Perbandingan Efek Fentanil dengan Ketamin terhadap Skor Pemulihan Pascaanestesi Umum Diukur dengan QoR-40 serta Perubahan Tekanan Darah dan Nadi pada Operasi Odontektomi

Adhitya Pratama, Erwin Pradian, M. Erias Erlangga

Abstract


Penggunaan fentanil pada anestesi umum memiliki pengaruh terhadap pemulihan pascaoperasi dan

penurunan hemodinamik saat induksi. Metode anestesi umum menggunakan analgetik nonopioid

diharapkan meningkatkan kualitas pemulihan pascaoperasi. Pemberian ketamin dosis subanestesi memberi efek analgetik dengan efek samping minimal serta perubahan tekanan darah dan nadi lebih stabil. Tujuan penelitian ini membandingkan efek fentanil dengan ketamin terhadap kualitas pemulihan serta perubahan tekanan darah dan nadi saat induksi. Penelitian ini merupakan uji klinis tersamar ganda pada 30 pasien yang menjalani operasi odontektomi dengan anestesi umum di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung dari Januari–Maret 2020. Pasien dibagi menjadi 2 kelompok, yaitu kelompok ketamin, diinduksi menggunakan ketamin 0,5 mg/kgBB dan kelompok fentanil, diinduksi menggunakan fentanil 1,5 mcg/kgBB. Data dianalisis dengan uji-t tidak berpasangan, Uji Mann Whitney, dan Uji Kolmogorov-smirnov dengan nilai p<0,05 dianggap bermakna. Terdapat penurunan tekanan darah dan nadi yang signifikan (p<0,05) di menit ke-1, 3, dan 5 pada grup fentanil. Penilaian QoR-40 pada kelompok ketamin memiliki angka lebih tinggi (181,07±5,32) dibanding dengan kelompok fentanil (176,60±2,59) secara bermakna (p<0,05). Simpulan, skor pemulihan pascaanestesi umum dengan ketamin lebih tinggi dibanding dengan fentanil pada operasi odontektomi yang dinilai dengan QoR-40 dan ketamin dengan dosis subanestesi saat induksi menunjukkan hemodinamik yang lebih stabil dibanding dengan induksi menggunakan fentanil.

 

Comparison of Fentanyl and Ketamine’s Effects on Post-General Anesthesia Recovery Scores Measured by QoR-40 and Changes in Blood Pressure and Pulse in Odontectomy Surgery

The use of fentanyl in general anesthesia has side effects that may prolong postoperative recovery and hemodynamic decline when induction. Methods of general anesthesia without fentanyl may improve the quality of postoperative recovery. Ketamine in subanesthetic doses has analgesic effects with minimal side effects and more stable blood pressure and pulse changes. This study aimed to compare fentanyl and ketamine’s effects on quality of recovery and changes in blood pressure and pulse. This was a double-blinded clinical study in 30 patients with odontectomy under general anesthesia in Dr. Hasan Sadikin General Hospital from January–March 2020. Patients were divided into two groups, a ketamine group, induced using 0.5 mg/kgBW ketamine, and a fentanyl group, induced using 1,5 mcg/kgBW fentanyl. Data were analyzed using the unpaired t-test, Mann Whitney, and Kolmogorov-Smirnov test, a p-value of <0.05 was considered significant. Values of QoR-40 in the ketamine group had a significantly (p<0.05) higher value (181.07±5.32) compared to the fentanyl group (176,60±2,59). In conclusion, the quality of post-general anesthesia recovery using ketamine is higher than fentanyl in odontectomy evaluated using QoR-40. Induction using subanesthetic  doses of ketamine shows more stable hemodynamic than fentanyl.


Keywords


Fentanil, ketamin, odontektomi, QoR-40, skor pemulihan pascaanestesi umum

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DOI: https://doi.org/10.15851/jap.v8n3.2096



 

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