COST-EFFECTIVENESS DEXKETOPROFEN VS KETOROLAC IN CAESAREAN PATIENTS AT 'X' HOSPITAL, PANDEGLANG

Authors

  • Yusransyah Yusransyah Pharmacy Study Program, Sekolah Tinggi Ilmu Kesehatan Salsabila Serang, Banten, Indonesia
  • Stiani Sofi Nurmay Pharmacy Study Program, Sekolah Tinggi Ilmu Kesehatan Salsabila Serang
  • Chairani Farahdina Pharmacy Study Program, Sekolah Tinggi Ilmu Kesehatan Salsabila Serang
  • Rizki Latifah Nur Pharmacy Study Program, Sekolah Tinggi Ilmu Kesehatan Salsabila Serang
  • Udin Baha Pharmacy Study Program, Sekolah Tinggi Ilmu Kesehatan Salsabila Serang

DOI:

https://doi.org/10.36423/pharmacoscript.v8i2.2150

Keywords:

dexketoprofen, ketorolac, sectio caesarea, cost-effectiveness analysis

Abstract

Post-cesarean section pain must be treated promptly and appropriately to prevent chronic conditions. Dexketoprofen and Ketorolac are non-narcotic analgesics commonly used to manage such pain. This study aimed to analyse the cost-effectiveness of dexketoprofen and ketorolac in patients undergoing cesarean sections at Mother and Child Hospital "X" in Pandeglang. The study used a cross-sectional design with cost-effectiveness analysis, specifically the Average Cost-Effectiveness Ratio (ACER). Pain intensity was measured one hour after surgery using the Faces Pain Rating Scale and Visual Analog Scale (VAS). Inclusion criteria were patients who underwent cesarean section and received non-narcotic analgesics. A total of 90 patients participated: 39 in the dexketoprofen group and 51 in the ketorolac group. Data were analyzed using ACER and the Mann-Whitney test. The ACER, based on the Faces Pain Rating Scale, showed a cost of IDR 1,142 for the dexketoprofen group and IDR 958.03 for the ketorolac group. Using the VAS, the cost was IDR 1,110 for dexketoprofen and IDR 657.45 for ketorolac. Statistical results showed a p-value < 0.05 for both pain measurement tools, indicating a significant difference in effectiveness between the two therapies. Based on both instruments, ketorolac was more cost-effective than dexketoprofen in managing post-cesarean section pain. This finding suggests that ketorolac may be a preferable option in clinical settings where cost and effectiveness are key considerations for post-operative analgesia in cesarean section patients.

References

Agustari, F., Novitasari, D., & Septian Mixrova Sebayang. (2022). Implementasi teknik penurunan nyeri menggunakan metode Kompres hangat pada pasien post sectio caesarea dengan spinal Anestesi. Jurnal Pengabdian Kepada Masyarakat (JPKM) - Aphelion, 4(Desember), 603–608. http://jurnal.globalhealthsciencegroup.com/index.php/JPM

Andreyani, L., & Bhakti, W. K. (2023). Validitas Skala Ukur Nyeri Visual Analog and Numerik Ranting Scales (Vanrs) Terhadap Penilaian Nyeri. Jambura Journal of Health Sciences and Research, 5(2), 730–736. https://doi.org/10.35971/jjhsr.v5i2.19140

Arsyawina, Mardiyono, & Sarkum. (n.d.). Skala Critical-Care Pain Observation Tool (CPOT) dan Wong-Baker Faces Pain Rating Scale dalam Menilai Derajat Nyeri pada Pasien dengan Ventilasi Mekanik Arsyawina Mardiyono Sarkum. 0–5.

Aykaç, E., Büyükkoçak, Ü., Köse, E. A., & Sagsoz, N. (2012). The comparison of the analgesic effect of dexketoprofen trometamol with lornoxicam and placebo on post-cesarean delivery pain. Anestezi Dergisi, 20, 80–85.

Bayrampour, H., Heaman, M., Duncan, K. A., & Tough, S. (2012). Advanced maternal age and risk perception: a qualitative study. BMC Pregnancy and Childbirth, 12, 100. https://doi.org/10.1186/1471-2393-12-100

Bramita, Y., Astuti, T., Murhan, A., & Kodri. (2024). Faktor-Faktor Yang Berhubungan Dengan Kecemasan Pasien Pre Operasi Seksio Sesarea Di Rumah Sakit Umum Handayani Kotabum. Malahayati Health Student Journal, 4(8).

Ceyhan, D., Bilir, A., & Güleç, M. S. (2016). Evaluation of the analgesic efficacy of dexketoprofen added to paracetamol. Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi, 44(6), 312–316. https://doi.org/10.5152/TJAR.2016.89106

Febriana, A., Indra, P., Janiartha, A., Megasari, K., Priyatno, B., & Nugroho, C. (2021). Perbandingan efektivitas ketorolac, deksketoprofen, dan parasetamol dalam mengurangi rasa nyeri dengan menggunakan penilaian visual analogue scale (VAS) pada pasien pasca pembedahan ortopedi ekstremitas inferior di RSUD Nganjuk, Jawa Timur, Indonesia. Intisari Sains Medis | Intisari Sains Medis, 12(1), 370–373. https://doi.org/10.15562/ism.v12i1.957

Glick, I., Kadish, E., & Rottenstreich, M. (2021). Management of Pregnancy in Women of Advanced Maternal Age: Improving Outcomes for Mother and Baby. International Journal of Women’s Health, 13, 751–759. https://doi.org/10.2147/IJWH.S283216

Hamilton, P. M. (1995). Dasar-Dasar Keperawatan Maternitas (6th ed.). Penerbit Buku Kedokteran EGC.

Hanna, M., & Moon, J. Y. (2019). A review of dexketoprofen trometamol in acute pain. Current Medical Research and Opinion, 35(2), 189–202. https://doi.org/10.1080/03007995.2018.1457016

Hostage, J., Kolettis, D., Sverdlov, D., Ludgin, J., Drzymalski, D., Sweigart, B., Mhatre, M., & House, M. (2023). Increased Scheduled Intravenous Ketorolac After Cesarean Delivery and Its Effect on Opioid Use: A Randomized Controlled Trial. Obstetrics and Gynecology, 141(4), 783–790. https://doi.org/10.1097/AOG.0000000000005120

Kementerian Kesehatan RI. (2018). Riset Kesehatan Dasar (RISKESDAS). Kementerian Kesehatan RI.

Kementrian Kesehatan RI. (2013). Pedoman Penerapan Kajian Farmakoekonomi. Kementerian Kesehatan RI.

Marginson, S., Cantwell, B., Platonova, D., & Smolentseva, A. (2023). Assessing the Contributions of Higher Education. In Assessing the Contributions of Higher Education. https://doi.org/10.4337/9781035307173

Mariyam, & Widodo, S. (2012). Pengaruh Guided Imagery Terhadap Tingkat Nyeri Anak Usia 7-13 Tahun Saat Dilakukan Pemasangan Infus Di Rsud Kota Semarang. Jurnal Unimus, 228–235.

McNicol, E. D., Ferguson, M. C., & Schumann, R. (2021). Single-dose intravenous ketorolac for acute postoperative pain in adults. The Cochrane Database of Systematic Reviews, 5(5), CD013263. https://doi.org/10.1002/14651858.CD013263.pub2

Mita, R. S., & Husni, P. (2017). Pemberian Pemahaman Mengenai Penggunaan Obat Analgesik Secara Rasional Pada Masyarakat Di Arjasari Kabupaten Bandung. Aplikasi Ipteks Untuk Masyarakat, 6(3), 193–194.

Montgomery, G. H., Schnur, J. B., Erblich, J., Diefenbach, M. A., & Bovbjerg, D. H. (2010). Presurgery Psychological Factors Predict Pain, Nausea, and Fatigue One Week After Breast Cancer Surgery. Journal of Pain and Symptom Management, 39(6), 1043–1052. https://doi.org/10.1016/j.jpainsymman.2009.11.318

Nurfita, Hanggara, A., & Jaka, F. (2018). Analisis Biaya Minimal dan Efektivitas Penggunaan Analgesik Pada Pasien Bedah Sesar di Salah Satu Rumah Sakit Samarinda. Proceeding of the 8th Mulawarman Pharmaceuticals Conferences.

Octasari, P. M., & Inawati, M. (2021). Penurunan Skala Nyeri Penggunaan Ketorolak Injeksi Pada Pasien Operasi Sesar Di Rumah Sakit Roemani Muhammadiyah Semarang. Media Farmasi Indonesia, 16(2), 1663–1669. https://doi.org/10.53359/mfi.v16i2.179

Paluwih, N. A., Sihombing, R. M., & Lebdawicaksaputri, K. (2019). the Difference of Pain Scale Using Numeric Rating Scale and Visual Analog Scale in Post-Operative Patients. Nursing Current Jurnal Keperawatan, 7(1), 52. https://doi.org/10.19166/nc.v7i1.2224

Patrocínio, L. G., Rangel, M. D. O., Miziara, G. S. M., Rodrigues, A. M., Patrocínio, J. A., & Patrocinio, T. G. (2007). A comparative study between Ketorolac and Ketoprofen in postoperative pain after uvulopalatopharyngoplasty. Brazilian Journal of Otorhinolaryngology, 73(3), 339–342. https://doi.org/10.1016/S1808-8694(15)30077-X

Pratitdya, G., Rehatta, N. M., & Susila, D. (2020). Perbandingan Interpretasi Skala Nyeri Antara Nrs-Vas-Wbfs Oleh Pasien Pasca Operasi Elektif Orthopedi Di Rsud Dr. Soetomo. Care : Jurnal Ilmiah Ilmu Kesehatan, 8(3), 447. https://doi.org/10.33366/jc.v8i3.1802

Prawirohardjo, S. (2008). Ilmu Kebidanan. Ilmu Kebidanan Sarwono Prawirohardjo, 460–474.

Sugianti, R. (2020). Tingkat Nyeri Pada Pasien Post Sectio Caesarea Primipara Dan Multipara Di Ruang Mawar Rsu Anwar Medika Sidoarjo. Sekolah Tinggi Ilmu Kesehatan Bina Sehat PPNI Mojokerto.

Yam, M. F., Loh, Y. C., Tan, C. S., Khadijah Adam, S., Abdul Manan, N., & Basir, R. (2018). General Pathways of Pain Sensation and the Major Neurotransmitters Involved in Pain Regulation. International Journal of Molecular Sciences, 19(8). https://doi.org/10.3390/ijms19082164

Yiwa, O. M. (2022). Gambaran Respon Nyeri Pasien Pasca Bedah Sectio Ceasarea Setelah Pemberian Analgetik Ketamin Intravena Di Ruang Pemulihan (Recorvery Room) Rs Karitas Weitabula Nusa Tenggara Timur. Institut Teknologi dan Kesehatan Bali.

Downloads

Published

2025-08-31