PERBEDAAN PENGARUH PEMBERIAN KETOROLAK DAN DEKSKETOPROFEN SEBAGAI ANALGESIA PASCA BEDAH TERHADAP AGREGASI TROMBOSIT THE DIFFERENCE EFFECTS OF KETOROLAC AND DEXKETOPROFEN ADMINISTRATION AS POST OPERATIVE ANALGESIC ON THROMBOCYTE AGGREGATION

Abstract

ABSTRAK Latar belakang dan tujuan : Penggunaan OAINS sebagai analgesia pasca bedah mempunyai pengaruh menghambat agregasi trombosit berdasarkan rasio COX-1 / COX- 2 yang dimiliki. Penelitian ini bertujuan mengamati perbedaan pengaruh pemberian ketorolak dan deksketoprofen sebagai analgesia pasca bedah terhadap agregasi trombosit. Metode : Penelitian eksperimental dengan desain Randomized Controlled Trial Pretest Postest Design yang menjalani operasi ortopedi dengan anestesi umum. Pasien dibagi menjadi 2 kelompok (n:24), kelompok Ketorolak atau Deksketoprofen sebagai obat analgesi yang diberi sejak awal induksi sampai dengan 2 hari pasca bedah. Semua spesimen dilakukan pemeriksaan Tes Agregasi Trombosit menggunakan metode PACKS-4. Uji statistik menggunakan paired t-test untuk sebelum sesudah perlakuan pada masing-masing kelompok dan independent t-test untuk sesudah perlakuan antara kedua kelompok. Hasil : karakteristik data penderita maupun variabel homogen dan terdistribusi normal (p>0,05). Penelitian ini didapatkan perbedaan persentase agregasi maksimal trombosit bermakna (p<0,0001) sesudah pemberian ketorolak 45 menit (59,83±10,31), 2 hari (62,78±9,00) dan sesudah pemberian deksketoprofen 45 menit (68,29±11,20), 2 hari (71,52±8,60). Terdapat perbedaan bermakna persentase agregasi trombosit antara kelompok ketorolak dan deksketoprofen 45 menit dan 2 hari sesudah perlakuan (p=0,009) dan (p=0,001). Terdapat perbedaan bermakna pada perubahan persentase agregasi maksimal trombosit sesudah 45 menit dan 2 hari sesudah perlakuan antara kedua kelompok (p= 0,001), (p=0,002) Kesimpulan : Ketorolak secara bermakna menurunkan persentase agregasi maksimal trombosit lebih besar daripada deksketoprofen setelah pemberian 45 menit dan 2 hari pasca bedah. Kata Kunci : ketorolak, deksketoprofen, analgesia pasca bedah, ADP, agregasi trombosit ABSTRACT Background and Objective: NSAID as perioperative analgesic agent usage is said to inhibit thrombocyte aggregation depend on COX-1/COX-2 ratio. The aim of this study was to determine the difference effects of ketorolac and dexketoprofen as post operative analgesic on thrombocyte aggregation. Method : An experimental study with Randomized Control Trial design on 48 patients undergoing general anesthesia. Samples were divided into two groups (n:24, each), The 1st and the 2nd group each received Ketorolac or Dexketoprofen as the analgesic drug perioperative during the procedure, that was given at the beginning of induction until two days post operative. Specimen were taken from each group before treatment (preoperative) and after treatment (45 minutes after treatment, and 2 days post operative). Statistical analyses were performed with paired t-test and independent t-test (with level of significance, p < 0.05). Result : The patients’ characteristics and variables data were homogeny and normal distribution. We found a significant difference (p< 0.0001) in percentage of maximal thrombocyte aggregation after 45 minutes (59,83±10,31), and 2 days (62,78±9,00) administration of ketorolac and after 45 minutes (68,29±11,20), and 2 days (71,52±8,60) administration of dexketoprofen. We found a significant difference in percentage of maximal thrombocyte aggregation after 45 minutes and 2 days administration between ketorolac and dexketoprofen groups (p=0,009) , (p = 0.001). There was significant difference on delta pre and post 45 minutes and 2 days administration ketorolac and dexketoprofen (p=0,001), (p=0,002) Conclusion : Ketorolac significantly reduced the percentage of maximal thrombocyte aggregation after 45 minutes and 2 days administration than dexketoprofen. Keywords : ketorolac, dexketoprofen, postoperative analgesic, ADP, thrombocyte aggregation