Electronic Theses and Dissertation

Pendahuluan: Insidensi tinggi cedera otak traumatic di seluruh dunia disertai dampaknya selain kematian adalah terhadap kualitas hidup yang meliputi perubahan kognitif, deficit motoric dan abnormaliats sensorik. Setelah cedera otak traumatic, model hewan coba menunjukkan respon berlebih terhadap stimulus nyeri ringan, kondisi yang menyerupai nyeri kronik yang tampak pada pasien manusia cedera otak traumatik.
Metodologi: Penelitian ini menggunakan eksperimen hewan coba dengan desain pretest dan post test sehingga efek intervensi pada kelompok eksperimen dapat dibandingkan dengan kelompok control. Model tikus cedera otak traumatic dilakukan dengan Feeney weight drop model, sampel diberikan agen analgetik sesuai kelompoknya per 8 jam secara intravena selama 3 hari. Penilaian ambang batas nyeri dilakukan sebelum dan sesudah perlakuan, serta beberapa interval waktu yaitu 1 jam, 6 jam, 24 jam, 72 jam dan 7 hari pasca perlakuan cedera otak traumatik.
Hasil: Tes sensitivitas nyeri tertinggi (sebagai ambang batas nyeri terendah) didapatkan pada 6 jam dan 24 jam pasca trauma. Hasil tes Von Frey turun signifikan pada grup kontrol sementara grup intervensi mulai meningkat sejak 6 jam dan perbaikan stabil tampak pada grup dexmedetomidine dan parasetamol hingga penilaian sensori pada 72 jam. Saat hari ke 7 pasca perlakuan trauma, sensitivitas nyeri kelompok dexmedetomidine dan parasetamol mendekati seperti baseline sebelum perlakuan trauma, sementara kelompok control berada jauh dari baseline. Terdapat perbedaan signifikan penilaian Von Frey antara kelompok kontrol dan intervensi (dexmedetomidine dan parasetamol) sesuai hasil uji statistic Friedman (nilai p< 0.05). Kesimpulan: Kedua agen analgetic (dexmedetomidine dan parasetamol) menunjukkan perbaikan ambang batas nyeri pada fase awal setelah cedera otak traumatic dan perbaikan ambang batas nyeri yang mendekati baseline sebelum COT dibandingkan dengan kelompok kontrol.
Kata Kunci : Sensitivitas Nyeri, Cedera Otak Traumatik, Tes Von Frey

Introduction: High incidency of traumatic brain injury worldwide with its impact on life outcomes besides death including cognitive changes, motor deficits and sensory abnormalities. TBI in rat models frequently results in heightened sensitivity to pain, termed hyperalgesia or allodynia. After TBI, these animals often exhibit exaggerated responses to otherwise mild pain stimuli, a condition mimicking chronic pain observed in human TBI patients. Methodology: This study was an animal experimental laboratory with pretest and posttest control group design. This design allows researchers to measure the effect of treatment (intervention) on the experimental group by comparing the control group with the paracetamol and dexmedetomidine treatment groups. A TBI rat model developed with Feeney weight drop model, samples were given analgesic agents according to the group intravenously per 8 hours for three days. Measurement of pain thresholds was carried out before and after treatment in several time intervals, which were 1 hour, 6 hours, 24 hours, 72 hours, and 7 days after TBI. Results: The highest pain sensitivity level (referred to lowest pain threshold and lowest Von Frey test) occurred at 6 and 24 hours post trauma. As the Von Frey test result drop significantly in control group yet the intervention group’s sensitivity result start to elevate gradually from 6 hour and stable improvement were seen in both dexmedetomidine and asetaminophen group until 72 hour measurement. At 7 days after intervention, the dexmedetomidine and paracetamol groups pain sensitivity level were almost equally the same as before the TBI. But, the control group sensitivity level was far from baseline score before TBI. There was significant difference in Von Frey assessment between the control and intervention (dexmedetomidine and acetaminophen) groups according to statistic (p value > 0.05). Conclusion: Both analgesic agents (dexmedetomidine and acetaminophen) showed improvement of pain sensitivity threshold at early phase after traumatic brain injury and recover the pain sensitivity threshold near to baseline state before TBI while the control group did not. Keywords: Pain Sensitivity, Traumatic Brain Injury, Von Frey Test