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Deksametason Untuk Mengurangi Respon Inflamasi Pada Bedah Jantung Berdasarkan Kadar C-Reactive Protein Plasma

Bagian Anestesiologi dan Terapi Intensif; Fakultas Kedokteran; Universitas Diponegoro/ RSUP Dr. Kariadi; Semarang, Indonesia

Published: 1 Mar 2019.
Open Access Copyright 2019 JAI (Jurnal Anestesiologi Indonesia)

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Abstract

Latar belakang: Bedah jantung terbuka merupakan salah satu jenis operasi dengan trauma yang cukup besar, dalam pelaksanaannya menggunakan mesin Cardiopulmonary Bypass (CPB). Penggunaan mesin CPB menyebabkan respon inflamasi yang luas dan ditandai dengan peningkatan C-Reactive Protein (CRP). Salah satu cara untuk menekan produksi CRP ini dengan menggunakan deksametason. Dosis deksametason dengan teknik pemberian premedikasi yang sering digunakan yaitu 1 mg/kgbb dan 2 mg/kgbb.

Tujuan: Membandingkan efek deksametason dengan dosis 1 mg/kgbb dan dosis 2 mg/kgbb sebagai premedikasi terhadap kadar CRP pasca CPB pada operasi jantung.

Metode: Penelitian ini merupakan uji klinik acak yang mengikutsertakan 18 pasien bedah jantung dengan anestesi umum dan menggunakan mesin CPB. Sampel dibagi 2 kelompok, yaitu deksametason dosis 1 mg/kgbb dan dosis 2 mg/kgbb sebagai premedikasi. Membandingkan jumlah CRP pada masing-masing dosis deksametason saat praoperasi dan pascaoperasi.

Hasil: Pada penelitian ini, tidak ditemukan peningkatan yang bermakna dari kadar CRP pada kedua kelompok (deksametason 1 mg/kg [p=0,813] dan deksametason 2 mg/kg [p=0,115]). Perbandingan kadar CRP pascaoperasi antara kelompok deksametason 1 mg/kg dengan kelompok deksametason 2 mg/kg didapatkan hasil yang tidak bermakna (p=0,596),

Simpulan: Tidak didapatkan perbedaan antara pemberian premedikasi deksametason 1 mg/kg dengan deksametason 2 mg/kg dalam menurunkan respon inflamasi pada operasi jantung dengan CPB.

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Keywords: bedah jantung; CPB; CRP; deksametason; inflamasi; premedikasi

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