Perbandingan Klonidin 0,5 mg/kgBB Intravena dengan Tramadol 0,5 mg/kgBB Intravena Sebagai Profilaksis Kejadian Menggigil Pascaanestesia Spinal pada Seksio Sesarea
Abstract
Menggigil merupakan komplikasi yang sering terjadi pascaanestesi spinal, akibat gangguan kontrol termoregulasi. Klonidin merupakan agonis adrenergik α2 yang memiliki efek antihipertensi, analgetik, sedasi, dan antimenggigil. Tujuan penelitian ini untuk menilai perbandingan klonidin 0,5 μg/kgBB dengan tramadol 0,5 mg/kgBB dalam menurunkan kejadian menggigil pada pasien yang menjalani seksio sesarea dengan anestesi spinal. Metode penelitian adalah uji klinis acak terkontrol tersamar ganda pada 58 pasien yang menjalani operasi seksio sesarea di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Januari−April 2014, usia 18−45 tahun, status fisik menurut American Society of Anesthesiologist (ASA) II dan dibagi secara acak menjadi 2 kelompok, yaitu kelompok yang menerima klonidin 0,5 μg/kgBB intravena dan kelompok tramadol 0,5 mg/kgBB intravena sebelum dilakukan anestesi spinal dengan bupivakain 12,5 mg. Analisis statistik menggunakan uji-t, uji chi-kuadrat, dan Uji Eksak Fisher. Hasil penelitian menunjukkan kejadian menggigil pada kelompok klonidin lebih sedikit bila dibandingkan dengan kelompok tramadol, baik di kamar operasi (3,44% vs 10,34%) maupun di ruang pemulihan (3,44% vs 17,24%). Simpulan dari penelitian ini menunjukkan bahwa pemberian klonidin 0,5 μg/kgBB intravena sebelum anestesi spinal pada seksio sesarea mengurangi kejadian menggigil dan efek samping.
Kata kunci: Klonidin, menggigil, pascaanestesi spinal, tramadol
Comparison of Intravenous 0.5 mg/kgBW Clonidine Intravenous and 0.5 mg/kgBW Tramadol as Post Spinal Anesthesia Shivering Prophylactic Agent in Caesarean Section
Abstract
Shivering, as a result of impaired thermoregulatory control, is known as a frequent complication of post-spinal anesthesia. Clonidine is an α2-adrenergic agonist that has anti-hypertensive, analgesic, sedation and anti-shivering effects. The purpose of this study is to compare the use of 0.5 μg/kgBW clonidine with 0.5 mg/kgBW tramadol in reducing the incidence of shivering in patients undergoing cesarean section with spinal anesthesia. The method applied was the double-blind randomized controlled clinical trial in 58 patients undergoing caesarean surgery at the Dr. Hasan Sadikin General Hospital Bandung in the period of January−April 2014, age 18−45 years, American Society of Anesthesiologist (ASA) physical status II, and divided into two groups; a group receiving 5 μg/kgBW intravenous clonidine and a group receiving 0.5 mg/kgBW intravenously tramadol prior to spinal anesthesia with bupivacaine 12.5 mg. The statistical analyses used were the t test, chi-square test and Fisher’s Exact test. The incidence of shivering were less in the clonidine group compared to the tramadol group in operating theatre (3.44% vs 10.34) and recovery room (3.44% vs 17.24%). The conclusion of this study showed that the administration of 0.5 μg/kgBW clonidine intravenously before spinal anesthesia for cesarean section reduces the incidence of shivering and side effects.
Keywords: Clonidine, post spinal anesthesia, shivering, tramadol
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