Pengaruh Duduk 5 Menit Dibanding dengan Langsung Dibaringkan pada Pasien yang Dilakukan Anestesi Spinal dengan Bupivakain Hiperbarik 0,5% 10 mg terhadap Perubahan Tekanan Arteri Rata-rata dan Blokade Sensorik

Raditya Fauzan, Doddy Tavianto, Ruli Herman Sitanggang

Abstract


Anestesi spinal sering kali mengakibatkan hipotensi karena blokade simpatis yang tinggi. Penelitian ini bertujuan melihat pengaruh duduk 5 menit dibanding dengan langsung dibaringkan setelah pemberian anestesi spinal dengan bupivakain 0,5% hiperbarik 10 mg terhadap tekanan arteri rata-rata dan ketinggian blokade sensorik. Penelitian dilakukan dengan metode acak terkontrol tersamar tunggal pada 36 orang pasien dengan status fisik American Society of Anesthesiologist (ASA) I–II yang menjalani operasi perut bagian bawah dan ekstermitas bawah di Rumah Sakit Umum Dr. Hasan Sadikin Bandung pada bulan Maret–Mei 2015. Analisis statistik tekanan arteri rata-rata menggunakan Uji Mann-Whitney dan ketinggian blokade sensorik dengan Uji Kolmogorov Smirnov. Penurunan tekanan arteri rata-rata kelompok 1 (duduk selama 5 menit) lebih sedikit dibanding dengan kelompok 2 (langsung dibaringkan) dengan perbedaan yang bermakna (p<0,05). Ketinggian blokade sensorik rata-rata kelompok 1 terbanyak pada T10 (14 dari 18) dan kelompok 2 pada T6 (8 dari 18). Simpulan, posisi duduk selama 5 menit setelah anestesi spinal dengan bupivakain 0,5% hiperbarik 10 mg menyebabkan penurunan tekanan arteri rata-rata lebih kecil dan ketinggian blokade sensorik lebih rendah dibanding dengan posisi langsung dibaringkan.

Kata kunci: Anestesi spinal, bupivakain 0,5% hiperbarik, blokade sensorik, posisi badan, tekanan arteri rata-rata


Effects of 5-Minute Sitting Compared to Immediately Lying Down After 10 mg of 0.5% Hiperbaric Bupivacaine Administration on Mean Arterial Pressure and Level of Sensory Blockade in Patients Receiving Spinal Anesthesia

Abstract

Spinal anesthesia frequently results in hypotension due to high sympathetic blockade. The aim of this study was to examine effect of sitting for 5 minutes compared to immediately lying down after 10 mg of 0.5% hiperbaric bupivacaine administration with regards to the mean arterial pressure and level sensory blockade in patients who underwentd spinal anesthesia. This was a single blind randomized controlled trial in 36 patients with American Society of Anesthesiologists (ASA) I–II undergoing lower abdominal and lower extremities surgery under spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung during the period of March to May 2015. Data were statistically analyzed using Mann Whitney test for mean arterial pressure and Kolmogorov Smirnov test for level sensory blockade. The results showed a decrease of mean arterial pressure in group 1 (sitting 5 minutes) which was lower than group 2 (immediately lying down) with significant difference (p<0.05). Level of sensory blockade in group 1 at T 10 (14 from 18) was higher than in group 2 at T6 (8 from 18, p=0.001). It is concluded in this study that sitting for 5 minutes after spinal anesthesia using 10 mg 0.5%. bupivacaine hiperbaric decreases the intraoperative sensory of blockade height and mean arterial pressure.

Key words: Bupivacaine, body potition, mean arterial preassure, sensory blockade, spinal anesthesia

 

DOI: 10.15851/jap.v4n1.746


Keywords


Anestesi spinal, bupivakain 0,5% hiperbarik, blokade sensorik, posisi badan, tekanan arteri rata-rata

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