Perbandingan efektifitas prabeban koloid gelatin 40 KD ml/kgbb dan kristaloid ringer laktat 10 ml/kgbb untuk mengurangi kejadian ponv pasca operasi ginekologi dengan anestesi umum
SANTOSO, R. Eka, DR. Dr. Sri Rahardjo, Sp.An.,KNA.NCC
2010 | Tesis |Pendahuluan. Kejadian PONV pada operasi ginekologi mayor sekitar 58%. Keadaan hipovolemia, hipoperfusi mempengaruhi terjadinya PONV. Pemberian prabeban koloid gelatin 40 KD dapat menurunkan kejadian PONV dengan cara mempertahankan keadaan euvolemi. Tujuan penelitian ini menilai efektifitas prabeban koloid gelatin 40 KD 10 ml/kgbb dibandingkan dengan kristaloid Ringer Laktat 10 ml/kgbb dalam mengurangi kejadian PONV pasca operasi ginekologi. Metode. Desain penelitian menggunakan double blind, bersifat randomized control trial (RCT) pada 126 pasien yang dilakukan operasi elektif ginekologi dengan anestesi umum di Instalasi Bedah Sentral RSUP Dr. Sardjito Yogyakarta dan rumah sakit jejaring pada bulan Agustus – Oktober 2010. Kelompok A diberikan koloid gelatin 40 KD 10 ml/kgbb dan kelompok B diberikan kristaloid Ringer Laktat 10 ml/kgbb. Kejadian PONV dinilai saat mulai sadar, menit 15, 30, 45, 60, 75, 90, 105, 120, 135, 150, 165, 180, 240 dan 360. Analisa data menggunakan independen tes dan chi square tes dengan tingkat kepercayaan 95%, dan dianggap bermakna bila p < 0,05. Hasil penelitian. Kejadian PONV pada kelompok prabeban koloid gelatin 40 KD 10 ml/kgbb sebanyak 4 orang (6,3%) lebih rendah secara bermakna dibanding kelompok kristaloid Ringer Laktat 10 ml/kgbb sebanyak 12 orang (19%) p<0,05 (p=0,023). Kesimpulan. Pemberian prabeban koloid gelatin 40 KD 10 ml/kgbb dapat menekan kejadian PONV dibandingkan dengan prabeban kristaloid ringer laktat 10 ml/kgbb pada pasca operasi ginekologi dengan anestesi umum (p < 0,05).
Background. The incidence of PONV in major gynecologic surgeries was approximately 58%. The conditions of hypovolemia and hypoperfusion contribute to the occurrence of PONV. The administration of Gellatin colloid 40 kDa preoperatively can reduce PONV occurrence by maintaining euvolemic state. The aim of this study was to assess the effectivity of the administration of 10 ml/kg BW Gellatin colloid 40 kDa and 10 ml/kg BW Ringer’s Lactat crystalloid in lowering the incidence of PONV after gynecologic surgeries. Method. This study employed a double blind, randomized controlled trial design. The population of this study was patients who underwent elective gynecologic surgery under general anesthesia in Central Installation for Surgery in Dr. Sardjito General Hospital Yogyakarta and its networking teaching hospitals including Klaten District Hospital, Bantul District Hospital, Sleman District Hospital, Yogyakarta City District Hospital, Banyumas District Hospital and Cilacap District Hospital from August 2010 to October 2010. The subject of this research: A total of 120 patients were divided into two groups. Group A received 10 ml/kg BW Gellatin colloid 40kDa whereas group B received 10 ml/kg BW Ringer’s Lactat crystalloid preoperatively. PONV was assessed when the patients started to wake up and in the subsequent 15’, 30’, 45’, 60’, 75’, 90’, 105’, 120’, 135’, 150’, 165’, 180’, 240’ and 360’. We performed independent-test and chi-square test for data analysis with a confidence interval of 95%; p<0,05 is considered as significant. Results. PONV occurred in 4 patients (6,3%) in the Gellatin group, this was significantly lower than that in the Ringer’s Lactat group of 12 patients (19%), p < 0,05 (p=0,023). Conclusion. The preoperative administration of 10 ml/kg BW Gellatin colloid 40 kDa could better reduce PONV incidence compared to 10 ml/kg BW Ringer’s Lactat crystalloid after gynecologic surgeries under general anesthesia (p<0,05).
Kata Kunci : PONV,Operasi ginekologi,Koloid,Kristaloid
