Clinical Research Directory

Inclusion Criteria: 1. Patients with Class II or Class III skeletal deformities who underwent bimaxillary orthognathic surgery due to dentofacial deformities. 2. ASA I-II physical status patients. 3. Patients aged between 18 and 45 years. 4. Patients who received anesthesia induction and maintenance with propofol (0.2-0.6 mg/kg/hour) titrated to maintain an entropy score between 40-60, and remifentanil (0.05-0.5 mg/kg/hour) adjusted to maintain a Surgical Pleth Index (SPI) between 20-50. 5. Patients who received a combination of local anesthetic and ketamine. 6. Patients who were administered patient-controlled analgesia (PCA) at the end of the surgery and whose opioid consumption via PCA was monitored during the first 24 hours postoperatively. 7. Patients whose nausea-vomiting scores and need for antiemetics were recorded. 8. Patients with complete documentation of anesthesia records, including entropy scores, SPI values, and total doses of propofol and remifentanil administered. 9. Patients with completed postoperative edema follow-up forms. Exclusion Criteria: 1. Patients with a known allergy to ketamine. 2. Patients with uncontrolled systemic diseases. 3. Patients using psychotropic medications. 4. Patients with a history of substance abuse. 5. Patients with chronic pain lasting longer than 3 months. 6. Patients using analgesic or hypnotic medications for more than 2 weeks. 7. Cases in which complications occurred during surgery that required deviation from the standard orthognathic surgical protocol and could potentially affect postoperative pain levels (e.g., bad split, unexpectedly prolonged surgical duration, etc.).