Peningkatan Risiko Stroke Non-Hemoragik Setelah Pemberian Ketorolac Pada Pasien Dengan Proktokolitis: Laporan Kasus
(1) Universitas Muhammadiyah Yogyakarta
(2) Universitas Muhammadiyah Yogyakarta
(3) Universitas Muhammadiyah Yogyakarta
(*) Corresponding Author
Abstract
Latar Belakang: Stroke non-hemoragik disebabkan oleh penyumbatan arteri yang mengurangi aliran darah dan oksigen ke otak, menyebabkan kematian jaringan saraf. Di Indonesia, prevalensi stroke meningkat dari 7% pada tahun 2013 menjadi 10,9% pada tahun 2018, dengan sekitar 2,1 juta penyintas. Faktor risiko utama meliputi hipertensi, diabetes, dislipidemia, obesitas, dan merokok. Obat anti-inflamasi nonsteroid seperti ketorolac diketahui dapat meningkatkan risiko kejadian kardiovaskular, termasuk stroke non-hemoragik, terutama pada pasien dengan penyakit inflamasi kronis.
Kasus: Seorang pria berusia 57 tahun datang ke IGD RSUD Kota Yogyakarta dengan keluhan nyeri perut, sulit buang air besar dan buang angin sejak 3 bulan yang lalu. Kemudian pasien diberikan infus asering, injeksi ketorolac dan ranitidin. Tiga jam kemudian pasien tiba-tiba sulit diajak komunikasi, tampak linglung, sulit bicara dan sulit menggerakkan tubuh sisi kiri. MSCT Scan upper dan lower abdomen menunjukkan dolichocolon dengan proktokolitis, sedangkan CT-Scan kepala non kontras menunjukkan lesi hipodens regio oksipital kanan dengan kesan infark hiperakut. Diagnosis ditegakkan sebagai stroke non hemoragik dengan proktokolitis.
Kesimpulan: Ketorolac dapat meningkatkan agregasi trombosit, vasokonstriksi, serta ketidakseimbangan prostasiklin tromboksan A2, sehingga memperbesar risiko trombosis serebral. Oleh karena itu, pemberian ketorolac harus dipertimbangkan secara hati-hati. Alternatif analgesik dengan risiko kardiovaskular dan gastrointestinal lebih rendah, serta pemantauan yang sangat dianjurkan untuk mencegah komplikasi serius.
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DOI: https://doi.org/10.26714/medart.7.2.2025.46-56
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Faculty of Medicine, Universitas Muhammadiyah Semarang
Jl. Kedungmundu Raya No. 18, Semarang, Indonesia
Email: medica.arteriana@unimus.ac.id