Klonidin 1,5 Mcg/Kgbb Intravena Dibandingkan Dengan Fentanil 2 Mcg/ Kgbb Intravena Terhadap Respon Hemodinamik Akibat Tindakan Laringoskopi dan Intubasi Endotrakeal
ABSTRACT
Background: Laryngoscopy and endotracheal intubation are procedure that often performed in general anesthesia and in airway management. Hemodynamic stability is altered as a response this procedure, and preventive measures were taken to minimize it. Clonidine were expected to stabilize hemodinamic during this procedure.
Objectives: To assess the effect of premedication clonidine 1.5 mcg / kgBW intravenous premedication compared with fentanyl 2 mcg / kgBW intravenously on the hemodynamic response after laryngoscopy and endotracheal intubation.
Method: This study was conducted in 40 patients divided into 2 groups with double blind clinical trials. Who received clonidine 1.5 mcg / kgBW (group C, n = 20) and that got fentanyl 2 mcg / kg (group F, n = 20), both induced with propofol 2 mg / kgBW, and atracurium 0.5 mg / kgBW. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were measured at
basal, after administration of clonidine or fentanyl, after induction of anesthesia, endotracheal intubation time, and 1.2 minutes, 3,4,5 after endotracheal intubation.
Result: Despite an increase HR, SBP, DBP and MAP when intubation but obtained a lower decline in group K. In group C there is a significant decrease in first minute systolic pressure (p=0.013), 2nd minute systolic pressure(p = 0.037), 1st minute diastolic pressure (p = 0.048), 1st minute MAP (p = 0.012) after endotracheal intubation.
Conclusion: Clonidine 1.5 mcg / kgBW and intravenous fentanyl 2 mcg/kgBW alike can suppress the hemodynamic response at laryngoscopy and endotracheal intubation, but in this study is more significan on clonidine.
 
Keywords : Clonidine, fentanyl, hemodynamic response, laryngoscopy, endotracheal intubation.
ABSTRAK
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.
 
Kata kunci : Klonidin, fentanil, respon hemodinamik, laringoskopi, intubasi
Artikel Sekarang
Dipublikasi pada 01 November 2014
Penulis :
» Agus Susanto DL
» A Husni Tanra
Kategori : Penelitian
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Dari Jurnal
Volume V Nomor 3, November 2013 Cover JAI
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