PENGARUH INFUS DEKSTROSA 2,5 % NaCl 0,45% TERHADAP KADAR GLUKOSA DARAH PERIOPERATIF PADA PASIEN PEDIATRI THE INFLUENCE OF 2,5 % DEXTROSE 0,45% NaCl INFUSION ON PERIOPERATIVE BLOOD GLUCOSE LEVEL IN PEDIATRIC PATIENT ( THE EFFECT OF 2, 5 % DEXTROSE 0,45 % NaCl INFUSION ON PERIOPERATIVE BLOOD GLUCOSE LEVEL IN PEDIATRIC PATIENTS)

Alfanti, Erna Fitriana (2007) PENGARUH INFUS DEKSTROSA 2,5 % NaCl 0,45% TERHADAP KADAR GLUKOSA DARAH PERIOPERATIF PADA PASIEN PEDIATRI THE INFLUENCE OF 2,5 % DEXTROSE 0,45% NaCl INFUSION ON PERIOPERATIVE BLOOD GLUCOSE LEVEL IN PEDIATRIC PATIENT ( THE EFFECT OF 2, 5 % DEXTROSE 0,45 % NaCl INFUSION ON PERIOPERATIVE BLOOD GLUCOSE LEVEL IN PEDIATRIC PATIENTS). Masters thesis, Program Pascasarjana Universitas Diponegoro.

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Abstract

Latar belakang penelitian: Dari pasien pediatri yang di puasakan, semua cairan rutin diberikan harus mengandung glukosa dengan alasan pada anak hanya sedikit mempunyai cadangan glikogen di hepar ,sehingga bila pemasukan peroral terhenti selama beberapa waktu akan dengan mudah menjadi hipoglikemia yang dapat berakibat fatal terutama bagi sel otak.Selama ini diberikan cairan Dekstrosa 5 % NaCl 0,45 % tetapi menyebabkan hiperglikemia post operasi. Sehingga kita memberikan cairan infus Dekstrosa 2,5 % NaCl 0,45 % yang mempunyai kadar glukosa lebih kecil. Tujuan: Untuk membandingkan Dekstrosa 5 % NaCl 0,45 % dan Dekstrosa 2,5 % NaCl 0,45 % dalam mencegah terjadinya hipoglikemia dan hiperglikemia durante dan setelah operasi pada pasien pediatri Metode: Penelitian ini merupakan uji klinik tahap 1 ( subyek manusia ) pada 48 penderita yang menjalani operasi dengan anestesi umum. Semua penderita dipuasakan 4 jam dan diberi obat premedikasi.Pengambilan sampel darah perifer untuk pemeriksaan GDS preinduksi, pasca induksi, tiap 30 menit durante operasi.Penderita dikelompokkan secara random menjadi 2 kelompok. Kelompok I mendapat infus Dekstrosa 5% NaCl 0,45 % dan kelompok II mendapat infus Dekstrosa 2,5 % NaCl 0,45 %. Akan dilakukan uji normalitas distribusi kadar glukosa darah dengan menggunakan Kolmogorov-Smirnov test. Apabila p > 0,05 maka distribusinya disebut normal. Analisis analitik akan dilakukan untuk menguji perbedaan kadar glukosa antar kelompok dengan independent-t-test ( distribusi normal .Uji beda kadar glukosa antar kelompok dengan menggunakan paired t-test (distribusi normal ) Hasil : Karakteristik umum subyek pada masing – masing kelompok memiliki distribusi yang normal (p > 0,05), didapatkan data yang homogen ( perbedaan yang tidak bermakna, p> 0,05 ) dari semua variabel .Data sebelum perlakuan pada kelompok I ( p= 0,109 ) dan kelompok II ( p=0,106 ) memberikan hasil nilai kadar glukosa darah berdistribusi normal ( p > 0,05 ). Prainduksi ( p = 0,762 ) sampai sesaat setelah induksi ( 0,714 ) terjadi kenaikan kadar glukosa darah namun tidak bermakna ( p> 0,05 ) . Kadar glukosa antar kelompok berbeda bermakna pasca operasi mulai menit 30 sampai menit 150 ( p=0,00 ). Kadar glukosa darah pada kelompok I saat prainduksi 102,36±4,31 mg/dl, pasca induksi 106,0±44,17 mg/dl , 30 menit 107,28±6,05 mg/dl, 60 menit 108,68±7,64 mg/dl, 90 menit 110,36±9,26 mg/dl, 120 menit 112,16±16,07 mg/dl dan 150 menit 114,64±22,38 mg/dl. Uji normalitas variabel glukosa darah dilihat dari waktu, masing-masing kelompok memiliki distribusi yang normal ( p> 0,05 ) .Uji beda kadar glukosa darah antara kedua kelompok memberikan hasil berbeda bermakna ( p> 0,05 ). Simpulan: Pemberian cairan infus Dekstrosa 2,5 % NaCl 0,45 % secara bermakna lebih baik tidak menyebabkan terjadinya hipoglikemia dan hiperglikemia selama dan setelah operasi pada pasien pediatri Back ground: In pediatric patients who undergo fasting period, every routine fluid infusion given should contain glucose because children had less glycogen supply in their liver, which can lead to fatal hypoglycemia especially for brain cell if oral glucose intakes are discontinued in few moments. Over the time, we usually use 5 % dextrose 0,45 % NaCl, but this may cause postoperative hyperglycemia. Therefore, we used 2,5 % dextrose 0,45 % NaCl which have less level of dextrose. Objective: To compare the effectiveness of 5% Dextrose 0,45 % NaCl and 2,5 % Dextrose 0,45 % NaCl to prevent hypoglycemia and hyperglycemia during and after surgery in pediatric patientst. Method: This research was a clinical trial stage 1 (human sample) on 48 patients undergoing surgery by general anesthesia. All patients underwent 4 hours fasting period and received premediacation. Peripheral blood sampling was performed before and after induction, and every 30 minutes during surgery for blood glucose measurement. Patients were randomly divided in two groups. Group I received 5% Dextrose 0,45 % NaCl infusion and group two received 2,5 % Dextrose 0,45 % NaCl. The normality distribution of blood glucose level was tested by using Kolmogorov-Smirnov test. A normal distribution was determined by p > 0,05. Analytical analysis was done to evaluate the difference of blood glucose level between two groups by using independent-t-test (normal distribution). The difference test of blood glucose between two groups were performed by using paired t-test (normal distribution) Result: The general characteristics of the subjects in each group had a normal distribution (p > 0,05), showing homogen data (no significant difference; p> 0,05) on all variables. Data before treatment in Group I (p=0,109) and group II ( p=106) gave normal blood glucose level distribution ( p>0,05). There was a non significant increase of blood glucose level (p > 0.05) between preinduction (p = 0.762) and postinduction (p = 0.714). There was a significant difference on blood glucose level between the two groups 30 minutes and 150 minutes after induction (p = 0.00). Blood glucose level in group I preinduction 102,36 ±4,31mg/dl,postinduction 106,0 ±44,17mg/dl , 30 menit 107,28 ±6,05 mg/dl, 60 menit 108,68 ±7,64 mg/dl, 90 menit 110,36 ±9,26 mg/dl, 120 menit 112,16 ±16,07 mg/dl dan 150 menit 114,64 ±22,38mg/dl. From periodic blood glucose level normality test, each group had normal distribution (p > 0.05). The difference test of blood glucose level between the two groups gave a significant difference (p > 0.05). Conclusion: Infusion of 2,5 % Dextrose 0,45% NaCl significantly better not cause hypoglycemia from preoperative fasting and postoperative hyperglycemia in pediatric patients.

Item Type:Thesis (Masters)
Subjects:R Medicine > R Medicine (General)
Divisions:School of Postgraduate (mixed) > Master Program in Biomedical Science
ID Code:17418
Deposited By:Mr UPT Perpus 2
Deposited On:23 Jul 2010 11:22
Last Modified:23 Jul 2010 11:22

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