Kadar Substansi P Serum Pada Pemberian Parasetamol Intravena Perioperatif Pada Pasien Kraniotomi

Abstract

Background: Pain management after craniotomy is very important, 60-84% patient experience moderate to severe pain. Postoperative pain especially transmitted by C fiber neurons involved neuropeptide Substance P (SP). Postoperative opioid analgesia gives some adverse effect, such as allergy, gastrointestinal effect, nausea. vomiting, hypotension, sedation, repiratory depression and urinary retention. Paracetamol has opioid sparing effect that may reduce the need of opioid analgesia, and also inhibits SP mediated hyperalgesia. Objective: To study the effect of perioperative intravenous paracetamol on SP level in post craniotomy patientMethods: Forty subject aged 18 -45 years underwent elective craniotomy intracerebral tumour resection who have ASA physical status I-II, divided into 2 groups. P group received 1000 mg intravenous paracetamol every 6 hours during 24 hours postoperative, K group received placebo. Postoperative analgesia using morphine syringe pump 0,01 mg/Kg/hour titration to VAS. SP serum levels were examined with Cusabio substance Elisa kit ELx 800 before and 12 hours after surgery. Visual Analog Scale noted in 1, 6, 12, and 24 hours postoperative. Total amount of morphine given, nausea and vomiting was noted.Results: Preoperative SP level in P group was 16,89± 31,395 pg/ml and 36,58 ± 46,960 pg/ml postoperatively. Preoperative SP Level in K group was 9,58 ± 10,656 pg/ ml and 26,09 ± 22,506 pg/ml postoperatively. SP level elevation in P group and K group were 19,69± 28,625 pg/ml and 16,51 ± 14,972 pg/ml. Postoperative SP level and the elevation were not significantly different between two groups (p=0,793 and p=0,540), VAS and total amount of morphine given was significantly different (p<0,05). Conclusion:Perioperative intravenous paracetamol reduced morphine consumption and gave better VAS in post craniotomy patient, but did not affected postoperative SP level.

Aroma Terapi Peppermint dapat Menurunkan Kejadian Nausea pada Pasien Post Operasi Sectio Caesarea

“…Penurunan tekanan darah, kekurangan oksigen, kecemasan atau faktor psikologis, penggunaan obat sebelum pengobatan, puasa yang tidak adekuat, dan adanya iritasi lemak tubuh yang merupakan salah satu penyebab dari terjadinya mual serta muntah setelah anestesi spinal. 7 Mual dan muntah setelah operasi dapat mengakibatkan morbiditas, kekurangan cairan, ketidakseimbangan elektrolit, stretch stitching, perdarahan, hipertensi vaskular, ruptur esofagus, dan obstruksi jalan napas. 8 Hal ini menyebabkan keterlambatan pasien keluar, yang tentunya mempengaruhi biaya pengobatan, dan mual muntah yang terus-menerus dapat menyebabkan disfungsi peralatan kritis (ginjal dan hati) dan dapat menyebabkan kematian.…”