HUBUNGAN ANTARA KADAR KORTISOL SERUM, KUANTITAS NEUTROFIL SEGMEN DAN INFILTRASI ANESTETIK LOKAL LEVOBUPIVAKAIN PADA PENYEMBUHAN LUKA TIKUS WISTAR THE CORRELATION BETWEEN THE LEVEL OF SERUM CORTISOL, SEGMENTED NEUTROPHIL AND LEVOBUPIVACAINE INFILTRAHON ON WISTAR RATS WOUND HEALING

Abstract

Background : Post operative acute pain stimulates corticotropin releasing factor and adrenal to release cortisol. The use of local anaesthetic infiltration is consider to control acute pain and will decrease the level of cortisol. Levobupivacaine is a long acting local anaesthetic, suitable for pain control. Cortisol has an ability to depress segmented neutrophil Objective : To prove the correlation between the level of serum cortisol, the number of segmented neutrophil and levobupivacaine infiltration. Methods : This study was an animal experimental study, randomized post test only control group design, 15 Wistar rats were divided into 3 groups. Group I, control, group II, rats that got incisions without levobupivacaine infiltration and group III, rats that got incisions and levobupivacaine infiltration every el hours for 24 hours. On lst day, blood sample was taken and analyzed for the level of serum cortisol, absolute neutrophil count and the number of segmented neutrophil from tissue biopsy was done. Data were analyzed using Kruskal-Wallis test. The correlation between the level of serum cortisol and the number of segmented neutrophil were analyzed using Spearmans correlation test. Results : There was a significant difference on the level of serum cortisol between group I, II and III, 00.002). There was no significant difference of absolute neutrophil count between group I, II and III, (p----.0.100). There was a significant difference on the number of segmented neutrophil from tissue biopsy between group I, II and III, 00.007). There was no correlation between the level of serum cortisol and the number of segmented neutrophil (p=0.839). Conclusions : The level of serum cortisol in levobupivacaine infiltration group are lower than that without levobupivacaine infiltration. The number of tissue segmented neutrophils are greater in levobupivacaine infiltration group and there's no significant difference concerning absolute neutrophil count between those two groups. There's no correlation between the level of serum cortisol and the number of segmented neutrophil on wound healing process. Latar belakang . Nyeri akut pasta pembedahan merangsang corticotropin releasing factor dan adrenal untuk melepaskan kortisol. Infiltrasi anestetik lokal terbukti mengurangi nyeri akut, menurunkan kortisol Levobupivakain, anestetik lokal durasi panjang efektif mengurangi nyeri akut. Kortisol menyebabkan depresi neutrofil segmen. Tujuan Membuktikan adanya hubungan antara kadar kortisol serum, neutrofil segmen dan infiltrasi anestetik lokal Ievobupivakain pada penyembuhan luka. Metode : Dilakukan penelitian eksperimental pada hewan coba tikus Wistar, dengan desain randomized post test only control group. Sampel 15 ekor dibagi menjadi 3 kelompok; kelompok I kontrol, kelompok II insisi subkutis, kelompok III insisi subkutis dan infiltrasi levobupivakain setiap 8 jam selama 24 jam_ Diperiksa kadar kortisol serum, absolute neutrophil count serta neutrofil segmen jaringan pada jam ke-24 pasta insisi. Data dianalisis dengan uji beds Kruskal¬Wallis. Hubungan antara kadar kortisol serum dan neutrofil segmen dianalisis menggunakan uji korelasi Spearman. Basil Kadar kortisol serum antara kelompok I, II dan III berbeda bermakna (p-,002). Absolute neutrophil count antara kelompok I, II dan III berbeda talc bermakna (r0,100). Kuantitas neutrofil segmen jaringan antara kelompok I, II dan III berbeda bermakna (p=0,007). Hubungan antara kadar kortisol serum dan kuantitas neutrofil segmen talc bermakna (r=0,057), (r0,839). Simpulan Kadar kortisol serum kelompok infiltrasi levobupivakain lebih rendah dibandingkan kelompok tanpa infiltrasi levobupivakain. Absolute neutrophil count darah kelompok infiltrasi dibandingkan tanpa infiltrasi levobupivakain berbeda tak bermakna. Kuantitas neutrofil segmen jaringan pada kelompok infiltrasi levobupivakain lebih besar dibandingkan kelompok tanpa infiltrasi levobupivakain. Tidak terdapat hubungan antara kadar kortisol serum dan neutrofil segmen pada proses penyembuhan luka