Main Article Content
Abstract
Limited evidence was available on the use of analgesic post-transurethral resection among patients with Benign Prostate Hyperplasia (BPH). This research was conducted at dr. Harjono Ponorogo Regional Public Hospital in September – November 2021. A total of 90 patients with BPH was randomly assigned to receive Ketorolac injection 30 mg (n=45) and Metamizole 1000 mg injection (n=45) post-TURP. Numeric Rating Scale (NRS) was used to measure the level of pain before surgery (T0); and 30 minutes (T1), 1 hour (T2), 2 hours (T3), 4 (T4) and 6 hours (T5) after surgery. In addition, haemoglobin (Hb) values and adverse events were observed. Inferential statistical tests were used to analyze differences between the two groups. The level of pain in the Metamizole group was lower than Ketorolac group at T1 and T2 (2.71 versus 2.18, p=0.001; and 2.51 versus 2.11, p=0.000; respectively). The AUC values between the two groups showed a statistical difference (p=0.02). The Hb values pre- and post-TURP were significantly different in Metamizole as well as Ketorolac groups (all p=0.001), but there was no difference between groups. This finding indicates that Metamizole injection can be considered as an alternative  for post-TURP analgesic with better availability and lower cost
Keywords
Article Details
References
- Lacy, C.F., Amstrong, L.L., Goldman, M.P. and Lanco, L.L., 2009, Drug Information Handbook, edisi 17, Ohio, Lexi-Comp.
- Aziato, L., Dedey, F., Marfo, K., et al., 2015, Validation of three pain scales among adult postoperative patients in Ghana, BMC Nursing, 14(1), pp. 1–9. doi:10.1186/s12912-015-0094-6.
- Bader, P., Echtle, D. and Fonteyne, F., et al., 2012, Guidelines on pain management, European Association of Urology, pp. 65.
- Bhatta, P.,, Raya, A., Yadav, U.K., Kumar, V., Shahi, S. and Sing, A., 2021, Median duration of hospital stay after early removal of foley’s catheter among patients undergoing transurethral resection of prostate: A descriptive cross-sectional study, Journal of the Nepal Medical Association, 59(239), pp. 688–691. doi:10.31729/jnma.6384.
- Chavez-Tapia, N.C., et al., 2010, Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding, Cochrane Database of Systematic Reviews [Preprint], 9. doi:10.1002/14651858.cd002907.pub2.
- Chou, R., et al., 2016, Management of postoperative pain: A clinical practice guideline from the American pain society, the American society of regional anesthesia and pain medicine, and the American society of anesthesiologists’ committee on regional anesthesia, executive commi’, Journal of Pain, 17(2), pp. 131–157. doi:10.1016/j.jpain.2015.12.008.
- Francesca, F., Bader P, Echtle, D., Giunta, F. and Williams, J., 2003, EAU guidelines on pain management, Eur Urol, 44(4), pp.383-389.
- Gerbershagen, H.J., et al., 2011, Determination of moderate-to-severe postoperative pain on the numeric rating scale: A cut-off point analysis applying four different methods, British Journal of Anaesthesia, 107(4), pp. 619–626. doi:10.1093/bja/aer195.
- Jasiecka, A., Mas̈lanka, T. and Jaroszewski, J.J., 2014, Pharmacological characteristics of metamizole, Polish Journal of Veterinary Sciences, 17(1), pp. 207–214. doi:10.2478/pjvs-2014-0030.
- Kara, C., et al., 2010, Analgesic efficacy and safety of nonsteroidal anti-inflammatory drugs after transurethral resection of prostate, International Braz J Urol, 36(1), pp. 49–54. doi:10.1590/S1677-55382010000100008.
- Kementerian Kesehatan Republik Indonesia (Kemenkes RI), 2016, Pedoman Formularium Nasional, Jakarta, Kemenkes RI.
- Von Korff, M., Jensen, M.P. and Karoly, P., 2000, Assessing global pain severity by self-report in clinical and health services research, Spine, 25(24), pp. 3140–3151. doi:10.1097/00007632-200012150-00009.
- Lim, K. B., 2017, Epidemiology of clinical benign prostatic hyperplasia, Asian Journal of Urology, 4(3), pp. 148–151. doi:10.1016/j.ajur.2017.06.004.
- Mahendrakrisna, D., Maulana, A. and Erwin, K., 2016, Factors associated with the duration of hospitalization in patients in Mataram’, Berkala Ilmiah Kedokteran Duta Wacana, 1(2), pp. 102–108.
- Mama, K.R. and Contino, E.K., 2015, Postoperative pain control, In: Robinson’s Current Therapy in Equine Medicine, Edisi 7, Amsterdam, Elsevier Inc., pp. 60–62. doi:10.1016/B978-1-4557-4555-5.00015-7.
- O’Donnell, A.M. and Foo, I.T.H., 2009, Anaesthesia for transurethral resection of the prostate, Continuing Education in Anaesthesia, Critical Care and Pain, 9(3), pp. 92–96. doi:10.1093/bjaceaccp/mkp012.
- Purnomo, B.B., 2003, Dasar-dasar urologi, Edisi 2, Jakarta, Fakultas Kedokteran UI. doi:10.1016/b978-343741510-4.50023-7.
- Sastroasmoro, S., 2011, Perkiraan besar sampel dalam penelitian klinis, In: Dasar-dasar Metodologi Penelitian, Jakarta, Sagung Seto, pp. 359.
- Tjahjodjati, et al., 2017, Panduan penatalaksanaan klinis pembesaran prostat jinak (Benign Prostatic Hyperplasia / BPH ), Ikatan Ahli Urologi Indonesia (IAUI).
- Ye, Z., et al., 2020, Gastrointestinal bleeding prophylaxis for critically ill patients: A clinical practice guideline, British Medical Journal, 368 (January), pp. 1–9. doi:10.1136/bmj.l6722.
References
Lacy, C.F., Amstrong, L.L., Goldman, M.P. and Lanco, L.L., 2009, Drug Information Handbook, edisi 17, Ohio, Lexi-Comp.
Aziato, L., Dedey, F., Marfo, K., et al., 2015, Validation of three pain scales among adult postoperative patients in Ghana, BMC Nursing, 14(1), pp. 1–9. doi:10.1186/s12912-015-0094-6.
Bader, P., Echtle, D. and Fonteyne, F., et al., 2012, Guidelines on pain management, European Association of Urology, pp. 65.
Bhatta, P.,, Raya, A., Yadav, U.K., Kumar, V., Shahi, S. and Sing, A., 2021, Median duration of hospital stay after early removal of foley’s catheter among patients undergoing transurethral resection of prostate: A descriptive cross-sectional study, Journal of the Nepal Medical Association, 59(239), pp. 688–691. doi:10.31729/jnma.6384.
Chavez-Tapia, N.C., et al., 2010, Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding, Cochrane Database of Systematic Reviews [Preprint], 9. doi:10.1002/14651858.cd002907.pub2.
Chou, R., et al., 2016, Management of postoperative pain: A clinical practice guideline from the American pain society, the American society of regional anesthesia and pain medicine, and the American society of anesthesiologists’ committee on regional anesthesia, executive commi’, Journal of Pain, 17(2), pp. 131–157. doi:10.1016/j.jpain.2015.12.008.
Francesca, F., Bader P, Echtle, D., Giunta, F. and Williams, J., 2003, EAU guidelines on pain management, Eur Urol, 44(4), pp.383-389.
Gerbershagen, H.J., et al., 2011, Determination of moderate-to-severe postoperative pain on the numeric rating scale: A cut-off point analysis applying four different methods, British Journal of Anaesthesia, 107(4), pp. 619–626. doi:10.1093/bja/aer195.
Jasiecka, A., Mas̈lanka, T. and Jaroszewski, J.J., 2014, Pharmacological characteristics of metamizole, Polish Journal of Veterinary Sciences, 17(1), pp. 207–214. doi:10.2478/pjvs-2014-0030.
Kara, C., et al., 2010, Analgesic efficacy and safety of nonsteroidal anti-inflammatory drugs after transurethral resection of prostate, International Braz J Urol, 36(1), pp. 49–54. doi:10.1590/S1677-55382010000100008.
Kementerian Kesehatan Republik Indonesia (Kemenkes RI), 2016, Pedoman Formularium Nasional, Jakarta, Kemenkes RI.
Von Korff, M., Jensen, M.P. and Karoly, P., 2000, Assessing global pain severity by self-report in clinical and health services research, Spine, 25(24), pp. 3140–3151. doi:10.1097/00007632-200012150-00009.
Lim, K. B., 2017, Epidemiology of clinical benign prostatic hyperplasia, Asian Journal of Urology, 4(3), pp. 148–151. doi:10.1016/j.ajur.2017.06.004.
Mahendrakrisna, D., Maulana, A. and Erwin, K., 2016, Factors associated with the duration of hospitalization in patients in Mataram’, Berkala Ilmiah Kedokteran Duta Wacana, 1(2), pp. 102–108.
Mama, K.R. and Contino, E.K., 2015, Postoperative pain control, In: Robinson’s Current Therapy in Equine Medicine, Edisi 7, Amsterdam, Elsevier Inc., pp. 60–62. doi:10.1016/B978-1-4557-4555-5.00015-7.
O’Donnell, A.M. and Foo, I.T.H., 2009, Anaesthesia for transurethral resection of the prostate, Continuing Education in Anaesthesia, Critical Care and Pain, 9(3), pp. 92–96. doi:10.1093/bjaceaccp/mkp012.
Purnomo, B.B., 2003, Dasar-dasar urologi, Edisi 2, Jakarta, Fakultas Kedokteran UI. doi:10.1016/b978-343741510-4.50023-7.
Sastroasmoro, S., 2011, Perkiraan besar sampel dalam penelitian klinis, In: Dasar-dasar Metodologi Penelitian, Jakarta, Sagung Seto, pp. 359.
Tjahjodjati, et al., 2017, Panduan penatalaksanaan klinis pembesaran prostat jinak (Benign Prostatic Hyperplasia / BPH ), Ikatan Ahli Urologi Indonesia (IAUI).
Ye, Z., et al., 2020, Gastrointestinal bleeding prophylaxis for critically ill patients: A clinical practice guideline, British Medical Journal, 368 (January), pp. 1–9. doi:10.1136/bmj.l6722.