Evaluasi Komparatif Efektivitas, Keamanan, dan Biaya Tramadol Versus Metamizol pada Tatalaksana Nyeri Pasien Pasca-Intervensi di RSUD Jayapura
Yullia Helsa Satia, Prof. Dr. apt. Arief Nurrochmad, M.Si., M.Sc; Prof. Dr. apt. Zullies Ikawati
2026 | Tesis | S2 Mag.Farmasi Klinik
Nyeri pascaintervensi merupakan
komplikasi umum setelah biopsi dan eksisi yang dapat memengaruhi kenyamanan
serta kualitas hidup pasien. Di RSUD Jayapura, tramadol dan metamizol injeksi
merupakan analgesik yang sering digunakan, namun bukti mengenai efektivitas,
keamanan, dan cost-effectiveness keduanya masih terbatas. Penelitian ini
bertujuan membandingkan efektivitas, kejadian efek samping, dan cost-effectiveness
tramadol injeksi 100 mg dengan metamizol injeksi 1 g pada pasien pascaintervensi
biopsi dan eksisi.
Penelitian observasional dengan
desain kohort prospektif dilakukan di Instalasi Rawat Inap RSUD Jayapura pada
Desember 2025–April 2026. Sebanyak 70 pasien direkrut secara consecutive
sampling dan dikelompokkan berdasarkan terapi yang diterima. Efektivitas
dinilai berdasarkan perubahan skor Numeric Rating Scale (NRS), keamanan
berdasarkan kejadian efek samping, sedangkan cost-effectiveness
dianalisis menggunakan Cost-Effectiveness Ratio (CER) dan Incremental
Cost-Effectiveness Ratio (ICER). Analisis statistik menggunakan Wilcoxon
Signed-Rank Test, Mann-Whitney U Test, Chi-square/Fisher Exact
Test, dan ANCOVA.
Hasil penelitian ini menunjukan bahwa kedua terapi menurunkan nyeri secara signifikan, dengan ?NRS sebesar 3,20 ± 0,76 pada kelompok tramadol dan 3,06 ± 0,68 pada kelompok metamizol, tanpa perbedaan bermakna antar kelompok (p = 0,522). Hasil tetap konsisten setelah penyesuaian menggunakan ANCOVA (p = 0,416). Selama periode observasi tidak ditemukan efek samping. Tramadol memiliki nilai CER lebih rendah dibandingkan metamizol Antrain (Rp75.271 vs Rp90.057 per satu poin NRS). Analisis ICER menunjukkan nilai negatif, yang mengindikasikan bahwa tramadol merupakan strategi dominan, yaitu memberikan efektivitas yang sedikit lebih tinggi dengan biaya yang lebih rendah dibandingkan metamizol Antrain. Dengan demikian, tramadol dan metamizol memiliki efektivitas yang sebanding, namun tramadol lebih cost-effective dengan profil keamanan yang baik selama periode observasi.
Post-intervention pain is a common
complication following biopsy and excision that may affect patient comfort and
quality of life. At RSUD Jayapura, injectable tramadol and
metamizole are commonly used for pain management; however, evidence regarding
their effectiveness, safety, and cost-effectiveness remains limited.
This study aimed to compare the effectiveness, adverse events, and
cost-effectiveness of injectable tramadol 100 mg and injectable metamizole 1 g
in patients undergoing biopsy and excision procedures. This prospective observational
cohort study was conducted at the inpatient wards of RSUD Jayapura from December 2025 to April 2026. A total of 70 patients were
recruited using consecutive sampling and grouped according to the analgesic
therapy received. Effectiveness was assessed using changes in the
Numeric Rating Scale (NRS), safety was evaluated based on adverse events,
while cost-effectiveness was analyzed using the Cost-Effectiveness Ratio (CER)
and Incremental Cost-Effectiveness Ratio (ICER). Statistical analyses were
performed using the Wilcoxon Signed-Rank Test, Mann-Whitney U Test,
Chi-square/Fisher Exact Test, and ANCOVA. The results showed that both
therapies significantly reduced pain, with a mean NRS of 3.20 ± 0.76 in the
tramadol group and 3.06 ± 0.68 in the metamizole group, with no significant
difference between groups (p = 0.522). The findings remained consistent after
adjustment using ANCOVA (p = 0.416). No adverse events were observed during the
study period. Tramadol demonstrated a lower CER than branded metamizole
(Antrain) (IDR 75,271 vs IDR 90,057 per one-point reduction in NRS). ICER
analysis yielded a negative value, indicating that tramadol was the dominant
strategy, providing slightly greater effectiveness at a lower cost than branded
metamizole. In conclusion, tramadol and metamizole demonstrated comparable effectiveness; however, tramadol was more cost-effective while both
therapies showed a favorable safety profile during the observation period.
Kata Kunci : nyeri pascaintervensi, biopsi, eksisi, tramadol, metamizole
