PERBANDINGAN KEJADIAN MUAL MUNTAH PADA ANESTESI SPINAL ANTARA INFUS KONTINYU EFEDRIN DAN PRELOAD HAES STERIL 6 %

Abstract

Background : Nausea vomiting can increased aspiration risk, where this sympthom is often occure on spinal anesthesia and the incidence almost 25% . It caused by many factors, but the main is hipotension, which can be prevented by giving vasopressor or fluid loading. The aim of this study is to compare the incidence of nausea vomiting on spinal anesthesia between ephedrine continuous infusion and HAES Steril 6% preload. Method : This experimental study using post test only control group design , conducted in 44 patients underwent elective surgery of lower abdomen, perineum and lower extremities, divided into group I ( ephedrine ) and group II ( HAES Steril 6% ). Spinal anesthesia was performed using bupivacaine heavy 0.5 % . Group I was given ephedrine continuous infusion at a rate 5mg/minute for the first 2 minute and then 1mg/minute for the next 18 minute right after spinal anesthesia. Group II was given HAES Steril 6% 7.5 ml/KgBW in 10 minutes as preload, 20 minutes before spinal anesthesia. Systolic blood pressure, diastolic blood pressure and heart rate were measured every minute for the first 20 minutes and every 2 minutes for the next 10 minutes. The incidence of naysea vomitingg were recorded on both groups. Data was analyzed by using independence T-test , Chi-Square Test and ANOVA at significancy level p<0.05. Results : Demographic data and preoperative clinical state have similar distribution on both groups. The incidence of hypotension is 1/22 ( 4.54 %) in group I and 7/22 ( 31.81%) in Group I I, the difference is statistically significant ( p<0.05). Repeat measures of sytolic blood pressure within the first 30 minutes shows significant difference between 2 groups ( p<0.05 ). The incidence of nausea vomiting is significant difference ( p<0.05 ) between 2 groups. There are no significant difference in hypertension and tachycardia. Conclusion : Ephedrine continuous infusion 5mg/minute, the fisrt 2 minutes and then 1mg/minute for the next 18 minutes right after spinal anesthesia. Is more effective to prevent nausea vomiting compare with preload HAES Steril 6% 7.5 ml/Kg BW. Key Words : Ephedrine continuous infusion, preload coloid, nausea vomiting, spinal anesthesia