Perbandingan Efek Ketamin Subdose dan Dexmedetomidine Intraoperatif Terhadap Indeks Qcon dan Qnox Pada Pasien yang Menjalani Operasi Tulang Belakang dengan Teknik Anestesi Umum

Abstract

Background: Assessment of consciousness and nociception during general anesthesia is crucial for maintaining hemodynamic stability and avoiding over- or under-sedation. qCON and qNOX indices, derived from electroencephalography (EEG), are useful parameters for real-time monitoring of the patient's level of consciousness and pain response. Ketamine and dexmedetomidine, as anesthetic adjuvants, have distinct mechanisms in modulating consciousness and nociception. Objective: To compare the intraoperative effects of subdose ketamine and dexmedetomidine on qCON and qNOX indices in patients undergoing spinal surgery under general anesthesia. Methods: This was a randomized clinical trial involving 42 patients undergoing spinal surgery. Subjects were divided into two groups: ketamine and dexmedetomidine. Parameters measured included qCON and qNOX values at five time points (pre-induction, intubation, incision, 2 hours post-incision, and extubation), total intraoperative fentanyl and sevoflurane requirements, and pain score (NRS) two hours postoperatively. Data were analyzed using the Mann- Whitney test and repeated measures ANOVA with a significance level of p<0.05. Results: There were significant differences in qCON and qNOX values between the two groups at several time points. No significant differences were observed in fentanyl requirement, mean sevoflurane concentration, or NRS scores two hours postoperatively (p>0.05). Conclusion: Subdose ketamine and dexmedetomidine showed different effects on qCON and qNOX indices, reflecting differences in anesthetic depth and pain perception. qCON values were lower in the dexmedetomidine group during intubation, incision, and extubation. Conversely, qNOX values were lower in the ketamine group at intubation, incision, and 2 hours post-incision.