Perbandingan Ketepatan Pengukuran Tekanan Balon Pipa Endotrakeal setelah Intubasi antara Metode Palpasi pada Pilot Balon dan Teknik Melepas Spuit secara Pasif

Abstract

Metode palpasi pada pilot balon merupakan teknik yang tidak akurat untuk menentukan tekanan balon pipa endotrakeal (endotracheal tube/ETT). Tujuan penelitian ini membandingkan ketepatan pengukuran tekanan balon ETT antara metode palpasi pada pilot balon (MP) dan teknik melepas spuit secara pasif (MSP). Penelitian dilakukan pada bulan Juni 2014 di Rumah Sakit Dr. Hasan Sadikin Bandung, menggunakan metode kuantitatif eksperimen dengan rancangan uji acak silang tersamar tunggal. Subjek penelitian adalah 94 orang pasien berusia 18−65 tahun dengan status fisik American Society of Anesthesiologists (ASA) I–III, yang menjalani pembedahan dengan anestesi umum secara intubasi endotrakeal. Saat akan dilakukan intubasi, balon ETT dikembangkan dengan dua teknik yang berbeda kelompok metode palpasi (n=48) dan kelompok teknik melepas spuit secara pasif (n=46). Data hasil penelitian dianalisis menggunakan uji-t tidak berpasangan dan uji chi-kuadrat. Hasil penelitian didapatkan tekanan rata-rata pada kelompok MP 57,7±26,0 cmH2O dan MSP 28,7±4,5 cmH2O, sedangkan untuk ketepatan pengukuran pada kelompok MSP 56,5% dan kelompok MP 6,2% (p<0,001). Simpulan penelitian ini menunjukkan bahwa metode palpasi merupakan teknik pengukuran tekanan balon ETT yang tidak adekuat.

Kata kunci: Metode palpasi pada pilot balon, teknik melepas spuit secara pasif, endotracheal tube

Comparison between Pilot Balloon Palpation Method and Passive Release Technique on the Accuracy of Measurements of  Endotracheal Tube Cuff Pressure


Estimation of cuff pressure by palpating the pilot balloon is not accurate to determine the cuff pressure of endotracheal tube (ETT). Hence, this study we conducted to compare the accuracy of indirect measurements between pilot balloon palpation method (MP) and passive release technique (MSP). This was a single blind randomized crossover study performed in june 2014 at Dr. Hasan Sadikin General Hospital Bandung, in which patients received each technique and as a control group. Subjects were 94 patients aged 18−65 years old with American Society of Anesthesiologists (ASA) physical status I−III who underwent surgery requiring tracheal intubation. These subjects were randomized into two groups. After induction of anesthesia, the cuff was inflated with two different techniques: pilot balloon palpation technique (n=48) and passive release technique (n=46). Data were statistically analyzed using independent t-test and chi-square test. The mean cuff pressures of group MP was 57.7±26.0 cmH2O and for group MSP was 28.7±4.5 cmH2O,  whereas the precision of measurements in the MSP group was 56.5% and 6.2% in the MP group (p<0.001). It is conclude that the palpation method for cuff inflation are inadequate. Therefore, it is suggested that the endotracheal tube cuff pressure must be kept within the optimal range using a standard manometer.

Key words: Endotracheal cuff pressure, passive release technique, pilot balloon palpation method

 DOI: 10.15851/jap.v3n3.608