Efektivitas Analgesik Terhadap Intensitas Nyeri Pasca Seksio Sesarea Berdasarkan NRS (Numeric Rating Scale): Sebuah Tinjauan Literatur

Abstract

Post-cesarean section (CS) pain is a clinical problem faced by many postpartum mothers and, if not properly managed, can hinder early mobilization, disrupt breastfeeding, and increase the risk of chronic post-surgical pain. This article aims to analyze analgesic usage patterns and their relationship to the effectiveness of pain intensity reduction following CS, as measured using the Numeric Rating Scale (NRS). A systematic literature search was conducted across the Google Scholar, PubMed, Garuda, and ResearchGate databases, covering publications from 2011 to 2025, yielding 15 articles eligible for further analysis, consisting of five hospital-based observational/descriptive studies in Indonesia, two randomized clinical trials, and eight literature reviews and clinical guidelines. The results of the analysis indicate that injectable ketorolac 30 mg remains the primary non-opioid analgesic of choice in several hospitals in Indonesia and can reduce the mean pain scale by 1.09 to 1.46 points within the first 3–8 hours post-surgery, with 63.6–95.1% of patients achieving mild pain category following therapy. A multimodal regimen combining paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) administered preventively was shown to produce lower NRS scores both at rest and during movement at the 4th, 8th, and 12th postoperative hours compared to monotherapy (p<0.05), with an opioid-sparing effect of 20–50%, while intrathecal morphine remains the gold standard for long-term analgesia with a duration of action of 14–36 hours. It can be concluded that the use of scheduled multimodal analgesics, with appropriate dosing and timing, produces better and more consistent post-CS pain control compared to single-agent analgesic use, and its implementation should therefore be strengthened through evidence-based pain management protocols in healthcare facilities.