Oleh admin kalbemed pada May 16, 2018 06:00

Parasetamol Intravena Bermanfaat untuk Penanganan Nyeri Paska Tonsilektomi

Nyeri paska tonsilektomi merupakan salah satu hal yang menjadi perhatian pada pasien pasca operasi. Pemberian analgesik sering tidak adekuat pada kasus ini. Penggunaan opioid sering dilakukan sebelum dan segera setelah operasi selesai. Namun, opioid sering menyebabkan efek samping seperti mual, muntah, pusing, efek sedasi dan depresi nafas, sehingga penggunaannya harus diawasi secara ketat. AINS (Anti Inflamasi Non-Steroid) efektif dalam menangani nyeri ringan dan sedang. Penggunaan AINS seringkali menurunkan penggunaan opioid dan menurunkan kejadian efek samping dari opioid. Namun AINS juga memiliki efek samping mengganggu homeostasis yang disebabkan karena penurunan fungsi platelet. AINS menghambat agregasi platelet untuk beberapa jam.

Parasetamol injeksi dipertimbangkan sebagai analgesik non-opioid untuk menangani nyeri post-operasi dan nyeri derajat sedang, jika diperlukan juga dapat digunakan untuk menangani nyeri derajat berat. Paracetamol tidak mengganggu fungsi platelet dan tidak memanjangkan perdarahan seperti AINS, sehingga lebih aman digunakan pada post-tonsilektomi, karena operasi tonsilektomi berisiko perdarahan.

Penelitian yang dilakukan pada 76 pasien dewasa dengan tonsilektomi dengan anestesi umum  menunjukkan bahwa pemberian parasetamol injeksi bermanfaat untuk penanganan nyeri pasca tonsilektomi. Dalam studi tersebut, setelah tindakan operasi, pasien diberikan parasetamol injeksi 1 gram atau plasebo menggunakan NaCl 0,9% dengan interval 6 jam. Tidak ada pemberian analgesik lain pada penelitian ini. Setelah pemberian, pelaporan efek samping juga dicatat.

Hasilnya terdapat perubahan signifikan nyeri pada pasien yang diberikan parasetamol dan plasebo baik pada saat istirahat dan saat menelan. Efek samping yang banyak dilaporkan adalah mual muntah dan nyeri kepala baik pada grup dengan parasetamol maupun plasebo. Namun efek samping lebih banyak dirasakan pada grup plasebo. Hal ini menunjukkan bahwa parasetamol aman dan jarang menimbulkan efek samping pada praktik pemberiannya.

Dari hasil tersebut menujukkan bahwa penggunaan parasetamol pada operasi post-tonsilektomi menunjukkan hasil yang cepat dan efektif dalam menurunkan nyeri baik pada fase istirahat maupun saat menelan. Selain itu, efek sampingnya juga ringan sehingga parasetamol aman diberikan.[AFY]



Image: Ilustrasi
Referensi:
1. Atef A, Fawaz AA. Intravenous paracetamol is highly effective in pain treatment after tonsillectomy in adults. Eur Arch Otorhinolaryngol. 2008. 265:351-5.
2. Reiner SA, Sawyer WP, Clark KF, Wood MW. Safety of outpatient tonsillectomy and adenoidectomy. Otolaryngol Head Neck Surg.1990. 102:161–168.
3. Salonen A, Kokki H, Nuutinen J. Recovery after tonsillectomy in adults: a three-week follow-up study. Laryngoscope. 2002. 112(1):94–98

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