Perbedaan Respon Hemodinamik Akibat Tindakan Laringoskopi dan Intubasi pada Pemberian Intravena Fentanyl dan Magnesium Sulfat Dibandingkan dengan Fentanyl dan Lidokain
Abstract
Abstrak: Tindakan laringoskopi dan intubasi endotrakhea pada anastesi umum dapat menyebabkan terjadinya peningkatan hemodinamik berupa hipertensi, takikardi, dan dapat membahayakan pasien-pasien yang mempunyai faktor resiko seperti penyakit jantung koroner, hipertensi, miokard infark, kelainan serebrovaskular, dan tirotoksikosis. Tujuan penelitian ini adalah untuk membandingkan perbedaan respon peningkatan hemodinamik pada pemberian fentanil dan magnesium sulfat (MgSO4) dengan fentanil dan lidokain akibat tindakan laringoskopi dan intubasi endotrakhea. Subjek penelitian adalah 30 pasien yang menjalani pembedahan elektif dengan anestesi umum intubasi endotrakhea, usia 18 50 tahun, ASA 1. Pasien dibagi secara acak menjadi dua kelompok (kelompok M dan L). Premedikasi fentanyl ditambah MgSO4 intravena diberikan kepada Kelompok M, sedangkan premedikasi fentanyl ditambah Lidokain intravena diberikan kepada kelompok L Tidak dijumpai perbedaan yang bermakna pada nilai tekanan darah sistolik (TDS), tekanan darah diastolik (TDD), denyut jantung (DJ), Rate Pressure Product (RPP) dan tekanan arteri rerata (TAR) antara kelompok M dan kelompok L pada pengamatan menit ke-1, ke-3 dan ke-5 setelah tindakan laringoskopi dan intubasi. Simpulan, tidak ada perbedaan respon hemodinamik akibat tindakan laringoskopi dan intubasi endotrakhea antara fentanyl ditambah MgSO4 dan Fentanyl ditambah lidokain.
Kata kunci: laringoskopi, intubasi endotrakhea, lidokain, magnesium sulfat, Rate Pressure Product
Full Text:
PDFReferences
Butterworth IV JF, Mackey DC, Wasnick JD. Airway management . In: Morgan & Mikhails Clinical anesthesiology. 5th ed. New York: Mc Graw Hill, 2013. p 309-41
Atmawan DB, Villyastuti YW, Harahap MS. Perbedaan tekanan darah, laju jantung, dan Rate Pressure Product (RPP) pada pemberian lidokain 1.5 mg/kgBB intravena sebelum intubasi dibandingkan pemasangan Laryngeal Mask Airway (LMA). Jurnal Anestesiologi Indonesia. 2013;5(1):11-21
Reynolds SF, Heffner J. Airway management of the critically ill patient: rapid-sequence intubation. Chest. 2005;127(4):1397-412.
Panda NB, Bharti N, Prasad S. Minimal effective dose of magnesium sulfate for attenuation of intubation response in hypertensive patients. J Clin Anesth. 2013;25:92-7.
Hassani V, Movassaghi G, Goodarzi V, Safari S. Comparison of fentanyl and fentanyl plus lidocaine on attenuation of hemodynamic response to tracheal intubation in controlled hypertensive patients undergoing general anesthesia. Anesth Pain. 2013;2(3):115-8
Safavi M, Honarmand A. Attenuation of cardiovascular responses to laryngoscopy and tracheal intubation. M.E.J Anest. 2008;19(6):1349-60
Malde A, Sarode V. Attenuation of the hemodynamic to endotracheal intubation: fentanyl versus lignocaine. The Internet Journal of Anesthesiology. 2006 Volume 12 Number 1
Gupta A, Wakhloo R, Gupta V, Mehta A, Kapoor BB. Comparison of esmolol and lignocain for attenuation of cardiovascular stress response to laryngoscopy and endotracheal intubation. JK Science. 2009;11(2):78-81
Al-Sabbagh MS. Comparative effects of fentanyl, midazolam, lignocaine and propranolol on controlling the hemodynamic pressor response during laryngoscopy and intubation. Iraqi J Pharm Sci. 2010;19(2):24-30
Butterworth IV JF, Mackey DC, Wasnick JD. Anesthesia for patients with cardiovascular disease. In: Morgan & Mikhails Clinical anesthesiology. 5th ed. New York: Mc Graw Hill, 2013. p 375-434
Nooraei N, Dehkordi ME, Radpay B, Teimoorian H, Mohajerani SA. Effects of Intravenous magnesium sulfate and lidocaine on hemodynamic variables following direct laryngoscopy and intubation in elective surgery patients. Tannaffos. 2013;12(1):57-63
Miller RD. Choice of anesthetic technique. In: Miller RD, Pardo MC. Basics of anesthesia. 6th ed. Philadelphia: Elsevier Saunders, 2011. p 190-97
Frakes MA. Rapid sequence induction medications: An Update. Journal of Emergency Nursing. 2003;29(6):533-40
Stackhouse RA, Infosino A. Airway management. In: Miller RD, Pardo MC. Basics of anesthesia. 6th ed. Philadelphia: Elsevier Saunders, 2011. p 219-51
Bajwa SJS, Kaur J, Singh A, Parmar SS, Singh G, Kulshresta A et al. Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine. Indian J Anaesth. 2012;56(2):123-8
Govindaiah MH, Suryanarayana VB, Vas P, Jennifer LV, Chandra SBC. Can Calcium and sodium channel blockers attenuate hemodynamic responses to endotracheal intubation?. Eur J Gen Med. 2008;5(4):198-207.
Gupta R, Dubey M, Naithani, Bhargava A. Clinical efficacy of combination of diltiazem and lidocaine in attenuating hemodynamic changes during tracheal intubation and comparing the response when they are used alone. The Internet Journal of Anesthesiology. 2012 Volume 30 Number 4
Kothari D, Mehrotra A, Choudhary B, Mehra A. Effect of intravenous magnesium sulfate and fentanyl citrate on circulatory changes during anaesthesia and surgery: A clinical study . Indian J Anaesth. 2008;52(6):800-4.
Kumar S, Mishra MN, Mishra LS, Bathla S. Comparative study of the efficacy i.v. esmolol, diltiazem and magnesium sulphate in attenuating haemodynamic response to laryngoscopy and tracheal intubation. Indian J Anaesth. 2003;47(1):41-4.
Hashiesh SA. Is magnesium sulphate superior to lidocaine in attenuating the stress response to endotracheal intubation?. El-Minia Medical Bulletin. 2008;19(1):18-26
Sener EB, Ustun E, Ustun B, Sarihasan B. Hemodynamic responses and upper airway morbidity following tracheal intubation in patients with hypertension: coventional laryngoscopy versus an intubating laryngeal mask airway. Clinics (Sao Paulo). 2012;67(1):49-54
DOI: https://doi.org/10.30596/bf.v3i3.2067
DOI (PDF): https://doi.org/10.30596/bf.v3i3.2067.g2287
Refbacks
- There are currently no refbacks.
JURNAL BULETIN FARMATERA
Gedung Kampus 1 Universitas Muhammadiyah Sumatera Utara (UMSU) Lantai II, Laboratorium Farmakologi dan Terapi Fakultas Kedokteran UMSU Jalan Gedung Arca No. 53 Medan Sumatera Utara Indonesia, Kode Pos 20217.
Contact (WA): 0812-6208-2844
E-mail: jurnalpanduhusada@umsu.ac.id
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.