Perbandingan Efek Pemberian Eritromisin 250 mg Oral dengan Metoklopramid 10 mg Oral terhadap Jumlah dan pH Cairan Lambung pada Pasien yang Menjalani Operasi Elektif dengan Anestesi Umum

Andi Mursali, Tinni T. Maskoen, Doddy Tavianto

Abstract


Aspirasi pulmonal akibat isi lambung merupakan penyebab kematian yang berhubungan dengan anestesi. Eritromisin 250 mg oral dan metoklopramid 10 mg oral digunakan untuk menurunkan jumlah dan meningkatkan pH cairan lambung. Penelitian ini bertujuan membandingkan efek eritromisin 250 mg oral dan metoklopramid 10 mg oral terhadap jumlah dan pH cairan lambung pasien yang menjalani operasi elektif dengan anestesi umum. Penelitian ini merupakan uji klinis acak buta ganda pada 42 pasien yang termasuk dalam kriteria inklusi pasien dengan American Society of Anesthesiologist (ASA) kelas I, usia 18–60 tahun, dijadwalkan operasi elektif dengan anestesi umum dan diintubasi di Rumah Sakit Dr Hasan Sadikin Bandung periode Agustus–September 2015. Pasien dibagi menjadi 2 kelompok 21 orang masing-masing. Kelompok A mendapatkan eritromisin 250 mg oral dan kelompok B metoklopramid 10 mg oral yang diberikan 1 jam sebelum induksi anestesi. Setelah dilakukan intubasi, cairan lambung diambil menggunakan spuit 50 mL melalui nasogastric tube (NGT) no 18, dimasukkan ke gelas ukur, diukur jumlah dan pH nya. Analisis statistik menggunakan uji Mann–Whitney. Hasil menunjukkan kelompok A didapatkan 90,5% pasien dengan jumlah cairan <25 mL, sedangkan kelompok B 57,1%, perbedaan bermakna secara statistik (p<0,014). Simpulan, eritomisin 250 mg oral lebih menurunkan jumlah dan meningkatkan pH cairan lambung dibanding dengan metoklopramid 10 mg oral pada pasien yang menjalani anestesi umum.


Kata kunci: Eritromisin, jumlah cairan lambung, metoklopramid, pH cairan lambung

 

Comparison of the Effect of 250 mg Oral Erythromycine and 10 mg Oral Metoclopramide on Gastric Fluid Volume and pH in Patients Undergoing Elective Operation in General Anesthesia

Pulmonary aspiration caused by gastric contents is one of the leading causes of anesthesia-related deaths. Combination of >25 mL volume and a <2.5 pH is a high risk to lung damage. Oral Erythromycin 250 mg and Oral metoclopramide 10 mg can be used to reduce the gastric fluid volume and increase the gastric fluid pH. The purpose of this study was compare the effects between oral erythromycin 250 mg and oral metoclopramide 10 mg on the volume and pH of gastric fluid in patients undergoing elective general anesthesia. This study was a double blind randomized clinical trial on 42 patients who met the inclusion criteria. Patients were divided into 2 groups with 21 patients in each group. Group A received 250 mg of oral erythromycin and group B received 10 mg of metoclopramide, 1 hour before the induction of anesthesia.After intubation, gastric fluid was collected using a 50 mL syringe via the nasogastric tube (NGT). It was then placed in a beaker glass to have its volume and pH measured. A statistical analysis using the Mann–Whitney test was performed. In group A, 90.5% of patients were found to have gastric fluid volume <25 mL, while group B had 57.1%, in which the difference was statistically significant (p <0.014). Hence, the administration of erythromycin 250 mg orally is more effective in reducing the gastric fluid volume and increasing the gastric fluid pH compared to oral administration of etoclopramide 10 mg in patients undergoing general anesthesia.

Key words: Erythromycin, gastric fluid volume, metoclopramid, gastric pH


DOI: 10.15851/jap.v5n1.1000



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