Perbandingan Efek Durasi Blokade Sensorik dan Motorik, Gejolak Hemodinamik, serta Efek Samping Deksmedetomidin dengan Fentanil sebagai Adjuvan pada Anestesi Spinal

Heri Dwi Purnomo, Fitri Hapsari Dewi, Frans Kausario Muslihan


Fentanil dan deksmedetomidin merupakan agen yang berpotensi baik sebagai adjuvan anestesi spinal. Penelitian ini bertujuan menilai kecepatan mula kerja, pemanjangan lama kerja blokade sensorik dan motorik anestesi spinal, termasuk pengaruhnya terhadap gejolak hemodinamik serta efek samping. Penelitian ini merupakan single blind randomized control trial untuk membandingkan pengaruh penambahan deksmedetomidin 3 mcg dengan fentanil 25 mcg pada lidokain 75 mg hiperbarik yang diberikan sebagai anestesi spinal di kamar instalasi bedah sentral RSUD Dr. Moewardi Surakarta bulan Maret–Mei 2018. Subjek penelitian adalah pasien usia 19–64 tahun yang menjalani pembedahan abdomen bagian bawah dan ekstremitas bawah secara elektif dengan anestesi spinal dengan ASA I dan II. Hasil penelitian menunjukkan bahwa terdapat pengaruh penambahan deksmedetomidin dan fentanil pada lidokain 5% yang diberikan sebagai anestesi spinal, dengan menilai perbedaan kecepatan onset dan pemanjangan durasi blokade sensorik dan motorik, yaitu penambahan deksmedetomidin 3 mcg (diencerkan dalam NaCl 0,9% 0,5 mL) pada 1,5 mL Lidokain 5% lebih efektif dalam pemanjangan durasi blokade sensorik dan motorik dibanding dengan penambahan fentani 25 mcg (0,5 mL) pada 1,5 mL lidokain 5% dan tidak berbeda pengaruhnya pada perubahan tanda vital dan juga tidak meningkatkan efek samping.


Comparison of Effects of Sensory and Motor Blockade Duration, Hemodynamic Fluctuations, and Side Effects of Dexmedetomidine with Fentanyl as Adjuvant in Spinal Anesthesia

Fentanyl and dexmedetomidine are potentially suitable adjuvants to spinal anesthesia. This study aimed to assess the initial onset of work and prolongation of the duration of sensory and motor blockade of spinal anesthesia, including the effect on hemodynamic turbulence that appears and the occurrence of adverse effects. This study was a single-blind randomized control trial, comparing the impact of adding 3 mcg of dexmedetomidine with 25 mcg fentanyl on hyperbaric lidocaine 75 mg given as spinal anesthesia in the operating room of the central surgical installation of RSUD Dr. Moewardi Surakarta from March–May 2018. The research subjects were patients aged 19–64 who underwent elective abdominal and lower extremity surgery under spinal anesthesia with ASA I and II physical status and obtained informed consent. Based on the results of the study, it found that there was an effect of adding dexmedetomidine and fentanyl to 5% lidocaine given as spinal anesthesia by assessing the difference in the speed of onset and the prolongation of the duration of sensory and motor blockade. The addition of dexmedetomidine 3 mcg (diluted in 0.9% NaCl 0.5 mL) to 1.5 mL lidocaine was 5% more effective in prolonging the duration of sensory and motor blockade compared to 25 mcg fentanyl (0.5 mL) at 1.5 mL 5% lidocaine and no difference in changes in vital signs. Moreover, it also did not increase the occurrence of side effects.



Adjuvan, deksmedetomidin, fentanil, spinal

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