Penurunan Skala Nyeri Penderita Endometriosis Sebelum dan Sesudah Pembedahan Laparoskopi Konservatif dengan atau Tanpa Diikuti Terapi Medikamentosa di RSUD Dr. Soetomo

Aida Musyarrofah, Relly Yanuari Primariawan

= http://dx.doi.org/10.20473/mog.V23I12015.10-16
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Abstract


Tujuan: Mengetahui perubahan keluhan nyeri penderita endo-metriosis sebelum dan sesudah pembedahan laparoskopi konservatif dengan atau tanpa diikuti terapi medikamentosa di RSUD dr. Soetomo.

Bahan dan Metode: Studi ini merupakan penelitian deskriptif analitik pada penderita dengan keluhan nyeri panggul yang dicurigai menderita endometriosis dan akan dilakukan pembedahan laparoskopi konservatif serta memenuhi kriteria inklusi dan eksklusi. Subyek penelitian dievaluasi skala keluhan nyeri panggul kronik, dismenorea, dan dispareunia sebelum dilakukan laparoskopi dan setelah dilakukan laparoskopi pada bulan ke-1, bulan ke-2 dan bulan ke-3 dengan menggunakan skala numerik verbal mulai 0 sampai 10. Terapi medikamentosa yang diterima penderita setelah laparoskopi konservatif juga dicatat. Studi ini dilakukan si RSUD dr.Soetomo bulan Juli sampai Desember 2013.

Hasil: Didapatkan 28 penderita yang memenuhi kriteria inklusi dan eksklusi serta dilakukan pembedahan laparoskopi konservatif, 2 penderita putus uji dan 26 penderita diikuti sampai bulan ke-3 pascapembedahan. Rata-rata skor r-AFS endometriosis 26,27 (rentang 3-60). Berdasarkan uji Wilcoxon, pada 1 bulan pertama didapatkan perubahan rata-rata skala nyeri panggul kronik 0,92 ± 0,24 (p:0,002), dismenorea 2,77 ± 0,33 (p:0,000) dan dispareunia 0,15 ± 0,07 (p:0,046). Pada interval bulan 1 dan bulan 2, didapatkan perubahan rata-rata skala nyeri panggul kronik 0,23 ± 0,10 (p:0,02), dismenorea 0,85 ± 0,19 (p:0,001). Pada interval bulan 2 dan bulan 3, didapatkan perubahan rata-rata skala nyeri panggul kronik 0,15 ± 0,09 (p:0,10), dismenorea 0,31 ± 0,10 (p:0,014).

Simpulan: Tidak didapatkan perubahan skala dispareuni pada interval bulan 1 dan bulan 2 maupun bulan 2 dan bulan 3. Penurunan bermakna skala nyeri kronik terjadi sampai 2 bulan, penurunan bermakna skala dismenorea terjadi sampai 3 bulan, dan penurunan bermakna skala dispareuni terjadi sampai 1 bulan setelah pembedahan laparoskopi konservatif.

Keywords


nyeri, endometriosis, skala numerik verbal, laparoskopi konservatif, terapi medikamentosa

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