Tesis

Hubungan Blok Deep Parasternal Intercostal Plane Bilateral Terhadap Nyeri Kronik pada Pasien Pascabedah Jantung Dewasa

Latar belakang: Nyeri kronik pascabedah jantung merupakan masalah klinis yang cukup bermakna dengan prevalensi yang masih cukup tinggi. Nyeri kronik pascabedah dapat menyebabkan gangguan kesehatan mental dan menurunkan kulitas hidup. Teknik blok deep parasternal intecostal plane (DPIP) merupakan teknik manajemen nyeripasca bedah yang terbukti efektif dalam menurunkan derajat nyeri akut dan konsumsi opioid pascabedah. Objektif: Mengetahui bahwa blok DPIP bilateral dapat menurunkan insidens nyeri kronik pada pasien pascabedah jantung dewasa. Metode: Penelitian ini menggunakan desain kohort retrospektif pada pasien pascabedah jantung dewasa di RSUPN Dr. Cipto Mangunkusumo, selama bulan Juni 2024—Juli 2024. Pengaruh blok DPIP bilateral dan karakteristik sampel dianalisis terhadap kejadian nyeri kronik pascabedah. Hasil: Penelitian ini menemukan bahwa insidensi nyeri kronik pascabedah mencapai 27,6%. Tidak ditemukan hubungan bermakna antara penggunana blok DPIP bilateral terhadap kejadian nyeri kronik pascabedah (p=1.000). Selain itu, tidak ditemukan hubungan bermakna antara blok DPIP bilateral dengan derajat nyeri (p=0.597) dan brief pain inventory (BPI). Namun, ditemukan hubungan bermakna antara kejadian nyeri kronik pasca bedah terhadap jenis kelamin (p=0.018) dan jangka waktu bedah (p < 0.001). Kesimpulan: Kejadian nyeri kronik pascabedah masih cukup tinggi. Tidak ditemukan hubungan bermakna antara penggunaan blok DPIP bilateral terhadap insidens nyeri kronik pascabedah jantung terbuka, severitas nyeri, maupun BPI. Penelitian selanjutnya diperlukan untuk membentuk stratifikasi risiko serta teknik manajemen nyeri untuk mengurangi insidensi nyeri kronik pascabedah.
Kata Kunci: Nyeri kronik pascabedah, blok DPIP bilateral, operasi jantung dewasa, manajemen nyeri


Background: Chronic pain post-cardiac surgery is a significant clinical problem with a prevalence that is still quite high. Chronic pain after surgery can cause mental health disorders and reduce quality of life. The deep parasternal intecostal plane (DPIP) block technique is a post-surgical pain management technique that has been proven effective in reducing the degree of acute pain and post-surgical opioid consumption. Objective: To analyze the association between bilateral DPIP block and the incidence of chronic pain in adult post-cardiac surgery patients. Methods: Retrospective cohort study was conducted in adult post-cardiac surgery patients at Dr. Cipto Mangunkusumo National Hospital, during June 2024—July 2024. The effect of bilateral DPIP block and sample characteristics were analyzed on the incidence of chronic post-operative pain. Results: This study found that the incidence of chronic postoperative pain reached 27.6%. No significant relationship was found between the use of bilateral DPIP blocks and the incidence of chronic postoperative pain (p = 1,000). In addition, no significant relationship was found between bilateral DPIP blocks and the degree of pain (p = 0.597) and brief pain inventory (BPI). However, a significant relationship was found between the incidence of chronic postoperative pain and gender (p = 0.018) and surgical duration (p < 0.001). Conclusion: The incidence of chronic postoperative pain is still high. No significant relationship was found between the use of bilateral DPIP block and the incidence of chronic pain after open heart surgery, pain severity, or BPI. Further research is needed to establish risk stratification and pain management techniques to reduce the incidence of chronic postoperative pain.
Keywords: Chronic postoperative pain, bilateral DPIP block, adult cardiac surgery, pain management