Perbandingan Angka Keberhasilan dan Lama Intubasi antara Metode Laringoskopi Direk dan Videolaringoskopi pada Pasien Obesitas
Abstract
Obesitas merupakan salah satu prediktor independen jalan napas sulit. Laringoskopi direk menggunakan laringoskop Macintosh merupakan teknik standar yang paling sering digunakan untuk intubasi endotrakeal. Penggunaan videolaringoskop (VL) telah meningkatkan angka keberhasilan intubasi pada pasien dengan jalan napas sulit dan memberikan waktu intubasi yang lebih singkat dibanding dengan laringoskopi direk. Penelitian ini bertujuan mengetahui perbandingan angka keberhasilan dan lama intubasi antara metode laringoskopi direk dan videolaringoskopi pada pasien obesitas. Penelitian ini menggunakan metode prospektif analitik komparatif eksperimental, randomized single blind study dengan jumlah sampel sebanyak 22 pasien di Instalasi Bedah Sentral RSUP Dr. Hasan Sadikin Bandung pada periode November 2020–Januari 2021. Analisis statistik menggunakan Uji Eksak Fisher dan t dua kelompok independen. Dilakukan penilaian keberhasilan dan lama waktu intubasi endotrakeal setiap kelompok yang diuji. Pada kelompok VL, intubasi endotrakeal berhasil dilakukan pada 11 subjek dengan tidak ada subjek gagal, sementara pada kelompok direk didapatkan 6 subjek berhasil dan 5 subjek gagal. Lama intubasi pada kelompok VL rerata 27,69±7,73 detik dan kelompok direk 26,73±4,53 detik. Penelitian ini memberikan hasil angka keberhasilan intubasi endotrakeal dengan metode videolaringoskopi lebih tinggi secara signifikan (p<0,05) dengan waktu intubasi lebih lama yang tidak signifikan secara statistik (p>0,05). Simpulan, penggunaan metode videolaringoskopi pada saat intubasi pada pasien obesitas meningkatkan keberhasilan intubasi, namun tidak mempersingkat lama waktu intubasi.
Comparison of Success Rate and Intubation Time between Direct Laryngoscopy and Videolaryngoscopy Methods on Obese Patients
Obesity is one of independent predictors of difficult airway. Direct laryngoscopy with Macintosh blade is the frequent standard technique for endotracheal intubation. The use of videolaryngoscope has increased the success rate of intubation in patients with difficult airway and provided a shorter intubation time compared to direct laryngoscopy. The purpose of the study was to compare the result and time discrepancy when intubating obese patients with direct laryngoscopy and videolaryngoscopy methods. This study used prospective analytical comparative experimental, randomized single blind methods, on 22 patients at the central operating theatre Dr. Hasan Sadikin Hospital, Bandung during November 2020–January 2021. The study assessed the successful result and duration in doing endotracheal intubation from each study groups. In videolaryngoscopy group, 11 subjects were intubated successfully with no subject failed, while in group with direct laryngoscopy, 6 subjects were intubated successfully and 5 subjects failed. The mean time duration rate used to intubate in videolaryngoscopy group was 27.69±7.73 seconds, meanwhile in group with direct laryngoscopy was 26.73±4.53 seconds. The study shows higher successful rate of endotracheal intubation significantly (p<0.05) and longer time duration of intubation that is not significant statistically (p>0.05) in videolaryngoscopy group. In conclusion, intubation using videolaryngoscope increase the success of intubation but not lessen the duration of intubation time in obese patients.
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DOI: https://doi.org/10.15851/jap.v9n2.2426
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