DOI: https://doi.org/10.14710/jai.v6i3.9122

Perbandingan Penggunaan Triamcinolone Acetonide Dan Gel Larut Air Pada Pipa Endotrakea Terhadap Angka Kejadian Nyeri Tenggorok

1RSUD Dr. Soewondo,, Indonesia

2Kendal, Indonesia

3Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Diponegoro/ RSUP Dr. Kariadi, Indonesia

4 Semarang, Indonesia

View all affiliations
Published: 1 Nov 2014.
Open Access Copyright 2014 JAI (Jurnal Anestesiologi Indonesia)

Citation Format:
Abstract

Latar Belakang : Salah satu komplikasi pemasangan pipa endotrakea adalah nyeri tenggorok paska operasi akibat kerusakan mukosa trakea. Pemberian lubrikasi pada pipa endotrakea diharapkan mampu mengurangi angka kejadian nyeri tenggorok. Triamcinolon acetonide gel mengandung kortikosteroid disamping dapat sebagai agen lubrikasi juga mempunyai efek anti inflamasi.

Tujuan : Membandingkan efek lubrikasi pipa endotrakea dengan triamcinolone acetonide gel dan gel larut air terhadap angka kejadian nyeri tenggorok paska intubasi.

Metode : 50 pasien yang menjalani operasi elektif dengan anestesi umum di RSUP Dr.Kariadi Semarang dan memenuhi kriteria inklusi dibagi secara acak menjadi 2 kelompok. Induksi menggunakan propofol 2 mg/kgBB iv, rokuronium 0,6 mg/kgBB iv dan fentanyl 1 mcg/kgBB iv kemudian dilakukan intubasi dilakukan intubasi dengan pipa endotrakea high volume low pressure non kinking dengan ukuran 7.0 untuk perempuan dan 7,5 untuk laki-laki. Kelompok 1 (K1) diberikan triamcinolone acetonide in orabase 0,1 % pada pipa endotrakea, kelompok 2 (K2) diberikan gel larut air pada pipa endotrakea (K-Y jelly) masing-masing diberikan 0,5 cc dilubrikasikan pada pipa endotrakea sepanjang 15 cm dari ujung distal. Selanjutnya cuff dikembangkan dengan udara dalam spuit 20 cc sampai tidak terdengar kebocoran udara napas. Rumatan anestesi dengan isofluran 1-1,5 % dalam O2 dan N2O 50% dan pelumpuh otot rokuronium intermiten. Analgetik diberikan ketorolak 30 mg dan tramadol 2 mg/kgBB iv. Selesai operasi, ekstubasi pipa endotrakea dilakukan saat pasien sudah sadar. Dilakukan observasi nyeri tenggorok 1 jam, 6 jam dan 24 jam setelah ekstubasi.

Hasil : Angka kejadian nyeri tenggorok paska intubasi endotrakea pada kelompok 1 lebih kecil dibandingkan pada kelompok 2, tetapi tidak bermakna secara statistik (p>0,05).

Kesimpulan : Pemberian lubrikasi pipa endotrakea dengan triamcinolone acetonide gel dapat mengurangi angka kejadian nyeri tenggorok

Fulltext View|Download
Keywords: triamcinolone acetonide; gel larut air; intubasi komplikasi endotrakeal; nyeri tenggorok

Article Metrics:

Article Info
Section: Original Articles
Language : ID
Recent articles
Perbandingan Penggunaan Triamcinolone Acetonide dan Lidocaine Pada Pipa Endotrakea Terhadap Angka Kejadian Nyeri Tenggorok Pasca Intubasi Pada Anestesi Umum Pengaruh Ketorolak dan Parekoksib Terhadap Gambaran Histopatologi Gaster Tikus Wistar Kadar Serum Substansi P Pada Pemberian Klonidin Sebagai Ajuvan Analgesia Epidural Anestesi Spinal Pada Seksio Sesaria Wanita Dengan Tetralogy Fallot Tidak Terkoreksi Patofisiologi Penyakit Jantung Koroner More recent articles
Most cited articles
Patofisiologi Penyakit Jantung Koroner Midazolam Intravena Dosis Rendah Tidak Mempengaruhi Nitric Oxide Intraperitoneal Mencit Balb/C Yang Terpapar Lipopolisakarida More cited articles
  1. Shaaban AR, Kamal SM. Comparison between betamethasone gel applied over endotracheal tube and ketamine gargle for attenuating postoperative sore throat, cough and hoarseness of voice. Middle East Journal of Anesthesiology. 2012;21:513-520
  2. Edomwonyi NP, Ekwere LT, Omo E, Rupasinghe A. Postoperative throat complications after tracheal intubation. Annals of African Medicine. 2006;5:28-32
  3. Kazemi A, Amini A. The effect of betamethasone gel in reducing sore throat, cough, and hoarseness after laryngo-tracheal intubation. Middle East Journal of Anesthesiology. 2007;19:197-204
  4. Ayoub Mc, Ghobashy A, Koch ME, Mc Grimley L, Pascale V, Qadir S, dkk. Widespread application of typical steroid to decrease sore throat, hoarseness, and cough after tracheal intubation. Anesth Analg 1998:87:714-6
  5. Sumathi PA, Shenoy T, Ambareesha M, Krishna HM, Controlled Comparison between betamethasone gel and lidocaine jelly applied over tracheal tube to reduce postoperative sore throat, cough and hoarseness of voice. Br J Anaesth 2008:100:215-8
  6. Rajkumar G, Eshwori L, Konyak PY et al. Prophyactic ketamine gargle to reduce post-operative sore throat following endotracheal intubation. J Med Soc. 2012;26:175-9
  7. Park SY, Kim SH, Lee SJ et al. Appication of triamcinolone acetonide paste to the endotracheal tube reduces post opearative sore throat ; a randomized controlled trial. Canadian Journal of Anaesthesia. 2011;58:436-442
  8. Morgan GE, Mikhail MS, Murray MJ. Clinical Anesthesiologi 5thed. Airway management. Mc Graw Hill Education. United States. 2013;19:309-40
  9. Soenarjo, Jatmiko HD : Anestesiologi. Intubasi Endotrakea. Ikatan Dokter Spesialis Anestesi dan Reanimasi (IDSAI) Cabang Jawa Tengah. Semarang. 2010;11:197-206
  10. Finucane BT, Tsui BCH, Santora AH. Principle of airway management. Basic Equipment for Airway Management. Springer. New York. 2011;4:118-119
  11. Miller RD. Basics of Anesthesia 5th ed. Preoperative Preparation and Intraoperative management. Churchill livingstone elseiver. Philadelphia;2007:218
  12. Higgins PP, Chung F, Mezei G. Postoperative sorethroat after ambulatory surgery. British Journal of Anaesthesiology.2002;88:582-4
  13. Domino K, Posner K, Caplan RA, Cheney F. Airway injury during anesthesia: a closed claim analysis. Anesthesiology.1999;91(6):1703-11
  14. Al-Qahtahni AS, Messahel FM. Quality improvement in anesthetics practice-incidence of sore throat after using small tracheal tube. Middle East Journal of Anesthesiology.2005;18(1):179-83
  15. Kwok SL, Irish JC. Traumatic complication of intubation and other airway management procedures. Anesthesiology Clinics of North America.2002;20(4):953-69
  16. McHardy FE, Chung F. Post operative sore throat: cause, prevention and treatment. Anesthesia. 1999;54:444-453
  17. Seegobin RD, Hasselt Van GL. Endotracheal cuff pressure and tracheal mucosal blood flow: Endoscopy study of effects of four large volume cuffs. British Medical Journal. 1984;228:965-68
  18. Loeser EA, Daniel L, Stanley TH. Endotracheal tube cuff design and postoperative sorethroat. Anesthesiology.1976;45(6):684-7
  19. Hagberg R, Krier C. Complications of managing the airway. Best Practice and Research Clinical Anesthesiology. 2005;19:641-659
  20. Suzuki N, Kooguchi K,Mizobe T. Postoperative hoarseness and sorethroat after tracheal intubation:Effect of a low intracuff of pressure of endotracheal tube and usefullness of cuff pressure. Japanese Journal of Anesthesiology.1999;48(10):1091-5
  21. Flemming DC. Hazards of Tracheal Intubation. Complications in anesthesiology. Pensylvania: J.B. Lippincott. 1983;165-171
  22. Quinn FB,Stroud RH, Rassekh CH. Laryngeal injury as a result of endotracheal intubation. 1999
  23. Myles PS, lacono GA, Hunt JO, et al. Risk of respiratory complications and wound infections in patients undergoing ambulatory surgery: smokers versus nonsmokers. Anesthesiology. 2002;97(4):842-7
  24. Christensen AM, Larsen WH, Lundby L, Jakobsen KB. Post operative throat complaints after tracheal intubation. Br J Anaesth. 1994;6:786-787
  25. Sout DM, Bishop MJ, Dwersteg JF, Cullen BF. Correlation of endotracheal tube size with sore throat and hoarseness following general anaesthesia. Anesthesiology 1987;38:363-367
  26. Kloub R. Sore throat following tracheal intubation. Middle East J. Anesthesiol. 2001;16:29-40
  27. Derendrof H, Meltzer EO. Molecular and clinical pharmacology of intranasal corticosteroid:clinical and therapeutic implications. Allergy. 2008;63:1292-300
  28. Park SY, Kim MJ, Kim MG, Lee SJ, Ok SY, Kim SI. Triamcinolone acetonide paste applied over the laryngeal mask airway to reduce the severity of postoperative sore throat. Soonchunyang Medical Science. 2011;17(1):7-10
  29. Katz M, Gans EH. Topical corticosteroids, structure-activity and theglucocorticoid receptor: discovery and development: a process of “Planned serendipity”. J. Pharm Sci.2008;97:2936-47

Last update:

No citation recorded.

Last update: 2024-11-22 04:00:26

No citation recorded.