Perbandingan Efektifitas Larutan Antiseptik Kombinasi Chlorexidine Gluconate Cetrimide - Alkohol 70% Dengan Povidone Iodine 10 % Terhadap Kepadatan Kuman Pada Tindakan Anestesi Spinal
ABSTRACT

Background : Bacterial infections can be caused by neuraxial technique. The Etiologic of Bacterial infection are use equipment , wrong aseptic techniques, or the type of used antiseptic solution. Antiseptic solution commonly used in spinal anesthesia are a povidone iodine and chlorhexidine. Chlorhexidine gluconate solution is a powerful antiseptic solution and has broad spectrum effect, and effective against almost all of the bacteria (Gram-positive and Gram-negative) and nosocomial fungi. Povidone iodine has a activity to killed gram negative and positive  microorganisms and can  can penetrate cell wall then inhibits bacterial synthesis of protein

Objective : understanding in effectivity of combination Chlorhexdine gluconate cetrimide-alcohol 70% compare to Povidone iodine 10% to bacterial density In spinal anesthesia

Methods : This design of this study was single blind true experimental in 32 with patients aged of 18-40 years oíd, with physical status ASA I-II who underwent spinal anesthesia. This study of two groups : Chlorexidine gluconate cetrimide- alcohol 70% group (clor) and Povidone Iodine 10% group (pov). First Swab was taken from the patient before treatment, second swab was taken after treatment. Cerebrospinal fluid be also aspirated for culture. The results were analyzed with paired sample t test (before and after the treatment) and independent sample t test (after treatment), and p-value < 0,05 was considered significant.

Results : The incidence of bacterial density in Chlorexidine group 1,4% and in povidone group was 4,1%. The bacterial density incidence was more frequent in the Povidone group than chloreidine group. Mean of bacterial density after the treatment in the group Chlorexidine was 0.0625, whereas the Povidone group  was 1,0625. The decrease of bacterial density in the clor group is lower then povidone iodine.

Conclusion : Antiseptic solution of Chlorexidine gluconate cetrimide combine with alcohol 70% is more effective than povidone iodine in reducing bacterial density after spinal anesthesia

Keywords : Antiseptic solution, Bacterial density, Chlorexidine, Povidone iodine.
ABSTRAK

Latar belakang : Infeksi bakteri dapat disebabkan oleh tehnik neuraxial. Salah satu faktor penyebab  infeksi bakteri adalah  peralatan yang digunakan, tehnik aseptik yang salah, atau larutan anti septik yang dipakai. Larutan antiseptik yang biasa digunakan pada anestesi spinal adalah chlorhexidine dan povidone iodine. Chlorhexidine gluconate adalah larutan antiseptik yang kuat dan  berspektrum luas,  efektif melawan hampir semua bakteri (gram positif dan gram negatif) dan jamur nosokomial . Povidone iodine memiliki aktivitas melawan mikroorganisme b gram negatif maupun gram postif dan dapat menembus dinding sel serta menghambat sintesis protein bakteri

Tujuan : Mengetahui Efektifitas  larutan antiseptik kombinasi Chlorhexdine gluconate cetrimide – alkohol 70% dengan pemakaian Povidone iodine 10%  terhadap kepadatan kuman pada tindakan  anestesi spinal

Metode : Penelitian eksperimental dengan rancangan “single blind true experimental design” pada 32 pasien dengan usia 18 – 40 tahun, status fisik ASA I-II yang menjalani tindakan anestesi spinal. Terdiri dari 2 kelompok: kelompok Chlorexidine gluconate cetrimide-alkohol 70% (clor) dan kelompok Povidone Iodine 10% (pov). Dilakukan pengambilan swab I pada punggung pasien sebelum perlakuan. Dan pengambilan swab II setelah mendapat perlakuan dan mengambil cairan serebrospinal untuk dikultur. Analisa hasil dengan uji statistik dilakukan uji beda t berpasangan (sebelum dan sesudah perlakuan) dan uji t dua sampel bebas (sesudah perlakuan), dengan derajat kemaknaan yaitu nilai p< 0,05.

Hasil : Insidensi kepadatan kuman pada kelompok clor sebesar 1,4% sedangkan pada kelompok pov 4,1%. Insidensi kepadatan kuman lebih banyak pada kelompok povidone iodine. Dari rata-rata penurunan kepadatan kuman sesudah perlakuan kelompok chlorexidine mean = 0,0625, sedangkan pada kelompok povidone mean = 1,0625. Rata-rata penurunan kepadatan kuman pada kelompok chlorexidine lebih kecil.

Simpulan : Efektifitas antiseptik kombinasi Chlorexidine gluconate cetrimide-alkohol 70 % lebih baik bila dibandingkan antiseptik Povidone iodine 10%  terhadap kepadatan kuman pada tindakan anestesi spinal.

 

Kata kunci : Chlorexidine, kepadatan kuman, larutan antiseptik, Povidone iodine
Artikel Sekarang
Dipublikasi pada 01 March 2015
Penulis :
» Khadafi Indrawan
» Wiwi Jaya
» Noorhamdani
Kategori : Penelitian
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Dari Jurnal
Volume VII Nomor 1, Maret 2015 Cover JAI
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