Perbandingan respon hemodinamik selama laringoskopi dan intubasi trakea antara ondansetron dengan lidokain intravena pada anestesi umum

ISWATI, Diah, dr. I G. Ngurah Rai Artika, Sp.AnK

2003 | Tesis | PPDS I Anestesiologi dan Reanimasi

Tujuan : membandingkan efek pemberian ondansetron dan Kdokain intravena sebelum induksi dalam upaya menekan respon hemodinamik selama laringoskopi dan intubasi trakea. Rancangan penelitian : Randomized controlled trial dengan pembutaan ganda. Ruang lingkup : Pria dan wanita yang menjalani bedah mayor elektif di Instalasi Bedah Sentral RSUP Dr. Sarjito. Subyek : Tigapuluh pasien berumur 18-45 tahun, Body mass Index (BMI) dalam batas normal (18,5-24,9), status fisik ASA 1. Intervensi : Subyek dilokasikan secara acak dibagi 2 kelompok, kelompok yang mendapat ondansetron 0,1 mg/kgbb dan kelompok yang mendapat lidokain 1,5 mg/kgbb, masing-masing 10 menit dan 2 menit sebelum laringoskopi dilakukan. Pengukuran utama : Tekanan darah dan laju nadi dicatat sesudah mendapat infus larutan ringer dextrose dan Midazolam 0,5 mg/kgbb, kemudian 1 menit sebelum dan sesudah injeksi ondansetron atau lidokain, pada waktu induksi, dan segera setelah terintubasi, lalu 1,4,7 dan 10 menit sesudah terintubasi. Hasil : Tidak terdapat perbedaan peningkatan respon hemodinamik pada kelompok ondansetron maupun hdokain. Tekanan sistolik, tekanan diastolik dan laju nadi sesudah intubasi lebih rendah pada kelompok ondansetron, tetapi tidak ada perbedaan secara statistik (p>0,05). Walaupun bila dibandingkan dengan keadaan hemodinarmk setelah mendapat ondansetron atau hdokain, terdapat perbedaan yang bermakna antara perubahan laju nadi pada kelompok ondansetron dan hdokain. Tidak ditemukan adanya efek samping pemberian ondansetron dan hdokain pada penehtian ini. Kesimpulan : Pemberian ondansetron intravena tidak efektif untuk mencegah respon hemodinamik selama laringoskopi dan intubasi trakea, sama halnya dengan pemberian hdokain intravena.

Purpose : To compared the effects of an IV administration of ondansetron and lidocaine before induction on hemodynamic responses associated wMi laiyngoscopy and tracheal intubation. Design : Double-blinded, ramdomized controlled trial. Setting : Male and female patients underwent elective major surgery, were performed general anesthesia in the central operating theatre of Sardjito General Hospital. Subjects : Thirty patients, age 18-45 y old, body mass index IBMn within normal limit (range 18,5-24,9), physically status ASA 1. Intervension: The subjects were randomly allocated to receive ondansetron (0.1 ing/kg) or Udocaine (1.5 mg/kg) 10 or 3 minutes before tracheal intubation, respectively.. Main outcome measurements : Blood pressures and heart rate were recorded after they received ringer dextrose solution and Midazolam 0,5 mg/kgbb as premedication at the operating theatre, and then 1 min before and after injection of ondansetron or hdocaine, durante induction, and immediately intubated, 1, 4, 7 and 10 min after intubation. Results : No different in increasing of hemodynamic responses to laryngoscopy and intubation in both the ondansetron and lidocaine groups. Systolic blood pressures, diastolic pressures and heart rate after intubation were lower in the ondansetron group when compared with lidocaine group, but it were not significant (P>0.05). Eventhough increasing in heart rate were significantly lower in the ondansetron group at compare with lidocaine group (P < 0.05) when the calculation perfomed on the hemodynamics condition after they received ondansetron or lidocaine. No adverse ondansetron effects were detected. Conclusions: The IV administration of ondansetron blimted cardiovascular response produced by laiyngoscopy and tracheal intubation uneffectively, and this effect had no different when compared with IV Udocaine.

Kata Kunci : Anestesi Umum,Respon Hemodinamik,Laringoskopi dan Intubasi Trakea