 1.189–2.492; p = 0.004) were independent predictors of CPSP at M6. Minimal pain at D1 (OR = 1.443; CI = 1.008–2.064; p = 0.045) and maximal pain at M6 (OR = 1.665; CI = 1.340–2.069; p < 0.001) were independent predictors for CPSP at M12. CPSP is an important issue after otorhinolaryngological surgery. Better instrument for perioperative assessment should be defined to identify patients at risk for CPSP.


Sign in / Sign up

Export Citation Format

Share Document