Perbandingan Keberhasilan dan Waktu Intubasi Endotrakeal pada Manekin antara Bantal Intubasi Standar dan Bantal Intubasi Modifikasi

Sendy Setiawan Permana, Erwin Pradian, Dedi Fitri Yadi

Abstract


Intubasi pipa endotrakeal adalah standar baku manajemen jalan napas. Direct laryngoscopy dengan memposisikan kepala dan leher secara sniffing position menggunakan bantal agar visualisasi glotis optimal merupakan kunci untuk melakukan tindakan intubasi endotrakea. Tujuan penelitian adalah membandingkan keberhasilan dan lama waktu intubasi endotrakea pada manekin menggunakan bantal intubasi standar dengan bantal intubasi modifikasi. Penelitian menggunakan metode crossover randomized study dengan teknik nonprobability sampling oleh 31 orang residen anestesi pada manekin di ruang skill lab Departemen Anestesiologi dan Terapi Intesif FK Unpad  RSUP Dr. Hasan Sadikin Bandung periode Februari 2018. Penelitian dibagi menjadi kelompok bantal intubasi standar (A) melakukan intubasi endotrakeal menggunakan bantal intubasi standar dilanjutkan menggunakan bantal intubasi modifikasi. Kelompok bantal modifikasi (B) melakukan intubasi endotrakeal dengan bantal intubasi modifikasi dilanjutkan menggunakan bantal intubasi standar, dinilai keberhasilan dan lama waktu intubasi. Data dianalisis dengan uji-t dan Uji Mann-Whitney dengan p<0,05 dianggap bermakna. Analisis data statistik menunjukkan angka keberhasilan yang sama pada kedua kelompok, sedangkan lama waktu intubasi endotrakea lebih singkat pada kelompok bantal modifikasi dibanding dengan kelompok bantal standar yang berbeda bermakna (p<0,05). Simpulan penelitian menunjukkan waktu intubasi menggunakan bantal intubasi modifikasi lebih singkat dibanding dengan menggunakan bantal standar, sedangkan keberhasilan intubasi sama pada kedua kelompok.

Kata kunci: Bantal intubasi, intubasi endotrakea, sniffing position


Comparison of Successful Intubation and Time of Intubation in Mannequin using Standard Intubation Pillow and Modified Intubation Pillow

Endothracheal intubation is the gold standard in airway management. Direct laryngoscopy by positioning the head and the neck in a sniffing position with the help of a pillow will facilitate optimal visualization of the trachea, which is the key to a successful endotracheal intubation. The purpose of this study was to assess the time needed to intubate mannequin using modified intubation pillow when compared to standard intubation pillow. This was a crossover randomized study using nonprobability sampling technique conducted inn March 2018 on of 31 anesthesia residents who were working on a mannequin in the Skill Laboratory of Anesthesiology and Intensive Therapy Department of Dr. Hasan Sadikin General Central Hospital. Subjects were divided into two groups: group A that used the standard intubation pillow, followed by the modified intubation pillow and group B that used the modified intubation pillow, followed by the standard intubation pillow. The success rate and the time needed to intubate were recorded. Data were analyzed using t-test and Mann-Whitney test with a p score of <0.05 considered to be significant. The statistical analysis showed the same success rate in both groups, while the time needed to intubate was shorter in the modified pillow group with p<0.05. Hence, the use of modified intubation pillow shorten the time needed to intubate, while the success rate is similar when compared to standard pillow.

Key words: Endotracheal intubation, intubation pillow, sniffing position


 


Keywords


Bantal intubasi, intubasi endotrakea, sniffing position

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References


Hagberg CA, Artime CA. Airway management in adult. Dalam: Miller RD, penyunting. Edisi ke-8. Philadelphia: Elsevier Saunders; 2015. Hlm. 1647–83 .

El-Orbany M, Woehlck H, Salem MR. Head and neck postion for direct laryngoscopy. Anesth Analg. 2011; vol (113):103–9.

Horton WA , Fahy L, Charters P. defining a standard intubating position using “angel finder”. Br J Anaesth. 1989;62:6–12.

Adnet F, baillard C, Borron SW, Denantes C, Lefebvre L. Randomized study comparing the “sniff position: with simple head extension for laryngoscopic view in elective surgery patients. Anesthesiology. 2001 ; vol (4):836-41.

Kitamura Y, Isono S, Suzuki N, Sato Y, Nishino T. Dynamic interaction of craniofacial structure during head positioning and direct laryngoscopy in anesthezied patients with and without difficult laryngoscopy. Anesthesiology. 2007;107:875–83.

Park SH, Park HP, Jeon YT, Hwang JW, Kim JH, Bahk JH. A comparison of direct laryngoscopic views depending on pillow height. J Anesth 2010;24:526–30.

Kim H, Chang JE, Min SW, Lee JW, Ji S, Hwang JY. A comparison of direct laryngoscopic views in different head and neck position in edentulous patient. AJEM. 2016; vol (9);1855–58.

Schmitt JH, Mang H. Head and neck elevation beyond the sniffing position improves laryngeal view in case of difficult direct laryngoscopy. J Clin Anesth 2002;14:335–8.

Levitan RM, Mechem CC, Ochroch EA. Head-elevated laryngoscopy position: improving laryngeal exposure during laryngoscopy by increasing head elevation. Ann Emerg Med. 2003;41:322–30.

Rich Jm. Use of an elevation pillow to produce the head-elevated laryngoscopy position for airway management in morbidly obese and large framed patients. Anesth Analg. 2004;98: 264–5 .

Mathis A, Muller JP. Intubation time with and without inflatable intubation device. Eur. J. Anaesthesiol. 2007;24:197–8.

Cook TM, Scott S, Mihai R: Litigation related to airway and respiratory complications of anaesthesia: An analysis of claims against the NHS in England. 1995–2007. Anaesthesia 2010;65:556–63.

Cooper JB, Taqueti VR: A brief history of the development of mannequin simulators for clinical education and training. Qual Saf Health Care. 2004; 13 (Suppl 1):i11–8.

Schaefer JJ 3rd: Simulators and difficult airway management skills. Paediatr Anaesth. 2004;14:28–37.

Rai MR, Popat MT: Evaluation of airway equipment: Man or manikin? Anaesthesia 2011;66:1–39.

Cook TM: Novel airway devices: Spoilt for choice? Anaesthesia 2003; 58:107–10.

Siu LW, Boet S, Borges BC, Bruppacher HR, LeBlanc V, Naik VN, Riem N, Chandra DB, Joo HS: High-fidelity simulation demonstrates the influence of anesthesiologists’ age and years from residency on emergency cricothyroidotomy skills. Anesth Analg 2010;111:955–60.

Kory PD, Eisen LA, Adachi M, Ribaudo VA, Rosenthal ME, Mayo PH: Initial airway management skills of senior residents: Simulation training compared with traditional training. Chest 2007;132:1927–31.

Jones F, Passos-Neto CE, Braghioli OFM. Simulation in Medical Education: Brief History and Methodology. PPCR 2015. Hlm 56-63.




DOI: https://doi.org/10.15851/jap.v6n3.1363

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