Electronic Theses and Dissertation

Latar Belakang : Nyeri pasca operasi dialami oleh sebagian besar pasien yang menjalani prosedur pembedahan. Terdapat banyak penelitian yang melaporkan manfaat penggunaan campuran opioid onset cepat dan long-acting untuk analgesia epidural dan intratekal. Kombinasi morfin-fentanil sering digunakan untuk anestesi spinal untuk mencapai kontrol nyeri yang cepat dan diperpanjang.
Metodologi Penelitian : Penelitian ini merupakan penelitian analitik obserNRSional untuk menilai perbedaan postoperative analgesia pada pasien spinal anestesi bupivakain kombinasi Fentanil dan bupivakain kombinasi Morfin. Penelitian ini telah mendapat persetujuan etik. Populasi pada penelitian ini seluruh pasien yang akan menjalani pembedahan ekstremitas bawah dengan anastesi spinal. Subjek penelitian yang dipilih sesuai dengan kriteria inklusi dan eksklusi. Pada penelitian sampel di bagi dua kelompok yaitu kelompok bupivakain kombinasi morfin dan kelompok bupivakain kombinasi fentanil.
Hasil Penelitian : Dalam penelitian ini, didapatkan bahwa terdapat perbedaan postoperative analgesia antar kedua kelompok. Secara keseluruhan, NRS pada kelompok morfin lebih rendah dibandingkan kelompok fentanil. Meskipun pada 3 jam pasca operasi tidak ditemukan perbedaan yang signifikan antar variable (p=0,579), namun pengamatan pada 6 jam dan 12 jam pasca operasi ditemukan perbedaan yang signifikan (masing-masing, p=0,008 dan p=0,034).. Pada kedua kelompok, dilakukan pengamatan munculnya efek samping hingga 24 jam pasca operasi. Dari pengamatan tersebut tidak ditemukan adanya efek samping berat seperti depresi pernafasan maupun henti jantung. Efek samping yang paling banyak muncul adalah mual dan gatal.
Kesimpulan : Morfin lebih baik dalam mengontrol postoperative analgesia dibandingkan fentanil.Tidak ditemukan efek samping serius berupa depresi pernafasan sehingga dapat disimpulkan bahwa morfin dalam rentang dosis 100-150μg intratekal aman digunakan sebagai adjuvant bupivakain.
Kata Kunci : postoperative analgesia, spinal anestesi, fentanil, morfin, NRS

Background : Postoperative pain is experienced by the majority of patients undergoing surgical procedures. There are many studies reporting the benefit of using a mixture of fast-acting and long-acting opioids for epidural and intrathecal analgesia. The morphine-fentanyl combination is often used for spinal anesthesia to achieve rapid and prolonged pain control. Research Methodology : This study is an observational analytic study to assess differences in postoperative analgesia in spinal anesthesia patients with bupivacaine combined with Fentayl and bupivacaine combined with Morphine. This study has received ethical approval. The population in this study were all patients who would undergo lower extremity surgery under spinal anesthesia. The research subjects were selected according to the inclusion and exclusion criteria. In the study, the samples were divided into two groups, namely the morphine combination bupivacaine group and the fentanil combination bupivacaine group. Research Results : In this study, it was found that there were differences in postoperative analgesia between the two groups. Overall, the NRS in the morfine group was lower than that in the fentanil group. Although at 3 hours postoperatively there was no significant difference between variables (p=0.579), observations at 6 hours and 12 hours postoperatively found significant differences (respectively, p=0.008 and p=0.034). In both group, the appearance of side effects was observed up to 24 hours postoperatively. From these observations, there were no serious side effects such as respiratory depression or cardiac arrest. The most common side effects are nausea and itching. Conclusion : Morphine is better at controlling postoperative analgesia than fentanyl. No serious side effects such as respiratory depression were found, so it can be concluded that morfine in the intrathecal dose range of 100-150μg is safe to use as an adjuvant to bupivacaine. Keywords : postoperative analgesia, spinal anesthesia, fentanil, morphine, NRS