EFEKTIVITAS IBUPROFEN SUPPOSITORIA SEBAGAI PREEMPTIVE ANALGESIA TERHADAP NYERI POSTOPERATIVE PADA PASIEN PEDIATRI YANG MENJALANI OPERASI ELEKTIF DENGAN GENERAL ANESTESI

Background : Preemptive analgesia, an evolving clinical concept. Involves the introduction of an analgesic regimen before the onset of noxious stimuli, with the goal of preventing sensitization of the nervous system to subsequent stimuli that could amplify pain. Pain is inevitable after any surgery. The purpose of preemptive analgesia is to reduce postoperative pain, contributing to a more comfortable recovery period and reducing the need for narcotic pain control. Objective : To compare the effect of preemptive analgesia with postoperative analgesia using ibuprofen suppositoria in pediatric patients undergoing operations with general anesthesia (with postoperative expected pain moderate to severe) Methods : in this randomized, double-blind study, thirty children, aging 1 – 18 years, undergoing elective surgery were ramdomly allocated to received ibuprofen suppositoria (n=15) or placebo (n=15), immediately after induction of general anesthesia. The vitals sign were monitored during operation. Postoperative pain was assessed at 0 min, 30 min ,60 min, 120 min in recovery room. Postoperative rescue analgesic ( fentanyl 1 – 2 mcg/kg IV ) was supplemented when pain score was > 4 . The amount of rescue analgesic needed during operation and after operation was also assessed Results : No significant difference between ibuprofen group and control group was noted in pain scores at 0 min (p=0,415), 30 min(p=0,108), 60 min(p=0,274), 120 min (p=0,254) .It was found that ibuprofen grup can reduce the need for opioid during operation compared to control group (p=0,008), but there is no significant difference between two goups after operation(p=0,208).The side effects were mild and similar in both groups. Conclusion : These result provide evidence that preemptive ibuprofen may reduce the need opiod during operation, but not improve to reduce the need opiod after operation and to reduce postoperative pain Keywords : Postoperative analgesia, general anesthesia, ibuprofen suppositoria, preemptive analgesi