DOI: https://doi.org/10.14710/jai.v7i2.9825

Meperidin, Ketamin dan Klonidin Efektif Untuk Terapi Menggigil pada Sectio Secaria dengan Anestesi Spinal

1Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Unversitas Diponegoro/ RSUP Dr. Kariadi, Indonesia

2Semarang, Indonesia

Published: 1 Jul 2015.

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Abstract

Latar Belakang : Anestesi spinal banyak dilakukan pada sectio cesarea, tetapi anestesi spinal dapat menimbulkan menggigil pada periode perioperatif. Menggigil menyebabkan pasien tidak nyaman, membahayakan pasien dan mengacaukan pemantauan peri dan postoperatif. Ondansetron, meperidin, klonidin, dan ketamin adalah obat-obatan yang dapat mengatasi menggigil.

Tujuan :  mengetahui angka kejadian menggigil pada section secaria pada pasien yang mendapat ondansetron, dan menilai efektivitas terapi menggigil dari meperidin, klonidin, dan ketamin pada sectio secaria dengan anestesi spinal

Metode : pasien pasien sectio secaria dengan anestesi spinal yang memenuhi kriteria inklusi dan ekslusi, diberikan premedikasi 0,25 mg sulfas atropin dan 4 mg ondansetron setengah jam sebelum tindakan . Dilakukan anestesi spinal dengan bupivakain hiperbarik. Bila terjadi hipotensi diterapi dengan efedrin, bila terjadi bradikardi diberikan sulfas atropin. Dilakukan pengamatan pada onset dan beratnya menggigil. Pasien yang menggigil kemudian dikelompokkan kedalam 3 kelompok. Kelompok M diterapi dengan 25 mg meperidin. Kelompok K mendapat terapi 25 mg ketamin dan kelompok L mendapat terapi 75 mcg klonidin. Respon terapi diukur sejak penyuntikan terapi sampai hilangnya menggigil. Terapi dianggap berhasil bila dalam waktu 15 menit tanda menggigil hilang. Dilakukan pengamatan tentang skor sedasi dan efek samping mengenai nausea, vomitus, bradikardi, hipotensi,tanda alergi, mengigau, depresi respirasi dan efek samping yang lain. Bila terjadi efek samping diterapi dengan cara yang sesuai.

Hasil : Menggigil terjadi pada 46% pasien. Ketiga kelompok menunjukkan perbedaan yang tidak bermakna, baik dalam hal respon terapi maupun keberhasilan terapi.

Simpulan : Menggigil terjadi pada 46% pasien sectio secaria dengan anestesi spinal yang mendapat ondansetron sebelumnya. Meperidin, ketamin dan klonidin efektif dan mempunyai efektivitas yang sama untuk terapi menggigil pada sectio secaria dengan anestesi spinal.

 

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Keywords: menggigil; sectio caesaria; ondansentron; meperidin; ketamin; klonidin

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