Efektivitas dan Efisiensi Pencatatan efek Opioid pada Pasien Pascaoperasi di RSUP Dr. Sardjito, Indonesia

Abstract

Nyeri merupakan pengalaman sensoris dan emosional yang tidak menyenangkan terkait dengan kerusakan jaringan aktual atau potensial. Nyeri dapat terjadi saat preoperasi, durante, dan pascaoperasi. Pada umumnya, manajemen nyeri intra dan pascaoperasi menggunakan opioid. Penelitian ini bertujuan menilai efektivitas dan efisiensi pencatatan evaluasi penggunaan opioid intraoperatif dan pascaoperasi dan dilaksanakan pada Maret–Oktober 2019 di RSUP Dr. Sarjito Yogyakarta. Penelitian ini menggunakan desain kohort retrospektif untuk melihat efektivitas dan efisiensi pemberian opioid intraoperatif terhadap efek analgesia pascaoperasi dengan mengukur skala NRS, prevalensi kejadian efek samping opioid post-operative nausea and vomiting (PONV), recovery room length of stay (LOS), serta penggunaan obat analgetik pascaoperasi. Pencatatan rekam medis yang kurang lengkap sehingga tidak dapat menilai efektivitas penggunaan opioid intraoperative yang baik. Penggunaan opioid pascaoperasi memiliki hubungan yang bermakna dengan skor NRS 12 jam pascaoperasi dan kejadian komplikasi (p=0,025;p=0,028). Penggunaan opioid intraoperatif maupun pascaoperasi terhadap skor NRS, kejadian komplikasi, maupun lamanya waktu rawat di recovery room tidak terdapat hubungan yang bermakna. Simpulan, pencatatan evaluasi penggunaan opioid intraoperative dan pascaoperasi di rekam medis masih belum lengkap. Penggunaan opioid intraoperatif tidak bermakna dalam menurunkan skor NRS, menurunkan kejadian komplikasi pascaoperasi, memperpendek lama rawat di recovery room , namun apabila opioid dilanjutkan pemberian pascabedah menurunkan NRS, tetapi efek  samping opioid lebih tinggi. Effectiveness and Efficiency of Opioid Effects Recording in Postoperative Patients at Sardjito General Hospital, Indonesia Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Postoperative pain is a pain felt by patients after a series of operations. In general, intraoperative and postoperative pains are treated with an opioid. This study aimed to determine the effectiveness and efficiency of recording evaluation of intraoperative and postoperative opioid use in patients. This study used a retrospective cohort design to identify the effectiveness and efficiency of intraoperative opioid administration on the postoperative analgesia effect by measuring the NRS scale, the prevalence of side effects of postoperative nausea and vomiting (PONV), Recovery Room length of stay (LOS), and the administration of postoperative analgesics. Due to incomplete medical records, it cannot assess the effectiveness of a good intraoperative opioid. Postoperative opioid use has a significant correlation with NRS score 12 hours postoperatively and the complication incidence (p=0.025, p=0.028). There was no significant relationship between either intraoperative or postoperative opioids to NRS score, adverse events, and length of stay in the Recovery Room. In conclusion, the recording of pain management in intraoperative and postoperative opioid use in the medical record is still incomplete. The intraoperative opioids use does not significantly reduce the NRS score, decrease the postoperative complications, and shorten the length of stay in the Recovery Room. If opioids are continued, postoperative administration significantly lower NRS; however, the side effects of opioids are higher.