PERBANDINGAN EKSPRESI SEL T CD4+ DI JARINGAN SEKITAR LUKA DENGAN DAN TANPA INFILTRASI LEVOBUPIVAKAIN PADA NYERI PASCA INSISI Studi Imunohistokimia pada Tikus Wistar COMPARISON OF CD4+ T CELL EXPRESSION BETWEEN LEVOBUPIVACAIN AND NON LEVOBUPIVACAIN TREATED TISSUE SURROUND WOUND AFTER INCISION PAIN Immunohistochernistry Study on Wistar rat

Abstract

Background : CD4+ T cells have a prominent role on the wound healing due to its ability to produce cytokines and growth factors. The acute pain occurs after wound could depress the immune function that leads to the inhibition of the wound healing processes. Local anestetic which has a long duration effect such as levobupivacain could be used to relief the pain so that protect the depression of immune function. Objective : To compare the CD4+ T cells expression between levobupivakain and non levobupivacain treated tissue surround the wound. Methode : This laboratoric experimental study was design with randomized post test only control group method. Ten female rat were randomly devided in to two groups. 2 cm of skin incision was perfomed to all rats. After the incision, Levobupivacain infiltration were given every 8 hours for 24 hours to the second group. No levobupivacain was given to the first group. On day 5 the rats were sacrified and the tissue surround the wound were taken for immunohistochemistry stainning. The CD4+ T cells expression were analyzed for histologic scoring. Independent T-test was used for statistic analysis. Result : It was demonstrated in this study that the histologic score of CD4+ T cells of the levobupivacain treated group (group 2) was signicicantly higher than group I (without levobupivacain). (mean 12.68±1.58 vs 9.16±1.01 respectively, p.1,003 ; p<0,05). Conclusion : The CD4+ T cells expression were significanly higher in levobupivacain treated group than non levobupivacain group on the tissue surround the wound Latar belakang : Sel T CD4+ merupakan salah satu komponen sistem imun yang ikut berperan dalam penyembuhan luka, karena memproduksi sitokin dan faktor pertumbuhan. Nyeri akut pada luka akan menekan sistem imun, sehingga menghambat penyembuhan luka. Untuk menghilangkan nyeri digunakan anestesi lokal levobupivakain yang sangat balk untuk menghilangkan nyeri akut dan mempunyai durasi yang panjang. Tu uan : Membandingkan ekspresi sel T CD4+ di jaringan sekitar luka dengan dan tanpa infiltrasi levobupivakain. Metode : Dilakukan penelitian eksperimental laboratorik dengan disain "Randomized Post test only control group design", pada sepuluh ekor tikus Wistar. Kelompok penelitian dibagi menjadi dua kelompok secara acak masing masing lima ekor, Kelompok 1, tikus yang dilakukan insisi 2 cm, tanpa diberikan infiltrasi levobupivakain,Keiompok 2, tikus yang dilakukan insisi 2 cm, diberikan infiltrasi levobupivakain tiap 8 jam selama 24 jam. Ekspresi Set T CD4+ pada sekitar luka insisi dinilai dengan skor histologi dari preparat dengan menggunakan pengecatan secara imunohistokimia, yang diambil dan biopsi jaringan pada hari ke 5. Metode perhitungan statistik menggunakan independent samples T — test. Hasil : Pada penelitian menunjukkan pada jaringan insisi basil rerata skor histologi sel T CD4 + pada kelompok levobupivakain lebih tinggi (12.68±1.58) dibanding kelompok tanpa levobupivakain (9.16±1.01). Perhitungan statistik antara kedua kelompok tanpa levobupivakain dan dengan kelompok levobupivakain berbeda bermakna (p=0.003 ; p<0.05). Kesimpulan : Terdapat perbedaan ekspresi sel T CD4+ di jaringan sekitar luka dengan infiltrasi levobupivakain lebih tinggi dibanding tanpa levobupivakain.