HALAMAN PENGESAHAN

Referat berjudul:

Syok

Oleh:

Rieska Yunika Machyar

Mohammad Areza

Preetibah Ratenavelu

Telah diterima dan disahkan sebagai salah satu syarat dalam mengikuti

Kepaniteraan Klinik di Bagian/Departemen Anestesiologi dan Terapi Intensif

Fakultas Kedokteran Univesitas Sriwijaya/Rumah Sakit dr. Mohammad Hoesin

periode 26 Mei hingga 30 Juni 2014.

Palembang, 12 Juni 2014

Pembimbing,

dr. Endang, SpAn,

ii

KATA PENGANTAR

Segala puji penyusun hanturkan kepada Allah SWT. yang selalu

memberikan rahmat kepada penulis sehingga penulis dapat menyelesaikan referat

yang berjudul “Syok”.

Penulis juga menyampaikan terima kasih kepada semua pihak yang

membantu dalam penulisan referat ini, terutama kepada dr.Endang, SpAn, sebagai

pembimbing penulisan referat ini.

Dengan penulisan tinjauan pustaka ini, penulis berharap semua pihak yang

membaca dapat lebih memahami mekanisme dan tatalaksana nyeri, serta dapat

bermanfaat bagi calon dokter umum khususnya, serta bagi kesehatan masyarakat

secara umum.

Palembang, 26 September 2014

Penulis

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DAFTAR ISI

HALAMAN JUDUL......................................................................................................... i

HALAMAN PENGESAHAN........................................................................................... ii

KATA PENGANTAR....................................................................................................... iii

DAFTAR ISI...................................................................................................................... iv

DAFTAR TABEL............................................................................................................. v

DAFTAR GAMBAR......................................................................................................... vi

BAB I PENDAHULUAN.................................................................................................. 1

BAB II TINJAUAN PUSTAKA...................................................................................... 2

2.1. Definisi Syok...................................................................................................... 2

2.2. Klasifikasi Syok.................................................................................................. 3

2.2.1. Nyeri Akut............................................................................................ 3

2.2.2. Nyeri Kronik......................................................................................... 4

2.3. Patofisiologi Nyeri.............................................................................................. 6

2.3.1. Jalur Nyeri............................................................................................. 6

2.3.2. Nyeri Nosiseptif.................................................................................... 11

2.3.3. Nyeri Neuropatik................................................................................... 15

2.3.4. Nyeri inflamasi...................................................................................... 16

2.3.5. Respons Sistemik terhadap Nyeri......................................................... 19

2.4. Penilaian Nyeri................................................................................................... 21

2.4.1. Wong-Baker Faces Pain Rating Scale.................................................. 21

2.4.2. Verbal Rating Scale (VRS)................................................................... 22

2.4.3. Numerical Rating Scale (NRS)............................................................. 22

2.4.4. Visual Analogue Scale (VAS)............................................................... 22

2.5. Manajemen Nyeri............................................................................................... 23

2.5.1. Manajemen Farmakologis..................................................................... 24

2.5.2. Manajemen Fisik dan Psikologik.......................................................... 31

2.5.3. Akupuntur............................................................................................. 33

BAB III KESIMPULAN .................................................................................................. 34

DAFTAR PUSTAKA........................................................................................................ 36

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DAFTAR TABEL

Tabel 1. Pola alih nyeri viseral........................................................................................... 5

Tabel 2. Klasifikasi serabut saraf perifer............................................................................ 12

Tabel 3. Mediator utama pada nyeri................................................................................... 14

Tabel 4. Serabut saraf lamina Rexed pada korda spinalis.................................................. 15

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DAFTAR GAMBAR

Gambar 1. Jalur nyeri.......................................................................................................... 6

Gambar 2. Area somatosensori pada girus postsentralis.................................................... 8

Gambar 3. Lamina Rexed pada korda spinalis................................................................... 9

Gambar 4. Jalur nyeri aferen (ascending) dan eferen (descending)................................... 10

Gambar 5. Teori gerbang dalam mekanisme nyeri............................................................. 11

Gambar 6. Neuroma pada cedera akson............................................................................. 16

Gambar 7. Peran dari nerve growth factor (NGF) pada sensitisasi perifer........................ 17

Gambar 8. Mekanisme sensitasi perifer dan sentral........................................................... 19

Gambar 9. Wong-Baker faces pain rating scale................................................................. 21

Gambar 10. Verbal rating scale.......................................................................................... 22

Gambar 11. Numerical rating scale.................................................................................... 22

Gambar 12. Visual analogue scale..................................................................................... 23

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