PERBEDAAN EFEK KARDIOVASKULER PADA
ANESTESI INHALASI ENFLURAN ANTARA TEKNIK MEDIUM-FLOW DAN HIGH-FLOW SEMICLOSED SYSTEM

Rakhmad Hidayat1). M. Sofyan Harahap2)

ABSTRACT

Background: The anesthesia procedure may effects to all system of the body, including cardiovascular. Enflurane inhalation is one of common used drugs in general anesthesia with high-flow even very high-flow semiclosed system technique. The objective of this study was proving that medium-flow semiclosed system technique can be use safely without decreasing the quality of anesthesia.
Methods: This was an observational analytic study using cross sectional design, with 44 samples of medical records of patients experiencing elective surgery with general anesthesia at Kariadi Hospital Semarang. The sample fullfilled inclussion criterias; 16-40 years old, Body Mass Index (BMI) 20-25 kg/m2, status of physical of American Society Of Anesthesiologist (ASA) I-II, surgery duration 1-3 hours. From 44 samples divided into two groups. Group I treated with inhalation general anaesthesia with medium-flow semiclosed system using N2O 50 % in O2 with 2 l/minute fresh gas flow (FGF) acceleration and enflurane. Group 2 conducted inhalation general anesthesia with high-flow semiclosed system using N2O 50 % in O2 with 6 l/minute (FGF) acceleration and enflurane. The data was analysed using Kolmogorov-Smirnov and Independent T-test.
Results: There was no significant difference in cardiovascular effects on enflurane anesthetic medium-flow and high-flow semiclosed system. The systolic and diastolic pressure, as well as the pulse at 15, 30, 45 and 60 minutes have p>0,05. At 60 minutes, the diastolic pressure between groups have a significant different (p<0,05), the diastolic in medium-flow was higher than high-flow technique.
Conclusion: There was no difference of cardiovascular effect on enflurane anaesthetic between medium-flow and high-flow semiclosed system technique.

Key Words: enflurane, medium-flow, high-flow, semiclosed system.

ABSTRAK

Latar belakang: Tindakan anestesi bisa menimbulkan efek pada semua sistem pada tubuh, misalnya pada sistem kardiovaskuler. Salah satu teknik anestesi umum yang sering digunakan adalah memakai inhalasi enfluran dengan teknik high-flow bahkan very high-flow semiclosed system. Tujuan penelitian ini adalah membuktikan bahwa teknik medium-flow semiclosed system dapat digunakan dengan aman tanpa mengurangi kualitas anestesi.
Metode: Studi analitik ini dengan rancangan cross sectional. Sampel dari 44 penderita yang menjalani operasi elektif dengan anestesi umum di Instalasi Bedah Sentral RSUP Dr. Kariadi Semarang yang memenuhi kriteria; umur 16-40 tahun, Body Mass Index (BMI) 20-25 kg/m2, status fisik American Society of Anesthesiologist (ASA) I-II, dan lama operasi 1-3 jam. Sampel dibagi menjadi 2 kelompok; kelompok 1 dilakukan anestesi umum inhalasi dengan teknik medium-flow semiclosed system menggunakan N2O 50 % dalam O2 dengan laju aliran gas segar (FGF) 2 l/menit dan enfluran; kelompok 2 dilakukan anestesi umum inhalasi dengan teknik high-flow semiclosed system menggunakan N2O 50 % dalam O2 dengan laju FGF 6 l/menit dan enfluran. Uji normalitas data dengan Kolmogorov-Smirnov, uji beda dengan Independent T-test.
Hasil: Pengukuran fungsi kardiovaskuler yang meliputi tekanan sistolik, tekanan diastolik, dan frekuensi nadi pada menit ke-15, 30, 45 dan 60 antar kelompok berbeda tidak bermakna (p>0,05). Pada menit ke-60, tekanan diastolik antar kelompok terdapat perbedaan bermakna (p<0,05), dimana tekanan diastolik pada teknik medium-flow lebih tinggi daripada tekanan diastolik pada teknik high-flow.
Simpulan: Teknik anestesi inhalasi enfluran medium-flow semiclosed system mempunyai efek kardiovaskuler yang sama dibanding dengan teknik high-flow semiclosed system.

Kata Kunci: enfluran, medium-flow, high-flow, semiclosed system.

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