Electronic Theses and Dissertation

Pendahuluan: Cedera Otak Traumatik (COT) merupakan kerusakan jaringan intrakranial yang disebabkan oleh proses mekanik yang berasal dari luar yang menyebabkan kerusakan otak, baik secara struktur maunpun fungsi. Setelah cedera otak traumatik, 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 kontrol. Model tikus cedera otak traumatik 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 fentanyl dan tramadol hingga penilaian sensori pada 72 jam. Saat hari ke 7 pasca perlakuan trauma, sensitivitas nyeri kelompok fentanyl dan tramadol mendekati seperti baseline sebelum perlakuan trauma, sementara kelompok kontrol berada jauh dari baseline. Terdapat perbedaan signifikan penilaian Von Frey antara kelompok kontrol dan intervensi (fentanyl dan tramadol) sesuai hasil uji statistik Friedman (nilai p< 0.05).
Kesimpulan: Kedua agen analgetik (fentanyl dan tramadol) menunjukkan perbaikan ambang batas nyeri pada fase awal setelah cedera otak traumatik 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: Traumatic Brain Injury (TBI) is intracranial tissue damage caused by mechanical processes originating from outside that cause structurally and functionally brain damage. 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 fentanyl and tramadol 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 fentanyl and tramadol group until 72 hour measurement. At 7 days after intervention, the fentanyl and tramadol 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 (fentanyl and tramadol) groups according to statistic (p value > 0.05). Conclusion: Both analgesic agents (fentanyl and tramadol) 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