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All Journal Jurnal Anestesiologi Indonesia
Taufik Eko Nugroho
Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Diponegoro, Semarang|Universitas Diponegoro
Health Professions Medicine & Pharmacology Public Health

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Breakthrough Cancer Pain: The Current Pharmacological Management Mochamat Mochamat; Taufik Eko Nugroho; Satrio Adi Wicaksono
JAI (Jurnal Anestesiologi Indonesia) Vol 14, No 1 (2022): Jurnal Anestesiologi Indonesia
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.44701

Abstract

Background: Breakthrough pain (BTP) is a transient increase in pain that occurs on a background of stable pain. It contributes substantially to the suffering experienced by most cancer patients. The pharmacologic options for management of BTP have been expanded considerably in the past decade. Opioids remain the most effective pharmaceuticals used for the BTP case. In this systematic review we attempted to provide the currently available clinical data about pharmacological treatment for breakthrough cancer pain.Objective: To evaluate the efficacy of pharmacological treatments for Breakthrough painMethods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and PubMed for the last ten years (from September 2010 to September 2020. Further potentially relevant studies were identified from reference lists of studies marked for inclusion and relevant reviews. Two review authors independently assessed trial quality and extracted data. We screened the search results and included studies if they met the selection criteria.Result: We screened 205 publications of which 14 met the inclusion criteria. In total, we analysed data from 2129 participants. Overall, participant with BTP were treated with short acting opioid. Literature searching did not find any published evidence of non opioid drug to treat the BTP. Most adverse effects of the investigated drugs seemed to be moderate.Conclusion: The findings of this review suggest that rapid onset opioids play significant role for BTP. Future studies may be conducted to explore the efficacy and safety profiles each regimen for patients with certain categories of cancer.
Perbandingan Pengaruh Pemberian Ketamin 0,1 mg/KgBB dan Parasetamol 1000 mg Secara Intravena Terhadap Kadar Interleukin-6 pada Pasien Pasca Lower Limb Orthopedic Surgery Taufik Eko Nugroho; Adi Sakti Setionegoro; Aria Dian Primatika; Satrio Adi Wicaksono
JAI (Jurnal Anestesiologi Indonesia) Vol 14, No 1 (2022): Jurnal Anestesiologi Indonesia
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v14i1.45221

Abstract

Latar Belakang: Lower limb orthopedic surgery merupakan tindakan bedah ortopedik pada ekstremitas inferior yang meliputi tulang, sendi, dan vaskular. Peningkatan interleukin-6 (IL-6) sistemik setelah pembedahan meningkatkan morbiditas dan mortalitas pascaoperasi. Sebagai analgesik, ketamin dan parasetamol mempengaruhi ekspresi IL-6.Tujuan: Penelitian ini adalah untuk membandingkan pengaruh pemberian ketamin 0,1mg/Kg IV dengan parasetamol 1000 mg IV terhadap kadar IL-6 pada pasien pasca lower limb orthopedic surgery yang mendapatkan regional anestesi.Metode: Penelitian ini menggunakan randomized control trial pada 54 pasien yang telah menjalani lower limb orthopaedic surgery dan memenuhi kriteria inklusi dan eksklusi. Sampel dibagi menjadi 3 kelompok yang terdiri dari kontrol (K); epidural bupivakain 0,125%, perlakuan 1 (P1); dengan tambahan ketamin 0,1 mg/KgBB IV dan perlakuan 2 (P2); dengan tambahan parasetamol 1000 mg IV pascaoperasi. Sampel darah diambil 2 jam pascaoperasi untuk diukur kadar IL-6 menggunakan metode enzyme linked immunosorbent assay (ELISA).Hasil: Penelitian ini menghasilan nilai rerata IL-6 kelompok K = 72,22±66,93 pg/ml; P1 = 7,18±4,18 pg/ml dan P2 = 7,00±2,92 pg/ml. Uji Kruskal Wallis menunjukkan nilai signifikan (p=0,000). Hasil penelitian menunjukkan nilai signifikan pada K terhadap P1 (p=0,000) dan K terhadap P2 (p=0,000), sedangkan P1 terhadap P2 tidak signifikan (p=0,438).Kesimpulan: Pemberian ketamin atau parasetamol pasca lower limb orthopaedic surgery secara signifikan menurunkan kadar IL-6. Tidak ada perbedaan antara ketamin dan parasetamol dalam menurunkan kadar IL-6 pascaoperasi lower limb orthopedic surgery. 
Co-Authors Adi Sakti Setionegoro Aria Dian Primatika Mochamat Mochamat Satrio Adi Wicaksono