Insidensi Awareness pada Pasien Pediatrik dengan Anestesi Umum di Gedung Bedah Sentral Terpadu RSUP Dr. Sardjito, Yogyakarta

KUNTUM BASITHA, dr. Djayanti Sari, M.Kes., Sp.An., KAP;dr. Yunita Widyastuti, M.Kes., Sp.An., KAP, Ph.D

2015 | Skripsi | S1 PENDIDIKAN DOKTER

Latar Belakang : Awareness intraoperatif merupakan hal yang terjadi akibat proses anestesi yang tidak adekuat. Awareness merupakan kejadian yang sangat dihindari sehingga insidensinya kecil, yakni pada dewasa sebanyak 0,1% sementara pada anak sebanyak 0,8%. Meski begitu, dampak yang ditimbulkan cukup signifikan terhadap kondisi psikologis dan kepuasan pasien mengenai proses bedah. Penelitian mengenai awareness pada pasien pediatrik belum pernah dilakukan sebelumnya. Tujuan : Mengetahui insidensi awareness pada pasien pediatrik di GBST RSUP Dr. Sardjito. Metode : Penelitian ini menggunakan desain studi observasional. Pasien pediatrik usia 1-18 tahun yang menjalani bedah elektif dengan anestesi umum diukur kedalaman anestesinya menggunakan monitor Index of Consciousness (IoC) dan skor PRST. Tanda awareness lainnya juga dicatat. Hasil yang didapatkan kemudian dikelompokkan sesuai usia, jenis kelamin, status fisik, jenis operasi dan medikasi yang digunakan. Hasil : Insidensi awareness ditemukan pada satu subjek (2.8%) berdasarkan nilai positif pada IoC dan skor PRST. Gerakan tubuh juga tampak pada tiga subjek (8.5%), namun tidak digolongkan sebagai awareness positif. Kesimpulan: Penelitian ini menemukan adanya kejadian awareness di RSUP Dr. Sardjito. Pengambilan keputusan dengan cepat dan tepat saat terjadinya awareness merupakan hal penting untuk meningkatkan keamanan dan kenyamanan pasien saat tindakan anestesi dan bedah.

Background: Intraoperative awareness is a phenomenon caused by inadequate anesthesia. Awareness is a fully avoided case which makes its incidence low, as many as 0.1% in adult and 0.8% in pediatric patient. In spite of the fact, significant impact in patient's psychological condition and satisfaction of the surgery are yielded. Research for awareness in pediatric has never been conducted in Dr. Sardjito General Hospital. Objective: To find out awareness incidence in pediatric patient in Dr. Sardjito General Hospital. Methods: This study was an observational study, 35 pediatric patients aged 1-18 years who went elective surgery under general anesthesia were recruited. Their depth of anesthesia measured by Index of Consciousness (IoC) monitor and PRST score. Another sign of awareness were also recorded. The result then divided into some categories, by age, sex, physical status, type of surgery and medication usage. Result: Awareness found in one subjects (2.8%) based on positive result in IoC and PRST score. Movement also observed in three subjects (8.5%), but couldn't be included as positive awareness. Conclusion: The finding shows the occurrence of intraoperative awareness in Dr. Sardjito General Hospital. The precise decision making is needed when awareness take place to ensure patient safety in anesthesia and surgery practice.

Kata Kunci : Anestesi, Pediatrik, Awareness Intraoperative