Perbandingan Quantium Consciousness Index dan Quantium Noxious Index pada Pemberian Ketamine Subdose Dibandingkan dengan Kombinasi Fentanyl dan Midazolam pada Pasien Post Operasi di ICU

Abstract

Background: Improper pain management in postoperative patients can increase complications in the respiratory, metabolic, and infectious systems, which in turn lead to increased patient morbidity and mortality. In postoperative patients in the ICU, not only analgesics are needed but also sedation so that the patient can remain calm during treatment, especially patients with mechanical ventilation. The use of subdose ketamine instead of fentanyl and midazolam as sedative analgesic agents can be done by using the measurement parameters of the quantium consciousness index (qCON) and quantium noxious index (qNOX) in measuring the depth of sedation and adequacy of analgesics as a new alternative to nociceptive monitoring methods with more objective results. Objective: Obtain results of comparing qCON and qNOX in postoperative patients by administering subdose ketamine compared to a combination of fentanyl and midazolam in RSUP Haji Adam Malik Medan. Methods: The research design is randomized clinical trial with a double-blind method. After obtaining approval from the Ethics Committee of the Faculty of Medicine, Universitas Sumatera Utara, Medan, 44 research samples were collected which, after fulfilling the inclusion criteria, were randomly divided into 2 groups. Group A received a subdose of ketamine and group B received a combination of fentanyl and midazolam. The research data obtained were tested using SPSS. Results: There were differences in the median, minimum and maximum values of qCON and qNOX in the groups given subdose ketamine and fentanyl and midazolam but these were not statistically significant (p > 0.05) at T0, T1 and T2. Conclusion: Administering a subdose of ketamine can provide sedation and analgesia comparable to those of fentanyl and midazolam.