Karya Tulis Akhir

Agrina Nurlisyari, dr. Siswanto Sastrowijoto, Sp.T.H.T.K.L(K)., M.H.; Dr. dr. Luh Putu Lusy Indrawati, M.Kes., Sp.T.H.T.K.L(K)

2018 | Tesis-Spesialis | ILMU KESEHATAN TELINGA HIDUNG TENGGOROK BEDAH KEPALA DAN LEHER

Latar belakang : Visualisasi faring dan laring merupakan bagian penting dari pemeriksaan kepala dan leher. Tindakan faringolaringoskopi nasal fleksibel (Flexible Nasal Pharyngo-laryngoscopy/FNPL) dilakukan untuk pemeriksaan dan tata laksana struktur anatomi nasal, faring, dan laring pada praktek sehari-hari. Premedikasi Xylocaine® spray diberikan untuk mengurangi rasa tidak nyaman dan membantu pemeriksaan, diagnosis, dan tatalaksana pasien. Tujuan : Untuk menilai daya guna Xylocaine® spray pada mukosa hidung dan orofaring sebelum tindakan FNPL terhadap kenyamanan pasien dibanding tanpa Xylocaine® spray di poliklinik THTKL RSUP Dr. Sardjito, Yogyakarta. Metode : Penelitian ini merupakan suatu studi single-blind randomized controlled trial, dengan besaran sampel tiap kelompok 28 orang yang dilakukan di poliklinik THTKL RSUP Dr. Sardjito, Yogyakarta selama periode bulan April-Mei 2018 dengan sampel penelitian diambil secara acak. Subyek penelitian dilakukan evaluasi tekanan darah, laju nadi, skala nyeri, mual, tingkat kecemasan, dan kuesioner SF 36 sebelum tindakan, pasca tindakan menit ke-5 dan ke-15. Data dianalisa menggunakan Independent t-test, Mann Whitney test, dan Chi-square test. Hasil : Pengukuran tekanan sistolik, diastolik, laju nadi, dan skala nyeri antara pre tindakan, pasca tindakan menit ke-5 dan ke-15 menunjukkan tidak ada perbedaan yang bermakna (p>0,05). Terdapat perbedaan yang signifikan antara skor kenyamanan pre dan post endoskopi pada grup A (p=0,001). Pada penelitian ini juga terdapat pengaruh yang signifikan antara rasa nyeri terhadap kenyamanan pasien post endoskopi menit ke-5 dan ke-15 pada grup B (p<0,05). Terdapat pengaruh yang signifikan antara skor kecemasan terhadap kenyamanan pasien pre dan post endoskopi pada grup A (p<0,05). Akan tetapi, tidak terdapat pengaruh yang signifikan antara rasa mual terhadap kenyamanan pasien pre dan post endoskopi (p>0,05). Kesimpulan : Pemberian Xylocaine spray sebelum tindakan FNPL meningkatkan kenyamanan pasien dibanding tanpa Xylocaine spray.

Background : Visualization of the pharynx and larynx is an important part of head and neck examination. Flexible Nasal Pharyngo-laryngoscopy (FNPL) is performed for the examination and management of nasal, pharyngeal, and larynx anatomical structures in daily practice. Premedication with Xylocaine® spray is given to relieve discomfort and to help the examination, diagnosis, and management of the patient. Purpose : To assess the efficacy of Xylocaine® spray of the nasal and oropharyngeal mucosa before FNPL action on patient comfort compared to without Xylocaine® spray at ENT-HNS clinic RSUP Dr. Sardjito, Yogyakarta. Methods : This study was a single-blind randomized controlled trial study, with a sample size of each group of 28 people performed at ENT-HNS clinic RSUP Dr. Sardjito, Yogyakarta during the period of April-May 2018 with randomly selected research samples. The subjects were evaluated for blood pressure, pulse rate, pain scale, nausea, anxiety level, and SF 36 questionnaire before action, after the 5th and 15th minute of actions. Data were analyzed using Independent t-test, Mann Whitney test, and Chi-square test. Result : Measurement of systolic, diastolic, pulse rate, and pain scale between pre-action, post action of 5th and 15th minutes showed no significant difference (p> 0,05). However, there was a significant difference between comfort score for pre and post endoscopy in group A (p=0,001). In this study there was also a significant influence between pain after endoscopy within 5th and 15th minutes in group B (p <0.05). There was a significant influence between the anxiety score on pre and post-endoscopic with patient comfort in group A (p <0.05). However, there was no significant effect between nausea and patient comfort before and after endoscopy (p> 0.05). Conclusions : Administration of Xylocaine spray before FNPL showed an improvement of patient comfort compared to those without Xylocaine spray.

Kata Kunci : Xylocaine spray, faringolaringoskopi nasal fleksibel, endoskopi, kenyamanan pasien