Efektivitas Blok Ilioingunal Dalam Menurunkan Penggunaan Opioid Dan Skor Nyeri Pada Seksio Sesarea: Studi Acak Terkontrol
DOI:
https://doi.org/10.24843/JATI.2025.v01.i01.p02Kata Kunci:
blok ilioinguinal, patient controlled analgesia, seksio sesaria, abdominal blokAbstrak
Pendahuluan: Nyeri pascaoperasi seksio sesarea merupakan nyeri berat yang dapat mengganggu aktifitas ibu dan hubungan ikatan pertama kali antara ibu dan bayi. Tatalaksana nyeri hanya berfokus pada opioid dapat menyebabkan efek samping seperti mual, muntah, sedasi, dan depresi napas yang mengganggu ikatan ibu dan bayi. Saraf ilioinguinal menginervasi bagian abdomen bawah yang terlibat dalam insisi Pfannenstiel saat tindakan seksio sesarea sehingga blok ilioinguinal berpotensi mengatasi kedua permasalahan nyeri tersebut diatas pada pascaoperasi seksio sesarea.
Pasien dan Metode: Penelitian ini merupakan penelitian true experimental dengan rancangan yang digunakan adalah single blind randomized controlled trial yang membagi 70 subyek penelitian kedalam dua kelompok, yaitu kelompok blok ilioinguinal pascaoperasi seksio sesarea dan kelompok kontrol. Kedua kelompok juga diberikan patient controlled analgesia morfin Kemudian dilakukan evaluasi skala nyeri NRS pada jam ke-0, 3, 6, 12, dan 24 selama 24 jam pertama, penggunaan total morfin dalam 24 jam, dan kenaikan nilai NLR dan PLR yang terjadi. Keseluruhan data kemudian dibandingkan untuk melihat keberhasilan blok ilioinguinal dalam menangani nyeri pascaoperasi seksio sesarea.
Hasil: Penelitian ini menunjukkan bahwa kelompok blok ilioinguinal memiliki skor nyeri NRS pascaoperasi seksio sesarea yang lebih rendah dibandingkan kelompok kontrol, dan secara statistik bermakna (p < 0,001). Untuk penilaian konsumsi morfin dalam 24 jam, kelompok blok juga menggunakan morfin dalam jumlah yang lebih sedikit yaitu sebesar 4 mg dibandingkan kelompok kontrol yang hingga 22 mg dan bermakna secara statistik (p < 0,001). Kenaikan nilai NLR dan PLR juga terlihat lebih rendah pada kelompok blok dan bermakna secara statistik (p < 0,001).
Kesimpulan: Blok ilioinguinal mampu memberikan penanganan nyeri yang baik selama 24 jam pertama pascaoperasi seksio sesarea dengan mengurangi kebutuhan penggunaan morfin secara signifikan. Selain itu blok ilioinguinal juga mampu menekan respon inflamasi yang terlihat dari rendahnya kenaikan nilai NLR dan PLR dibandingkan dengan kelompok yang tidak menggunakan blok.
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