Perbandingan Ketinggian Bantal 4,5 cm dan 9 cm terhadap Visualisasi Glotis Saat Laringoskopi di Rumah Sakit Dr. Hasan Sadikin Bandung

Mohamad Deny Saeful Alam, Suwarman Suwarman, Ike Sri Redjeki

Abstract


Intubasi ialah prosedur baku mempertahankan patensi jalan napas dengan melihat secara langsung glotis melalui alat laringoskop. Visualisasi glotis akan lebih jelas pada saat tindakan laringoskopi langsung pada sniffing position. Ketinggian bantal yang berbeda akan memberikan visualisasi glotis yang berbeda pula. Penelitian ini merupakan penelitian eksperimen kuasi. Jumlah sampel penelitian 30 orang dengan 2 perlakuan berbeda, yaitu bantal dengan ketinggian 4,5 cm dan 9 cm. Pemilihan subjek penelitian dilakukan secara consecutive sampling dengan mengambil setiap subjek penelitian yang memenuhi kriteria inklusi. Subjek penelitian semua pasien yang menjalani operasi elektif dengan anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung periode Juli 2015 yang memenuhi kriteria inklusi. Tujuan penelitian ini adalah mengetahui pengaruh pemakaian bantal 4,5 cm dibanding dengan bantal 9 cm terhadap nilai visualisasi glotis.  Visualisasi glotis dengan ketinggian bantal yang berbeda pada saat tindakan laringoskopi langsung dinilai menggunakan skala kelas Cormarck–Lehane (CL) dan skor percentage of glotic opening (POGO). Distribusi data dengan uji Shapiro Wilks, nilai p ditentukan menggunakan uji Wilcoxon dan bermakna jika p<0,05. Hasil penelitian ini menunjukkan bahwa nilai skala CL modifikasi kedua bantal berada pada kisaran  skala 1 hingga 2c (p=0,007). Skor  POGO bantal ketinggian 4,5 cm berada pada kisaran  20–100% dengan rata-rata 69,33±21,48%. Bantal ketinggian 9 cm skor POGO berada pada kisaran 30,00–80,00% dengan nilai rata-rata 58,333±15,33% (p=0,001). Simpulan, penggunaan bantal ketinggian 4,5 cm memberikan visualisasi glotis yang lebih baik saat laringoskopi langsung dibanding dengan  bantal ketinggian 9 cm.


Comparison of 4.5 cm and 9 cm Pillow Height in Glottis Visualization on Laryngoscopy at Dr. Hasan Sadikin General Hospital

Intubation is a standard procedure to maintain patency of the airway by  directly visualizing glottis with a laryngoscope. Visualization of the glottis will be clearer when direct laryngoscopy is performed in sniffing position. Different pillows heights will provide different visualization of the glottis. This study was a quasi-experimental study on 30 subjects who were divided into 2 experimental groups of 4.5 cm and 9 cm pillow heights. Subjects were sampled consecutively according to the inclusion and exclusion criteria. The population was all patients underwent elective surgery with general anesthesia at Dr. Hasan Sadikin Hospital Bandung during the period of July 2015. The purpose of this study was to determine the effect of using a pillow height of 4.5 cm when compared to 9 cm pillow height on glottis visualization based on an assessment using Cormarck–Lehane (CL) scale and percentage of glotic opening (POGO) scores. Data distribution was tested by Shapiro Wilks while the p values were determined using Wilcoxon test and was considered meaningful if p<0.05. The results showed that the value of modified CL–class scale for both pillow heights were in the range scale of 1 to 2c (p=0.007). The POGO scores of the 4.5 cm pillow height was in the range of 20–100% with an average percentage of 69.33±21.48%, while the POGO scores of the 9 cm pillow height were in the range of 30.00–80.00% with an average score of 58.333±15.33% (p=0.001). Therefore, the use of 4.5 cm pillow height gives better glottis visualization in direct laryngoscopy compared to the 9 cm pillow height.


Keywords


Ketinggian bantal, laringoskopi langsung, sniffing position, visualisasi glotis

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DOI: https://doi.org/10.15851/jap.v5n3.1170

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