Efek Granisetron Intravena terhadap Perubahan Tekanan Darah pada Seksio Sesarea dengan Anestesi Spinal

Jaya Supriyanto, Suwarman Suwarman, Iwan Abdul Rachman

Abstract


Hipotensi merupakan komplikasi paling sering pada seksio sesarea dengan anestesi spinal. Pencegahan hipotensi dapat dilakukan dengan pemberian cairan, obat-obatan, pengurangan dosis obat anestesi lokal, dan intervensi mekanik. Granisetron sebagai antagonis reseptor 5hydroxytryptamine3 (5HT3) dapat digunakan untuk mencegah hipotensi pada seksio sesarea dengan anestesi spinal. Penelitian ini bertujuan mengetahui pengaruh pemberian granisetron 1 mg intravena terhadap perubahan tekanan darah pada seksio sesarea dengan anestesi spinal. Penelitian ini dilakukan periode Desember 2019–Februari 2020 di RSUP Dr. Hasan Sadikin Bandung. Metode penelitian ini adalah uji klinis tersamar ganda pada 34 pasien ASA II yang menjalani seksio sesarea dengan anestesi spinal. Subjek penelitian dibagi secara acak menjadi 2 kelompok, yaitu kelompok kontrol diberikan NaCl 0,9% dan kelompok granisetron diberikan granisetron 1 mg intravena pada 5 menit sebelum anestesi spinal. Tekanan darah diperiksa setiap 1 menit selama 20 menit setelah anestesi spinal, kemudian setiap 2,5 menit sampai operasi selesai. Data dianalisis dengan uji t, Uji Mann Whitney, dan Uji kolmogorov-smirnov, nilai p<0,05 dianggap bermakna. Kejadian hipotensi pada kelompok kontrol (79%) lebih tinggi dari kelompok granisetron (29%). Penurunan tekanan darah pada kelompok kontrol lebih besar dibanding dengan kelompok granisetron dengan perbedaan signifikan (p<0,05). Simpulan, pemberian granisetron 1 mg intravena dapat mengurangi kejadian hipotensi pada seksio sesarea dengan anestesi spinal.


Effect of Intravenous Granisetron on Blood Pressure in Cesarean Section under Spinal Anesthesia

Hypotension is the most frequent complication in cesarean section with spinal anesthesia. The prevention of hypotension includes fluid and drugs administration, lower local anesthetic doses, and mechanic interventions. Granisetron is a 5HT3 receptor antagonist that can be used to prevent hypotension in cesarean section with  spinal anesthesia. This study aimed to determine the effects of intravenous administration of 1 mg granisetron on blood pressure in patients undergoing cesarean section with spinal anesthesia. This study was a double blinded clinical study on 34 patients ASA II undergoing cesarean sections with spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, during the period of December 2019 to February 2020. Subjects were  divided randomly into 2 groups; a control group that received 0.9% NaCl  and a granisetron group that received 1 mg intravenous granisetron 5 minutes before spinal anesthesia.  Blood pressure was evaluated every minute for 20 minutes after the spinal anesthesia, and then every 2.5 minutes until the surgery was  completed.  Data were analyzed using t-test, Mann Whitney test, and Kolmogorov-Smirnov test with p value<0.05 considered significant. Incidence of hypotension in the control group was higher than the granisetron group (79%vs29%) with blood pressure decrease significantly higher in the control group (p<0.05). Thus, administration of intravenous 1 mg granisetron may reduce the incidence of hypotension in cesarean sections with spinal anesthesia.

Keywords


Anestesi spinal, hipotensi, granisetron, seksio sesarea

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DOI: https://doi.org/10.15851/jap.v8n2.2041



 

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