PENGARUH ANESTESI SEVOFLURAN DAN ENFLURAN TERHADAP KLIRENS KREATININ

Agrianto, Ranata (2005) PENGARUH ANESTESI SEVOFLURAN DAN ENFLURAN TERHADAP KLIRENS KREATININ. Masters thesis, Program Pasca Sarjana Universitas Diponegoro.

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Abstract

Background : High flow semiclosed system technique of anesthesia using sevoflurane and enflurane volatile agents in 4L/minute of Fresh Gas Flow within 2-3 hours has effect on creatinine clearance to patients with normal renal function. Objective : To discuss that sevoflurane had a better effect on renal function compared with enflurane using high flow semiclosed system technique of anesthesia with 4L/minute of Fresh Gas Flow. Methods : 48 patients, aged 16-40 years, with Body Mass Index of 20-25 kg/rn2 and ASA physical state I-II were randomly divided into 2 groups (n=24). All patients were fasted 6 hours and premedicated with atropine 0,01 mg/kg, midazolam 0,07 mg/kg intramuscular and ondansetron 4 mg intramuscular 30 minutes before induction of anesthesia. Patients received thiontal 5 mg/kg and atracurium besylate 0,5 mg/kg for induction and maintained by 02 50% and N20 , sevoflurane 2 vol% in 4L/minute of Fresh Gas Flow (Group I) and enflurane 1,7 vol% 4L/minute of Fresh Gas Flow (Group II); and incremental dose 0,2 mg/kg of atracurium besylate. The incremental dose 1 Rg/kg of fentanyl was given 20 minutes after the first fentanyl was given. Duration of operation was limited 2-3 hours and 6 hours post anesthesia the creatinine serum was checked in laboratorium of Kariadi General Hospital. Statistical analysis was performed using Chi Square and t test (independent test and paired t test) with p 2-tailed and a p-value < 0,05 was considered significant. Results : The characteristic datas, duration and variant of operation, and also clinical datas in two groups were not significantly different (p>0,05). The blood pressui-e, head rate, Sa0, intra operation were not significantly different between the two groups. The ereatinMe clearance datas in Group I and Group 11 were increased, 2,19% and 4,54% recpectively but did not difl'er significantly. Conclusion : The eflect of sevoflurane and enflurane on creatinine clearance using high flow technique 4L/minutes of FGF in 2-3 hours were not significantly different. Latar Belakang : Tehnik anestesi high-flow •emiclosed system sevofluran dan enfluran dengan aliran gas segar (F(319 4L/menit dengan lama operasi 2-3 jam dapat mempengaruhi klirens kreatinin pada keadaan ginjal normal. Tujuan : Mengetahui apakah anestesi sevofluran lebih baik pengaruhnya terhadap fungsi ginjal daripada anestesi enfluran dengan menggunakan tehnik anestesi high-flow semiclosed system 4L/menit. Metode : 48 pasien berusia 16-40 tahun dengan indeks massa tubuh 20-25 kg/rn2 dan status flsik ASA I-II secara random dibagi menjadi dua kelompok (n = 24). Semua pasien dipuasakan 6 jam dan diberikan premedikasi Sul fat Atropin 0,01 rng/kgBB, Midazolarn 0,07 mg/kgBB Lin dan Ondansetron 4 mg Lm 'A jam. sebelum induksi. Induksi diberikan thiopental 5 mg/kgBB dan atracuriumn besylate 0,5 mg/kgBB, fentanyl 2p.g/kgBB. Rurnatan anestesi dengan 02 50% dan N20 50%, sevofluran 2 vol.% 4L/rn (kelompok sevofluran) dan enfluran 1,7 vol.% 4L/m (kelompok enfluran) serta penambahan 0,2 rng/kgBB atracurium besylate untuk rumatan pelumpub otot. Rurnatan fentanyl diberikan 1 p.g/kgBB setelah 20 menit setelah pemberian fentanyl yang pertarna Larna operasi dibatasi 2-3 jam dan 6 jam post anestesi diperiksa sampel darahnya untuk memeriksa serum kreatininnya. Uji statistik menggunakan uji Chi-Square dan uji t (independent t test dan paired t test) dengan hargap 2 ekor dan derajat kemaknaanp < 0,05. Hasil : Data karakteristik, lama dan jenis operasi, serta data klinis awal pada kedua kelompok berbeda tidak bermakna > 0,05). Selama operasi tekanan darah, laju jantung, Sa02 juga berbeda tidak bermakna (p > 0,05). Data klirens kreatinin pada kelompok sevofluran maupun enfluran pada sebelurn operasi dan sesudah operasi teijadi peningkatan 2,19% pada kelompok sevofluran seria peningkatan 4,54% pada kelompok enfluran tetapi tidak bermakna. Kesimpulan : Selarna menggunakan anestesi inhalasi dengan teknik high flow 4L/m sevofluran dan enfluran dengan lama operasi 2-3 jam terjadi peningkatan tidak bernmkna nilai klirens kreatinin.

Item Type:Thesis (Masters)
Subjects:R Medicine > R Medicine (General)
Divisions:Postgraduate Program > Master Program in Biomedical Science
ID Code:12477
Deposited By:Mr UPT Perpus 1
Deposited On:31 May 2010 14:04
Last Modified:31 May 2010 14:04

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