PERBANDINGAN EFEKTIVITAS ANTARA PENAMBAHAN KETOROLAK 0,04 MG/KGBB/JAM SECARA KONTINU DAN BOLUS 30 MG/8 JAM INTRAVENA (Pada Analgesi Pasca Operasi Orthopedi dengan Fentanyl 0,25 Î1⁄4g/kgBB/Jam secara Kontinu)
| Main Authors: | , Elfi Husaini ANM, , Dr. Yusmien Uyun, SpAn, KAO |
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| Format: | Thesis NonPeerReviewed |
| Terbitan: |
[Yogyakarta] : Universitas Gadjah Mada
, 2014
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| Subjects: | |
| Online Access: |
https://repository.ugm.ac.id/133208/ http://etd.ugm.ac.id/index.php?mod=penelitian_detail&sub=PenelitianDetail&act=view&typ=html&buku_id=73768 |
Daftar Isi:
- Background : The concept of multimodal analgesia was introduced more than a decade ago as a technique to improve analgesia and reduce the incidence of opioid-related adverse events. This Concept declared that the achievement of sufficient analgesia due to the additive or synergistic effects between different classes of analgesics. A lower incidence of adverse effects might be caused by reduction in the doses of individual post operative pain drugs. The one of alternative intravenous multimodal analgesia is the addition of bolus or continuous ketorolac administration in to fentanyl as combination therapy. Objective : to compare effectivity of the addition between continuous ketorolac 0,04mg/kilogramBodyweight/hour and bolus intravenous ketorolac 30mg/kilogramBodyweight/8 hours as a orthopedic post operative multimodal analgesia with continuous fentanyl 0,25 Î1⁄4g kilogramBodyweight /hour. Methods : This is a double blinded randomized controlled trial. The scope of this study involves patients undergoing elective long bone orthopedic operation with spinal anesthesia in GBST RSUP Dr Sardjito Yogyakarta which consists of male and female. Aged 18-60 years and ASA physical status I and II. Subjects are divided into 2 groups, group KC (20 patients) given ketorolac 0.04 mg/kgBW/hour continuously and fentanyl 0.25 Î1⁄4g/kgBW/hour given. Group KB (20 patients) is given fentanyl 0.25 Î1⁄4g/kgBW/hour continuously and ketorolac 30 mg bolus every 8 hours. Post-operative analgesia effectiveness is measured with the frequency of additional analgesic is given as rescue drugs when VAS score is VAS>3 until VAS3 is achieved in 0-16 hours post operatively. Result : There is a highly significant difference in the number of patient with fentanyl rescue between group KK and group KB ( 0 vs 13) in 0 - 8 hours post operatively (p<0.01). Similarly, there is a highly significant difference in the number of patient with fentanyl rescue between group KK and group KB ( 2 vs 13) in 8-16 hours post operatively (p<0.01). Conclusion: The addition of ketorolac 0,04 mg/kgBW/hour continuously more effective than bolus 30 mg intravenous every 8 hour intravenously, in orthopedic post operative analgesia with fentanyl 0,25 Î1⁄4g/kilogramBodyweight/hour continuously