Perbandingan antara Pemberian Diet Oral Dini dan Tunda terhadap Bising Usus Pascabedah Sesar dengan Anestesi Spinal

Abstract

Inisiasi diet pascabedah masih merupakan kontroversi pada pasien pascabedah termasuk pada pasien pascabedah sesar. Penelitian ini bertujuan membandingkan waktu kembalinya fungsi gastrointestinal yang dilihat dari munculnya bising usus antara kelompok yang menerima diet oral dini dan diet oral tunda. Uji klinis acak terkontrol tersamar ganda dilakukan pada periode bulan April–Mei 2017 di RSUP Haji Adam Malik Medan, RS Universitas Sumatera Utara Medan, dan RSU Sundari Medan. Sebanyak 40 pasien yang memenuhi kriteria inklusi dan tidak termasuk eksklusi diamati waktu munculnya bising usus pascabedah sesar dan keluhan gastrointestinal yang muncul berupa mual, muntah, dan kembung. Dari 40 pasien tersebut, 20 subjek merupakan kelompok diet oral dini dan 20 subjek lagi merupakan kelompok diet oral tunda. Data dianalisis dengan menggunakan uji chi-square dan Mann-Whitney. Munculnya bising usus tidak berbeda signifikan (p>0,05) antara kedua kelompok dan tidak ada perbedaan yang signifikan dalam hal keluhan mual, muntah, dan kembung pascaoperasi antara kedua kelompok (p>0,05). Pemberian diet oral dini dapat diberikan 2 jam pascaoperasi bedah sesar tanpa penyulit dengan anestesi spinal tanpa keluhan gastrointestinal yang bermakna.

 Kata kunci: Anestesi spinal, bedah sesar, diet oral dini, diet oral tunda, keluhan gastrointestinal

Comparison of Peristaltic Sound between Early and Late Oral Diet Administration  in  Post-Caesarean Section Post-with Spinal Anesthesia

 A controversy still exists for post-operative diet administration, including for post-post-post-caesarean section patients. The aim of this study was to compare the return of gastrointestinal function reflected by the peristaltic sound between groups receiving early oral diets and late oral diets. This was a double blind randomized controlled trial performed from April to May 2017 in Haji Adam Malik General Hospital Medan, North Sumatera University Hospital, Medan, and Sundari General Hospital, Medang on 40 patients who met the inclusion and exclusion criteria. Subjects were observed to determine the time when bowel movement started as well as for gastrointestinal complaints. Of all 40sujects enrolled in this study, 20 were provided with early oral diet nd the remaining 20 subjects received late oral diet group. Data were then analyzed using chi-square and Mann-Whitney tesst The return of peristaltic sound was not significantly different between both groups (p>0.05). No significant difference found in the occurence of post-operative nausea, vomiting, and post-bloating between the two groups (p>0.05). Oral diet may be administered safely 2 hours after uncomplicated cesarean section under spinal anesthesia without any significant gastrointestinal complaint.

Key words: Cesarean section, delayed oral diet, early oral diet, gastrointestinal complication, spinal anesthesia