Perbandingan Efek Terapi Gabapentin dan Amitriptilin pada Pasien Stroke dengan Nyeri Neuropati
DOI:
https://doi.org/10.18196/mmjkk.v13i2.1059Keywords:
stroke, Gabapentin, Amitriptilin, skor nyeri, VAS, pain scoreAbstract
Stroke merupakan masalah bagi negara berkembang. Insidensi stroke di Indonesia 234 per 100.000 penduduk dan sekitar 2 - 8 % pasien stroke yang mengalami lesi serebrovaskular akan mengalami nyeri neuropati. Beberapa penelitian sudah membuktikan Gabapentin dan Amitriptilin dapat digunakan sebagai terapi nyeri neuropati namun belum ada yang membandingkan secara langsung pada pasien stroke dari segi efek dan efek samping. Tujuan penelitian ini untuk mengetahui perbandingan penggunaan Gabapentin dan Amitriptilin terhadap efek terapi pada pasien stroke iskemik dengan nyeri neuropati di Rumah Sakit Jogja. Metode yang digunakan pada penelitian ini adalah quasi experimental dengan consequtive sampling dengan sampel 23 pasien pada kelompok Gabapentin dan 18 pasien pada kelompok Amitriptilin serta dievaluasi skor nyeri selama 1 bulan dengan menggunakan Visual Analog Scale (VAS) setiap 2 minggu. Hasil penelitian menunjukkan pemakaian Gabapentin dan Amitriptilin selama 4 minggu menurunkan skor nyeri yang diukur dengan VAS, masing-masing 2,87±1,33 dan 2,44±0,78 dengan nilai p= 0,24 yang artinya tidak berbeda signifikan. Disimpulkan bahwa penggunaan Gabapentin dan Amitriptilin sebagai terapi nyeri neuropati pasien stroke perbedaannya tidak bermakna.
Stroke becomes significant problem for developing countries. In Indonesia, data show 234 incidents per 100,000 citizensand around 2 - 8 % stroke patients who suffer from cerebrovascular lesion will also suffer from central neuropathic pain. Some studies have showed that Gabapentin and Amitritilin can be used as neuropathic pain therapy but so far there has been no studies that directly compares the effectiveness and side effects in stroke patients. The objective of the research is to investigate the therapeutic effect comparison of Gabapentin and amitriptylin patients as neuropathic pain relief therapy in outpatient ischemic in Jogja Hospital. The method used in this research is quasi experimental with consequtive sampling with 23 patients in Gabapentin group and 18 patients in Amitriptilin group, and then they were evaluated pain scores in 1 month by Visual Analog Scale (VAS) every two weeks. The results of the research that use of Gabapentin and amitriptyline for 4 weeks showed a decrease in pain scores measured by VAS, respectively 2.87 ± 1.33 and 2.44 ± 0.78 with a p-value 0,24. It can be concluded that effectiveness in Gabapentin and Amitriptilin users as pain relief was not statistically different.
References
Goldstein LB, Adams R, Alberts MJ, Appel LJ, Brass LM, Bushnell CD, et al. Primary prevention of ischemic stroke: Guideline from the American Heart Association/American Stroke Association Stroke Council. Stroke, 2006; 37 (6): 1583-1633. Harrison’s Manual of Medicine, 16th ed, McGraw-Hill, Medical Publishing Division, New York.
Kollen B, Kwakkel G, Lindeman E. Functional Recovery after Stroke: a Review of Current Developments in Stroke Rehabilitation Research. Reviews on Recent Clinical Trials; 2006. 1 (1): 75-80.
Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart Disease and Stroke Statistics—2009 Update: A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, 2009; 119 (3): 480-6.
Misbach J., 2001. Stroke morbidity in Bogor area: a prospective observational analysis. The Journ of the Indonesian Med Assoc.; II (VI); 16.
Riset Kesehatan Dasar. 2007. Laporan Nasional 2207. Badan Penelitian dan Pengembangan Kesehatan, Departemen Keshatan RI 6. Boivie J. Central Pain from Brain Lesions. In: In: Max M (Ed), Pain 1999 -An Updated review: Refresher Course Syllabus. Seattle; IASP Press. 1999. p: 77-85
Lampl C, Yazdi K, Roper C. 2002. Amitriptilin in the Prophylaxis of Central Poststroke Pain: Preliminary Results of 39 Patients in a Placebo-Controlled, Long-Term Study. Stroke, 2002; 33 (12): 3030-2.
Ter-Ong C, Feng Sung S, Shun Wu C, Ning Lo CAn Open-label Study of Amitriptilin in Central Poststroke Paresthesia. Acta Neurol Taiwan, 2003; 12: 177-180.
Attal N, Brasseur L, Parker F, Chauvin M, Bouhassira D. Effects of Gabapentin on the Different Components of Peripheral and Central Neuropathic Pain Syndromes: a pilot study. Eur. Neurol. 1998; 40 (4): 191-200.
Morello CM, Leckband SG, Stoner CP, Moorhouse DF, Sahagian GA. Randomized Double Blind Study Comparing the Efficacy of Gabapentin with Amitriptilin on Diabetic Peripheral Neurophaty Pain. Arch Intern Med, 1999 ; 159 (16): 1931-1939.
Rintala DH, Holmes SA, Courtade D, Fiess RN, Tastard LV, Loubser PG. 2007. Comparison of the Effectiveness of Amitriptilin and Gabapentin on Chronic Neurophatic Pain in Persons with Spinal Cord Injury. Arch Phys Med Rehabil, 2007; 88 (12): 1547-1560.
Brunner dan Suddarth. Keperawatan Medikal Bedah Edisi 8 Volume 2. Jakarta : Penerbit Buku Kedokteran EGC. 2001.
Nicholson B. 2006. Differential Diagnosis: Nociceptive and Neuropathic Pain. Am J Manag Care, 2006; 12 (9):S256-62.
Argoff CE. Managing Neurophatic Pain: New Approaches for Today’s Clinical Practise. 2002. cited 2013 November from http://www.medscape.org/viewprogram/2361
Respond, RM. 2008. Terj. Lyrawati, D. 2009. Penilaian Nyeri. Hal 141-152. Diakses dari http://lyrawati.files.wordpress.com/2008/07/pemeriksan-dan-penilaian-nyeri.pdf
Mao J, Chen L. Gabapentin in Pain Management. Massachusetts General Hospital. Harvard Medical School. Boston. Anesth Analg, 2000; 91: 680-7
Anonim. FAQs about Gabapentin for Pain Relief, Cambridege Unviversity Hospitals NHS Foundation Trust. 2010. http://www.lb7. uscourts.gov/documents/12-11345.pdf
Richeimer S. Understanding Neurophatic Pain. 2007. ( cited 2013 November). Available from URL: http://www.spineuniverse.com
Backonja M, Beydoun A, Edwards KR, Schwartz SL, Fonseca V, Hes M. et al. Gabapentin for the Sympotomatic Treatment of Painful Neuropathy in Patients with Diabetes Mellitus: a Randomized Controlled Trial. JAMA, 1998; 280 (21): 211-4.
Dworkin RH, Backonja M, Rowbotham MC, Allen RR, Argoff CR, Bennett GJ, et al. 2003, Advances in Neurophatic Pain: Diagnosis, Mechanisms and Treatment Recommendations. Arc Neurol, 2003; 60 (11): 1524-34
Downloads
Published
Issue
Section
License
Copyright
Authors retain copyright and grant Mutiara Medika: Jurnal Kedokteran dan Kesehatan (MMJKK) the right of first publication with the work simultaneously licensed under an Attribution 4.0 International (CC BY 4.0) that allows others to remix, adapt and build upon the work with an acknowledgment of the work's authorship and of the initial publication in Mutiara Medika: Jurnal Kedokteran dan Kesehatan (MMJKK).
Authors are permitted to copy and redistribute the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Mutiara Medika: Jurnal Kedokteran dan Kesehatan (MMJKK).
License
Articles published in the Mutiara Medika: Jurnal Kedokteran dan Kesehatan (MMJKK) are licensed under an Attribution 4.0 International (CC BY 4.0) license. You are free to:
- Share — copy and redistribute the material in any medium or format.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
This license is acceptable for Free Cultural Works. The licensor cannot revoke these freedoms as long as you follow the license terms. Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
