Efek Dexmedetomidine 0,2 ug/kgbb Intravena terhadap Insiden Delirium saat Pulih Sadar dari Anestesi Umum pada Pasien Pediatrik

*Cahya Hendrawan  -  Bagian Anestesiologi, Perawatan Intensif dan Manajemen Nyeri, Fakultas Kedokteran, Universitas Hasanuddin, Indonesia
Syafri Kamsul Arif  -  Bagian Anestesiologi, Perawatan Intensif dan Manajemen Nyeri, Fakultas Kedokteran, Universitas Hasanuddin, Indonesia
Published: 1 Jul 2013.
Open Access
Citation Format:
Article Info
Section: Penelitian
Language: ID
In Vol 5, No 2 (2013): Jurnal Anestesiologi Indonesia
Statistics: 670 270
Abstract
Latar Belakang : Dexmedetomidine memberikan efek sedasi, analgesia, dan anxiolitiksetelah pemberian intravena. Isofluran dan sevofluran dihubungkan dengan angkakejadian delirium saat pulih sadar dari anestesi umum pada pasien pediatrik. Padapenelitian dengan menggunakan placebo sebagai kontrol, kami mengevaluasi efek daridosis tunggal dexmedetomidine pada delirium saat pulih sadar dari anestesi umumpada pasien pediatrik yang menjalani pembedahan elektif menggunakan anestesiumum dengan isofluran.
Metode : Pada penelitian acak tersamar ganda ini , 46 anak (usia 3-10 tahun) dipilihsecara acak mendapatkan dexmedetomidin 0,2ug/kgBB atau placebo pada akhirpembedahan. Semua pasien mendapatkan obat anestesi yang standar. Setelahpembedahan, nilai delirium saat pulih sadar dari anestesi umum diukur sampai 1 jampascabedah. Waktu ekstubasi, waktu pulih sadar, dan efek samping daridexmedetomidine dicatat. Setelah pembedahan nyeri pasien diukur denganmenggunakan objective pain scale (OPS) .
Hasil : Nilai delirium saat pulih sadar dari anestesi umum pada kelompokdexmedetomidine lebih baik daripada kelompok placebo (P<0,05). Nilai nyeri samapada kedua kelompok (P>0,05). Waktu ekstubasi dan waktu pulih sadar lebih panjangpada kelompok dexmedetomidin tetapi tidak bermakna secara statistik (P>0,05). Tidakada efek samping (hipotensi dan bradikardi) pada kedua kelompok.
Kesimpulan : Kami menyimpulkan bahwa Dexmedetomidine 0,2ug/kgBB intravenadapat mengurangi insiden delirium saat pulih sadar dari anestesi umum denganisofluran pada anak yang menjalani pembedahan elektif.
Keywords: dexmedetomidine; delirium; isofluran; anesthesia

Article Metrics:

  1. Lewis TV, Malviya S. A prospective cohort study of emergence agitation in the pediatric postanesthesia care unit. Anesth Analg 2003;96:1625-30.
  2. Mason LJ. Emergece delirium. In: Pitfalls of pediatric anesthesia, New York: Loma Linda University Publisher;2010.p.150-5
  3. Guler G, Akin A, Tosun Z, Ors S, Esmaoglu A, Boyaci A. Single-dose dexmedetomidine reduces agitation and provides smooth extubation after pediatric adenotonsillectomy. Pediatric Anesthesia 2005;15:762-6
  4. Syukry M, Cain JG. Dexmedetomidine prevents and treats agitation, delirium, and withdrawl. Int J Trauma 2007;17(1):24-6
  5. Ibacache ME, Munoz HR, Brandez V, Morales AR. Single dose dexmedetomidine reduce agitation after sevofluran anesthesia in children. Anesth Analg 2004;98(1):60-63
  6. Malviya S. Assessment of pain in children. Presennted at SPA annual meeting. 2006: 3-6
  7. McClain BC. Newer modalities for pain managements. Presented at SPA Annual Meeting. 2006: 1-6
  8. Mountain BW, Smithson L, Cramolini M, Wyatt TH, Newman M. Dexmedetomidine as a pediatric anesthetic premedication to reduce anxiety and to deter emergence delirium. AANA J 2011;79(3):219-23
  9. Weldon BC, Watcha MF, White PF. Oral midazolam in children: effect of time and adjunctive theraphy. Anesth Analg 1992;75(5)51-55
  10. Mountain BW, Smithson L, Cramolini M, Wyatt TH, Newman M. Dexmedetomidine as a pediatric anesthetic premedication to reduce anxiety and to deter emergence delirium. AANA J 2011;79(3):219-23
  11. Meyer RR, Munster P, Werner C, Barmbrink AM. Isofluran is associated with a similar incidence of agitation/delirium as sevofluran in young children: a randomised controlled study. Pediatr Anesth 2007;17(1):56-60
  12. Samira A, Bajwa FR, Fanzcha DC, Allan M. A Comparison of emergence delirium scales following general anesthesia in children. Pediatr Anaesth J 2010;20(8):704-11
  13. Tobias JD. Dexmedetomidine: Applications in pediatric critical care and pediatric anesthesiology. Pediatr Crit Care Med 2007;8:115-131
  14. Aarts A, Hagen VV, Russchen H. Does pharmacologic treatment prevent children from emergence agitation after sevofluran anesthesia? a systematic review. Eras J Med 2012;2(2):24-8

The Authors submitting a manuscript do so on the understanding that if accepted for publication, copyright of the article shall be assigned to JAI (Jurnal Anestesiologi Indonesia) and Department of Anesthesiology and Intensive Theraphy, Faculty of Medicine, Diponegoro University as publisher of the journal. Copyright encompasses exclusive rights to reproduce and deliver the article in all form and media, including reprints, photographs, microfilms, and any other similar reproductions, as well as translations. 

JAI (Jurnal Anestesiologi Indonesia) and Department of Anesthesiology and Intensive Theraphy, Faculty of Medicine, Diponegoro University and the Editors make every effort to ensure that no wrong or misleading data, opinions or statements be published in the journal. In any way, the contents of the articles and advertisements published in JAI (Jurnal Anestesiologi Indonesia) are the sole and exclusive responsibility of their respective authors and advertisers.

The Copyright Transfer Form can be downloaded here:[Copyright Transfer Form JAI]. The copyright form should be signed originally and send to the Editorial Office in the form of original mail, scanned document:  

 

Uripno Budiono (Editor-in-Chief)

Editorial Office of JAI (Jurnal Anestesiologi Indonesia)

Department of Anesthesiology and Intensive Theraphy, Faculty of Medicine, Diponegoro University/ Dr. Kariadi General Hospital Medical Center (RSUP Dr. Kariadi)

Jl. Dr. Soetomo No. 16 Semarang, Central Java, Indonesia, 50231

Telp. : (024) 8444346

Email : janestesiolgo@gmail.com