skip to main content

Kadar COHb (Karboksihemoglobin) pada Penggunaan Sevofluran dan Isofluran Pasien yang Menjalani Vitrektomi di Rumah Sakit Umum Pusat Dokter Kariadi

1Anesthesiology and Intensive Therapy Department, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Indonesia

2Anesthesiology and Intensive Therapy Resident, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Indonesia

Received: 10 Nov 2022; Published: 31 Mar 2023.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)

Citation Format:
Abstract

Latar Belakang: Sevofluran dan isofluran merupakan agen inhalasi yang sering digunakan sebagai maintenance anestesi umum selama operasi. Penggunaan sevofluran dan isofluran diketahui menghasilkan karbon monoksida (CO) dalam kontak dengan adsorbent atau penyerap CO2 tipe kering. Tiga puluh satu kasus keracunan CO intra-operatif ditemukan di RSUP Dr. Kariadi Semarang, dengan konsentrasi CO melebihi 1000 parts per million (ppm) dan konsentrasi karboksihemoglobin (COHb) mencapai lebih dari 30%. Pasien yang mengalami keracunan CO dengan kadar COHb yang tinggi dapat mengeluhkan gejala seperti sakit kepala, mual, muntah, pusing, dan kelemahan anggota gerak, bahkan dapat mengakibatkan pasien sulit sadar hingga kematian.

Tujuan: Mengetahui perubahan kadar COHb pada penggunaan agen inhalasi sevofluran dan isofluran pada pasien yang menjalani bedah vitrektomi di RSUP Dr. Kariadi Semarang.

Metode: Penelitian ini adalah eksperimental dengan non randomized control group pre-test post-test yang dilakukan di instalasi bedah sentral RSUP Dr. Kariadi selama 3 bulan. Kadar COHb diambil dengan sampel darah vena pada sebelum induksi dan 60 menit setelah induksi. Pemeriksaan kadar COHb menggunakan metode kuantitatif dengan Human COHb (carboxyhemoglobin) ELISA. Total subjek adalah 26 orang dengan rata-rata usia 48,27 tahun. Subjek dibagi menjadi 2 kelompok yaitu kelompok sevofluran dan isovluran dengan rata-rata durasi operasi selama 65 menit.

Hasil: Kadar COHb pre-test kelompok sevofluran dan isofluran adalah 4,34 dan 4,39. Kadar COHb post-test kelompok sevofluran dan isofluran adalah 4,48 dan 4,95.

Kesimpulan: Hal ini menunjukan bahwa nilai post-test COHb pada kelompok isoflurane lebih tinggi dengan peningkatan kadar COHb yang lebih besar dibandingkan dengan kelompok sevofluran. Isofluran menghasilkan kadar COHb lebih tinggi daripada sevofluran.

Note: This article has supplementary file(s).

Fulltext View|Download |  common.other
Copy Right Transfer Agreement
Subject
Type Other
  Download (667KB)    Indexing metadata
 common.other
Ethical Clearance dan Surat Ijin Penelitian
Subject
Type Other
  Download (80KB)    Indexing metadata
Keywords: anestesi; inhalasi; isofluran; kadar COHb; sevofluran

Article Metrics:

  1. Fang ZX, Eger EI, Laster MJ, Chortkoff BS, Kandel L, Ionescu P. Carbon Monoxide Production from Degradation of Desflurane, Enflurane, Isoflurane, Halothane, and Sevoflurane by Soda Lime and Baralyme Registered Trademark. Anesth Analg. 1995 Jun;80(6):1187–93. doi: 10.1097/00000539-199506000-00021
  2. Holak EJ, Mei DA, Dunning MB, Gundamraj R, Noseir R, Zhang L, et al. Carbon Monoxide Production from Sevoflurane Breakdown: Modeling of Exposures Under Clinical Conditions. Anesth Analg. 2003 Mar;757–64. doi: 10.1213/01.ANE.0000049584.64886.39
  3. Coppens MJ, Versichelen LFM, Rolly G, Mortier EP, Struys MMRF. The mechanisms of carbon monoxide production by inhalational agents. Anaesthesia. 2006 May;61(5):462–8. doi: 10.1111/j.1365-2044.2006.04536.x
  4. Lawes EG. Hidden hazards and dangers associated with the use of HME/filters in breathing circuits. Their effect on toxic metabolite production, pulse oximetry and airway resistance. Br J Anaesth. 2003 Aug;91(2):249–64. doi: 10.1093/bja/aeg154
  5. Aydin S. A short history, principles, and types of ELISA, and our laboratory experience with peptide/protein analyses using ELISA. Peptides (NY). 2015 Oct;72:4–15. doi: 10.1016/j.peptides.2015.04.012
  6. Frink EJ, Nogami WM, Morgan SE, Salmon RC. High Carboxyhemoglobin Concentrations Occur in Swine during Desflurane Anesthesia in the Presence of Partially Dried Carbon Dioxide Absorbents . Anesthesiology. 1997 Aug 1;87(2):308–16. doi: 10.1097/00000542-199708000-00018
  7. Moody A, Beutler B, Moody C. Predicting cost of inhalational anesthesia at low fresh gas flows: impact of a new generation carbon dioxide absorbent. Med Gas Res. 2020;10(2):64. doi: 10.4103/2045-9912.285558
  8. Sarner JB, Levine M, Davis PJ, Lerman J, Cook RD, Motoyama EK. Clinical Characteristics of Sevoflurane in Children . Anesthesiology. 1995 Jan 1;82(1):38–46. doi: 10.1097/00000542-199501000-00006
  9. Keijzer C, Perez RS, de Lange JJ. Carbon monoxide production from five volatile anesthetics in dry sodalime in a patient model: halothane and sevoflurane do produce carbon monoxide; temperature is a poor predictor of carbon monoxide production. BMC Anesthesiol. 2005 Dec 2;5(1):6. doi: 10.1186/1471-2253-5-6
  10. Anjana RR, Parikh P v., Mahla JK, Kelawala DN, Patel KP, Ashwath SN. Comparative evaluation of isoflurane and sevoflurane in avian patients. Vet World. 2021 May 4;1067–73. doi: 10.14202/vetworld.2021.1067-1073
  11. Deori P, Sarma KK, Nath PJ, Singh CK, Nath R. Physiological alteration, quality of anesthesia and economy of isoflurane in domestic chickens (Gallus domesticus). Vet World. 2017 May;10(5):493–7. doi: 10.14202/vetworld.2017.493-497
  12. Pardo M Miller RD. Basics of Anesthesia. Philadelphia PA: Elsevier; 2018
  13. Carbon Dioxide Absorbent Desiccation Safety Conference Convened by APSF - Anesthesia Patient Safety Foundation [Internet]. [cited 2022 Nov 8]. Available from: https://www.apsf.org/article/carbon-dioxide-absorbent-desiccation-safety-conference-convened-by-apsf/
  14. Bleecker ML. Carbon monoxide intoxication. In 2015. p. 191–203. doi: 10.1016/B978-0-444-62627-1.00024-X
  15. Gorman D, Drewry A, Huang YL, Sames C. The clinical toxicology of carbon monoxide. Toxicology. 2003 May 1;187(1):25–38. doi: 10.1016/s0300-483x(03)00005-2
  16. Levy RJ. Anesthesia-Related Carbon Monoxide Exposure. Anesth Analg. 2016 Sep;123(3):670–81. doi: 10.1213/ANE.0000000000001461
  17. Hampson NB, Piantadosi CA, Thom SR, Weaver LK. Practice Recommendations in the Diagnosis, Management, and Prevention of Carbon Monoxide Poisoning. Am J Respir Crit Care Med. 2012 Dec 1;186(11):1095–101. doi: 10.1164/rccm.201207-1284CI
  18. Ronzani M, Woyke S, Mair N, Gatterer H, Oberacher H, Plunser D, et al. The effect of desflurane, isoflurane and sevoflurane on the hemoglobin oxygen dissociation curve in human blood samples. Sci Rep. 2022;12(1):13633. doi: 10.1038/s41598-022-17789-6
  19. Vreman HJ, Stevenson DK, Zwart A. Analysis for carboxyhemoglobin by gas chromatography and multicomponent spectrophotometry compared. Clin Chem. 1987 May 1;33(5):694–7. doi: 10.1093/clinchem/33.5.694
  20. Wissing H, Kuhn I, Warnken U, Dudziak R. Carbon Monoxide Production from Desflurane, Enflurane, Halothane, Isoflurane, and Sevoflurane with Dry Soda Lime. Anesthesiology. 2001 Nov 1;95(5):1205–12. doi: 10.1097/00000542-200111000-00026

Last update:

No citation recorded.

Last update: 2024-11-20 07:13:21

No citation recorded.