RESPON KARDIOVASKULER PREMEDIKASI KLONIDIN PER ORAL 2 pG/KGBB, 3 pG/KGB13, 4 p.G/KGBB, DAN 5 ii.G/KGBB PADA LARINGOSKOPI INTUBASI

Sukamto , IG.L. (1998) RESPON KARDIOVASKULER PREMEDIKASI KLONIDIN PER ORAL 2 pG/KGBB, 3 pG/KGB13, 4 p.G/KGBB, DAN 5 ii.G/KGBB PADA LARINGOSKOPI INTUBASI. Masters thesis, program Pascasarjana Universitas Diponegoro.

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Abstract

The response of cadiovascular oral clonidine premedication has been studied with the various doses in intubation laryngoscopy. More dosage of oral clonidine premedication, will more affect the decrease of blood pressure and heart rate response in intubation laryngoscopy. The aim of the study is to define the oral clonidine premedication dose which is most effective to the cardiovascular respone in intubation laryngoscopy. The " Sample Stratified Random Sampling " study to 100 patients in the Central Surgical Operation Instalation in Dr. Kariadi General Hospital Semarang during 4 months ( March - June '98 ) has been divided into 5 groups. The subyect of the study are -patients undergoing elective‘ operations with general anesthesia and intubation facilities, male and. female, 16 - 60 years age, ASA I - II, with normal blood pressure, and without any contraindication to the medicines which is used, and no certain condition in dringking any sedative medicines or antihypertension and is according to the study_ After selection, the patients are divided into 4 treatment groups and 1 control group 0,01 mg/kgBW intramuscular and oral clonidine 2,3,4,5 .1,g/kgBW and without clonidine in the control group, 90 minutes before induction. Cristaloid fluid is given to replace the fasting period. Induction with penthotal 5 mg/kgBW intravenous and succinylcholine 1,5 mg/kgBW intravenous are used. After relaxation has been actived, the intubation laryngoscopy can be done. Anesthesia is maintained with N20 50 : 02 50 %, enflurane 0,8 - 1,0 vol.% and vecuronium 0,01 mg/kgBW intravenous. The systole blood pressure, diastole blood pressure, mean arterial pressure and heart rate has been measured with Criticon Dinamap 845 XT, in the conditions of : I before premedication, II just before induction, III in the induction, IV in the laryngoscopy, V in the intubation and VI just after intubation also 1,3,7 minutes after intubation. Statistic examination used ANOVA and t - test, with significant p < 0,05. There did not find the difference between the dose group before premedication ( p > 0,05 ), then it was found increas of the different cardivascular response by significantly appropiate the dose in all of the groups when intubation laryngoscopy ( p < 0,05 ). When the intubation was happened derivation of the different cardiovascular response significantly appropiate the great of premedication dose and solwly down until 7 minutes after intubation ( p < 0,05 ), but the different heart rate did not significant ( p > 0,05 ) and then if approached the position before premedication. The study of oral clonidine premedication was able to decrease the cardiovasclar response in intubation laryngoscopy and clonidine premedication dose 5 pg/kgBW was the most effective in decreasing the cardiovascular response Telah diteliti respon kardiovaskuler premectikasi kionidin per oral. (po) dengan berbagai dosis pada laringoskopi intubasi. Semakin besar dosis premedikasi klonidin po semakin besar pula turunnya respon tekanan darah dan laju jantung pada laringoskopi intubasi. Tujuan penelitian untuk rnenentukan dosis premedikasi klonidin po yang paling efektif terhadap respon kardiovaskuler pada laringoskopi intubasi. Penelitian dengan " Sample Stratified Random Sampling" terhadap 100 penderita dibagi 5 kelornpok di Instalasi Bedah Sentral RS Dr Kariadi Semarang, selama 4 bulan (Maret - Juni 1998) . Subyek penelitian adalah penderita program operasi elektif dengan anestesi umurn dan fasilitas intubasi, pria dan wanita, umur 16-60 tahun, ASA NI, tekanan darah dalam batas normal, tidak terdapat indikasi kontra terhadap obat yang dipakai, tidak sedang minum obat penenang atau anti hipertensi dan bersedia mengikuti penetitian. Setelah dilakukan seleksi penderita dibagi menjadi 5 kelompok yaitu : 4 kelompok perlakuan dan I kelompok kontrol, masing-masing sebanyak 20 orang. Sernua kelompok mendapat premedikasi sulfas atropin 0,01 mg/kg berat badan (bb) intra muskuler (im), dan klonidin 2,3,4,5 gg/kgbb po dan kelompok kontrol tanpa klonidin, 90 rnenit sebelum induksi. Diberikan cairan kristaloid secukupnya sebagai pengganti puasa Induksi pentotal 5 mg/kk bb iv, suksinillcolin 1,5 mg/kg bb iv.. Setelah rileks buka mulut lakukan laringoskopi intubasi. Rumatan anestesi dengan N20 50% : 02 50%, enflurane 0,8- 1,0 vol. %, vecuronium 0,01 mg/kg bb iv. Diukur tekanan darah sistol, tekanan darah diastot, tekanan arteri rata-rata dan laju jantung dengan alat "Critikon Dinamap 845 XT" pada kondisi I sebelum premedikasi, II sesaat sebelum induksi, III waktu induksi, IV saat laringoskopi, V saat intubasi, dan VI sesaat setelah intubasi, dan VII 1,3,7 menit setelah intubasi. Uji statistik menggunakan Anova dan t-test, dengan derajat kemaknaan p < 0,05. Tidak ditemukan perbedaan diantara kelompok dosis pada sebelum premedikasi ( p > 0,05 ), kemudian ditemukan peningkatan respon kardiovaskuler yang berbeda secara bermakna sesuai dosis pada semua kelompok saat laringoskopi intubasi ( p < 0,05 ). Setelah intubasi terjadi penurunan respon kardiovaskuler yang berbeda secara bermakn'a sesuai besarnya dosis premedikasi, dan terus menurun sampai 7 menit setelah intubasi (p < 0,05), tetapi pada laju jantung berbeda tidak bermakna (p > 0,05) kemudian mendekati posisi sebelurn premedikasi. Penelitian premedikasi po dapat mengurangi respon kardiovaskuler pada laringoskopi intubasi, dan dengan premedikasi klonidin dosis 5 ug/kg bb po adalah yang paling efektif (la lam mengurangi respon kardiovaskuler

Item Type:Thesis (Masters)
Subjects:R Medicine > R Medicine (General)
Divisions:Postgraduate Program > Master Program in Biomedical Science
ID Code:14247
Deposited By:Mr UPT Perpus 2
Deposited On:14 Jun 2010 08:11
Last Modified:14 Jun 2010 08:11

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