Pengaruh Penambahan Klonidin 75 mcg pada 12,5 mg Levobupivakain 0,5% Secara Intratekal terhadap Lama Kerja Blokade Sensorik dan Motorik untuk Bedah Ortopedi Ekstremitas Bawah

Abstract

Keterbatasan anestesi spinal antara lain ialah lama kerja blokade sensorik dan motorik terbatas. Penelitian ini bertujuan melihat pengaruh penambahan 75 mcg klonidin pada 12,5 mg levobupivakain 0,5% terhadap lama kerja blokade sensorik dan motorik pada anestesi spinal untuk bedah ortopedi ekstremitas bawah. Penelitian bersifat eksperimental prospektif dengan metode acak terkontrol tersamar ganda pada 36 sampel dengan kriteria American Society of Anesthesiologist (ASA) I-II yang menjalani operasi ortopedi ekstremitas bawah dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Juni–Agustus 2014. Kelompok levobupivakain dan klonidin (LK) mendapatkan 12,5 mg levobupivakain 0,5% ditambah klonidin 75 mcg. Kelompok levobupivakain dan salin (LS) mendapatkan  12,5 mg levobupivakain 0,5% ditambah NaCl 0,9% 0,5 mL. Data hasil penelitian diuji secara statistik menggunakan uji-t, Mann-Whitney, dan chi-kuadrat. Hasil penelitian menunjukkan lama kerja blokade sensorik kelompok LK lebih lama secara bermakna yaitu 244,44 (37,84) menit dibandingkan dengan kelompok LS, yaitu 107,89 (17,63) menit (p=0,000). Lama kerja blokade motorik kelompok LK lebih lama secara bermakna yaitu 278,72 (41,75) menit dibandingkan dengan kelompok LS, yaitu 128,39 (18,26) menit (p=0,000). Simpulan, penambahan klonidin 75 mcg pada 12,5 mg levobupivakain 0,5%  secara intratekal memerpanjang lama kerja blokade sensorik dan motorik.

Kata kunci: Anestesi spinal, klonidin, levobupivakain, lama kerja blokade sensorik, lama kerja blokade motorik

Effect of Clonidine 75 mcg Addition to Intrathecal 12.5 mg 0.5% Levobupivacaine on Sensoric and Motoric  Blockade Duration in Lower Extremity Orthopedic Surgery

Abstract

Spinal anesthesia has some limitations that  limits its use, such as limited duration of action in motoric and sensoric.  This research aimed to provide an overview on the effect of adding clonidine 75 mcg to 12.5 mg  0.5% levobupivacaine on the motoric and sensoric blockade action duration in lower extremity orthopedic surgery spinal anesthesia. This experimental prospective research used double blind randomized controlled trial approach on 36 patients with ASA I-II physical status who underwent lower extremity orthopedic surgery using spinal anesthesia in Dr. Hasan Sadikin General Hospital during the period of June to August 2014.  LC group, clonidine 75 mcg was added to 12.5 mg 0.5% levobupivacaine.  On LS group, 12.5 mg 0.5% mg levobupivacaine mixed with 0.5 mL 0.9% NaCl. The data were then statistically tested using t-test, Mann-Whitney, and chi-square. The result showed that the duration of action of sensoric blockade in LK group was significantly longer, i.e. 224.44 (37.84) minutes compared to LS group, i.e. 107.89 (17.63) minutes (p=0.000).  Duration of action of motoric blockade in LK group was significantly longer, i.e. 278,72 (41,75) minutes, compared to LS group, i.e. 128.39 (18.26) minutes (p=0.000). It is concluded that the additiona of clonidine 75 mcg to 12,5 mg 0,5% levobupivacaine significantly prolongs the duration of action of the motoric and sensoric blockade if given intrathecally.

Key words: Clonidine, duration of action, duration of action of motoric blockade, levobupivacaine, spinal anesthesia

DOI: 10.15851/jap.v3n1.374