PENGGUNAAN SKOR WATCHA UNTUK MENGIDENTIFIKASI FAKTOR YANG TERKAIT DENGAN EMERGENCE DELIRIUM PADA PASIEN PEDIATRIK YANG MENJALANI ANESTESI UMUM DI RSUP DR SARDJITO

ANINDITA PANCARANI, Dr. dr. Djayanti Sari, M.Kes., Sp.An.,KAP; dr. Yunita Widyastuti, M.Kes., Sp.An.,KAP, Ph.D

2019 | Skripsi | S1 KEDOKTERAN

Latar Belakang: Emergence Delirium (ED) adalah agitasi yang muncul pada anak-anak saat masa pemulihan dari anestesi umum. ED pada anak merupakan masalah besar post operasi yang meningkatkan risiko untuk menyakiti diri pasien dan menyebabkan komplikasi. Banyak faktor risiko untuk terjadinya ED tetapi, hingga saat ini masih belum diketahui secara pasti penyebab dan mekanisme ED karena kurangnya studi. Tujuan: Memprediksi insidensi menggunakan skor Watcha dan mengidentifikasi faktor risiko ED yang ditemukan pada pasien pediatrik di RSUP Dr Sardjito. Metode: Penelitian menggunakan desain cross- sectional. Data diambil dari pasien pediatrik yang menjalani anestesi umum di RSUP Dr Sardjito dan memenuhi kriteria dengan teknik tanpa probabilitas. Terdapat 12 variabel yang dicari keterkaitannya dengan kejadian ED yaitu umur, jenis kelamin, BMI, jenis operasi, teknik anestesi, pre-medikasi, induksi, maintenance, teknik regional anestesi, analgesik durante operasi, analgesik post-operasi dan kondisi mental pre-operasi (parental separation). Penelitian ini mengobservasi subjek pada 10 menit pertama sebelum induksi, setelah diberikan premedikasi secara intravena. Dinilai kondisi mental pre-operasi. Diinduksi dengan teknik inhalasi atau non-inhalasi. Diamati oleh ahli anestesi dan menilai pada tiga titik waktu per 10 menit. Data dianalisis dengan indepedent sample t-test, chi-square test, uji logistik univariat dan uji regresi multivariat. Hasil: Ditemukan 63% subjek didiagnosa ED dengan menggunakan skor Watcha. Faktor risiko umur, jenis kelamin dan jenis operasi memiliki nilai p signifikan pada uji analisis univariat tetapi tidak signifikan pada uji regresi logistik univariat dan multivariat. Kesimpulan: Tidak ada variabel yang memiliki hubungan dengan kejadian ED yang dinilai dengan skor Watcha.

Background: Emergence Delirium (ED) is a form of agitation on pediatric patient that arises during recovery from general anesthesia. Post surgical ED in children is a big problem because it increase risk of self-hurt and presence of complication ranging from the lighter ones to agitation. There are various risk factors of ED occurence but the exact cause and mechanism is still not known due to lack of studies. Aim: The aim of the study is to predict the amount of patient suffering from ED using Watcha Score and to identify risk factors related to occurence of ED on pediatric patient at RSUP Dr Sardjito. Method: The study uses cross sectional design. Data samples were taken from pediatric patient undergoing general anesthesia at RSUP Dr Sardjito that fulfills criteria with non probability sampling. There are twelve variables that are studied regarding its correlation with occurence of ED which are age, sex, BMI, type of surgery, anaesthetic technique, premedication, induction, maintenance, utility of regional anaesthesia, durante operative analgesia, post operative analgesia and pre operative mental condition (parental separation). The study observes patient at the first 10 minutes before induction but after given intravenous premedication. Mental condition is being assessed at pre operative. the induction of patient with inhalational and non inhalational anaesthetics is being observed and assessed by anaesthesiologist at three point of times per ten minute. Data analysis is done using independent sample t-test, chi-square test, logistic univariate test and multivariate regression test. Result: According to the obtained results, 63% of the subjects were diagnosed with ED using Watcha score. Risk factors as in age, sex and type of surgery have significant p value on univariat analysis test however not significant on univariat and multivariat logistic regression test. Conclusion: There is no variables correlated with occurence of ED assessed using Watcha score.

Kata Kunci : Emergensi delirium, faktor risiko, pediatrik, anestesi umum, skor watcha.