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"ABSTRAKLatar Belakang: Manajemen nyeri yang efektif pascabedah merupakan bagianyang penting pada perawatan pasien yang menjalani pembedahan. Penanganannyeri pascabedah laparoskopi nefrektomi donor ginjal sangat penting untukpemulihan dini. Epidural kontinyu merupakan teknik anestesi regional yangdigunakan pada operasi donor ginjal di RSCM, namun hasilnya belummemuaskan karena masih tingginya persentase pasien dengan derajat nyeri berat.Penelitian ini bertujuan untuk membandingkan efektivitas antara blok QuadratusLumborum (QL) bilateral dengan bantuan USG dan blok epidural kontinyuterhadap derajat nyeri dan kebutuhan morfin pascabedah.Metode: Penelitian ini merupakan uji kontrol acak pada 52 pasien sehat yangmendonorkan ginjal di Rumah Sakit Umum Pusat Nasional CiptoMangunkusumo. Dilakukan proses randomisasi pada subjek penelitian,didapatkan pada kelompok blok QL bilateral sebanyak 26 pasien dan epiduralkontinyu sebanyak 26 pasien. Sesaat sebelum pasien diekstubasi, subjek dalamkelompok blok QL mendapatkan bupivacaine 0,25% sebanyak 20 mL secarabilateral dan subjek pada kelompok epidural mendapatkan infus bupivakain0,125% 6 mL/jam secara kontinyu. Hasil dari penelitian ini dianalisis denganmenggunakan uji statistik Mann Whitney.Hasil: Hasil dari penelitian ini menunjukan tidak ada perbedaan bermaknaterhadap derajat nyeri NRS saat di RR, jam ke-2, jam ke-6, jam ke-12 dan jamke-24 (p = 0,412; 0,881; 0,655; 0,788; dan 0,895). Kebutuhan PCA morfin pada24 jam pascabedah pada setiap waktu pengukuran tidak ditemukan perbedaanbermakna (p = 0,823; 0,985; 0,693; dan 0,854). Skor Bromage, serta waktupertama kali pasien memencet PCA morfin ditemukan sama pada keduakelompok. Pada kelompok blok QL Sebanyak 6 orang (23,10%) yang merasakanmual dan 4 orang (15,4%) yang mengalami muntah. Pada kelompok blok epiduralkontinyu sebanyak 1 orang (3,8%) yang merasakan mual dan 1 orang (3,8%) yangmengalami muntah. Efek samping parestesia tidak ditemukan pada keduakelompok.Simpulan: Blok QL tidak memberikan efek analgesia yang lebih baik dibanding blok epidural kontinyu.

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ABSTRACTBackground: Post operative pain management is substantial. Regional anesthesia for renal transplant donor is advantageous for early recovery. Continous epidural regiment often used in renal donor patients. However, the benefits are not fully met due to high incidence of severe post operative pain. This study compares the effectivity of USG guided bilateral Quadratus Lumborum (QL) block with continous epidural block for post operative pain management. We evaluate the degree of pain and morphine consumption.Methods: This is a random clinical trial in Cipto Mangunkusumo hospital. The subjects were random clinical trial. Fifty two subjects were renal donors who underwent surgery in RSCM. Subjects were randomized and divided into two groups, continous epidural (26 subjects) and QL block (26 subjects). Prior extubation, the QL block groups received bilateral QL block with 20 ml of Bupivacain 0.25% and the epidural group were given 6 ml/hr of Bupivacain 0.125% continously via epidural. The subjects pain were rated with NRS pain score. Morphine consumption and adverse events (nausea, vomiting, and paresthesias) were noted. Data were analyzed with Mann-Whitney test.Results:This study showed no difference between both group regarding NRS pain score in RR, the first 2, 6, 12 and 24 hour (p = 0,412; 0,881; 0,655; 0,788; dan 0,895). There are no difference in morphine consumption in both group (first 2 hour p=0,823; first 6 hour p=0,985; first 12 hour p=0,693; and first 24 hour p=0,854). Bromage score and the first time subjects pressed the PCA device are similar. There are 6 subjects (23.1%) who experienced nausea and 4 subjects (15.4%) who experienced vomitus from the QL block group. One subject (3.8%) experienced nausea and 1 (3.8%) subject vomitted from the epidural group.Conclusion: The efficacy of QL block for 24 hour post-operative pain management is comparable with continous epidural analgesia following laparoscopic nephrectomy."

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