Perbandingan Efek Analgesia Pasca Bedah dari Ketamine 0,25 Mg / KgBB dengan Tramadol 0,25 Mg/ KgBB Subcutaneus pada Daerah Operasi

Abstract

Background: Postoperative pain is the most unwanted consequence of surgery. Its prevalence is

still high despite drugs and anesthesia techniques development. Combination of opioid and non- opioid analgesics has shown various result in postoperative pain management. Tramadol is a

codeine synthetic analog that binds to the μ-opiate receptor and inhibits monoaminergic neurotransmitters. Ketamine is an NMDA inhibitor which has an antinociceptive effect. Previous studies have shown various result regarding tramadol and ketamine effect. We try to explore the effectiveness of both drugs as pain management, mainly in 6 hours postoperative. Aim: This study was aimed to prove that ketamine 0.25 mg/BW may give better postoperative analgesia effect than tramadol 0.25 mg/BW subcutaneous injection at the surgical area. Methods: A total of 60 adult patients that underwent elective surgery of lower abdomen and extremity in Rumah Sakit Umum Pusat Haji Adam Malik Medan and Rumah Sakit Putri Hijau TK.11 Kesdam I/BB Medan, and matched our inclusion and exclusion criteria. Sample divided into two groups randomly: Group A was treated with ketamine 0.25 mg/kgBW injection, and Group B was treated with tramadol 0.25 mg/kgBW injection. The patients then examined with Numeric Rating Scale (NRS) in 0, 1, 2, 4, and 6 hours postoperative. Results: There was no significant difference in pain between two groups in 0 and 1 hour postoperative. However, there was a significant difference in pain between two groups in 2, 4 and 6 hours postoperative. Conclusion: Tramadol subcutaneous injection has better analgesia effectiveness than ketamine subcutaneous injection for postoperative pain management.