Efek Penambahan Deksametason 5 mg pada Bupivakain 0,5% terhadap Mula dan Lama Kerja Blokade Sensorik Anestesia Epidural untuk Operasi Ortopedi Ekstremitas Bawah

Abstract

Operasi ortopedi ekstremitas bawah dengan anestesia regional epidural memiliki kelemahan yaitu mula kerja yang lama. Penelitian ini bertujuan melihat efek penambahan 5 mg deksametason pada bupivakain 0,5% terhadap mula kerja dan lama kerja blokade sensoris. Penelitian prospektif eksperimental menggunakan uji klinis acak buta ganda pada 32 pasien dengan American Society of Anesthesiologist (ASA) I–II yang menjalani operasi ortopedi ekstremitas bawah dengan anestesi epidural di RSUP Dr. Hasan Sadikin Bandung pada Februari–Mei 2014. Pengambilan sampel dilakukan secara consecutive sampling dan random blok permutasi. Kelompok I, deksametason 5 mg ditambahkan ke dalam bupivakain 0,5% 15 mL. Kelompok II, bupivakain 0,5% ditambah NaCl 0,9% 15 mL. Hasil penelitian diuji secara statistika menggunakan uji-t dan Uji Mann-Whitney. Hasil penelitian menunjukkan mula kerja blokade sensorik kelompok I tidak lebih cepat, yaitu 13,56 menit dibanding dengan kelompok II, yaitu 14,31 menit (p=0,27). Lama kerja blokade sensorik kelompok I lebih lama, yaitu 399,81 menit dibanding dengan kelompok II, yaitu 227,43 menit (p=0,00). Simpulan, penambahan deksametason 5 mg pada bupivakain 0,5% 15 mL tidak mempercepat mula kerja blokade sensorik tetapi memperpanjang lama kerja blokade sensorik bupivakain 0,5% yang diberikan secara epidural.

Kata kunci: Anestesi epidural, blokade sensorik, bupivakain, deksametason, lama kerja, mula kerja

Effect of Dexamethasone 5 mg Addition to Bupivacaine 0.5% on Onset and Duration of Sensory Blockade in Epidural Anesthesia for Lower Extremity Orthopedic Surgery


Lower extremity orthopedic surgery performed with regional epidural anesthesia was still have weakness which is long onset of time. This study was conducted to determine the onset time and duration time of sensory blockade epidural anesthesia  between the use of dexamethasone 5 mg addition to 0.5% bupivacaine for lower limb orthophedic surgery. The study was using randomized controlled blind method on 32 ASA I–II patients undergoing lower limb orthopedic surgery under epidural anesthesia. Consecutive sampling and random allocation of block of permutation groups was applied. In group I, dexamethasone 5 mg was added to bupivacaine 0.5% 15 mL while in group II NaCl 1 mL was added to bupivacaine 0.5% 15 mL. The results were statistically tested using t-test and Mann-Whitney test. It was shown that the onset time of sensory blockade was not significantly faster when dexamethasone was added in bupivacaine 0.5%, 13.56 minutes versus 14.31 minutes (p=0.27). The duration time of sensory blockade in dexamethasone in bupivacaine 0.5% group was longer 399.81 minutes, compared to the bupivacaine 0.5% group, 227.43 minutes (p=0.00). In conclusions, the addition of dexamethasone 5 mg to bupivacaine 0.5% 15 mL does not produced faster onset time. However, the duration sensory blockade time is longer than bupivacaine 0,5% 15 mL is used

Key words: Bupivacaine, dexamethasone, duration time, epidural anesthesia, onset, sensory blockade

DOI: 10.15851/jap.v3n2.577