Perbandingan Efek Pemberian Norepinefrin Bolus Intravena dengan Norepinefrin Infus Kontinu dalam Tatalaksana Hipotensi, Laju Nadi, dan Nilai APGAR pada Seksio Sesarea dengan Anestesi Spinal

Abstract

Vasopresor sering digunakan dalam tatalaksana hipotensi anestesi spinal pada seksio sesarea. Penelitian bertujuan membandingkan efek pemberian norepinefrin bolus intravena dengan norepinefrin infus kontinu dalam tatalaksana hipotensi pada anestesi spinal pasien seksio sesarea dan pengaruh pada laju nadi serta nilai APGAR. Penelitian bersifat eksperimental acak tersamar ganda pada 44 ibu hamil status fisik American Society of Anesthesiologist (ASA) II yang menjalani seksio sesarea dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin Bandung pada September–November 2013. Subjek penelitian dibagi menjadi 2 kelompok yaitu kelompok  norepinefrin bolus intravena 4 µg (NB) dan kelompok norepinefrin infus kontinu 8 µg/menit (NK). Data dianalisis dengan uji-t, Uji Mann-Whitney, chi-kuadrat dan uji-t analysis of variance (ANOVA), nilai p<0,05 dianggap bermakna. Hasil penelitian menunjukkan bahwa peningkatan tekanan darah sistol, diastol, dan rata-rata lebih tinggi pada kelompok NB (p=0,000). Perubahan laju nadi secara umum pada kedua kelompok relatif stabil dan nilai APGAR menunjukkan perbedaan yang tidak bermakna (p>0,05). Simpulan penelitian ini adalah kedua cara pemberian norepinefrin ini dapat digunakan dalam tatalaksana hipotensi anestesi spinal tanpa memengaruhi laju nadi dan nilai APGAR.  
 
Kata kunci: Anestesi spinal, hipotensi, nilai APGAR, norepinefrin, seksio sesarea

Effect of Intravenous Norepinephrine Bolus and Norepinephrine Continuous Infusion on Hypotension Management, Heart Rate, and APGAR Score in Caesarean Section Patient under Spinal Anesthesia

Abstract

Vasopresors are commonly used for the treatment of hypotension in spinal anesthesia for cesarean section. This research aimed to compare intravenous bolus of norepinephrine to continuous infusion of norepinephrine effectiveness in hypotension management in caesarean section patient under spinal anesthesia and their effect on heart rate and APGAR Score, The experimental study was conducted in a double-blind randomized manner to 44 American Society of Anesthesiologist (ASA) physical status II pregnant women undergoing cesarean section with spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung within the period of September to -November 2013. The Study  subjects were grouped into two groups, the first group received 4 µg intravenous bolus of norepinephrine group (NB) and and the second received 8 µg/minute continuous infusion of norepinephrine group (NK).  Data were analyzed by t-test, Mann-Whitney test, chi-square and analysis of variance (ANOVA) t-test with p<0.05 was considered significant. The results showed that the increase in systolic, diastolic and mean arterial blood pressures were higher in the NB group (p=0.000). Changes in heart rate were generally relatively stable in both groups and APGAR score showed a non-significant difference (p>0.05). Conclusion from this study is the administration of norepinephrine in both ways can be used for the treatment of hypotension of spinal anesthesia without affecting the heart rate and APGAR score

Key words: APGAR score, caesarean section, hypotension, norepinephrine, spinal anaesthesia

DOI: 10.15851/jap.v3n1.375