Perbandingan Derajat Nyeri Setelah Pemberian Gabapentin dan Amitriptilin Sebagai Adjuvan Analgetik Pasien Nyeri Kanker di Poli Nyeri RSUP H. Adam Malik Medan

Abstract

Introduction Pain is a self defense mechanism that help signals that the human body is in at risk of injury or is in an ongoing injury. In malignancy pain is caused by activation of the nociceptor that is called nociceptive, while pain that is cause by the nervous system is called neuropathic pain. The treatment of cancer pain involve analgetic and adjuvant in the form of Gabapentin and Amytriptilin. Method This is a double blind randomized controlled study, with the population of pain clinic patient that suffers cancer pain with a NRS of severe pain with involvement of MST and paracetamol, sample then divided into 3 group that the patient receive adjuvant therapy involve Gabapentin, Amytriptilin, and placebo. Then the patient is evaluated is 1st (T1), 3rd(T2), and 7th day for the pain scale, pain DETECT and side effect. Results In this study NRS were initially found all patient suffer severe pain, in T1 in the Gabapentin group severe pain was decresased to 1 (1.8%) patient, in the Amytriptilin group was decreased to 3 (10.8%), in T2 there no patient that suffer severe pain in all of the group, moderate pain was found in Gabapentin group 15 (26,3%), on the Aamytriptilin group 15 (26.3%), and in the control group 14 (24.6%) patient. In T3 moderate pain was found in Gabapentin 12 (21.1%), Amytriptilin group 12 (21.2%) , and control group 15 (26.3%) for the pain DETECT score the average score is 29,4±5,3, with a significant difference were found in the T3 with a P value of 0.004, for side effect there are no significant difference Conclusion in this research there is no significant difference for the NRS between groups of Gabapentin, Amytriptilin, and Control group. In this study neuropathic pain is found to be significantly decrease NRS with the addition of adjuvant therapy in the 7th day, and there are no significant difference for the side effect for each group