Efektivitas premedikasi Klonidin oral 4 ug/kg dibanding diazepam oral 0,4 mg/kg untuk mengurangi kejadian agitasi perioperatif pada anak

MANUABA, I Gusti Putu, dr. Muhdar ABubakar, SpAN.KIC

2004 | Tesis | PPDS I Anestesiologi dan Reanimasi

Tujuan : Mengetahui pengaruh premedikasi klonidin dan diazepam oral pada anak usia 2-10 tahun terhadap kejadian agitasi perioperatif Desain : Randomized Controlled Trial dengan pembutaan ganda Ruang lingkup : Pasien anak yang menjalani operasi terencana dengan anestesi umum di GBST RS Dr. Sardjito Yogyakarta Subyek : Sebanyak 70 orang pasien anak, laki dan perempuan usia 2-10 tahun status fisik ASA I dan II Intervensi : Subyek dibagi 2 kelompok, tiap-tiap kelompok sebanyak 35 orang. Kelompok K mendapat premedikasi klonidin oral dosis 4 mcg/kg, sedangkan kelompok D mendapat premedikasi diazepam oral dosis 0,4 mg/kg. Semua premedikasi diberikan 90-105 menit sebelum dilakukan anestesi, diikuti pemberian atropine sulfas 30 menit kemudian. Di ruang persiapan, diamati tingkat kecemasan pasien dengan skala m-YPAS, tingkat sedasi dan kejadian efek samping tiap 30 menit. Tingkat agitasi preanestesi diamati saat pasien dipisah dari orang tua dan penerimaannya terhadap sungkup muka. Pasien diinfus di kamar operasi dan dilakukan induksi inhalasi. Selama anestesi diamati kejadian efek samping. Di ruang pulih sadar diamati lama waktu pulih sadar dan tingkat agitasi pasca anestesi Pengukuran utama: Tingkat agitasi pre dan pasca anestesi Hasil : Tingkat agitasi preanestesi pada kelompok klonidin 32% berbanding 76% pada kelompok diazepam. Tingkat agitasi pasca anestesi kelompok klonidin 44% dibanding 79% pada kelompok diazepam. Tidak ada perbedaan kejadian efek samping pada kedua kelompok Kesimpulan : Pemberian premedikasi klonidin oral dosis 4 mcg/kg 90-105 menit sebelum dilakukan anestesi efektif untuk menurunkan kejadian agitasi perioperatif dibandingkan premedikasi diazepam oral 0,4 mg/kg

Objective : To evaluate the efficacy of oral clonidine premedication 4 mcg/kgBW to reduce perioperative agitation compared to oral diazepam 0,4 mg/kgBW Design : Double blind randomized controlled trial Target population : Pediatric who underwent elective surgery under GA in the Sardjito Hospital, Yogyakarta Su0bject : 70 patients were recruited, consist of male and female, aged 2-10 y.o, with ASA physical state I and II. Interventions : Group K (35 person) were premedicated by oral clonidine 4 mcg/kgBW and group D (35 person) were by oral diazepam 0,4 mg/kgBW. All premedication was given 90-105 minutes before induction, then Sulfas Atropine was given 30 minutes later. Anxiety status was measured by m-YPAS every 30’; the sedation status and adverse reaction also measured. Preanesthetic agitation level were noted when patients was separated from their parents and introduced to facemask. Infusion cannula was done at the operating room and then inhalation induction was administered. During procedure, the adverse reaction to premedication was noted. At PACU, recovery time and postanesthetic agitation status were noted Main measurement : Pre and postanesthetic agitation level Result : Preanesthetic agitation level in clonidine group was 32% compared to 76% in diazepam group (p<0.01). Postanesthetic agitation level was 44% in clonidine group compared to 79% in diazepam group (p<0.05). There were no difference in adverse reaction in either two group (p>0.05) Conclusion : The oral clonidine premedication 4 mcg/kgBW administered 90-105 minutes before anesthesia was more effective to reduce perioperative agitation compared to oral diazepam 0,4 mg/kgBW

Kata Kunci : Rasio Keuangan,Kebangkrutan,Perusahaan Go Public,Paediatric premedication, Perioperative agitation; Adrenoseptor α2 agonis, Clonidine