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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.

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.

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Keywords: anestesi; inhalasi; isofluran; kadar COHb; sevofluran

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