Klonidin 1,5 Mcg/Kgbb Intravena Dibandingkan Dengan Fentanil 2 Mcg/ Kgbb Intravena Terhadap Respon Hemodinamik Akibat Tindakan Laringoskopi dan Intubasi Endotrakeal

*Agus Susanto -  Bagian Anestesiologi, Perawatan Intensif dan Manajemen Nyeri, Fakultas Kedokteran, Universitas Hasanuddin Makassar, Indonesia
Husni Tanra -  Bagian Anestesiologi, Perawatan Intensif dan Manajemen Nyeri, Fakultas Kedokteran, Universitas Hasanuddin Makassar, Indonesia
Published: 1 Nov 2013.
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Section: Penelitian
Language: ID
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Abstract
Latar Belakang : Laringoskopi dan intubasi endotrakhea suatu tindakan yang sering dilakukan pada anestesi umum maupun dalam manajemen jalan napas. Sering terjadigaejolak hemodinamik akibat tindakan ini, dan langkah-langkah penanggulangan perlu diambil untuk mencegah kejadian tersebut. Klonidin diharapkan dapat mengurangi gejolak hemodinamik akibat laringoskopi-intubasi. Tujuan : Menilai efek premedikasi klonidin 1,5 mcg/kgBB intravena dibandingkan dengan premedikasi fentanil 2 mcg/kgBB intravena terhadap respon hemodinamik akibat tindakan laringoskopi dan intubasi endotrakeal. Metode : Penelitian ini dilakukan pada 40 pasien dibagi dalam 2 kelompok dengan uji klinik tersamar ganda. Yang mendapat klonidin 1,5 mcg/kgBB (kelompok K, n=20) dan yang mendapat fentanil 2 mcg/kgBB (kelompok F,n=20), keduanya diinduksi dengan propofol 2 mg/kgBB dan atracurium 0.5 mg/kgBB. Laju jantung (LJ), tekanan darah sistolik (TDS), tekanan darah diastolik (TDD) dan tekanan arteri rerata (TAR) diukur saat basal, setelah pemberian klonidin atau fentanil, setelah induksi anestesi, saat intubasi endotrakeal, dan menit 1,2,3,4,5 setelah intubasi endotrakeal. Hasil : Meskipun terjadi peningkatan LJ, TDS,TDD dan TAR saat intubasi namun didapatkan penurunan lebih rendah pada kelompok K. Pada kelompok K terjadi penurunan TDS pada menit ke-1 (p0.013), menit ke-2(p=0.037) ,TDD menit ke-1 (p=0.048),TAR menit ke-1 (p=0.012) yang bermkana setelah intubasi endotrakeal.Kesimpulan: Klonidin 1,5 mcg/kgBB dan fentanil 2 mcg.kgbb intravena sama-sama dapat menekan respon hemodinamik saat laringoskopi dan intubasi endotrakeal namun pada penelitian ini lebih bermkna pada klonidin.
Keywords
klonidin; fentanil; respon hemodinamik; laringoskopi; intubasi

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