Perbandingan Angka Keberhasilan, Waktu dan Kenyamanan Intubasi Endotrakea antara Operator Posisi Berdiri dan Duduk pada Pasien Posisi Sniffing
Abstract
Kemampuan untuk visualisasi glotis saat melakukan tindakan laringoskopi direk merupakan kunci untuk melakukan tindakan intubasi endotrakea. Posisi sniffing dan ketinggian meja berpengaruh pada visualisasi glotis dan kenyamanan operator saat intubasi endotrakea. Namun, meja operasi sering ditemukan tidak berfungsi dengan baik. Ketersediaan kursi ergonomis diharapkan sebagai alternatif untuk menjawab permasalahan yang terjadi. Tujuan penelitian ini mengetahui perbandingan keberhasilan, waktu, dan kenyamanan operator pada intubasi endotrakea dengan pasien posisi sniffing menggunakan bantal kepala antara operator posisi berdiri dan duduk. Penelitian ini merupakan penelitian prospective randomized paralel trial, dilakukan pada 44 pasien yang menjalani operasi elektif dan emergensi dengan anestesi umum yang memenuhi kriteria inklusi dan tidak termasuk kriteria eksklusi. Penelitian dilakukan di ruang operasi elektif dan emergensi RSUP Dr. Hasan Sadikin pada bulan Oktober 2020. Analisis statistik menggunakan t independent test untuk lama intubasi dan kenyamanan pasien, sedangkan untuk data kategorik dengan uji chi-square. Keberhasilan dan lama waktu intubasi endotrakea pada pasien posisi sniffing menggunakan bantal dengan operator posisi berdiri dan duduk tidak terdapat perbedaan yang signifikan (p>0,05). Pada variabel skor kenyamanan intubasi endotrakea pada pasien posisi sniffing menggunakan bantal dengan operator posisi berdiri dan duduk terdapat perbedaan rerata yang sangat signifikan (p<0,01). Skor kenyamanan intubasi endotrakea posisi duduk lebih baik dibanding dengan posisi berdiri.
Comparison of Success Rate, Time and Comfort of Endotracheal Intubation between Operator Standing and Sitting Position with Patient Sniffing Position
The ability to visualize the glottis during direct laryngoscopy is the key to perform endotracheal intubation. Sniffing position and table height affect visualization of glottis and comfort of the operator. However, the operating table often does not function properly. This study aims to determine the correlation of intubation success rate, intubation time, and operator’s comfort in performing endotracheal intubation on a patient in a sniffing position using a head cushion between standing and sitting position of the operator. This was a prospective randomized trial. The study was conducted on 44 patients who underwent elective and emergency surgery under general anesthesia who qualified the inclusion criteria and did not include the exclusion criteria. The research was conducted in the elective operating room and emergency Dr. Hasan Sadikin Hospital in October 2020. Statistical analysis used the independent t test for intubation time and patient comfort, while for categorical data using the chi-square test. There was no significant difference (p>0.05) in intubation time and success rate of endotracheal intubation on patients in sniffing position using a head cushion between sitting and standing position of the operator. There was a significant mean difference (p<0.01) in operator’s comfort in performing endotracheal intubation on patients in sniffing position using a head cushion between sitting and standing position of the operator. The operator’s comfort score in performing endotracheal intubation was higher in sitting position compared to standing position.
Keywords
Full Text:
PDFReferences
Butterworth JF MD, Wasnick JD, penyunting. Airway management. Morgan and Mikhail’s clinical anestesiology. Edisi ke-6. New York: The MacGraw-Hill Companies; 2020.
Baker P, Timmerman A. Laryngoscopic tracheal intubation. Dalam: Hagberg CA, penyunting. Benumof and Hagberg’s airway management. Edisi ke-4. Philadelpia: Elsevier Saunders; 2018. hlm. 371–90.
Sinha S, Layek A, Bhattacharjee S, Hazra A. The effect of different pillow heights on direct laryngoscopic views: A prospective randomised controlled study. Egyptian J Anaesthesia. 2013 January 10;29:279–83.
Hagberg CA, Artime CA, Aziz MF. Airway management in adult. Dalam: Hagberg CA, penyunting. Benumof and Hagberg’s airway management. Edisi ke-4. Philadelpia: Elsevier Saunders; 2018. hlm. 1647–83.
Lee HC, Yun MJ, Hwang JW, Na HS, Kim DH, Park JY. Higher operating tables provide better laryngeal views for tracheal intubation. Br J Anaesth. 2014;112(4):749–55.
Bajwa S, Kaur J. Risk and safety concerns in anesthesiology practice: the present perspective. Anesth Essays Res. 2012;6(1):14–20.
Breckenridge JD, McAuley JH. Shoulder pain and disability index (SPADI). J Physiother. 2011;57(3):197.
Tandon M, Singh A, Saluja V, Dhankhar M, Pandey CK, Jain P. Validation of a new “objective pain score” vs. “numeric rating scale” for the evaluation of acute pain: a comparative study. Anesth Pain Med. 2016 Feb;6(1):e32101.
Parc J, Bischof J, King A, Greenberger S, Way D, Panchal A, dkk. A randomized comparison of in-hospital rescuer positions for endotracheal intubation in a difficult airway. Western J Emerg Med. 2018;19:660–7.
Chakraborty A. Sniffing position: is it just a gas? J Anaesthesiol Crit Care. 2018;1(3):12.
Amaro-Gahete FJ, Sanchez-Delgado G, Alcantara JMA, Martinez-Tellez B, Acosta FM, Merchan-Ramirez E, dkk. Energy expenditure differences across lying, sitting, and standing positions in young healthy adults. PLOS ONE. 2019;14(6):e0217029.
Cho IY, Park SY, Park JH, Kim TK, Jung TW, Lee HM. The effect of standing and different sitting positions on lumbar lordosis: radiographic study of 30 healthy volunteers. Asian Spine J. 2015 2015;9(5):762–9.
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(4):526–30.
Alam DSS, Redjki IS, Suwarman. Perbandingan ketinggian bantal 4,5 cm dan 9 cm terhadap visualisasi glotis saat laringoskopi di RSUP Dr. Hasan Sadikin Bandung. JAP. 2017;5(3):180–6.
DOI: https://doi.org/10.15851/jap.v9n2.2424
Article Metrics
Abstract view : 1111 timesPDF - 690 times
This Journal indexed by
JAP is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
View My Stats