Abstract
Surgical perioperative management undergoes updates to support postoperative patient outcomes. The concept of longer preoperative fasting times, cleansing ofthe gastrointestinal tract, and re-feeding after 3-5 days after surgery has begun to be abandoned which is then formulated into a new protocol called ERAS(Enhanced Recovery After Surgery) including preoperative counseling, optimization of nutrients, the use of standard anesthesia and analgesy drugs, as well asearly mobilization using the concept of preemptive analgesia. The use of low-dose ketamine for postoperative analgesia has evolved in part due to nmdaantagonistic properties that reduce central sensitization and opioid tolerance but are still controversial. This study aims to study the effects of low-dose ketamineas a preemptive and evaluate the total needs of opiods, as well as the length of time extubation with single blind experimental research. Patients with label A gotpreemptive therapy of subdose ketamine while label B got perioperative standard analgesia therapy. Analgesia in groups A and B is administered before surgery.Treatment control is done with single blind control that is the patient does not know the type of drug given. The comparison of the amount of fentanyl in the controlgroup and treatment in this study was significantly different (p=0.044). The old comparison of extubation in both groups obtained a significant p value (<0.0001).Preemptive administration of subdose ketamine effectively decreases the amount of fentanyl administration used during surgery and shortens the extucation time.
 Keywords: Preemptive; Ketamin subdose; Fentanil; Extucation Time.
Highlights
Surgical perioperative management is updated to support the outcome of postoperative patients
Didapatkan sampel penelitian 13 sampel untuk masingmasing kelompok, dengan mengingat kemungkinan drop out pasien sebanyak 20%, maka dilakukan pengambilan sampel sebanyak 15 pasien untuk masing – masing kelompok.Sampel penelitian kami adalah pasien yang menjalani operasi elektif yang menggunakan anestesi umum di RSUD dr
Investigation of the potentiation of the analgesic effects of fentanyl by ketamine in humans: a double-blinded, randomised, placebo controlled, crossover study of experimental pain [ISRCTN83088383]
Summary
Teknik Pengambilan Sampel elektif di RSUD dr.Soetomo, Surabaya dengan lama perawatan post operatif di ruangan lebih atau sama dengan 1 kali 24 jam. 7. Penderita atau keluarga bersedia menandatangani lembar persetujuan(informed consent) untuk ikut penelitian. Teknik pengambilan sampel dengan simple random sampling yaitu setiap sampel dipilih secara acak dan setiap individu memiliki kesempatan yang sama untuk dipilih menjadi subjek penelitian. Subjek penelitian kemudian diberikan label A dan B, label A untuk pasien yang mendapat preemptive ketamin. Kriteria Eksklusi subdose dan label B pasien yang mendapat terapi standar. Pasien sedang mengalami penyakit kelainan darah 4.
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