Efektivitas Analgesik dalam Manajemen Nyeri Tingkat Sedang Pasca Operasi Sectio Caesarea
DOI:
https://doi.org/10.29313/bcsp.v6i2.25640Keywords:
Analgesik Multimodal, Sectio Caesarea, Efektivitas AnalgesikAbstract
Abstract. Postoperative pain following Caesarean section (CS) requires effective analgesic management to promote optimal recovery. This study aimed to identify the analgesic utilization profile and evaluate the effectiveness of analgesic combinations for postoperative pain management in patients undergoing CS at a regional public hospital in Bandung, Indonesia. An analytical observational study with a retrospective design was conducted using medical records of patients who met the inclusion criteria. Analgesic effectiveness was assessed by changes in the Numeric Rating Scale (NRS) score during the first 24 hours after surgery. Data were analyzed using the Kolmogorov–Smirnov and Kruskal–Wallis tests. The results showed that the paracetamol–ketorolac combination was the most frequently prescribed regimen (110 patients; 81.5%), followed by paracetamol–tramadol (16 patients; 11.9%) and paracetamol–dexketoprofen (9 patients; 6.7%). Among patients with moderate pain, the paracetamol–dexketoprofen combination produced the greatest mean reduction in NRS score (Δ = 1.44). However, the Kruskal–Wallis test demonstrated no statistically significant difference in analgesic effectiveness among the three combinations in the moderate pain group (p > 0.05). These findings indicate that paracetamol–ketorolac, paracetamol–dexketoprofen, and paracetamol–tramadol provide comparable effectiveness for postoperative pain management after Caesarean section and may be selected according to patients' clinical conditions
Abstrak. Nyeri pasca operasi Sectio Caesarea (SC) merupakan komplikasi yang memerlukan penatalaksanaan analgesik yang efektif untuk mendukung proses pemulihan pasien. Penelitian ini bertujuan mengidentifikasi profil penggunaan analgesik serta mengevaluasi efektivitas kombinasi analgesik dalam manajemen nyeri pasca operasi SC di salah satu RSUD Kota Bandung. Penelitian ini menggunakan desain observasional analitik dengan pendekatan retrospektif terhadap data rekam medis pasien yang memenuhi kriteria inklusi. Efektivitas analgesik dievaluasi berdasarkan perubahan skor Numeric Rating Scale (NRS) selama 24 jam pertama pasca operasi dan dianalisis menggunakan uji Kolmogorov-Smirnov serta uji Kruskal-Wallis. Hasil penelitian menunjukkan bahwa kombinasi paracetamol-ketorolac merupakan regimen yang paling banyak digunakan yaitu sebanyak 110 pasien (81,5%), diikuti paracetamol-tramadol sebanyak 16 pasien (11,9%) dan paracetamol-dexketoprofen sebanyak 9 pasien (6,7%). Pada kelompok nyeri sedang kombinasi paracetamol-dexketoprofen memberikan rerata penurunan skor NRS tertinggi (Δ=1,44). Namun, uji Kruskal–Wallis menunjukkan tidak terdapat perbedaan efektivitas yang bermakna antar ketiga kombinasi analgesik baik pada kelompok nyeri sedang (p>0,05). Sehingga dapat disimpulkan kombinasi paracetamol-ketorolac, paracetamol-dexketoprofen, dan paracetamol-tramadol memiliki efektivitas yang relatif setara dalam manajemen nyeri pasca operasi Sectio Caesarea dan dapat digunakan sebagai pilihan terapi sesuai kondisi klinis pasien
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