PENGARUH PEMBERIAN ETOMIDATE TERHADAP KADAR GULA DARAH PASCA INDUKSI ANESTESI THE EFFECT OF ETOMIDATE ADMINISTRATION ON BLOOD GLUCOSE POST ANESTHESIA INDUCTION

Abstract

ABSTRAK Latar belakang : Kekhawatiran etomidate menyebabkan hipoglikemi menjadi masalah. Onset aksi cepat, profil kardiovaskular rendah dan kurang signifikan menyebabkan penurunan tekanan darah membuat etomidate menjadi pilihan obat anestesi induksi yang cukup baik. Tujuan : Membuktikan pengaruh pemberian etomidate dalam menyebabkan penurunan kadar gula darah. Metode : Merupakan penelitian pretest posttest controlled group design pada 40 pasien yang menjalani operasi dengan anestesi umum, dibagi menjadi 2 kelompok (n=20), kelompok 1, etomidate 0,2 mg/kg (E2) dan kelompok 2, etomidate 0,4 mg/kg (E4). Masing – masing kelompok diperiksa kadar gula darah sebelum, 2 jam dan 6 jam sesudah induksi. Uji statistik pair T-test dan Wilcoxon rank sum test terhadap E2 dan E4. Hasil : Pada E 2 terdapat perbedaan bermakna P=0,05 antara sebelum dan 2 jam sesudah perlakuan 106,95 ± 15,453 mg/dl - 96,40 ± 14,966 mg/dl; 2 jam dan 6 jam sesudah perlakuan P=0,016; 96,40 ± 14,966 mg/dl - 108,85 ± 27,238 mg/dl. Sedangkan pada E 4 terdapat perbedaan bermakna P=0,041 baik sebelum dan 2 jam sesudah 102,60 ± 12,696 mg/dl - 99,35 ± 15,938 mg/dl; sebelum dan 6 jam sesudah P=0,041; 102,60 ± 12,696 mg/dl - 98,25 ± 19,878 mg/dl; maupun 2 jam dan 6 jam sesudah perlakuan P=0,041; 99,35 ± 15,938 mg/dl - 98,25 ± 19,878 mg/dl. Tetapi tidak terdapat perbedaan bermakna antara E2 dan E4 dalam menyebabkan penurunan kadar gula darah baik 2 jam P=0,550; 96,40 ± 14,966 mg/dl - 99,35 ± 15,938 mg/dl, maupun sesudah 6 jam pemberian P=0,104; 108,85 ± 27,238 mg/dl - 98,25 ± 19,878 mg/dl. Secara statistik etomidate menurunkan kadar gula darah baik pada E2 maupun E4 tetapi masih dalam batas normal atau secara klinik tidak bermakna. Kesimpulan : Etomidate 0,2 mg/kg (E2) dan 0,4 mg/kg (E4) secara statistik bermakna menurunkan kadar gula darah pada 2 jam dan 6 jam sesudah induksi,tetapi secara klinis tidak bermakna. Sedangkan E4 tidak terbukti lebih menurunkan kadar gula darah lebih besar dibandingkan E2. Kata kunci : Etomidate, supresi adrenal, kadar gula darah. xx ABSTRACT Background : The apprehensiveness of etomidate that causing hypoglicaemia becomed problem. A rapid onset of action, a low cardiovascular risk profile, and less likely to cause a significant drop in blood pressure provide etomidate choose an anesthetic induction drug. Objective : To proved the usage effects of etomidate that causing decrement of blood glucose level. Method : Pretest posttest controlled group design on 40 patients who are undergoing surgery with general anesthesia, divided into two groups (n=20), group E2 and E4, which received etomidate 0,2 mg/kgbw and 0,4 mg/kgbw respectively. Each group was examined its blood glucose 3 times, before, 2 hours, and 6 hours after induction. All data in E2 and E4 were analyzed by paired T-test and Wilcoxon rank sum test. Result : Blood glucose of E2 were significantly different P=0,05 between before and 2 hours after intervention 106,95 ± 15,453 mg/dl - 96,40 ± 14,966 mg/dl; between 2 hours and 6 hours after intervention P=0,016; 96,40 ± 14,966 mg/dl - 108,85 ± 27,238 mg/dl.While blood glucose of E4 were significantly different P=0,041 between before and 2 hours after intervention 102,60 ± 12,696 mg/dl - 99,35 ± 15,938 mg/dl;between before and 6 hours after intervention P=0,041; 102,60 ± 12,696 mg/dl - 98,25 ± 19,878 mg/dl; and between 2 hours and 6 hours after intervention P=0,041;99,35 ± 15,938 mg/dl-98,25 ± 19,878 mg/dl. However, there were no significant differences between E2 and E4 in decreasing blood glucose on 2 hours P=0,550; 96,40 ± 14,966 mg/dl - 99,35 ± 15,938 mg/dl and 6 hours after intervention P=0.104;108,85 ± 27,238 mg/dl - 98,25 ± 19,878 mg/dl. Statistically, etomidate could caused decrement on blood glucose, both in group E2 and E4 but still in normal border or clinically insignificant. Conclusion : Etomidate 0,2 mg/kgbw (E2) and 0,4 mg/kgbw (E4) were statistically significant in decreasing blood glucose on 2 hours and 6 hours after induction but clinically insignifican. While E4 were not decreasing blood glucose higher than E2. Keywords : Etomidate, adrenal suppression, blood glucose