Perbedaan Respons Hemodinamik antara Penggunaan Levobupivakain dan Penambahan Klonidin 1 dan 2 Mcg/kgBB pada Scalp Block

Ardana Tri Arianto, Sugeng Budi Santosa, Syarif Afif

Abstract


Penambahan adjuvan pada levobupivakain dapat memperkuat dan memperpanjang efek analgesia pada blok saraf tepi. Klonidin memiliki aksi yang sinergis dengan agen lokal anestesi. Tujuan penelitian ini adalah mengetahui efektivitas penambahan klonidin 1 mcg/kgBB dan 2 mcg/kgBB pada scalp block sebagai analgetik kraniotomi. Penelitian dilakukan pada 30 pasien yang menjalani kraniotomi di RS Dr. Moewardi Surakarta selama periode bulan Mei–Agustus 2020 Desain penelitian yang digunakan adalah uji klinis tersamar acak ganda dengan analisis statistik menggunakan uji one-way ANOVA atau Kruskal Wallis. Subjek dibagi menjadi tiga kelompok, kelompok I: scalp block dengan levobupivakain 0,25%, kelompok II: scalp block ditambah klonidin 1 mcg/kgBB, kelompok III: scalp block ditambah klonidin 2 mcg/kgBB. Penilaian terhadap tekanan darah, MAP, laju nadi dilakukan sebelum intubasi, pemasangan pin, insisi kulit, dan insisi duramater. Hasil penlitian didapatkan perbedaan signifikan penambahan klonidin pada levobupivakain 0,25% dengan kelompok kontrol terutama pada laju nadi dan diastole. Klonidin 2 mcg/kgBB pada beberapa waktu menunjukkan perbedaan signifikan dibanding dengan penambahan dosis klonidin 1 mcg/kgBB. Simpulan, penambahan klonidin pada scalp block levobupivakain efektif menurunkan respons hemodinamik terutama laju nadi dan tekanan darah diastole

 

Differences in Hemodynamic Response to 1 and 2 mcg/kgBW Clonidine Addition to Scalp Block

Adding adjuvants to levobupivacaine can enhance and prolong the analgesic effect of peripheral nerve blocks. Clonidine has a synergistic action with local anesthetic agents. This study aimed to determine the effectiveness of adding clonidine 1 mcg/kgBW and 2 mcg/kgBW on scalp blocks as craniotomy analgesics. The study included 30 patients who underwent a craniotomy at Dr. Moewardi Hospital Surakarta in May-August 2020. The study design was a double-blind, randomized clinical trial with statistical analysis using one-way ANOVA or Kruskal Wallis trials. Subjects were divided into three groups: group I, scalp block with 0.25% levobupivacaine; group II, scalp block plus clonidine 1 mcg/kgBW; and group III, scalp block plus clonidine 2 mcg/kgBW. Assessment of blood pressure, MAP, and pulse rate was performed before intubation, pin placement, skin incision, and dura mater incision. The study results showed a significant difference in adding clonidine to 0.25% levobupivacaine with the control group, especially in the pulse rate and diastole. Clonidine 2 mcg/kgBW several times showed a significant difference compared to adding a dose of 1 mcg/kgBW clonidine. In conclusion, adding clonidine to levobupivacaine scalp block effectively reduces hemodynamic responses, especially pulse rate and diastolic blood pressure.


Keywords


Klonidin; kraniotomi; levobupivakain; scalp block

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DOI: https://doi.org/10.15851/jap.v10n1.2495

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