Perbandingan efektivitas parasetamol dengan kombinasi parasetamol-vitamin B untuk menurunkan intensitas nyeri akut nonneuropatik

https://doi.org/10.22146/bns.v19i2.69196

Roy Ariady(1*), Yudiyanta Yudiyanta(2), Paryono Paryono(3)

(1) KSM Saraf, RSUD Kartini, Jepara, Jawa Tengah
(2) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(3) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author

Abstract


Nociceptive pain is a pain induced by a stimulus to the nociceptor. Pain that occurs in less than 30 days is acute pain. Morbidity of nociceptive pain, such as headache, back pain, arthralgia and myalgia, is still quite high. Although these cases have low mortality rate, but it may interfere with daily activities, lowering productivity, and high number of visits requiring large medical expenses. The use of non-steroidal anti-inflammatory drugs (NSAIDs) is currently quite high and growing, with increasing side effects. The use of paracetamol and vitamin B (vitamin B1, B6 and B12) can reduce the intensity of non-neuropathic acute pain better than paracetamol alone. Non-selective COX inhibitory mechanism of paracetamol has minimal side effects compared to NSAIDs. Vitamin B itself has an analgesic effect and can maintain blood analgesic levels.

This study was conducted to determine the effectiveness of a combination of paracetamol and vitamin B to overcome acute non-neuropathic pain. The form of the study was an experimental study with randomized, double blind controlled trials. A total of 114 subjects became the sample of this study. Assesment of pain using Visual Analog Scale (VAS). From the result of bivariate analysis showed that the combination of paracetamol and vitamin B (p =0.028) had a relationship with VAS with multivariate analysis result showed the dominant variable to the decrease of pain with regression coefficient 10.84 and p =0.031 (p <0.05). This shows a non-neuropathic acute decrease with a combination of paracetamol and vitamin B 10.84 higher than with paracematol alone.

   


ABSTRAK

 

Nyeri nosiseptif merupakan suatu nyeri yang ditimbulkan oleh suatu rangsangan pada nosiseptor. Nyeri yang terjadi dalam waktu kurang dari 30 hari masuk dalam nyeri akut. Morbiditas nyeri nosiseptif masih cukup tinggi seperti nyeri kepala, nyeri pungung, artralgia, dan mialgia. Walaupun kasus tersebut memiliki nilai mortalitas yang rendah, tetapi kondisi tersebut dapat mengganggu aktivitas sehari-hari, menurunkan produktivitas, dan angka kunjungannya yang tinggi membutuhkan biaya pengobatan besar. Penggunaan obat antiinflamasi nonsteroid (OAINS) saat ini cukup tinggi dan semakin bertambah setiap tahunnya, dengan efek samping yang semakin banyak.

Penggunaan analgesik parasetamol dan vitamin B dalam hal ini vitamin B1, B6, dan B12 dikatakan dapat menurunkan intensitas nyeri akut nonneuropatik yang lebih baik dari pada pemberian parasetamol saja. Parasetamol memiliki mekanisme penghambatan COX nonselektif yang memiliki efek samping yang minimal dibandingkan OAINS. Vitamin B sendiri memiliki efek analgesik dan mampu mempertahankan kadar analgesik di dalam darah.

Penelitian ini dilakukan untuk mengetahui efektivitas kombinasi parasetamol dan vitamin B untuk menurunkan intensitas nyeri akut nonneuropatik. Bentuk penelitian adalah studi eksperimental dengan randomized controlled trial, double blind. Sebanyak 114 subjek menjadi sampel penelitian ini. Penilaian nyeri menggunakan visual analog scale (VAS). Dari hasil analisis bivariat menunjukkan variabel pemberian obat kombinasi parasetamol dan vitamin B (p =0,028) memiliki hubungan bermakna terhadap penurunan nilai VAS dengan hasil analisis multivariat menunjukkan variabel yang dominan mempengaruhi terhadap penurunan nyeri adalah obat dengan koefisien regresi 10,84 dan p =0,031 (p <0,05). Hal ini menunjukkan penurunan nyeri akut nonneuropatik dengan kombinasi parasetamol dan vitamin B 10,84 lebih tinggi dibandingkan dibandingkan parasematol saja.


Keywords


acute non-neuropathic pain; paracetamol; vitamin B

Full Text:

PDF


References

IASP. IASP Terminology [Internet]. 2008 [accessed 2018 Aug]. Available from: https://www.iasp-pain.org/Education/Content. aspx?ItemNumber=1698.

Cole BE. Pain Management: Classifying, Understanding, and Treating Pain. Hospital Physician. 2002;38:23-30.

Meliala L, Suryamiharja A, Purba JS, Sadeli HA. Nyeri Punggung Bawah. Jakarta: Kelompok Studi Nyeri Perhimpunan Dokter Spesialis Saraf Indonesia (PERDOSSI); 2003.

Schofield H. The Impact of Pain Reduction on Productivity and Cognitive Function [Internet]. Leonard Davis Institute of Health Economics. 2016 [accessed 2018 Mar 3]. Available from: https://ldi.upenn.edu/impact-pain-reduction-productivity-and- cognitive-function.

Ortiz MI, Molina MAR, Arai Y-CP, Romanò CL. Analgesic Drugs Combinations in the Treatment of Different Types of pain. Pain Research and Treatment. 2012;2012:1–2.

Info BPJS Kesehatan. Perubahan tarif INA-CBGs membuat biaya kesehatan lebih efektif. 2014;8. Available from: https://bpjs-kesehatan.go.id/bpjs/dmdocuments/ 2b67b6556b028d910d2ee8df4245e886.pdf.

Roth S. Coming to terms with nonsteroidal anti-inflammatory drug gastropathy. Drugs. 2012;72(7):873-879.

Zhou Y, Boudreau DM, Freedman AN. Trends in the use of aspirin and nonsteroidal anti-inflammatory drugs in the general

U.S. population. Pharmacoepidemiology and Drug Safety. 2014;23(1):43–50.

Laine L. Approaches to nonsteroidal anti-inflammatory drug use in the high-risk patient. Gastroenterology. 2001;120(3):594-606.

Capone ML, Tacconelli S, Rodriguez LG, Patrignani P. NSAIDs and cardiovascular disease: transducing human pharmacology results into clinical read-outs in the general population. Pharmacological Reports. 2010;62(3):530-535.

Harirforoosh S, Asghar W, Jamali F. Adverse effects of nonsteroidal antiinflammatory drugs: an update of gastrointestinal, cardiovascular and renal complications. Journal of Pharmacy & Pharmaceutical Sciences. 2013;16(5):821-847.

Choudhury D, Ahmed Z. Drug-associated renal dysfunction and injury. Nature Clinical Practice Nephrology. 2006;2(2):80-91.

Schellack N. An overview of gastropathy induced by nonsteroidal anti-inflammatory drugs: evidence-based pharmacy practice. SA Pharmaceutical Journal. 2012;79(4):12-18.

Leung L. From ladder to platform: a new concept for pain management. Journal of Primary Health Care. 2012;4(3):254- 258.

Mibielli MA, Geller M, Cohen JC, Goldberg SG, Cohen MT, Nunes CP, et al. Diclofenac plus B vitamins versus diclofenac monotherapy in lumbago: the DOLOR study. Current Medical Research and Opinion. 2009;25(11):2589-2599.

Shumyantseva VV, Shich EV, Machova AA, Bulko TV, Kukes VG, Sizova OS, et al. The influence of B-group vitamins on monooxygenase activity of cytochrome P450 3A4: Pharmacokinetics and electro analysis of the catalytic properties. Biochemistry (Moscow) Supplement Series B: Biomedical Chemistry. 2012;6(1):87-93.

Katzung BG, Master SB, Trevor AJ. Basic and clinical pharmacology. New York: McGraw-Hill Medical. 2012.

Galván-Montaño A, Reyes-García G, Suarez-Roa MdeLR AB. Analgesic efficacy between acetominophen+ B vitamins vs. acetominophen in pediatric ambulatory surgery. Cirugia y Cirujanos. 2010;78:400-409.



DOI: https://doi.org/10.22146/bns.v19i2.69196

Article Metrics

Abstract views : 2452 | views : 3668

Refbacks

  • There are currently no refbacks.


Copyright (c) 2021 Berkala NeuroSains

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.