Perbedaan Waktu Pulih Sadar Anestesi Umum Sevofluran dengan Premedikasi Midazolam dan tanpa Premedikasi Midazolam

Purwoko Purwoko, Ardana Tri Arianto, Djoko Tjahyo Nugroho

Abstract


Pemberian premedikasi midazolam memberikan efek sedasi yang panjang sehingga menimbulkan pulih sadar yang lebih lama. Tujuan penelitian ini adalah mengetahui perbedaan waktu pulih sadar anestesi umum sevofluran dengan dan tanpa premedikasi midazolam. Penelitian ini merupakan double blind randomized control trial pada 36 sampel yang telah memenuhi kriteria inklusi dan dilakukan di kamar instalasi bedah sentral RSUD Dr. Moewardi Surakarta pada bulan September–Oktober 2017. Sampel dilakukan operasi dengan anestesi umum inhalasi sevofluran. Sampel dibagi menjadi kelompok yang mendapatkan premedikasi midazolam 0,05 mg/kgBB i.v (kelompok A) dan tanpa premedikasi midazolam (kelompok B). Setelah selesai operasi, waktu pulih sadar dicatat menggunakan score Aldrete. Analisis statistik dilakukan menggunakan independent t-test (α=0,05 dan p<0,05). Waktu pulih sadar pada kelompok midazolam rerata 1381,00+237,80 detik, sedangkan pada kelompok kontrol rerata 597,89+179,89 detik (=0,000). Perbedaan rerata waktu pulih sadar antara kelompok premedikasi midazolam dan kontrol adalah 783,11 (640,28–925,94) detik. Waktu pulih sadar pada kelompok midazolam rerata 1381,00+237,80 detik,  sedangkan pada kelompok kontrol rerata 597,89+179,89 detik. Perbedaan selisih rerata waktu pulih sadar antara midazolam dan kontrol adalah 783,11 (640,28–925,94) detik. Terdapat perbedaan bermakna waktu pulih sadar antara kelompok midazolam dan kelompok kontrol. Simpulan, premedikasi midazolam pada anestesi umum sevofluran efektif dalam memperpanjang waktu pulih sadar.


Recovery Time Differences in Sevoflurane General Anesthesia with Midazolam and without Midazolam Premedication


Midazolam premedication reduces anxiety, and anterograde partial amnesia provides anesthesia induction and reduces unwanted changes in postoperative behavior. Midazolam has a prolonged sedative effect leading to a longer recovery time. The researcher was interested in investigating recovery time differences between sevoflurane general anesthetic with midazolam and without midazolam premedication. This study was a double-blind, randomized controlled trial on 36 samples that met the inclusion criteria and was conducted at the Central Surgical Unit of RSUD Dr. Moewardi Surakarta. The sample was planned to undergo surgery under the general anesthetic sevoflurane inhalation. The sample was divided into two groups: one group received midazolam premedication 0.05 mg/kg i.v. (group A) and a control group without midazolam premedication (group B). After surgery, recovery time was recorded using the Aldrete score. The statistical analysis used an independent t-test (α=0.05 and p<0.05). The mean recovery time in the group premedicated with midazolam was 1381.00+237.80 seconds, while in the control group, it was 597.89+179.89 seconds, p=0.000 (p<0.05). The difference in the mean recovery time between the midazolam premedication group and the control group was 783.11 (640.28–925.94) seconds. There was a significant difference in recovery time between groups with midazolam and without midazolam premedication. This study showed that midazolam premedication to sevoflurane general anesthetic was effective in prolonging recovery time (p=0.000).


Keywords


Midazolam, premedikasi, sevofluran, waktu pulih sadar

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References


  1. Butterworth JF, Mackey DC, Wasnick JD, penyunting. Morgan & Mikhail’s clinical anesthesiology. Edisi ke-5. New York: McGraw-Hill; 2013.
  2. Misal US, Joshi SA, Shaikh MM. Delayed recovery from anesthesia: a postgraduate educational review. Anesth Essays Res. 2016;10(2):164–72
  3. Singhal V, rabhakar H. Delayed emergence. Dalam: prabhakar, penyunting.Complications in neuroanesthesia. Amsterdam: Elsevier; 2016. hlm. 15–9.
  4. Sheen MJ, Chang FL, Ho ST. Anesthetic premedication: new horizons of an old practice. Acta Anaesthesiol Taiwanica. 2014;52(3):134–42.
  5. Cesarovic N, Jirkof P, Rettich A, Nicholls F, Arras M. Combining sevoflurane anesthesia with fentanyl–midazolam or s-ketamine in laboratory mice. J Am Assoc Lab Anim Sci. 2012;51(2):209–18.
  6. Reddy SD, Reddy DS. Midazolam as an anticonvulsant antidote for organophosphate intoxication—a pharmacotherapeutic appraisal. Epilepsia. 2015;56(6):813–21.
  7. Arvianto A, Oktaliansah E, Surahman E. Perbandingan antara sevofluran dan propofol menggunakan total intravenous anesthesia target controlled infusion terhadap waktu pulih sadar dan pemulangan pasien pada ekstirpasi fibroadenoma payudara. JAP. 2017;5(1):24–31.
  8. Prabhu MK, Mehandale SG. Comparison of oral dexmedetomidine versus oral midazolam as premedication to prevent emergence agitation after sevoflurane anaesthesia in paediatric patients. Indian J Anaesth. 2017;61(2):131.
  9. Gomes HSO, Gomes HS, Filho JS, Costa LR, Costa PS. Does sevoflurane add to outpatient procedural sedation in children? a randomised clinical trial. BMC Pediatr. 2017;17(1):1–10.
  10. Barash P, Cullen BF, Stoelting RK, Cahalan M, Stock MC, Ortega R. Clinical anesthesia. Edisi ke-7. Philadelphia: Wolters Kluwer Health; 2013.
  11. Brosius KK, Bannister CF. Effect of oral midazolam premedication on the awakening concentration of sevoflurane, recovery times and bispectral index in children. Paediatr Anaesth. 2001;11(5):585–90.
  12. Maeda S, Tomayasu Y, Higuchi H, Ishii-Maruhama M, Yamane A, Yabuki A, dkk. Independent factors affecting recovery time after sedation in patients with intellectual disabilities. Open Dent J. 2015;9(1):146–9.
  13. Miller JL, Capino AC, Thomas A, Couloures K, Johnson PN. Sedation and analgesia using medications delivered via the extravascular route in children undergoing laceration repair. J Pediatr Pharmacol Ther 2018;23(2):72–83.




DOI: https://doi.org/10.15851/jap.v10n2.2492

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