Efektivitas Penambahan Natrium Bikarbonat 1 mEq pada Lidokain 2% dalam Balon ETT untuk Pencegahan Nyeri Tenggorokan Pascaintubasi
Abstract
Pemberian lidokain dalam balon selang endotrakeal dapat berdifusi menyebar menembus dinding membran semipermeabel selang endotrakeal dan merangsang efek anestesi pada trakea. Alkalinisasi lidokain menggunakan natrium bikarbonat (NaHCO3) diprediksi dapat meningkatkan presentasi fraksi obat tidak terionisasi sehingga diharapkan dapat lebih efektif. Penelitian ini bertujuan mengetahui efektivitas penambahan natrium bikarbonat 1 mEq pada lidokain 2% dalam balon ETT untuk pencegahan nyeri tenggorokan pascaintubasi. Penelitian ini menggunakan metode double-blind randomized controlled trial dari Juli–September 2020 di Rumah Sakit Moewardi Surakarta. Teknik pengambilan sampel dilakukan dengan non-probability sampling dengan metode consecutive sampling yang berjumlah 36 pasien ASA I–II. Sesaat setelah intubasi, balon selang endotrakeal dikembangkan dengan lidokain 2% dan lidokain 2% ditambah NaHCO3 1 mEq pada tiap-tiap kelompok hingga tekanan 20–30 cmH2O. Pasien yang telah menjalani operasi dinilai skala nyeri tenggorokan pascaoperasi dan dievaluasi komplikasi yang terjadi selama 24 jam. Data demografik dan durasi anestesi pada kedua kelompok tidak berbeda bermakna secara statistik (p>0,05). Skor nyeri tenggorokan pada waktu 30–60 menit, 6–8 jam, dan 24 jam pascaoperasi, kelompok lidokain 2% ditambah NaHCO3 1 mEq (LN) lebih rendah dibanding dengan kelompok lidokain 2% murni (L). Berbeda bermakna secara statistik (p<0,05) pada waktu 30–60 menit dan 6–8 jam, tetapi tidak bermakna secara statistik (p>0,05) pada jam ke-24. Tidak didapatkan komplikasi berkaitan dengan overdosis. Simpulan, pada grup LN lebih efektif dibanding dengan grup L untuk pencegahan nyeri tenggorokan pascaintubasi.
Sodium Bicarbonate Efficacy to Lidocaine in Prevention of Sore Throat Post ETT Balloon Intubation
When lidocaine is injected into the ETT cuff, it spreads through the semi-permeable membrane wall and induces anesthesia in the trachea. Alkalinization of lidocaine with sodium bicarbonate (NaHCO3) to increase the non-ionized lidocaine is expected to be more effective. This study aimed to determine the effectiveness of adding one mEq NaHCO3 to lidocaine into the ETT cuff to prevent sore throat post-intubation. This study used a double-blind, randomized controlled trial from July to September 2020 at the Moewardi Regional General Hospital Surakarta. The method used was non-probability sampling with consecutive sampling, totaling 36 ASA I-II patients. Shortly after intubation, the ETT cuff was inflated with 2% lidocaine and 2% lidocaine plus one mEq NaHCO3 in each group. Patients who had undergone surgery were assessed on the postoperative sore throat scale and observed for complications for 24 hours. Both groups' demographic data and anesthesia duration were not statistically significant (p>0.05). Sore throat scores at 30-60 minutes, 6-8 hours, and 24 hours after surgery were lower in the 2% lidocaine plus one mEq NaHCO3 (LN) group than in the 2% lidocaine (L) group. It was statistically significant (p<0.05) at 30-60 minutes and 6-8 hours but not significant (p>0.05) at 24 hours. No complications were associated with lidocaine overdose, systemic toxicity, or ETT balloon rupture. In conclusion, the LN group is more effective than the L group in reducing the incidence of postoperative sore throat.
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DOI: https://doi.org/10.15851/jap.v10n2.2431
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