Perbandingan Efektivitas antara Ketamin Kumur dan Lidokain Spray untuk Mengurangi Nyeri Tenggorok, Batuk, dan Serak Pascaekstubasi

Purwoko Purwoko; Muhammad Husni Thamrin; Wahyu Hananto

doi:10.15851/jap.v9n3.2464

Perbandingan Efektivitas antara Ketamin Kumur dan Lidokain Spray untuk Mengurangi Nyeri Tenggorok, Batuk, dan Serak Pascaekstubasi

Purwoko Purwoko, Muhammad Husni Thamrin, Wahyu Hananto

Abstract

Nyeri tenggorok adalah komplikasi yang sering dikeluhkan pasien setelah penggunaan pipa endotrakeal pada tindakan anestesi umum. Kejadian nyeri tenggorok dapat dikurangi dengan pemberian agen analgetik. Tujuan penelitian ini mengetahui perbedaan efektivitas antara ketamin kumur dan lidokain spray untuk mengurangi nyeri tenggorok pascaekstubasi. Penelitian dilakukan di Instalasi Bedah Pusat dan kamar rawat inap RSUD Dr. Moewardi Surakarta, dimulai pada bulan Februari–Maret 2018. Penelitian ini bersifat eksperimental dengan double blind randomized control trial pada pasien yang dilakukan anestesi umum dan dipasang pipa endotrakea. Uji Mann Whitney U digunakan untuk mengolah data. Kelompok penelitian dibagi menjadi dua, yaitu kelompok ketamin kumur (I) dan lidokain spray (II). Ketamin kumur lebih efektif mengurangi nyeri tenggorokan, batuk, dan suara serak dibanding dengan lidokain spray mulai 1 jam pascaoperasi dan 6 jam pascaoperasi (p<0,05), sedangkan pada 24 jam pascaoperasi lidokain spray memiliki efektivitas yang hampir sama dengan ketamin kumur.

A Comparative Study on Effectiveness of Ketamine Gargle and Lidocaine Spray for Reducing Sore Throat, Cough, and Hoarseness Post-Extubation

Shore throat is a common complication of endotracheal tube placement under general anesthesia. Administering analgesic agents can reduce the incidence of shore throat. The study aimed to determine the difference in effectiveness between ketamine gargle and lidocaine spray to reduce post-extubation sore throat. The study was conducted at the Central Surgical Installation and Inpatient wards of Dr. Moewardi General Hospital Surakarta in February–March 2018. This experimental study used a double-blind, randomized control trial in patients undergoing general anesthesia with endotracheal tube placement. The Mann-Whitney U test was used to process the data. The research group was divided into ketamine gargle (I) and lidocaine spray (II). Ketamine gargle was more effective in reducing sore throat, cough, and hoarseness than lidocaine spray starting 1 hour postoperatively and 6 hours postoperatively (p<0.05). In contrast, at 24 hours, postoperative lidocaine spray was nearly as effective as ketamine gargle.

Keywords

Batuk, ketamin, lidokain, nyeri tenggorok, suara serak

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References

Kazemi A, Amini A. The effect of betamethasone gel in reducing sore throat, cough, and hoarseness after laryngo-tracheal intubation. Middle East J Anaesthesiol. 2007;19(1):197–204.

Hung NK, Wu CT, Chan SM, Lu CH, Huang YS, Yeh CC, dkk. Effect on postoperative sore throat of spraying the endotracheal tube cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine. Anesth Analg. 2010;111(4):882–6

Bangun CG, Solihat Y, Umar N. Perbandingan efek inflasi cuff lidokain HCl 2% 6 mL + natrium bikarbonat 7,5% 0,6 mL dengan lidokain HCl 1,5 mg/kgBB intravena terhadap kejadian batuk dan hemodinamik sebelum dan sesudah ekstubasi pada anestesi umum. CDK J. 2015;42(6):407–11.

Banihashem N, Alijanpour E, Hasannasab B, Zarei A. Prophylactic effects of lidocaine or beclomethasone spray on post-operative sore throat and cough after orotracheal intubation. Iran J Otorhinolaryngol. 2015;27(80):179–84.

Canbay O, Celebi N, Sahin A, Celiker V, Ozgen S, Aypar U. Ketamine gargle for attenuating postoperative sore throat. Br J Anaesth. 2008;100(4):490–3.

Rudra A, Ray S, Chatterjee S, Ahmed A, Ghosh S. Gargling with ketamine attenuates the postoperative sore throat. Indian J Anaesth. 2009;53(1):40–3.

Anesthesiology. Dalam: Bittner EA, Grecu L, George E, penyuting. Postoperative complications. Edisi ke-3. New York: McGraw Hill; 2017.

Jolly AS, Jain P, Sood J. Ketamine-current uses and future perspectives. J Anaesthesiology Clin Pharm. 2007;23:169–81.

Roth BL, Gibbons S, Arunotayanun W, Huang XP, Setola V, Treble R, dkk. The ketamine analogue methoxetamine and 3- and 4-methoxy analogues of phencyclidine are high affinity and selective ligands for the glutamate NMDA receptor [PLoS One. 2018;13(3):e0194984].

Olszewski M, Dolowa W, Matulewicz P, Kasicki S, Hunt MJ. NMDA receptor antagonist-enhanced high frequency oscillations: are they generated broadly or regionally specific?. Eur Neuropsychopharmacol. 2013;23(12):1795–805

Bassareo V, Cucca F, Cadoni C, Musio P, Di Chiara G. Differential influence of morphine sensitization on accumbens shell and core dopamine responses to morphine- and food-conditioned stimuli. Psychopharmacology (Berl). 2013;225(3):697–706.

Kapur J. Role of NMDA receptors in the pathophysiology and treatment of status epilepticus. Epilepsia Open. 2018;3(Suppl Suppl 2):165–8.

Waelbers T, Polis I, Vermeire S, Dobbeleir A, Eersels J, De Spiegeleer B, dkk. 5-HT2A receptors in the feline brain: 123I-5-I-R91150 kinetics and the influence of ketamine measured with micro-SPECT. J Nucl Med. 2013;54(8):1428–33.

Aroni F, Iacovidou N, Dontas I, Pourzitaki C, Xanthos T. Pharmacological aspects and potential new clinical applications of ketamine: reevaluation of an old drug. J Clin Pharmacol. 2009;49(8):957–64.

Rowland LM, Bustillo JR, Mullins PG, Jung RE, Lenroot R, Landgraf E, dkk. Effects of ketamine on anterior cingulate glutamate metabolism in healthy humans: a 4-T proton MRS study. Am J Psychiatry. 2005;162(2):394–6.

Zhu MM, Zhou QH, Zhu MH, Rong HB, Xu YM, Qian YN, dkk. Effects of nebulized ketamine on allergen-induced airway hyperresponsiveness and inflammation in actively sensitized Brown-Norway rats. J Inflamm (Lond). 2007;4:10.

Shimoda H, Shan SJ, Tanaka J, Maoka T. β-Cryptoxanthin suppresses UVB-induced melanogenesis in mouse: involvement of the inhibition of prostaglandin E2 and melanocyte-stimulating hormone pathways. J Pharm Pharmacol. 2012;64(8):1165–76.

Martinelli SM, DiLorenzo AN, Schell RM. Stoelting’s pharmacology and physiology in anesthetic practice. Edisi ke-5. Philadelphia: Wolters Kluwer; 2015.

Minogue SC, Ralph J, Lampa MJ. Laryngotracheal topicalization with lidocaine before intubation decreases the incidence of coughing on emergence from general anesthesia. Anesth Analg. 2004;99(4):1253–7.

Huang CJ, Tsai MC, Chen CT, Cheng CR, Wu KH, Wei TT. In vitro diffusion of lidocaine across endotracheal tube cuffs. Can J Anaesth. 1999;46(1):82–6.

Fagan C, Frizelle HP, Laffey J, Hannon V, Carey M. The effects of intracuff lidocaine on endotracheal-tube-induced emergence phenomena after general anesthesia. Anesth Analg. 2000;91(1):2015.

DOI: https://doi.org/10.15851/jap.v9n3.2464