PERUBAHAN KADAR GLUKOSA DARAH PERIOPERATIF PADA PASIEN PEDIATRI TERHADAP PEMBERIAN INFUS DEKSTROSA 2,5 % NaCl 0,45 %

Abstract

Background: 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. Methods: This research was a clinical trial desciptif (human sample) on 24 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). Results: 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. Conclusion: Infusion of 2,5 % Dextrose 0,45% NaCl significantly better not cause hypoglycemia from preoperative fasting and postoperative hyperglycemia in pediatric patients. Keywords: blood glucose, 2,5% Dextrose 0,45% NaCl,pediatric patients