Perbandingan Penggunaan Triamcinolone Acetonide dan Lidocaine Pada Pipa Endotrakea Terhadap Angka Kejadian Nyeri Tenggorok Pasca Intubasi Pada Anestesi Umum

*Erwin Ferdian  -  RSIA Aulia, Lenteng Agung, Indonesia
Soenarjo Soenarjo  -  Bagian Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Diponegoro/ RSUP Dr. Kariadi, Indonesia
Uripno Budiono  -  Bagian Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Diponegoro/ RSUP Dr. Kariadi, Indonesia
Published: 1 Nov 2014.
Open Access
Citation Format:
Abstract
Latar Belakang : Salah satu komplikasi pemasangan pipa endotrakea adalah nyeri tenggorok paska operasi akibat kerusakan mukosa trakhea. Triamcinolone 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 lidocaine jelly terhadap angka kejadian nyeri tenggorok paska intubasi. Metode : 58 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 Lidocaine 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 tenggorokan 1 jam, 6 jam dan 24 jam setelah ekstubasi. Hasil : Angka kejadian nyeri tenggorok paska intubasi endotrakea pada kelompok 1 lebih rendah dibandingkan pada kelompok 2. Kesimpulan : Triamcinolon acetonide jelly lebih baik dibanding lidocaine jelly dalam mengurangi nyeri tenggorok paska anestesi umum dengan intubasi.
Keywords: triamcinolone acetonide; lidocaine jelly; pipa endotrakea; nyeri tenggorokan

Article Metrics:

  1. Mc Hardy FE, Chung F. Postoperative sore throat: cause, prevention and treatment. Anaesthesia 1999; 54:444-53
  2. Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth 2002:88:582-4
  3. 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
  4. Katz M, Gans EH. Topical corticosteroids, structure-activity and the glucocorticoid receptor: discovery and development – a process of planned serendipity. J Pharm Sci 2008:97:2936-47
  5. Matysova L, Hajkova R, Sicha J, Solich P. Determination of methyl paraben, propyl paraben, triamcinolone acetonide and its degradation product in atopical cream by RP-HPLC. Anal Bioanal Chem 2003:376:440-3
  6. Park SY, Kim SH, Lee SJ, Chae WS, Jin HC, Lee JS dkk. Application of triamcinolone acetonide paste to the endotracheal tube reduces postoperative sore throat: a randomized controlled trial. Can J Anaesth 2011:58:436-442
  7. Selvaraj T, Dhanpal R. Evaluation of the application of topical steroids on the endotracheal tube in decreasing postoperative sore throat. J Anaesthesiol Clin Pharmacol 2002:18:167-70
  8. 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
  9. Kazemi A, Amini A. The effect of betamethasone gel in reducing sore throat, cough and hoarseness after laringotracheal intubation. Middle East J anesthesiol 2007:19:197-204
  10. Darendorf H, Meltzer EO. Molecular and clinical pharmacology of intranasal corticosteroids: Clinical and Therapeutic implications. Allergy 2008:63:1292-300
  11. Yao XL, Cowan MJ, Gladwin MT, Lawrence MM, Angus CW, Shelhamer JH. Dexamethasone alters arachidonats release from human epithelial cells by induction of P11 protein synthesis and inhibiting phospholipase A2 activity. J Biol Chem 1999: 274:17202-8
  12. Stride PC. Postoperative sore throat: topical hydrocortisone. Anaesthesia 1990:45:968-71
  13. Bagchi D, Mandal Mc, Das S, Sohoo T, Basu SR, Sakkar S. Efficacy of intravenous dexamethasone to reduce incidence of postoperative sore throat: A prospective randomized controlled trial. J Anaesthesiol Clin Pharmacol 2012:28:477-80
  14. Thomas S, Beevi S. Dexamethasone reduces the severity of postoperative sore throat. Can J anaesth 2007:54:897-901
  15. Park SH, Han SH, Do SH, Kim JW, Rhee KJ, Kim JH. Prophylacticdexamethasone decrease the incidence of sore throat and hoarseness after tracheal extubation with a double lumen endotracheal tube. Anesth analg 2008; 107:1814-8
  16. Ruangsin S, Wanasuwanakul T, Pattaravit N, Asim W. Effectiveness of a preoperative single dose intravenous dexamethasone in reducing the prevalence of postoperative sore throat after endotracheal intubation. J Med Assoc Thai 2012;95:657-60
  17. Tabari M, Soltani G, Zirak N, Alipour M, Khazaeni K. Comparison of effectiveness of betamethasone gel applied to the tracheal tube and iv dexamethasone on postoperative sore throat: A randomized controlled trial. Iran J Otorhinolaringol. 2013;73:215-20
  18. Kadri IA, Khazada TW, Samad A, Memon W. Post thyroidectomi sore throat: A common problem. Pak J Med Sci 2009:25:408:412
  19. Eidi M, Sayedtoutounchi SJ, Kolahduzan K, Sadeghian P, Sayedtoutounchi N. Comparing the effect of dexamethasone before and after tracheal intubation on sore throat after tympanoplasty surgery: a randomized controlled trial. Iran J otorhinolaryngol 2014:26:89-98
  20. Nurdin U, Lindholm CE, Wolgast M. Blood flow in the rabbit tracheal mucosa under normal conditions and under the influence of tracheal intubation. Acta anaesthesiol scand 1977:21:87-94
  21. Roberson DP, Binshtok AM, Blasl F, Bean BP, Wolf CJ. Targeting of Sodium Channel Blockers into nociceptors to produce long duration analgesia. A systematic study and review. Br J Pharmacol 2011;164:48-58
  22. Newton DJ, Mc Leod GA, Khan F, Belch JJ. Mechanisms influencing the vasoactive effects of lidocaine in human skin. Anaesthesia 2007:62:146-50
  23. Herlevsen P, Brehdal C, Hindsholm K, Kruhoffer PK. Prophylactic laringotracheal aerosolized lidocaine against postoperative sore throat. Acta Anaesthesiol scand 1992; 36:505-7
  24. Maruyama K, Sakai H, Miyazawa H, Iijima K, Toda N, Kawahara S, Hara K. Laryngotracheal application of lidocaine spray increases the incidence of postoperative sore throat after total intravenous anesthesia. J Anesth 2004:18:237-40
  25. Hara K, Maruyama K. Effect of additive in lidocaine spray on post operative sore throat, hoarseness and dysphagia after total intravenous anesthesia. Acta anaesthesiol scand 2005:49:463-7
  26. Doukumo DM, Faponle AF, Bolaji BO, Adenekan AT, Olateju SOA. Effect of lidocaine and K-Y jellies on sore throat, cough and hoarseness following endotracheal anaesthesia. J West Afr Coll Surg 2011 7;1:44-61
  27. Navarro RM, Baugman VL. Lidocaine in the endotracheal tube cuff reduces postoperative sore throat. J Clin Anesth 1997:9:394-7
  28. Huang CJ, Tsai MC, Chen CT, Cheng CR, Wu KH, Wei TT. In vitro diffusion of lidocaine across endotracheal cuff. Can J Anaesth 1999:46:82-6
  29. Soltani HA, Aghadavoudi O. The effect of different lidocaine application methods on postoperative cough and sore throat. J Clin Anest 2002:14:15-8
  30. Abbasi S, Mahjobipoor H, Sajedi P. The effect of lidocaine on reducing the tracheal mucosal damage following tracheal intubation. J Res Med Sci 2013:18:733-738

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