Perbedaan Skala Analog Visual Nyeri dan Kadar Protein C-reaktif Sensitivitas Tinggi Setelah Pemberian Fentanil dan Ketamin Perioperatif pada Pasien Pasca-laparotomi: Sebuah Uji Klinis Terkontrol Acak Buta Ganda
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DOI:
https://doi.org/10.55175/cdk.v53i08.1783Kata Kunci:
Fentanyl, high-sensitivity C-reactive protein, ketamine, laparotomi, nyeri pascaoperasiAbstrak
Pendahuluan: Nyeri pascaoperasi masih menjadi tantangan utama tata laksana perioperatif. Penelitian ini menganalisis perbedaan skor nyeri menggunakan visual analog scale (VAS) dan kadar high-sensitivity C-reactive protein (hsCRP) antara pemberian ketamine perioperatif dan fentanyl perioperatif pada pasien pascabedah laparotomi. Metode: Uji klinis acak tersamar ganda pada 24 pasien laparotomi yang dibagi menjadi kelompok ketamine (n = 12) dan fentanyl (n = 12). Kelompok ketamine menerima bolus 0,2 mg/kg dilanjutkan infus 0,1 mg/kg/jam, kelompok fentanyl mendapat infus 0,5 mcg/kg/jam selama operasi; pemberian obat dihentikan segera setelah ekstubasi. VAS dinilai pada jam ke-4 dan ke-8 pascaoperasi, kadar hsCRP diukur sebelum operasi dan 6 jam pascaoperasi. Analisis statistik menggunakan uji-t independen, Mann-Whitney U, dan korelasi Pearson. Hasil: Kelompok ketamine menunjukkan skor VAS lebih rendah signifikan pada jam ke-4 pascaoperasi (2,92 vs 5,25; p = 0,017), namun tidak ada perbedaan signifikan pada jam ke-8 (6,00 vs 5,75; p = 0,514). Kadar hsCRP pascaoperasi kelompok ketamine lebih rendah dibandingkan fentanyl (4,58 vs 7,77; p = 0,006). Terdapat korelasi positif antara peningkatan skor VAS dan kenaikan hsCRP (r = 0,566; p = 0,004). Simpulan: Ketamine memberikan analgesia superior pada periode awal pascaoperasi dan lebih efektif menekan respons inflamasi dibandingkan fentanyl. Namun, efek analgesik ketamine menurun setelah 8 jam, menunjukkan perlunya strategi multimodal untuk manajemen nyeri pascaoperasi yang berkelanjutan.
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