Manajemen Nyeri Kronis pada Kehamilan
Abstract
Menurut IASP ( International Association of the Study of Pain) nyeri didefinisikan sebagai “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or describe interm of such damage”. Nyeri adalah rasa inderawi dan pengalaman emosional yang tidak menyenangkan akibat adanya kerusakan jaringan yang nyata atau yang berpotensi rusak atau sesuatu yang tergambarkan seperti itu.Kelainan muskuloskeletal yang sering dialami oleh wanita hamil adalah berupa nyeri lumbopelvis pada kehamilan (pelvic girdle pain) dan nyeri kronis lumbal (low back pain).Adapun yang menyebabnya adalah faktor hormonal, faktor mekanis dan vaskuler. Manajemen untuk nyeri kronis pada wanita hamil dapat dilakukan melalui manajemen non farmakologis dan manajemen farmakologis. Manajemen non farmakologis dapat dikerjakan dengan cara fisioterapi, terapi distraksi, terapi musik, guided imaginary dan relaksasi. Untuk manajemen farmakologis, obat – obatan yang dapat diberikan adalah asetaminofen, NSAID dan analgesik opioid.
Management Chronic Pain in Pregnancy
Abstract
According to the IASP (International Association of the Study of Pain) pain is defined as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or describe the interim of such damage". Pain is a sensation and or emotional experience unpleasant and disturbing as a result of tissue damage, or potential tissue damage. Musculoskeletal disorders are often experienced by pregnant women is pelvic girdle pain and chronic pain lumbar. The etiology of that is the hormonal factor, mechanical factors and vascular factors. Management of chronic pain in pregnancy can be done through non-pharmacological management and pharmacological management. Non pharmacological management can be done by means of physiotherapy, distraction therapy, music therapy, guided imaginary and relaxation. For pharmacological management can be given is acetaminophen, NSAIDs and opioid analgesics.
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References
Borenstein D. Low Back Pain. Dalam: Waldman SD. Pain management, 2nd ed. Philadelphia, Saunders Elseiver, 2011; 87:695–700.
Thompson JA. Management of chronic pain. Dalam: Moppet IK, Thompson JA, Aitkenhead AR (eds). Smith and Aitkenhead’s Textbook of Anaesthesia, 6th ed. Philadelphia, Churchill Livingstone Elseiver. 2013; 46:932–47.
Preston R. Musculoskeletal Disorder. Dalam: Nathan N, Myhre JM, Beilin Y,Ngan Kee WD,Tsen LC,Wong CA, Chestnut DH (eds). Chestnut’S obstetric anesthesia: Principles And Practice, 5th ed. Philadelphia, Saunders Elsevier, 2014;48:1093–1112.
Fukuda K. Opioids. Dalam: Young WL,Wiener-Kronish JP,Fleisher LA,Eriksson LI,Miller RD (eds). Miller’s Anesthesia,7th ed. Philadelphia, Churchill Livingstone Elseiver, 2010;27:769-824.
Brogan S, Mandyam S, Drennan DA. Non-opioid analgesics. Dalam Egan TD, Hemmings HC (eds). Pharmacology and physiology for anesthesia foundations and clinical application. Philadelphia,Saunders Elseiver,2013;16:272–290.
Fitzgerald CM, Le J. Back pain in pregnancy requires practitioner creativity-Although this common condition isn’t always treated, nonsurgical approaches can provide relief.Biomechanics 2007;39:547–551.
Babb M, Koren G, Einarson A. Treating pain during pregnancy. Can Fam Physician 2010;56(1):25–27.
Rebar, Robert W. Low back pain is common during pregnancy. NEJM Journal Watch. General Medicine 2004;27: 123–134.
Knotkova H, Fine P, Portenoy R. Opioid rotation: The science and the limitations of the equianalgesic dose table. Journal of Pain and Symptom Management, 2010; 38:426–39.
Childers, Christine. Preventing and managing back pain during pregnancy. Physical Therapy 2005;85:1107–110.
Senthil KP, Eva C. Pregnancy-related low back pain or gestational back pain: too complex to handle or too simple to ignore? Indian Journal of Obstetrics and Gynaecology 2013;1:87–89.
Eggen HM, Stuge B, Mowinckel P, Jensen KS, Hagen KB. Can supervised group exercises including ergonomic advice reduce the prevalence and severity of low back pain and pelvic girdle pain in pregnancy? A Randomized Controlled Trial.Physical Therapy 2012;92:781–90.
Broussard CS, Rasmussen SA, Reefhuis J. Maternal treatment with opioid analgesics and risk for birth defects. National Birth Defects Prevention Study. Am J Obstet Gynecol. 2011;204:314.
White KP. Breaking thru the fibromyalgia fog – scientific proof fibromyalgia is real. http://www.healthline.com/health/fibromyalgia-and-pregnancy-expert-qa#1
Stevie. Medication for chronic pain patients.http://chronicpainsite.com/pj/?gclid=CjwKEAiAh560BRDu-aD93r-J_zoSJACrxZG205_-4p2PLdlIvxx4koXgNFpaGJHt3KNbGk_-PspjFhoCycPw_wcB
Waterfield J, Bartlam B, Bishop A, Holden MA, Barlas P, Foster NE. Therapst’s views and experiences of pregnancy-related low back pain and the role of acupuncture: qualitative exploration. Physical Therapy 2015;95:1234–243.
Vleeming A, Albert HB, Ostgaard HC. European guidelines for the diagnosis and treatment of pelvic girdle pain. EurSpineJ2008;17:794–19.
Gutke A, Ostgaard HC, Oberg B. Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning. Spine 2006;31:149–55.
Pool-Goudzwaard AL, Slieker ten Hove MCPH, Vierhout ME, Snijders CJ, Stoeckart R, Pool JJM, Mulder PH. Relations between pregnancy-related low back pain, pelvic floor activity and pelvic floor dysfunction. Int Urogynecol J 2005;16:468–74.
Padua R, Bondi R, Ceccarelli. Patieny-oriented assessment of back pain in pregnancy. Eur Spine J 2002;11: 272–75.
Jeffcot H. Exercises for low back pain in pregnancy. International Journal Childbirth Education 2008;23:9–12.
William WK, Margaret WN. Back pain symptomps and bone mineral density changes in pregnancy as measured by quantitative ultrasound. Gynecol Obstet Invest 2009;67:36–41.
Noren L, Ostgaard S, Johansson G. Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow up. Eur Spine J 2002;11:267–71.
Bergstrom C, Persson M, Mogren I. Pregnancy-related low back pain and pelvic girdle pain approxiametly14 months after pregnancy-pain status, self related health and family situation. BMC Pregnancy and Childbirth 2014;14:1–12.
Smith MD, Russel A, Hodges PW. Is there a relationship between parity, pregnancy, back pain and incontinence? Int Urogynecol J 2008;19:205–11.
Padua L, Caliandro P, Aprile L. Back pain in pregnancy: 1-year follow-up of untreated cases. Eur Spine J 2005;14:151–54.
Robin R, Felicity R. Back pain, pregnancy and childbirth postpartum pain is most likely to be a continuation of antepartum pain. British Medical Journal 1997;314:1062–064.
Sneag DB, Bendo JA. Review article pregnancy-related low back pain. http://www.ORTHOSuperSite.com.












Jurnal Anestesi Obstetri Indonesia