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Perbandingan Pengaruh Pemberian Ketamin 0,1 mg/KgBB dan Parasetamol 1000 mg Secara Intravena Terhadap Kadar Interleukin-6 pada Pasien Pasca Lower Limb Orthopedic Surgery

Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Diponegoro, Semarang, Indonesia

Received: 15 Mar 2022; Revised: 25 Mar 2022; Accepted: 20 Apr 2022; Available online: 16 Sep 2022; Published: 16 Sep 2022.

Citation Format:
Abstract

Latar Belakang: Lower limb orthopedic surgery merupakan tindakan bedah ortopedik pada ekstremitas inferior yang meliputi tulang, sendi, dan vaskular. Peningkatan interleukin-6 (IL-6) sistemik setelah pembedahan meningkatkan morbiditas dan mortalitas pascaoperasi. Sebagai analgesik, ketamin dan parasetamol mempengaruhi ekspresi IL-6.

Tujuan: Penelitian ini adalah untuk membandingkan pengaruh pemberian ketamin 0,1mg/Kg IV dengan parasetamol 1000 mg IV terhadap kadar IL-6 pada pasien pasca lower limb orthopedic surgery yang mendapatkan regional anestesi.

Metode: Penelitian ini menggunakan randomized control trial pada 54 pasien yang telah menjalani lower limb orthopaedic surgery dan memenuhi kriteria inklusi dan eksklusi. Sampel dibagi menjadi 3 kelompok yang terdiri dari kontrol (K); epidural bupivakain 0,125%, perlakuan 1 (P1); dengan tambahan ketamin 0,1 mg/KgBB IV dan perlakuan 2 (P2); dengan tambahan parasetamol 1000 mg IV pascaoperasi. Sampel darah diambil 2 jam pascaoperasi untuk diukur kadar IL-6 menggunakan metode enzyme linked immunosorbent assay (ELISA).

Hasil: Penelitian ini menghasilan nilai rerata IL-6 kelompok K = 72,22±66,93 pg/ml; P1 = 7,18±4,18 pg/ml dan P2 = 7,00±2,92 pg/ml. Uji Kruskal Wallis menunjukkan nilai signifikan (p=0,000). Hasil penelitian menunjukkan nilai signifikan pada K terhadap P1 (p=0,000) dan K terhadap P2 (p=0,000), sedangkan P1 terhadap P2 tidak signifikan (p=0,438).

Kesimpulan: Pemberian ketamin atau parasetamol pasca lower limb orthopaedic surgery secara signifikan menurunkan kadar IL-6. Tidak ada perbedaan antara ketamin dan parasetamol dalam menurunkan kadar IL-6 pascaoperasi lower limb orthopedic surgery. 

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Keywords: interleukin-6; ketamine; lower limb orthopaedic surgery; parasetamol; regional anestesi

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