Perbandingan antara Efektivitas Kombinasi Tramadol Ketorolac Intravena dengan Tramadol Intravena pada Penangangan Nyeri Fraktur
Abstract
Kurangnya uji klinis acak terkontrol untuk memeriksa efektivitas kombinasi tramadol-ketorolak dengan tramadol saja adalah alasan mengapa terapi tersebut belum dimasukkan ke dalam praktek klinis rutik. Tujuan dari penelitian ini adalah untuk membandingkan efektivitas kombinasi tramadol ketorolac intravena dengan tramadol intravena pada penangangan nyeri fraktur. Penelitian ini merupakan uji klinis acak terkontrol (RCT) dengan desain double-blind untuk membandingkan efektivitas analgesia intravena antara ketorolac, kombinasi tramadol-ketorolac, dan tramadol. Subjek terdiri dari 60 pasien dewasa di RSUD Kota Mataram, Januari-November 2023, dengan kriteria nyeri VAS ≥ 5. Teknik pengumpulan data menggunakan consecutive random sampling dan dianalisis menggunakan SPSS 17.0. Uji normalitas dilakukan dengan Shapiro-Wilk, dan perbandingan antar kelompok dianalisis menggunakan uji T dengan standar nilai p<0,05. Hasil analisis univariat penelitian ini menunjukkan mayoritas subjek berusia 46-55 tahun (43.3%), perempuan (66.7%), dengan BMI normal (68.3%) dan diagnosis fraktur tertutup (80%). Terdapat perbedaan signifikan dalam penurunan nilai VAS sebelum dan sesudah pemberian ketorolac, kombinasi tramadol-ketorolac, serta tramadol intravena. Penurunan VAS paling tinggi terlihat pada tramadol 2mg/kgBB IV. Uji statistik menunjukkan perbedaan bermakna antara ketorolac 1mg/kgBB vs kombinasi tramadol-ketorolac, ketorolac 1mg/kgBB vs tramadol 2mg/kgBB, dan kombinasi tramadol-ketorolac vs tramadol 2mg/kgBB (p<0,05). Pemberian tramadol 2mg/kgBB intravena lebih efektif menurunkan nyeri dibandingkan ketorolac atau kombinasi tramadol-ketorolac pada pasien fraktur.
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