PERBANDINGAN PENGARUH SEVOFLURAN DAN ISOFLURAN TERHADAP JUMLAH NEUTROFIL POLIMORFONUKLEAR DARAH TEPI COMPARISON OF THE EFFECT OF SEVOFLURANE AND ISOFLURANE ON THE NUMBER OF PERIPHERAL POLIMORPHONUCLEAR NEUTROPHIL

Firman, Bob (2007) PERBANDINGAN PENGARUH SEVOFLURAN DAN ISOFLURAN TERHADAP JUMLAH NEUTROFIL POLIMORFONUKLEAR DARAH TEPI COMPARISON OF THE EFFECT OF SEVOFLURANE AND ISOFLURANE ON THE NUMBER OF PERIPHERAL POLIMORPHONUCLEAR NEUTROPHIL. Masters thesis, program Pascasarjana Universitas Diponegoro.

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Abstract

Latar Belakang: Neutrofil polimorfonuklear berperan penting dalam mekanisme pertahanan tubuh terhadap invasi bakteri. Pada jaringan luka, neutrofil aktif menghancurkan kuman dalam beberapa tingkat, yaitu kemotaksis, adhesi endotel, menangkap, fagosit, dan membunuh. Jumlah polimorf yang menurun sering disertai dengan meningkatnya kerentanan terhadap infeksi. Agent anestesi inhalasi seperti sevofluran dan isofluran diketahui dapat menyebabkan dinamisasi jumlah neutrofil dalam sirkulasi. Tujuan: Membandingkan pengaruh anestesi dengan sevofluran dan isofluran terhadap jumlah neutrofil polimorfonuklear. Metode: Penelitian ini dirancang sebagai uji klinis acak tersamar ganda terhadap 36 orang pasien yang menjalani operasi elektif di RS.Dr.Kariadi Semarang, dengan umur 16-55 tahun, IMT 20-25 kg/m2, lama operasi 1-3 jam, dan ASA I. Sampel darah dari kedua kelompok diambil sebelum anestesi, menit 15, menit 60, dan setelah sadar. Jumlah leukosit dan neutrofil dihitung. Tekanan darah dan laju jantung dicatat. Uji statistik menggunakan Chi square dan t test dengan derajat kemaknaan p<0,05. Hasil: Karakteristik subyek penelitian menunjukkan hubungan yang tidak bermakna. Variabel tekanan darah, laju jantung, dan lama operasi juga tidak bermakna. Jumlah leukosit pada masing-masing kelompok tidak berbeda, begitu juga perbandingannya antar kedua kelompok. Jumlah neutrofil pada kelompok sevofluran menurun secara bermakna pada menit ke15 dan menit ke 60, tetapi tidak demikian pada saat sadar. Pada kelompok isofluran jumlah neutrofil tidak berbeda bermakna. Pada uji beda antara kedua kelompok, terdapat perbedaan yang signifikan jumlah neutrofil pada menit ke 60. Kesimpulan: Terdapat perbedaan yang bermakna pengaruh sevofluran dan isofluran terhadap jumlah neutrofil polimorfonuklear, yaitu pada menit ke 60. Backround: Polymorphonuclear neutrophils are important components of the immunological defence system which protect the human organism from invading bacteria. Following injury, neutrophils are activated resulting in chemotaxis, endothelial adhesion, diapedesis, binding and phagocytosis of foreign material and intra-cellular killing. Reducing number of neutrophils will be followed by increasing risk of infection. Inhaled anaesthesia such as sevoflurane and isoflurane are known to imply neutrophil circulation dinamization during surgery. Object: To compare the effect of anaesthesia with sevoflurane and isoflurane on the number of peripheral polymorphonuclear neutrophil . Methods: The study was designed as double blind randomly clinical trial on 36 patients underwent elective surgery at Dr Kariadi Hospital Semarang, 16-55 age, 20- 25 kg/m2 BMI, 1-3 hours surgery time, ASA I. Blood sample from sevoflurane and isoflurane groups were taken before anaesthesia, 15, 60 minutes, and after conscious stage. The absolute number of leucocytes and neutrophils were counted while blood pressure and heart rate recorded. In assessing the result, statistical significancy was tested by the Chi-square test and t-test with considered significant p < 0.05. Result: The characteristic data of the patients was not significantly different between the two groups, either blood pressure, heart rate, and time of surgery. There was no significant difference change on leucocytes number in each group and neither between the two groups. Neutrophils in sevoflurane group significantly reduced at 15 and 60 minutes, but not after conscious stage. In isoflurane group, neutrophils was not significantly different. And between two groups, significantly difference on neutrophils number found at 60 minutes. Conclusions: There is significant difference of the effect of sevoflurane and isoflurane on the peripheral polimorphonuclear neutrophil number, at 60 minutes.

Item Type:Thesis (Masters)
Subjects:R Medicine > R Medicine (General)
Divisions:Postgraduate Program > Master Program in Biomedical Science
ID Code:16831
Deposited By:Mr UPT Perpus 2
Deposited On:16 Jul 2010 09:29
Last Modified:16 Jul 2010 09:29

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