Penyetaraan Dosis Analgesik (Equianalgesic Dose) Oxycodone dengan Morfin Intravena Kontinu Paska Bedah Tulang Panjang dengan Anestesi Umum Di RSUP Haji Adam Malik Medan

Abstract

Background: Pain if not treated will have a negative impact on patients with post- surgical such as anxiety (sleep disorders), immunosuppression, hyperglycemia,

hemodynamic changes (hypertension, tachycardia), decreased breathing movements resulting in decreased ability to cough, fear of mobilization will increase the risk of thromboembolic complications and increase the release of catecholamines that cause an increase in vascular resistance, extending the catabolic phase, reducing blood flow to the lower extremities and lower the blood circulation to splanchnicus. Intravenous continous infusion analgesics is an effective technique for postoperative pain

management. Oxycodone and morphine are powerful analgesic drugs used for post- operative pain management. Until now there is no studies have been conducted to

assess the dose equivalency between the two drugs that can overcome postoperative pain with continous intravenous infusion of intravenous Objective: To get an equianalgesic dose of Oxycodone and Morphine continous intravenously to resolve pain with VAS assessment in patient with long bone surgery with general anesthesia Methods: This study was conducted using a double-blind randomized clinical trials after approval from the Ethics Committee of the Faculty of Medicine, Faculty of Medicine, University of North Sumatra, 48 samples were collected for the study, ages 21-60 years, PS ASA I-II, which will get an elective orthopedic surgery using general anesthesia techniques. Once calculated statistically, all samples were randomly divided into 2 groups. Oxycodone with group A received 5 mg initial bolus followed by a continuous infusion dose of I mg / hour and Morphine with 4 mg initial bolus followed by a continuous infusion dose of 0.5 mg / hour. The drug is given when the patient has completed extubation. The result data were tested by Mann Whitney, Chi-Square, with significance level 95% (p <0,05). Results: Mean drug dose for group that takes morphine amounted to 3.90 ± 0.46 mg more than the mean dose of group that takes Oxycodone which only amounted to 1.46 ± 0.51 mg. Mann-Whitney test showed no significant difference between the mean dose of medication two groups of research subjects (p <0.05).The results showed that the mean time to reach VAS :S 3 for the groups that were given Morphine was 2.13 ± 0.68 hours longer than the average time to reach the VAS :S 3 for the groups that were given Oxycodone is 1.46 ± 0, 51 hours (p <0.05). Conclusion: There is a equianalgesic dose in group Oxycodone and Morphine. Dose 1.4 mg oxycodone and morphine 3.9 mg intravenous continuous infusion effectively cope with post-surgical pain in patient with long bone surgery of Haji Adam Malik Hospital.