Perbandingan Pemberian 20 mL dengan 30 mL Bupivakain 0,5% terhadap Mula Kerja dan Lama Kerja Blokade Saraf Iskiadikus Pendekatan Parasakral Menggunakan Alat Stimulasi Saraf pada Operasi Ekstremitas Bawah

Canang irving Amrizal, Dedi Fitri Yadi, Rudi Kurniadi Kadarsah

Abstract


Blokade saraf iskiadikus pendekatan parasakral merupakan salah satu pilihan anestesi untuk operasi ekstremitas bawah. Blokade ini memiliki angka keberhasilan yang tinggi dan membutuhkan anestetik lokal yang lebih sedikit. Penelitian ini bertujuan membandingkan pemberian 20 mL dengan 30 mL bupivakain 0,5% terhadap mula kerja dan lama kerja blokade saraf iskiadikus pendekatan parasakral menggunakan alat stimulasi saraf di Rumah Sakit Dr. Hasan Sadikin Bandung dan RSD Dr. Slamet Garut selama periode bulan Oktober–November 2015. Penelitian eksperimental secara randomized controlled trial dilakukan pada 36 pasien dewasa yang menjalani operasi ekstremitas bawah. Pasien dibagi dalam dua kelompok secara acak, tiap-tiap kelompok terdiri atas 18 pasien. Kelompok A mendapatkan bupivakain 0,5% sebanyak 20 mL dan kelompok B mendapatkan 30 mL. Hasil menunjukkan bahwa mula kerja blokade sensorik dan motorik pada kedua kelompok tidak berbeda bermakna (p>0,05). Hasil penelitian menggunakan uji-t dan uji Mann Whitney menunjukkan bahwa lama kerja blokade sensorik dan motorik pada kelompok A lebih singkat bermakna dibanding dengan kelompok B (p<0,05). Simpulan penelitian ini adalah pemberian 20 mL bupivakain 0,5% pada blokade saraf iskiadikus pendekatan parasakral menghasilkan mula kerja blokade sensorik dan motorik yang sama cepat dan lama kerja blokade sensorik dan motorik yang lebih singkat dibanding dengan pemberian 30 mL bupivakain 0,5%.

Kata kunci: Blokade saraf iskiadikus, bupivakain, lama kerja blokade, mula kerja blokade, pendekatan parasakral


Comparison of Onset and Duration of Action between 20 mL with 30 mL of 0.5% Bupivacaine on Ischiadicus Nerve Block with Parasacral Approach Assisted by a Nerve Stimulator for Lower Ekstremity Surgery

Ischiadicus nerve block with parasacral approach is an anesthetic option for surgery in the lower extremity. This method offers many advantages such as high rate of successful block and less use of local anesthetic agent. The purpose of this study was to compare the onset and duration of action of ischiadicus nerve block with parasacral approach assisted by a nerve stimulator using 20 mL of 0.5% bupivacaine to 30 mL of 0.5% bupivacaine in Dr. Hasan Sadikin General Hospital Bandung and Dr. Slamet Hospital Garut between the period of October to November 2015. This experimental randomized controlled study was performed on 36 adult patients undergoing lower extremity surgeries. Patients were divided randomly into two groups consisting of 18 patients. Group A was given 20 mL of 0.5% bupivacaine while group B was given 30 mL of 0.5% bupivacaine. The onset and duration of action of sensory and motoric blocks were recorded. The t-test and Mann Whitney test used in this study showed that the duration of sensory and motoric blocks in group A was significantly shorter than that of group B (p<0.05). It is concluded that the ischiadicus nerve block with parasacral approach using 20 mL of 0.5% bupivacaine has the same onset but shorter duration of sensory and motoric blocks compared to 30 mL of 0.5% bupivacaine.

Key words: Bupivacaine, duration of block, ischiadicus nerve block, onset of block, parasacral approach


DOI: 10.15851/jap.v5n1.1004


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