Perbedaan Elektrolit Plasma dan Tekanan Darah antara Preload Ringer Asetat Malat Dibandingkan dengan Ringer Laktat
ABSTRACT

ABSTRACT

Background: Providing preload to prevent hypotension in spinal anesthesia may affect the balance of body's fluid.

Objectives: To observe the difference in change of plasma electrolyte concentrations (Na, K, Cl) and blood pressure after spinal anesthesia between preload 20cc/kgBB Ringer Acetate Malate (RAM) compared to Ringer's Lactate (RL).

Method: This is an experimental study phase II clinical trial randomized double-blind. The selection of samples obtained from consecutive random sampling with sample number 38. Group I (n = 19) received preload 20 cc/kg Ringer Acetate Malate and group II (n = 19) received preload 20 cc/kg Ringer's Lactate. Before granting preload, patient blood samples taken for examination electrolyte concentration (Na, K, Cl) plasma. After preload administration and 30 minutes after the blood samples were taken for examination electrolyte concentration and blood pressure measured. Statistical test with paired t-test test.

Result: The difference in Na concentration changes before preload and  Na after preload and Na 30 minutes after preload between the group was significantly different. While the difference in Natrium concentration changes in preload after preload compared with Na 30 minutes after preload between the group was not significantly different. Difference in K concentration changes in K  before preload, K after preload and K 30 minutes after preload between the group were not significantly different. Difference in Cl concentration changes Cl before 30 minutes after preload between the group significantly different. While the difference in Cl concentration changes of Cl before  preload and Cl concentrations after 30 minutes post preload between the group was not significantly different. Systolic pressure significantly different (p<0.005) between groups preload RAM and RL occurred between the 25th minute after spinal by the 30th minute after the spinal. As for the variable diastolic preassure significantly different (p<0.005) between groups preload RAM and RL occurred between the 15th minute after spinal and 20th minute after spinal

Conclusion: Ringer Acetate Malate rises Na and Cl  concentration in spinal anesthesia patient higher than Ringer Lactate immediately after loading, but no further electrolyte concentration difference were documented.  Blood pressure changes were not significantly different between groups

Keywords : preload RAM, preload RL, electrolytes (Na, K, Cl), blood pressure
ABSTRAK

ABSTRAK

Latar belakang: Pemberian preload untuk mencegah hipotensi pada anestesi spinal dapat mempengaruhi keseimbangan cairan tubuh.

Tujuan: Untuk melihat perbedaan elektrolit plasma dan tekanan darah antara preload RAM dibandingkan dengan RL.

Metode: Penelitian eksperimental uji klinis tahap II secara acak tersamar ganda. Pemilihan sampel secara Consecutive Random Sampling didapat jumlah sampel 38 orang. Kelompok I (n=19) mendapat preload 20 cc/kgBB RAM dan kelompok II (n=19) mendapat preload 20 cc/kgbb RL. Sebelum  preload, diambil sampel darah untuk pemeriksaan konsentrasi elektrolit plasma. Setelah  preload dan 30 menit setelah itu dilakukan pengambilan sampel darah untuk pemeriksaan konsentrasi elektrolit plasma. Pengukuran tekanan darah dilakukan sebelum anestesi spinal dan segera setelah anestesi spinal tiap 5 menit sampai 30 menit. Uji statistik dengan uji paired t-test.

Hasil: Selisih Na sebelum preload dan Na setelah preload dengan Na 30 menit setelah preload antara kelompok yang mendapat preload RAM dan RL berbeda bermakna. Sedangkan selisih Na setelah preload  dengan Na 30 menit setelah preload berbeda tidak bermakna. Selisih K sebelum  preload, K setelah preload dan 30 menit setelah preload dan K 30 menit setelah preload berbeda tidak bermakna. Selisih Cl sebelum dan Cl 30 menit setelah preload berbeda bermakna. Selisih Cl sebelum dan Cl setelah preload dan konsentrasi Cl setelah 30 menit preload berbeda tidak bermakna. Terdapat perbedaan tekanan sistolik yang bermakna antara kelompok preload  RAM dan RL  terjadi antara menit ke-25 sampai menit ke-30 setelah spinal. Sedangkan untuk variabel tekanan darah diastolik terdapat perbedaan yang bermakna antara kelompok preload  RAM dan RL  terjadi antara menit ke-15 sampai menit ke-20 setelah spinal.

Simpulan: RAM meningkatkan konsentrasi Na dan Cl lebih tinggi dibanding RL pada pasien dengan spinal anestesi segera setelah dilakukan loading, tetapi perbedaan konsentrasi elektrolit lebih jauh tidak ditemukan. Tidak ada perubahan tekanan darah yang bermakna diantara kedua kelompok.

 

Kata kunci : preload RAM, preload RL, elektrolit (Na, K, Cl), tekanan darah
Artikel Sekarang
Dipublikasi pada 01 March 2014
Penulis :
» Ifar Irianto Yudhowibowo
» Doso Sutiyono
» Widya Istanto Nurcahyo
Kategori : Penelitian
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Volume VI Nomor 1, Maret 2014 Cover JAI
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