PERBANDINGAN LAMA ANALGESI ANTARA BLOK SUBARAKHNOID LIDOKAIN 5 % HIPERBARIK DAN LIDOKAIN 5 % HIPERBARIK - PETIDIN.

Abstract

A study aimed to comparison duration of analgesia difference between groups of subarachnoid block hyperbaric lidocaine 5% and subarchnoi block hyperbaric lidocaine 5% - petidine Was carried out. The study used 40 samples of male pati.ens age among 20- 65 years old with physical status MA I -H, no contra indication agaiSnst lidocaine and petidine who were planned to get elective urology operation using subarchnoid block anestehsia technique. After .applying informed consent, using double blind randomized experimental design, the patient were divided into two groups that is, group A received subarachnoid block 100.mg hyperbaric liclocaine 5% and group B received subarachnoid block 100 mg hyperbariclidocaine 5% with petidine 10 mg, respectively. The onset of analgesi and motor blo•k, maximum analgesia level, two segment regression time, duration of motor block, blood Pressure, heart rate, respiration rate and incidence of adverse effets such as hypotension, bradycardia, nausea. and vomiting, respiration depression, shivering and urticaria. were variables recorded during subarachnoid block. Difference of demography data between the two groups was not sigiificant.. There were no significant differences among two group with regards to onset of analgesia and motor block, maximun analgesia level, and duration motor block ( i.e, p= 0,9029, p = 0,8797,p = 0,801, andp = 0,1452, respectively ) Two segment regression time of group B (-100,8 ±13,81 SD min ) was very significantly longer (p =0,0001 ) as compare to group A( = 62,35± 6,491 SD mM ). During subarachnoid block there were situation where decreasing of systolic, diastolic blood pressure and mean arterial pressure were significantly differ between two group, in which systolic pressure was in the 50 th, 60th, and 70th minute,(p=0,0334,p=0,0252,p-0,0136) diastolic pressure in the 30th, 40th. 60th, 70th minute(p-0,0301, p=0,0491, 7=0,0173, p=0,0040) and mean arterial pressure in the 60th and 70th minute.(p=0,03, p=0,042) Heart rate between groups was significantly different in the 40th, 50th, 60th and 70°1.(r=0,0282, /3=0,0232, p=0,0228, p=0,0137) Respiration rate, as well as incidence of hypotension, shivering, bradycardia,vomiting and nausea, on the other hand was not significantly different. This study suggests that applying of petidine 10 mg subarachnoid in subarachnoid block 100 mg hyperbaric lidocaine 5% prolonged duration of analgesia. without prolonged motoric block. Condition of hemodynamic is stable but still produce not significant adverse effects as nausea , vomiting and respiration depression A Thither study on manipulation of petidine subarakhnoid dosage using large number of samples is required. Telah dilakukan penelitian untuk menilai larim analgesi antara Wok subarakhnoid lidokain 5% hiperbarik dan lidokain 5% hiperbarik-petidin pada 40 orang penderita laki-laki dengan status fisik ASA I-11 , umur 20-65 tahun, tidak ada indikasi kontra terhadap pemberian lidokain dan petidin yang direncanakan menjalani operasi elektif urologi dengan menggunakan tehnik anestesi blok subarakhnoid. Setelah diberikan infbrined consent, dengan rancangan acak tersamar ganda penderita dibagi menjadi dna kelompok, masing-masing kelompok A mendapatkan Wok subarakhnoid lidokain 5% hiperbarik 100 mg ,-clan kelompok B mendapatkan Wok subarakhnoid lidokain 5% hiperbarik 100 mg ditambah petidin 10 mg. Mula kerja analgesi dan Wok ruotorik, level maksimal analgesi, waktu regresi 2 semen, lama Wok motorik, tekanan darah, laju jantung, laju nafas dan insidens efek samping nieliputi hipotensi, bradikardi, mual dan muntah, depresi naths, menggigil dan urtikaria dicatat selama Wok subarakhnoid. Tujuan penelitian ini adalah untuk membuktikan apakah penambahan petidin 10 mg subarakhnoid pada blok subarakhnoid lidokain 5% hiperbarik 100 mg lama anagesi lebih panjang dibandingkan Wok subarakhnoid lidokain 5% hiperbarik 100 mg. Tidak terdapat perbednan bermakna data cleniografi antara kedua kelompok. Mula kerja analgesi dan blok motorik, level maksimal analgesi dan lama Wok motorik kedua kelompok berbeda tidak bermakna (p = 0,9029, p= 0,8797, p= 0,801, danp = 0,1452 ) Waktu regresi 2 segment 100,8 ± 13,81 menit pada kelompok B secara bermalma lebih lama dibandingkan 62,35 ± 6,491 menit pada kelompok A ( p =0,0001 ). Selma blok subarakhnoid terdapat perbeclaan penurunan tekanan darah sistolik,tekanan darah diastolik, tekanan arteri rata-rata dan laju jantung yang berbeda bermakna antara kelompok A dan kelompok B; tekanan darah sistolik pada menit ke 50, 60 dan 70 ( p=0,0334,p= 0,025Z p=0,0136 ), tekanan darah diastolik pada menit ke 30, 40, 60, 70 (p= 0,0301,p= 0,0491, p= 0,0173,p= 0,0040 ) dan tekanan arteri rata-rata pada menit ke 60 dan 70 (p = 0,03 , p= 0,042 ). Laju jantung keduakelompok berbedabermakna pada menit 40, 50, 60,dan 70 ( p = 0,0282,p = 0,0232, p = 0,228, p = 0,0137), sedangkan laju nafas kedua kelompok berbeda tidak bermakna Insiden hipotensi, menggigil, bradikardi, mual-muntah dan urtikaria berbeda tidak bermakna antara kelompok A dan kelompok B. Dari basil penelitian ini dapat disimpulkan bahwa penambahan petidin 10 mg subarakhnoid pada blok subarakhnoid lidokain 5 % hiperbarik 100 mg, lama analgesi lebih panjang tanpa disertai dengan pemanjangan blok motorik Kondisi hemodinatnik yang stabil, tetapi juga menimbulkan efek samping mual-muntah dan depresi nafas yang berbeda tidak bermakna Perlu dilakukan penelitian lebih lanjut dengan dosis petidin subaraklmoid yang bervariasi dan jumlah sampel lebih banyak.