Introduction: Postoperative pain is the most undesirable consequence of the surgery. If it is not managed properly, it can lead to a long healing. However, assessment and treatment of postoperative pain in surgical wards still have not received attention. Differences in patient's pain level after surgery and after being transferred to the surgical ward is very important in monitoring the effectiveness postoperative pain management. Objective: This study was conducted to determine the overview of pain level experienced by patients following orthopedic surgery and to know the individual factors that can affect the patient's pain level. Method and Material: This research was observational analytic with 43 orthopedic postoperative patients as a sample. The Patients' pain level were measured by the Numeric Rating Scale (NRS) at one hour after surgery and 24 hours after surgery. Result and Discussion:The Pain level one hour after surgery varied between pain level 0 as much as 53% to pain level 8 as much as 4.7%. The results of measurements of pain 24 hours after surgery only 23.3% of the patients who did not complain of pain, and there was a patient who experienced pain level 10. The results of the statistical calculation, the difference between the level of pain one hour and 24 hours post-surgery obtained value of p=0.037 (p<0.05). Conclusion: There was a significant difference between the pain level at one hour and 24 hours post-surgery. It might be due to the process of peripheral and central sensitization in patients with delayed pain management. It also may be influenced by individual factors as well as medical personnel. ABSTRAKPendahuluan: Nyeri post operasi adalah konsekuensi paling tidak diinginkan dari pembedahan, dan jika tidak dikelola dengan baik dapat menyebabkan penyembuhan yang lama. Namun, penilaian dan penanganan nyeri post operasi di bangsal bedah masih belum mendapat perhatian. Perbedaan tingkat nyeri pasien setelah operasi dan setelah pasien dipindah ke bangsal bedah sangat penting dalam memantau efektivitas manajemen nyeri post operasi. Tujuan: Penelitian ini dilakukan untuk mengetahui gambaran tingkat nyeri yang dialami oleh pasien setelah operasi ortopedi dan mengetahui faktor individu yang dapat berpengaruh pada tingkat nyeri pasien. Metode dan Bahan: Penelitian ini merupakan penelitian analitik observasional dengan 43 pasien post operasi ortopedi sebagai sampel. Tingkat nyeri pasien diukur dengan Numeric Rating Scale (NRS) pada satu jam setelah operasi dan 24 jam setelah operasi. Hasil dan Pembahasan: Tingkat nyeri saat satu jam post operasi bervariasi antara tingkat nyeri 0 sebanyak 53% ke level nyeri 8 sebanyak 4,7%. Hasil pengukuran nyeri pada 24 jam setelah operasi hanya 23,3% dari pasien yang tidak mengeluh nyeri, dan ada pasien yang mengalami tingkat nyeri 10. Hasil pengukuran nyeri 24 jam setelah operasi hanya 23,3% dari pasien yang tidak mengeluh nyeri dan ada pasien yang mengalami tingkat nyeri 10. Hasil perhitungan statistik perbedaan antara tingkat nyeri satu jam post operasi dan 24...

Introduction: The use of ketamine and tramadol as postoperative analgesics for pediatric are still relatively rare, especially orally administrated. As an analgesic, ketamine blocks the NMDA receptor, the main excitatory transmitter in CNS; whereas tramadol blocks serotonin and norepinephrine uptake, thus preventing pain transmission on the spinal cord. Objective: The aim of this study is to compare the effectiveness of oral ketamine and oral tramadol as analgesics for postoperative acute pain in children. Method: A double-blind randomized clinical trial was conducted at Dr. Soetomo Hospital. The hospital ethical committee had approved this study. The subject includes thirty children aged 5-10 years old who fulfilled the inclusion criteria. They were divided into either ketamine groups or the tramadol group, in which each group consisting of fifteen patients. The regimen dosage that been given was 2mg/kg tramadol and ketamine as postoperative oral analgesics in the form of simple syrup. The FLACC table was used to evaluate pain score before and after administration of drugs (30-minutes, 1-hour, 2-hours, 3-hours, 4-hours, and at discharge from the recovery room). Result and Discussion: Based on the quantitative parameter of the FLACC (scale 0-10), there was a significant difference (p<0.05) between the first-hour postoperative administration and patient discharge from the recovery room. The patient of ketamine group had far lower FLACC value compared to the tramadol group. Rescue analgesics in the form of intravenous fentanyl were given to one patient (6.7%) in the ketamine group and  four patients (26.7%) in the tramadol group. Conclusion: Ketamine proved to be a better and more effective postoperative oral analgesic compared to tramadol in this study.

Introduction: The use of ketamine and tramadol as postoperative analgesics for pediatric are still relatively rare, especially orally administrated. As an analgesic, ketamine blocks the NMDA receptor, the main excitatory transmitter in CNS; whereas tramadol blocks serotonin and norepinephrine uptake, thus preventing pain transmission on the spinal cord. Objective: The aim of this study is to compare the effectiveness of oral ketamine and oral tramadol as analgesics for postoperative acute pain in children. Method: A double-blind randomized clinical trial was conducted at Dr. Soetomo Hospital. The hospital ethical committee had approved this study. The subject includes thirty children aged 5-10 years old who fulfilled the inclusion criteria. They were divided into either ketamine groups or the tramadol group, in which each group consisting of fifteen patients. The regimen dosage that been given was 2mg/kg tramadol and ketamine as postoperative oral analgesics in the form of simple syrup. The FLACC table was used to evaluate pain score before and after administration of drugs (30-minutes, 1-hour, 2-hours, 3-hours, 4-hours, and at discharge from the recovery room). Result and Discussion: Based on the quantitative parameter of the FLACC (scale 0-10), there was a significant difference (p<0.05) between the first-hour postoperative administration and patient discharge from the recovery room. The patient of ketamine group had far lower FLACC value compared to the tramadol group. Rescue analgesics in the form of intravenous fentanyl were given to one patient (6.7%) in the ketamine group and  four patients (26.7%) in the tramadol group. Conclusion: Ketamine proved to be a better and more effective postoperative oral analgesic compared to tramadol in this study.