Efektivitas Penggunaan Prewarming dan Water Warming untuk Mengurangi Penurunan Suhu Intraoperatif pada Operasi Ortopedi Ekstremitas Bawah dengan Anestesi Spinal

Abstract

Laju penurunan suhu inti tubuh dapat dikurangi dengan tindakan pemanasan sebelum operasi (prewarming) selama 30 menit dan menggunakan alas penghangat water warming selama operasi. Tujuan penelitian ini untuk mengetahui efektivitas prewarming dan alas penghangat water warming dalam mengurangi penurunan suhu intraoperatif. Penelitian dilakukan dengan metode acak terkontrol buta tunggal terhadap 30 pasien di ruang operasi bedah sentral Rumah Sakit Dr. Hasan Sadikin Bandung pada Mei–Juli 2013 yang dikelompokkan menjadi tiga, yaitu kelompok yang dilakukan prewarming selama 30 menit dan menggunakan alas penghangat water warming selama operasi, kelompok pasien yang menggunakan alas penghangat water warming selama operasi, dan kelompok kontrol. Pencatatan suhu inti tubuh dilakukan pada membran timpani tiap 15 menit sejak awal induksi sampai operasi selesai. Analisis data hasil penelitian dilakukan dengan uji statistik yaitu uji chi-kuadrat, uji-t, Uji Friedman dan uji analysis of variance (ANOVA) dengan nilai p<0,05 dianggap bermakna. Suhu inti tubuh rata-rata pada kelompok prewarming dan water warming 36,62 °C (p=0,023), kelompok water warming 36,24 °C (p<0,001), dan kelompok kontrol 35,94 °C (p<0,001) yang secara statistik berbeda signifikan. Simpulan penelitian ini adalah penggunaan prewarming dan water warming dapat mengurangi dan memperlambat derajat penurunan suhu selama operasi.

Kata kunci: Prewarming, suhu inti tubuh, water warming

Effectiveness of Prewarming and Water Warming to Reduce Intraoperative Temperature Decrease on Spinal Anesthesia for Lower Extremity Orthopedic Surgery

The decline rate of core body temperature can be reduced by perioperative care such as prewarming (the application of heat to patient’s body prior to surgery) for 30 minutes and by using a water warming pad during surgery. The purpose of this study was to determine the effectiveness of prewarming and water warming pad to reduce intraoperative temperature decrease on spinal anesthesia. This study was conducted by a single-blind randomized controlled trials method involving 30 patients in central operating theatre Dr. Hasan Sadikin Hospital-Bandung within May–July 2013 were classified into three groups, the group of prewarming patients performed for 30 minutes and were using water warming pad during surgery; the group of patients without prewarming and were using water warming pad during surgery; and the control group. Core body temperature on tympanic membrane was recorded every 15 minutes from the initial induction through the end of operation. The result data were analyzed by using chi-square (χ2) test, t test, Friedman Test and ANOVA test, in which the value of p<0.05 was considered significant. Average core body temperature of the prewarming and water warming pad group was 36.62 °C (p=0.023), the water warming pad group was 36.24 °C (p<0.001), and the control group was 35.94 °C (p<0.001), this result statistically significant. The conclusion of this study is prewarming prior to surgery and the use of water warming pad during surgery could reduce temperature decline rate during operation.

Key words:  Core body temperature, prewarming, water warming 

DOI: 10.15851/jap.v1n2.119