Pengaruh Pemberian Minuman Karbohidrat (Maltodekstrin 12,5%) Praoperasi terhadap Kejadian Mual dan Muntah Pascamastektomi

Andre Aditya; Iwan Fuadi; Iwan Abdul Rachman

doi:10.15851/jap.v8n2.2039

Pengaruh Pemberian Minuman Karbohidrat (Maltodekstrin 12,5%) Praoperasi terhadap Kejadian Mual dan Muntah Pascamastektomi

Andre Aditya, Iwan Fuadi, Iwan Abdul Rachman

Abstract

Mual dan muntah pascaoperasi (postoperative nausea and vomiting, PONV) menjadi masalah yang umum terjadi setelah operasi mastektomi dengan angka kejadian berkisar 21–92%. Pemberian minuman karbohidrat (CHO) praoperasi ditawarkan sebagai sebuah solusi menurunkan PONV dan juga merupakan salah satu komponen penting dan disarankan untuk mencapai enhanced recovery after surgery (ERAS). CHO berhubungan dengan penurunan katabolisme dan resistensi insulin pascaoperasi. Penelitian ini bertujuan mengetahui pengaruh pemberian minuman berkarbohidrat (CHO) oral sebelum operasi terhadap tingkat kejadian PONV pascaoperasi mastektomi. Penelitian menggunakan eksperimental uji acak buta tunggal di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada November 2019–Februari 2020. Sebanyak 46 pasien dibagi menjadi dua kelompok, yakni kelompok K (kelompok kontrol, air mineral, n=23 subjek) dan kelompok C (kelompok CHO, n=23 subjek). Analisis data hasil penelitian dilakukan dengan Uji Mann-hitney. Kejadian mual muntah pada kelompok kontrol lebih besar dibanding dengan kelompok CHO pada menit 0–30 (57% vs 22%), pada menit 30–60 (91% vs 61%), dan pada menit 60–120 (78% vs 61%) dengan perbedaan yang bermakna (p<0,05). Simpulan, pemberian minuman karbohidrat praoperasi dapat menurunkan kejadian mual muntah pascamastektomi dibandingkan dengan kelompok kontrol.

Effect of Preoperative Oral Carbohydrate Supplementation (Maltodextrin 12.5%) on Post-Mastectomy Nausea and Vomiting Incidence

Postoperative nausea and vomiting (PONV) is a common problem after surgery. Mastectomy is one of surgeries with a high-risk for PONV, which is seen in 21–92% of the patients. Preoperative carbohydrate (CHO) drinks are offered to reduce PONV. The provision of CHO is also important as it is recommended to obtain enhanced recovery after surgery (ERAS). CHO is associated with reduced catabolism and postoperative insulin resistance. This study aimed to determine the effect of oral carbohydrate (CHO) drinks before surgery on the incidence of postoperative PONV in mastectomy. This was an experimental single-blind randomized study conducted in Dr. Hasan Sadikin General Hospital (RSHS) Bandung, Indonesia. A total of 46 patients were divided into two groups, namely group K (control group, mineral water, n=23 subjects) and group C (CHO group, n=23 subjects). Data collected were then analyzed using the Mann Whitney test and the results showed that during PONV incidence rates were significantly higher 0–30 minutes after the surgery (57% vs 22%), 30–60 minutes after the surgery (91% vs 61%), and 60–120 minutes (78% vs 61%) (p < 0.05). Therefore, the administration of preoperative carbohydrate drinks can reduce the incidence of postoperative nausea and vomiting in mastectomy.

Keywords

Mastektomi, maltodekstrin 12,5%, CHO, post operative nausea vomiting, enhanced recovery after surgery

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DOI: https://doi.org/10.15851/jap.v8n2.2039