Tesis

Wrist Ankle Acupuncture Sebagai Pilihan Terapi Terhadap Nyeri Paska Arthroplasti Panggul Total = Wrist Ankle Acupuncture as a Treatmment for Post Total Hip Arthroplasty Pain.

Pendahuluan: Arthroplasti panggul total merupakan salah satu tindakan bedah orthopedi yang paling efektif biaya dengan tingkat keberhasilan yang konsisten, dapat merestorasi fungsional dan meningkatkan kualitas hidup pasien. Namun, nyeri paska operasi ini dapat berdampak buruk pada pemulihan dini pasien paska operasi, mobilitas paska operasi, meningkatkan risiko penyakit tromboemboli vena, dan menghambat rehabilitasi. Wrist ankle acupuncture (WAA) merupakan teknik akupunktur yang menggunakan titik yang lebih sedikit, insersi jarum dangkal dan stimulasi yang lebih ringan. WAA sebagai analgesia multimodal paska bedah orthopedi bermanfaat menurunkan nyeri, dan meningkatkan mobilisasi dini pasien dan mempercepat pemulihan. Metode: Desain penelitian adalah uji klinis acak terkontrol tersamar ganda. Sebanyak 32 orang subyek penelitian dibagi kedalam kelompok perlakuan (n=16) dan kelompok kontrol (n=16). Kelompok perlakuan mendapat 2 kali sesi WAA dan terapi standar. Kelompok kontrol mendapat 2 sesi sham WAA dan terapi standar. Retensi jarum selama 4 jam. Seluruh subyek di nilai intensitas nyeri dengan skor Visual Analog Scale (VAS) pada 24 jam, 48 jam, 3 hari dan 7 hari paska operasi. Seluruh subyek juga dicatat pada hari keberapa mulai dapat mobilisasi duduk dan belajar berjalan dengan alat bantu. Hasil: Kelompok perlakuan menunjukkan penurunan intensitas nyeri yang signifikan secara klinis dan statistik dibanding kelompok kontrol pada penilaian setelah akupunktur sesi 2. Pada penilaian 3 hari dan 7 hari setelah operasi didapatkan perbedaan signifikan secara statistik. Kelompok perlakuan menunjukkan kecepatan mobilisasi dini (duduk dan belajar berjalan dengan alat bantu) yang lebih baik dibanding kelompok kontrol Kesimpulan: Kombinasi wrist ankle acupuncture dan terapi standar dapat menurunkan intensitas nyeri dan mempercepat mobilisasi paska operasi arthroplasti panggul total. Diperlukan setidaknya 2 sesi terapi akupunktur agar penurunan intensitas nyeri bermakna klinis dan statistik.
Kata kunci: akupunktur, wrist ankle acupuncture, arthroplasty panggul total, nyeri, mobilisasi


Introduction: Total hip arthroplasty is one of the most cost-effective orthopedic surgical procedures with consistent success rates, it can restore functionality and improve the patient's quality of life. However, the postoperative pain of this procedure may have negative impact on the patient's early postoperative recovery, postoperative mobility, and hinder rehabilitation. Wrist ankle acupuncture (WAA) is an acupuncture technique that uses fewer points, inserts fine needles and milder stimulation. WAA as multimodal analgesia after orthopedic surgery is useful for reducing pain, and increasing early mobilization of patients and speeding up recovery. Methods: The research design was a double-blind, randomized controlled clinical trial. A total of 32 research subjects were divided into treatment group (n=16) and control group (n=16). The treatment group received 2 sessions of WAA and standard therapy. The control group received 2 sessions of sham WAA and standard therapy. Needle retention was 4 hours. All subjects were assessed for pain intensity using the Visual Analog Scale (VAS) score at 24 hours, 48 hours, 3 days and 7 days after surgery. All subjects were also recorded on when the first time they were able to sit and learn to walk with assisted device Results: After the second session of WAA (within 48 hours post surgery) The treatment group showed a clinically and statistically significant reduction in pain intensity compared to the control group. At the 3 days and 7 days post-surgical assessment there were statistically significant reduction of pain found. The treatment group showed better speed of early mobilization (sitting and learning to walk with assistive devices) than the control group. Conclusion: The combination of wrist ankle acupuncture and standard therapy can reduce pain intensity and speed up mobilization of post total hip arthroplasty patients. At least 2 sessions of acupuncture therapy were required for clinically and statistically significant reduction of pain intensity
Keyword: acupuncture, wrist ankle acupuncture, total hip arthroplasty, pain, mobilization