Pustaka Ilmiah Universitas Padjadjaran

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The Comparison of Ibuprofen and Celecoxib Effect on Tibial Fracture Healing in Wistar Mice: a Biomechanical Analysis

Pendahuluan. Untuk mengatasi nyeri pasca operasi, pasien fraktur yang dioperasi selalu diberikan analgetik anti inflamasi non steroid. Akan tetapi, analgetik tersebut diyakini dapat menghambat proses inflamasi yang diperlukan dalam penyembuhan patah tulang. Perbedaan antara AINS selektif dan nonselektif dalam menghambat fraktur perlu dievaluasi dalam manjemen fraktur. Bahan dan cara kerja. Penelitian merupakan penelitian eksperimental yang melibatkan 90 tikus Wistar usia dibawah 6 bulan. Tikus tersebut dialokasikan secara acak ke dalam tiga kelompok untuk mendapatkan AINS selektif, AINS non-selektif, atau akuades. Pada awal penelitian, tibia tikus difrakturisasi dan diimobilisasi. Setelah 30 hari, tikus dikorbankan. Tibia tikus diambil dan diuji secara biomekanik kualitas penyembuhannya. Hasil uji penelitain kemudian di analisa dengan analisis multivariat. Hasil. Terdapat perbedaan yang bermakna gaya lateral bending dan torsi antara kelompok penelitian (p<0,05). Analisis univariat mendapati bahwa perbedaan tersebut disebabkan perbedaan antara kelompok ibuprofen dan celecoxib. Perbanding gaya torsi antara ibuprofen dan kontrol tidak signifikan (p>0,05). Simpulan. Ibuprofen memberikan efek supresi penyembuhan tulang yang lebih rendah dibandingkan celecoxib dalam uji bending dan torsi.

Introduction. Operated fracture patients are always given analgesic to overcome postoperative pain. Analgesic being given is non-steroidal anti-inflammatory drugs which also give anti-inflammatory effect. However, anti-inflammatory effect is believed to inhibit inflammation which is needed in fracture healing. The differences between selective and non-selective NSAID in inhibiting fracture healing need to be evaluated in the planning of fracture management. Materials and methods. We conducted an experimental research involving 90 Wistar mice aged below 6 months. They were randomly allocated into 3 groups to receive either non-selective NSAID (ibuprofen), selective NSAID (celecoxib) or aquades. At the beginning of the study, tibia of the mouse was fracturized and immobilized. After 30 days, mice were sacrificed and their tibiae were mechanically tested to examine the quality of the callus. The results were statistically analyzed using multivariate analysis. Results. There were significant differences in lateral bending and torsion force among groups (p<0.05). Univariate analysis revealed they were due to the difference between ibuprofen and celecoxib. Comparison of torsion force between ibuprofen and control was insignificant (p>0.05). Conclusions. Ibuprofen provides less suppresion effect on fracture healing biomechanicaly than celecoxib with significant difference in the bending and torsion test.