PERBANDINGAN PERUBAHAN KADAR GULA DARAH PLASMA PADA PEMBERIAN PREOPERATIF SORBITOL 25 GRAM / 500 ML (TUTOFUSIN) DENGAN RINGER LAKTAT (RL) PADA PASIEN OPERASI ELEKTIF

DELFRIANI TAMBA, DR. dr. Sudadi, SpAn, KNA, KAR.; Dr. I G Ngurah Rai Artika, SpAn, KAKV, KAR

2017 | Tesis-Spesialis | SP ILMU ANESTESIOLOGI DAN REANIMASI

Latar belakang : Kontrol gula darah perioperatif berpengaruh terhadap morbiditas dan mortalitas pasien baik intra operatif maupun pasca operatif. Stress respon sering dikaitkan dengan peningkatan glukagon dan resistensi insulin yang menyebabkan hiperglikemia. Kombinasi kerusakan jaringan, puasa, perdarahan, obat-obatan dan suhu yang terjadi menyebabkan respon stres. Tujuan : Membandingkan perbedaan perubahan kadar gula darah plasma pada pemberian cairan preoperatif Sorbitol 25 gram / 500 ml (Tutofusin ) dengan pemberian Ringer Laktat (RL) pada pasien operasi elektif. Metode : Subjek penelitian ini sebanyak 66 orang yang memenuhi kriteria inklusi dan dilakukan secara double blind randomized control trial. Dilakukan pemeriksaan gula darah plasma preoperatif, kemudian kelompok perlakuan mendapat infus sorbitol 25 garm / 500 mL (Tutofusin 500 cc) sebelum operasi dan kelompok kontrol mendapat infus RL 500 cc sebelum operasi. Kemudian dilakukan pemeriksaan kadar gula darah plasma sebelum induksi dan setelah di ruang pemulihan. Hasil : Rerata perbedaan perubahan gula darah plasma preoperatif - induksi kelompok Sorbitol dengan kelompok Ringer Laktat tidak berbeda bermakna. Perubahan gula darah plasma preoperatif - induksi pada kelompok sorbitol terdapat 12 sampel yang meningkat dengan rerata perubahan gula darah plasma 13,38 +-12,57 dan 20 sampel yang menurun dengan rerata perubahan gula darah plasma 25, 45 +-16,83. Pada kelompok ringer laktat terdapat 7 sampel yang meningkat dengan rerata perubahan gula darah plasma 15,0+-10,77 dan 25 sampel yang menurun dengan rerata perubahan gula darah plasma 24,48 +-23,97. Kesimpulan : Pemberian preoperatif Sorbitol 25 gram / 500 ml (Tutofusin ) dibandingkan dengan Ringer Laktat pada pasien operasi elektif menunjukkan hasil perubahan gula darah plasma tidak berbeda bermakna.

Background : Perioperative blood glucose control was effected on morbidity and mortality both intra-operative and post-operative. Stress response often associated with increased glucagon and insulin resistance causes hyperglycemia. The combination of tissue damage, fasting, bleeding, drugs and temperatures lead to stress response. Objective : This study aims to compare the changes plasma blood glucose between sorbitol 25 gram / 500 ml (Tutofusin) and Lactate Ringer preoperatively administration in elective surgery patient. Methods : The study was design prospective randomized control trial including 66 patients who qualified the inclusion criteria. Blood glucose was measured preoperatively and then treatment group received intravenous sorbitol 25 gram / 500 mL (Tutofusin 500 cc) and control group received intravenous RL 500 cc before surgery. Then continued examination of blood glucose levels before induction and after surgery in the recovery room. Results: Mean preoperative - induction blood plasma glucose changes between Sorbitol and Ringer Lactate group did not differ significantly. Mean preoperative - induction plasma blood glucose changes in sorbitol group have 12 samples increased which mean of changes 13.38 +- 12.57 and 20 samples decreased which mean of changes 25,45 +- 16,83. Lactate Ringer group have 7 samples increased which mean of change 15,0 +- 10,77 and 25 sample decreased which mean of change 24,48 +- 23,97. Conclusion : Preoperatively Sorbitol 25 gram / 500 ml (Tutofusin ) compared with Ringer Lactate in elective surgery patients showed not significant difference in plasma blood glucose.

Kata Kunci : gula darah plasma, preoperatif, sorbitol, blood glucose, preoperative, sorbitol