Artikel PDF

Ariosta1), Imam Budiwiyono1), Herniah Asti Wulanjani2)

THE DIFFERENCE OF PAIN RESPONSE IN THE PATIENTS UNDERGONE BONE MARROW PUCTURE WITH AND WITHOUT MIDAZOLAM PREMEDICATION

ABSTRACT

Background: Bone marrow puncture fordisease diagnostic is performed by indication. Bone marrow puncture procedure often using midazolam premedication for avoiding pain but not all. The objectiveisto analize differentiationof pain response in BMP patients with midazolam and without premedication.

Methods: Observational analytic study with cross sectional. Sampling is performed by consecutive of 26 adult patients whom require BMP procedure. The study was conducted in Dr. Kariadi Hospital and Telogorejo Hospital, Semarang. Observational were made in groupof BMP with midazolam and without premedication. Pain intensity was measured by Wong Baker faces pain (WBFP); pain response was measured by mean arterial pressure (MAP), heart rate, cortisol level and glucose level. Differentiation test used independent t test for heart rate and cortisol level; and Mann Whitney test for MAP and glucose level.

Results: There are difference of MAP (p=0.002) and cortisol level (p=0.035) between midazolam group and without premedication. There are no difference WBFP (p=0.468) and heart rate (p=0.719) between midazolam premedication group and without premedication.

Conclusion: Midazolam premedication in BMP procedure can reduce pain response, which is characterized by decrease of MAP and cortisol level.

Keywords: pain response, bone marrow puncture, midazolam premedication

ABSTRAK

Latar belakang: Tindakan punksi sumsum tulang (PST/bone marrow puncture/BMP) memerlukan indikasi dalam menunjang diagnosis penyakit. Prosedur punksi sumsum tulang sering menggunakan premedikasi midazolam dalam mencegah sebagian nyeri. Tujuan dari penelitian ini adalah untuk menganalisa perbedaan respon nyeri pada pasien BMP dengan premedikasi midazolam dan tanpa premedikasi.

Metode: Penelitian observasional analitik dengan pendekatan cross sectional. Pengambilan sampel dengan consecutive sampling pada

26 pasien yang membutuhkan tindakan punksi sumsum tulang. Penelitian dilakukan di RSUP Dr. Kariadi dan RS Telogorejo Semarang. Observasi dilakukan dengan membandingkan kelompok PST dengan premedikasi dan tanpa premedikasi midazolam. Intensitas nyeri diukur dengan Wong Baker faces pain (WBFP); respon nyeri diukur dengan mean arterial pressure (MAP), laju nadi, kadar kortisol dan kadar glukosa. Uji beda menggunakan independent t test untuk laju nadi dan kadar kortisol; dan Mann Whitney test untuk MAP dan kadar glukosa.

Hasil: Terdapat perbedaan bermakna MAP (p=0,002) dan kadar kortisol (p=0,035) antara kelompok premedikasi dan tanpa premedikasi midazolam. Tidak terdapat perbedaan bermakna WBFP (p=0,468) dan laju nadi (p=0,719) antara kelompok premedikasi dan tanpa premedikasi midazolam.

Simpulan: Premedikasi midazolam dalam tindakan PST dapat menurunkan respon nyeri ditandai dengan penurunan MAP kadar kortisol.

Kata Kunci : respon nyeri, punksi sumsum tulang, premedikasi midazolam

Leave a Reply