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Laparotomy is a major surgical procedure associated with a high risk of acute postoperative pain. According to Gan (2017), if pain is not properly managed, it can progress to chronic pain. (Toro et al., 2018) reported that severe pain on the first postoperative day is still commonly found in laparotomy patients, while (Small & Laycock, 2020) indicated that moderate to severe pain within the first 24 hours following major surgery remains a significant clinical issue. This study aims to evaluate the effectiveness of pharmacological pain management following laparotomy under general anesthesia, specifically to identify the types of opioid analgesics used, analyze their effectiveness in reducing pain intensity, identify side effects, and examine administration techniques and routes. This study employed a Systematic Literature Review (SLR) method following the PRISMA guidelines. Literature searches were conducted in the PubMed, ScienceDirect, and SpringerLink databases covering the years 2015–2026. The included studies comprised randomized controlled trials (RCTs), cohort studies, and retrospective studies addressing opioid pharmacological pain management in adult patients following laparotomy under general anesthesia. Study quality assessment was performed using the Joanna Briggs Institute (JBI) instrument. A total of 11 studies met the inclusion criteria. The results of the systematic literature review indicate that opioids are effective in reducing postoperative pain following laparotomy under general anesthesia. The most commonly used opioids are morphine, fentanyl, and oxycodone. Of all the opioids reviewed, oxycodone provided the best pain control, while intrathecal morphine was most effective in reducing the need for supplemental opioids during the early postoperative period. Other opioids, such as extended-release dinalbuphine sebacate and tegileridine, are also effective, but the number of studies is still limited. The most common side effects are nausea, vomiting, pruritus, sedation, and dizziness. Pharmacological pain management using opioids is effective in reducing the intensity of postoperative pain following laparotomy under general anesthesia. Morphine, fentanyl, and oxycodone are the most commonly used opioids. Oxycodone and intrathecal morphine have shown good results in improving pain control and reducing the need for supplemental opioids. The selection of opioid type, dosage, and administration technique must be tailored to the patient’s clinical condition to achieve optimal analgesia with minimal side effects.

 Chronic pain is pain that persistent and will continue beyond the proper healing time, there are two time points used in daily practice, namely 3 months and 6 months after the first injury. Sensitivity of peripheral nociceptive neurons and central underlying the process of transition from acute pain to chronic pain. There are several factors that influence the increasing incidence of postoperative chronic pain including preoperative, intraoperative and postoperative factors. Untreated acute postoperative pain also increases the risk of increasing chronic postoperative pain. In Asia, the prevalence of chronic pain varies widely, between 7% in Malaysia to 60% in Cambodia. The prevalence of postoperative chronic pain in adults is reported to be around 20% in developed countries. The incidence includes all ages with a higher incidence in women and the elderly. The purpose of this study was to describe the characteristics of postoperative chronic pain in outpatients in the surgical polyclinic and obstetrics and gynecology polyclinic at RSU Medan. The type of research used in this study was Observational with a Cross Sectional method approach. Based on the research that has been done, it was found that ages 26-35 years experienced the most chronic pain, namely as much as 29.8% and women experienced more chronic pain compared to men. Based on this study it was found that the majority of respondents experienced moderate pain intensity as many as 36 respondents (63.2%). There were descriptions of characteristics that were mostly 26-35 years old.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are a widely used class of medications for managing pain and inflammation. However, long-term use of NSAIDs has been associated with an increased risk of gastrointestinal disorders, including Gastroesophageal Reflux Disease (GERD). This study aims to analyze the impact of NSAID use on GERD patients based on recent research findings. The literature search was conducted through national and international databases such as Elsevier, Google Scholar, and the National Institutes of Health (NIH) National Library of Medicine, using keywords including GERD, NSAID, LES (Lower Esophageal Sphincter), gastric acid, reflux, and regurgitation. A total of 25 journal articles published between 2016 and 2024 were used as data sources. The findings indicate that NSAIDs inhibiting cyclooxygenase-1 (COX-1) can reduce prostaglandin production, which plays a protective role in the gastric mucosa, thereby increasing the risk of irritation and acid reflux. Conversely, selective COX-2 NSAIDs have a lower risk of gastrointestinal side effects, making them a safer alternative for patients with chronic pain and inflammation. This study highlights the importance of selecting the appropriate type of NSAID and monitoring its long-term use to minimize the risk of gastrointestinal disorders, particularly in patients with a history of GERD. By considering these factors, it is hoped that complications related to NSAID use in patients with digestive issues can be reduced.

Vulvodynia is a chronic pain condition affecting the vulva that significantly impacts women’s quality of life. Accurate and early diagnosis poses a challenge due to the often-overlapping symptoms with other conditions and the lack of definitive diagnostic tests. This paper proposes the use of expert system methods as a diagnostic tool for vulvodynia in women. The expert system, integrating medical knowledge with inference algorithms, is designed to analyze symptoms, medical history, and test results to provide accurate diagnoses and treatment recommendations. The study involves the development and evaluation of a computer-based expert system prototype that uses clinical data and medical decision-making to enhance the accuracy of vulvodynia diagnosis. Preliminary results indicate that the expert system can improve diagnostic rates and reduce the time required for identifying this condition, offering a potentially valuable tool for medical professionals in clinical practice.