PENGARUH B-2 AGONIS SELEKTIF TERHADAP KADAR KALIUM DARAH AKlBAT PEMBERIAN SUKSAMETONIUM

Abstract

The increase of potassium consentration to suxamettionitim administration often causes problems especially if the potassium consentration increases abruptly or in a short time.. The study of selective p-2 agonist's effect on potassium serum level following stconnethonium administration had been conducted to sixty patients undergoing general anesthesia in central operating theatre at Dr. Kariadi General -Hospital in Semarang. The aim of this study was to discover the effect of albuterol or terbutaline on potassium serum level following euxamethonium administration. There were three groups of sample, each consisted of twenty patients. Patients in group I received 2 mg of oral albuterol 2,7 hours or 2 hours 42 minute before induction, and those in group II : 2,5 mg oral terbutaline 2 hours before anesthetical induction, and those in group III received oral asylum before induction. Patients included in this study were male aged 16-40 years old, athletic type posture and ideal body weight (B14120-24 Kg/m2). All of them were in ASA physical status I-U, and no contra indication for suxamethonium. Patients having medication which may influence potassium semi level, taking potassium supplement, having any disorder of muscle and metabolic process were excluded. The potassium serum level was measured before premedication given. Albuterol was the premedication for group I, terbutaline, those in group II, and asylum in group III. All patients were induced using pentollud (5 mg/Kg) and endhotracheal intubation was facilitated by intravenous administration of suxametbonium (1,5 mg/1(h). There minutes after anesthetical induction, blood sample was taken to measure the potassium serum level in each group. The study revealed that, there was no statistically significant difference (p > 0,05) of potassium serum level between group I (-0,13 ± 0,1) and group II (- 0,16 ± 0,9). The potassium level on group I (- 0,13 ± 0,1) and group II (- 0,16 ± 0,9) statistically differed (p < 0,05) from that of group III (0,34 ± 0,11). This study concluded that selective p-2 agonist could decrease the potassium serum level following suxamethonium administration. Albuterol is as effective as terbutaline in decreasing potassium serum level following suxamethonium administration Kenaikan konsentrasi kalium sehubtmgan dengan pemberian suksametonium sating menimbulkan masalah, terutama bila peningkatannya mendadak atau dalam waktu yang cepat. Telah dilakukan penelitian tentang pengaruh p-2 agonis selektif terhadap kadar kalium akibat pemberian suksametonium pada 60 penderita yang menjalani anestesi umum di Instalasi Bedah Sentral RSUP Dokter Kariadi Semarang. Tujuan dari penelitian int, amok mencari bukti obyektif pengaruh pemberian albuterol atau terbutalin terhadap kadar kalium akibat pemberian suksametonium. Penelitian mengumpulkan masing-masing 20 penderita yang mendapat albuterol 2 mg per oral 2,7 jam sebelum induksi (kelompok I), 20 penderita yang mendapatkan terbutalin 2,5 mg per oral 2 jam sebelum induksi (kelompok II) dan 20 penderita mendapat amylum per oral sebelum induksi (kelompok DI). Penderita status fisik I-II, umur 16-40 tahun, laki-laki, tine fisik atletik dengan berm badan ideal (EMI 20-24 Kg/m2), tidak terdapat kelainan metabolisme, kelainan otot, tidak mendapat suplemen kalitan, tidak dalam pengobatan dengan obat yang mempengaruhi kadar kalium darah dan tidak ada kontra indikasi dengan suksametonium. Sampel dotal% masing-masing pasien diambil untuk diperiksa kadar kalium pada seat pemberian obat premedikasi. Premedikasi dengan albuterol untuk kelompok I, terbutalin untuk kelompok II dan amylum untuk kelompok DI Indikasi dengan pentotal 5 mg/KgBB IV dan fasilitas intubasi dengan suksametonium 1,5 mg/KgBB IV, 3 menit setelah induksi unmet darah diambil untuk diperiksa kadar kaliumn pada ketiga kelompok. Hasil penelitian menunjukkan pembandingan perubahan kadar kalium antara kelompok albuterol (-0,13 ± 0,1) dengan kelompok terbutalin (-0,16 ± 0,9), secara statistik berbeda tapi tidak bermakna (p > 0,05). Perbandingan antara kelompok albuterol (-0,13 ± 0,1), terbutalin (-0,16 ± 0,9) dengan kelompok amylum (0,35 ± 0,11), secara statistik berbeda berrnalam (n < 0,05). Kesimpulan dari penelitian ini adalah 13-2 agonis selcktif dapat memtrunkan kadar kalium akibat pemberian suksametonium. Albuterol dan terbutal in keduanya menipakan obat golongan p-z agonis selektif, mempunyai struktur kimia yang hampir sama efek•tifinya dalam menurunkan kadar kalium darah akibat pemberian suksametonitun. rata kiencl fl-2 agonis selektif hiperkakati, s-uksametonium