DOI: https://doi.org/10.14710/jai.v5i1.6552

Perbedaan Tekanan Darah, Laju Jantung dan Rate Pressure Product (RPP) Pada Pemberian Lidokain 1,5 Mg/Kgbb Intravena Sebelum Intubasi Dibandingkan Pemasangan Laryngeal Mask Airway (LMA)

1Bagian Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Diponegoro/ RSUP Dr. Kariadi, , Indonesia

2Semarang, Indonesia

Published: 1 Mar 2013.
Open Access Copyright 2013 JAI (Jurnal Anestesiologi Indonesia)

Citation Format:
Abstract
Latar belakang: Intubasi endotrakeal merupakan tindakan pengelolaan jalan nafas yang sering dilakukan di bidang anestesiologi. Akan tetapi tindakan ini dapat menyebabkan gejolak kardiovaskuler berupa perubahan tekanan darah, laju jantung  dan disritmia. Terdapat berbagai teknik dan pengunaan obat untuk mengurangi kondisi tersebut, diantaranya memberikan lidokain intravena sebelum intubasi.
Tujuan: Mengetahui perbedaan tekanan darah, laju jantung dan RPP pada pemberian lidokain intravena sebelum laringoskopi intubasi dibandingkan dengan pemasangan LMAMetode: 36 pasien ASA I-II yang menjalani operasi elektif dalam anestesi umum dibagi menjadi 2 kelompok. Kelompok 1 diberi lidokain 1,5 mg/kgBB dan dilakukan laringoskopi intubasi. Kelompok 2 dilakukan pemasangan LMA. Dilakukan pencatatan tekanan darah sistolik (TDS), diastolik (TDD), tekanan arteri rerata (TAR), laju jantung (LJ) dan Rate Pressure Product (RPP) sebelum induksi anestesi, sebelum perlakuan (intubasi atau pemasangan LMA) dan setelah perlakuan pada menit ke-1, ke-2, ke-5 dan ke-10.
Hasil: Tidak ada perbedaan signifikan antar kelompok meliputi usia, BMI, jenis kelamin maupun tekanan darah sebelum induksi. Peningkatan tekanan darah dan laju jantung pada kelompok 1 lebih tinggi dibandingkan kelompok 2, dengan nilai tertinggi di menit ke-1meliputi TDS (140,47±27,17), TDD (88,89 ± 16,72), TAR (108,84 ± 18,84), LJ (90,37 ± 11,96) dan RPP (12806,89 ± 3410,49). Perbedaan ini bermakna dibandingkan kelompok 1 pada menit ke-1 dan ke-2 setelah perlakuan.
Simpulan: Terdapat peningkatan bermakna tekanan darah, laju jantung dan RPP pada tindakan laringoskopi intubasi yang diberi lidokain 1,5 mg/kgBB intravenadibandingkan pemasangan LMA.
Fulltext View|Download
Keywords: lidokain; intubasi; tekanan darah; laju jantung; RPP; LMA

Article Metrics:

Article Info
Section: Original Articles
Language : ID
Recent articles
Perbedaan Tekanan Balon Pipa Endotrakeal Setelah Perubahan Posisi Supine ke Lateral Decubitus Pengaruh Pemberian Fentanyl 1μg/Kgbb Sebagai Ajuvan pada Bupivacaine 0,5% Terhadap Onset Blok Motorik dan Sensorik Pasien yang Dilakukan Anestesi Epidural Efek Pemberian Pre-emptive Fentanyl 25 μg terhadap Kejadian Batuk Setelah Bolus Fentanyl 2 μg/kg IV (Fentanyl Induced Cough) Priapismus Intraoperatif pada Hemoroidektomi dan URS dengan Anestesi Spinal Anestesi Epidural Thorakal pada Tumor Phyllodes More recent articles
Most cited articles
Midazolam Intravena Dosis Rendah Tidak Mempengaruhi Nitric Oxide Intraperitoneal Mencit Balb/C Yang Terpapar Lipopolisakarida Patofisiologi Penyakit Jantung Koroner More cited articles
  1. Airway Management. In: Morgan GE, Mikhail MS, Murray MJ, editors. Clinical Anesthesiology. 4th ed. New York. McGraw-Hill; 2006: 91-116
  2. Hagberg C, Georgi R, Krier C. Complications of managing the airway. Best Practice & Research Clinical Anaesthesiology. 2005; 19(4): 641-59
  3. Sener EB, Ustun E, Sarihasan B. Hemodynamic responses and upper airway morbidity following tracheal intubation in patients with hypertension: Conventional laryngoscopy versus an intubating laryngeal mask airway. Clinics. 2012;67(1):49-54
  4. Siddiqui, Khan FZH. Haemodynamic response to Tracheal Intubation via intubating laryngeal mask airway versus Direct Laryngoscopic Tracheal Intubation. J Pak Med Assoc. January 2007; 57(1): 11-4
  5. Simpson GD, Ross MJ, McKeown DW, Ray DC. Tracheal intubation in the critically ill: a multi-centre national study of practice and complications. British Journal of Anaesthesia 2012; 108 (5): 792–9
  6. Montazari K, Naghibi K, Hashemi SJ. Comparison of hemodynamic changes after insertion of laryngeal mask airway, face mask and endotracheal intubation. Acta Medica Iranica. 2004; 42(6): 437-40
  7. Flemming DC, Orkin Fk, Kirby RR. Hazards of tracheal intubation. In: Nikolous G, Robert RK. Complication in anesthesiology. 2nd ed. Philadelphia: Lippincottraven; 1996: 229-37
  8. Shribman AJ, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anesth; 1997: 59:295-99
  9. Mohseni G, Kolyaei A, Farshchian M, Rezaei M, Ghadami N. Comparison between effects of intravenous lidocaine and sublingual nifedipine on preventing blood pressure increase in laryngoscopy Open Access Journal of Clinical Trials. June 2010; 2: 89–92
  10. Irgari IP, Nurcahyo WI. Perbedaan respon kardiovaskuler antara fentanil 2µg/kg dan klonidin 3µg/kg pada tindakan laringoskopi dan intubasi. [Karya Tulis Ilmiah]. Semarang: Universitas Diponegoro; 2010
  11. Stoelting RK, Hillier SC. Cardiac antidysrhythmic drugs. In: Pharmacology and physiology in anesthetic practice. 2th ed. Philadelphia: Lippincott William & Wilkins; 2006: 370-86
  12. Vivancos GG, Klampt JG, Garcia LV. Effects of 2 mg.kg-1 of intravenous lidocaine on the latency of two different dose of rocuronium and on the hemodynamic response to orotracheal intubation. Revista Brasileira de Anestesiologia. February 2011; 61(1): 1-12
  13. Ansari M, Javadi H, Pourbehi M, Moqharrabi M, Rayzan M, Semnani S, Et al. The Association of rate pressure product (RPP) and myocardial perfusion imaging (MPI) findings: a preliminary study. Perfusion. May 2012; 27(3):207-13
  14. Sukron. Perbandingan Efek Magnesium Sulfat 30 mg/kgBB Intravena dengan Lidokain 1,5 mg/kgBB terhadap Respon Kardiovaskuler Akibat Tindakan Laringoskopi dan Intubasi. Semarang: Bagian Anestesi Fakultas Kedokteran Universitas Diponegoro, 2009. 56 pp. Tesis
  15. Brimacombe J. The advantages of the LMA over the tracheal tube or facemask: a meta-analysis. Canadian Journal of Anaesthesia. 1995;42:1017-23
  16. Yu SH, Beirne OR. Laryngeal Mask Airway have a lower risk of airway complications compared with endotracheal intubation: a systematic review. J Oral Maxillofac Surg 2010; 68:2359-2376
  17. Anita N, Shetty, Shinde VS, Chaudari LS. A comparative study of various airway devices as regards ease of insertion and haemodynamic responses. Indian Journal of Anaesthesia, April 2004; 48 (2) : 134-137
  18. Shetty AN, Shinde VS, Chaudhari LS. A comparative study of various airway devices as regards ease of insertion and haemodynamic responses. Indian J Anaesth. 2004; 48(2): 134-7
  19. Tahir MS, Khan NA, Masood M, Yousaf M, Waris S. A comparison of pressor responses following laryngeal mask airway vs laryngoscopy and endotrakheal tube insertion. Anaesth Pain & Intensive Care; 12(1):11-5
  20. Mahjoubifar M, Boroojeny SB. Hemodynamic changes during orotracheal intubation with glidescope and direct laryngoscope. Iranian Red Crescent Medical Journal. 2010; 12(4): 406-8
  21. Safaee MH, Sepdikar A, Eftekharian HR. Hemodynamic variation following induction and tracheal intubation. MEJ ANESTH, 2007; 19(3): 603-10
  22. McCleane GJ, Fogarty DF, Watters CH. Factors that influence the induction dose of propofol. Anaesthesia. Jan 1991;46(1):59-61
  23. Adachi YU, watanabe K, Higuchi H, Satoh T. The Determinants of Propofol Induction of Anesthesia Dose. Anesthesia and analgesia. March 2001; 92(3): 656-61
  24. Kazama T, Ikeda K, Morita K, Ikeda T, Kikura M, Sato S. Relation between Initial Blood Distribution Volume and Propofol Induction Dose Requirement Anesthesiology. February 2001; 94(2):205–10
  25. Tam S, Chung F, Campbell M. Intravenous Lidocaine: Optimal Time of Injection before Tracheal Intubation. Anest Analg. 1987; 66: 1036-8
  26. Oczenski W, Krenn H, Dahaba A, Binder M, Irene SK, Jellinek, et al. Hemodynamic and catecholamine stress responses to insertion of combitube, laryngeal mask airway or tracheal intubation. Anesth analg 1999; 88 1389-94
  27. Smith P, Smith FJ, Becker PJ. Haemodynamic response to laryngoscopy with and without tracheal intubation. Southern African Journal of Anesthesia and Analgesia 2008; 14(3):23-6
  28. Barak M, Ziser A, Greenberg A, Lischinsky S, Rosenberg B. Hemodynamic and catecholamine response to tracheal intubation: direct laryngoscopy compared with fiberoptic intubation. J Clin Anesth. 2003 Mar;15(2):132-6
  29. Zhang GH, Xue FS, Sun HY, Li CW, Sun HT, Li P, et al. Comparative study of hemodynamic responses to orotracheal intubation with intubating laryngeal mask airway. Chin Med J (Engl). 2006 Jun 5;119(11):899-904
  30. Mahjoubifar M, Boroojeny SB. Hemodynamic changes during orotracheal intubation with glidescope and direct laryngoscope. Iranian Red Crescent Medical Journal. 2010; 12(4): 406-8
  31. Henderson J. Airway management in the adult. In: Miller RD, editor. Anesthesia 7th ed. Philadelphia. Churchil Livingstone; 2010: 1573-1610
  32. Cardiovascular physiology and anesthesia. In: Morgan GE, Mikhail MS, Murray MJ, editors. Anesthesiology. 4th ed. New York. McGraw-Hill; 2005: 429-30
  33. Hasyim M, Budiono U. Perbandingan efek diltiazem dan lidokain terhadap respon kardiovaskuler pada tindakan laringoskopi dan intubasi. Semarang: Bagian Anestesiologi Fakultas Kedokteran Universitas Diponegoro, 2004. 32 pp. Tesis
  34. Nagpal S, Gupta K, Ahuja J. Rate pressure product – a diagnostic tool in determining the cardiovascular risk in postmenopausal women . IJCRR. (2012), [cited February 27, 2013]; 4(20): 134-138

Last update:

No citation recorded.

Last update: 2024-11-13 18:08:59

No citation recorded.