Blokade Peribulbar dengan Adjuvan Fentanil: Efek Hemodinamik dan Analgetik pada Vitrektomi

Dedi Fitri Yadi, Siti Fairuz Nadya, Radian Ahmad Halimi, Doddy Tavianto, Erwin Pradian, Iwan Fuadi

Abstract


Operasi vitrektomi membutuhkan analgesia adekuat dan stabilitas hemodinamik, terutama pada pasien usia lanjut dengan komorbiditas. Ropivakain adalah anestesi lokal yang umum digunakan untuk blokade peribulbar, namun kualitas bloknya dapat ditingkatkan dengan penambahan opioid seperti fentanil. Studi ini merupakan penelitian pertama yang membandingkan efektivitas ropivakain 0,75% dengan kombinasi ropivakain 0,75% dan fentanil 3 μg/mL pada tekanan darah dan kualitas analgesia pada operasi vitrektomi. Desain penelitian ini adalah single blind randomized controlled trial yang melibatkan 54 pasien yang menjalani vitrektomi. Penelitian dibagi menjadi dua kelompok yang masing-masing terdiri 27 pasien: kelompok R yang menerima ropivakain 0,75% dan kelompok RF yang menerima ropivakain 0,75% dan fentanil 3 μg/ml. Tekanan darah sistolik, diastolik, MAP, serta kualitas analgesia (NRS) diukur pada tiga waktu yaitu sebelum, selama dan setelah operasi. Analisis statistik menggunakan uji t tidak berpasangan, Mann Whitney dan Chi-Square. Hasil penelitian menunjukkan bahwa tidak terdapat perbedaan bermakna dalam perubahan tekanan darah sistolik, diastolik, dan MAP antara kedua kelompok (p>0,05). Kualitas analgesia yang dinilai menggunakan NRS juga tidak menunjukkan perbedaan signifikan (p>0,05). Kesimpulan penelitian ini adalah kombinasi ropivakain 0,75 % dan fentanil 3 mcg/ml memberikan hasil yang sebanding dengan ropivakain 0,75 % saja dalam hal stabilitas hemodinamik dan kualitas analgesia pada operasi vitrektomi.


Keywords


Blokade peribulbar; fentanil; ropivakain; stabilitas hemodinamik; vitrektomi

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DOI: https://doi.org/10.15851/jap.v13n2.4413

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