<![CDATA[Pemberian adjuvan analgetik dan sedatif intraoperatif bisa mengurangi pemakaian fentanil dan propofol sehingga akan mengurangi efek samping. Magnesium sulfat (MgSO4) mempunyai efek analgetik dan sedatif dengan bekerja sebagai antagonis reseptor N-Methyl D-Aspartat (NMDA) dan menghambat saluran kalsium (Ca-channel blocker). Penelitian ini bertujuan untuk mengetahui efektivitas pemberian MgSO4 untuk mengurangi penggunaan fentanil dan propofol intraoperatif. Penelitian dilakukan di Central Operating Theatre (COT) Rumah Sakit Dr. Hasan Sadikin Bandung sejak bulan Agustus−Oktober 2013 dengan uji klinis acak tersamar ganda pada 58 pasien yang menjalani histerektomi dengan anestesi umum. Pasien dibagi dalam 2 kelompok, masing-masing 29 orang. Kelompok MgSO4 mendapatkan MgSO4 30 mg/kgBB sebelum induksi anestesi dilanjutkan 10 mg/kgBB/jam sampai akhir operasi. Kelompok kontrol mendapatkan NaCl 0,9% dengan jumlah yang sama. Anestesi yang adekuat dinilai dengan patient response to surgical stimulus (PRST) dan bispectral index (BIS). Data hasil penelitian diuji dengan uji-t dan Uji Mann-Whitney. Hasil penelitian didapatkan bahwa dengan pemberian MgSO4 untuk mempertahankan nilai BIS 40−60 dan PRST 2−4 menggunakan fentanil dan propofol yang lebih sedikit dibanding dengan kelompok kontrol, dengan pebedaan sangat bermakna (p<0,01). Simpulan penelitian ini adalah pemakaian MgSO4 bisa mengurangi kebutuhan fentanil dan propofol intraoperatif.
Kata kunci: Bispectral index, fentanil, propofol, patient response to surgical stimulus
Administration of intraoperative analgetic adjuvant will reduce major fentanyl requirement dose, in consideration of increasing fentanyl dose denotes more side effects. Magnesium sulphate (MgSO4 )acts as NMDA receptor – antagonist and blocks calcium channel (Ca channel blocker) and give effect analgesia and anesthesia. The aim of this study is to understand effectiveness of magnesium sulphate administration to reduce fentanyl and propofol requirement intraoperative.This study was conducted with double blind randomized controlled trial method to 58 patients who underwent hysterectomy in general anesthesia and divided into two groups of 29 persons .The MgSO4 group was administered 30mg/kgBW MgSO4 intravenously before induction and 10 mg/kgBW during surgery. The NaCl group was administered NaCl 0,9% intravenous. In both groups, PRST and BIS was assessed. This test results in administration of magnesium sulphate to maintain BIS score 40−60 and PRST 2–4 could reduce dose fentanyl and propofol requirement dose the lower in magnesium group (p<0,01). The Conclusion of this study is there is MgSO4 can reduce fentanyl and propofol intraoperatif.
Key words: Bispectral index, fentanyl, propofol, patient response to surgical stimulus
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