PEMAKAIAN ROKURONIUM DAN SUKSINILKOLIN SEBAGAI F'ASILITAS INTUBASI PIPA ENDOTRAKHEA

Abstract

Background: Succinylcholine is the drug of choice to facilitate airway control during rapid inducfion. The adverse reactions of succinylcholine are myalgia, changes of blood pressure, bradycardi even asistole, malignant hypertermi, increased intragasric pressure and intracranial pressure. Rocuronium is the new nondepolarizing muscle relaxant with a brief onset of action, but devoid of the adverse reactions associated with succinylcholine. Rocuronium can be used as an alternative to succinylcholine. Objective: To compared rocuronium with succinylcholine for rapid-sequence induction of anesthesia and scored the intubating conditions. Method: The study was conducted in Kariadi General Hospital from September until December 2000. Fourty patients, ASA 1-2, age between 15-40 years old with Randomized Control Trial study design were devided into two groups, succinylcholine and rocuronium group.. Patients were premedicated with atropine sulfas 0,01mg/kg and midazolam 0,07mg/kg and received 5 mg/kg thiopental for induction of anesthesia Patients were injected succinylcholine 1 mg/kg or rocuronium 0,06 mg/kg. Sixty seconds after receiving a muscle relaxant, the trachea was intubated and the intubating conditions were scored. Statistical analysa use nest. Result: Intubating conditions were excellent (17 patients) or good (3 patients) in succinyicholine group and excelent (13 patient) or good (7 patients) in rocuronium group. Intubating conditions were not significantly different (p>0,05) between the rocuronium group and succinylcholine group. Conclution: It is concluded that intubating conditions after administration of both drugs are similar. Latar belakang: Suksinilkolin masih merupakan pelumpuh otot pilihan untuk fasilitas penguasaan jalan napas pada induksi cepat. Kelemahan dad suksinilkolin antara lain nyeri otot, perubahan tekanan darah, bradikardi bahkan asistole, hipertermi malign; peningkatan tekanan intragastrik serta intrakranial. Rokuronium adalah pelumpuh otot non depolarisasi dengan mula kerja cepat tapi tidak mempunyai sifat menigikan seperti suksinilkolin, dapat sebagai alternatif pengganti. Tnjuan: Membandingkan rokuronium dengan suksinilkolin untnk induksi cepat dengan menilai kondisi intubasi yang dihasilkan oleh kedua obat Metoda: Penelitian dilakukan di Rumah Sakit Umum Karim:1i sejak bulan September hingga Desember 2000. Empat puluh pasien (ASA 1-2) , 1540 tahun dengan rEtncangan penelitian Randomized Control Trial, penderita dibagi dua kelompok yaitu kelompok suksinilkolin dan rokuronium. Pasien dipremedikasi dengan sulfas atropin 0,01 mg/kg dan midazolam 0,07 mg/kg seda tiopental 5 mg/kg untuk induksi. Pasien diberi rokuronium 0,6 mg/kg (n=20) Mau suksinilkolin 1 mg/kg (n=20) intravena Enampulult detik setelah pemberian pelumpuh otot dilakukan intubasi trakhea dan kondisi intubasi dinilai. Analisa statistik menggunakan West Hasil: Didapat kondisi intubasi sangat baik (17 orang) serta baik (3 orang) pada kelompok yang mendapat suksinilkolin dan sangat baik (13 orang) serta baik (7 orang) path kelompok rokuronium. Tidak ada perbedaan yang bermakna (p>0,05) untuk kondisi intubasi kedua kelompok