Werda Laksana, Ngurah Putu
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Efektivitas Penambahan Sufentanil 10 mg pada Anestesi Epidural 15 mL Levobupivakain 0,5% untuk Tindakan Operasi Ekstremitas Bawah Werda Laksana, Ngurah Putu; , Zulkifli; Harimin, Kusuma; , Theodorus
Majalah Anestesia dan Critical Care Vol 32 No 2 (2014): Juni
Publisher : Perdatin Pusat

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Abstract

Walaupun memiliki profil keamanan yang lebih baik daripada racemic, levobupivakain tetap memiliki mula kerja lambat dan lama kerja terbatas. Kombinasi opioid lipofilik sufentanil-levobupivakain akan memberikan efek sinergistik sehingga memperbaiki kekurangan tersebut, tetapi masih sedikit penelitian yang menilai kombinasi ini. Tujuan penelitian ini adalah untuk menilai efektivitas penambahan sufentanil 10 μg pada anestesi epidural levobupivakain 0,5% 15 mL dalam hal mula dan lama kerja blokade sensorik-motorik. Uji klinik randomized control trial (RCT) telah dilakukan terhadap 44 pasien (dibagi 2 kelompok; kelompok I (sufentanil 10 μg), kelompok II (2 mL NaCl 0,9%)) yang menjalani operasi ekstremitas bawah dengan anestesi epidural levobupivakain 0,5% di RSUP Dr. Mohammad Hoesin Palembang dari bulan Mei–Agustus 2013 yang memenuhi kriteria inklusi. Dilakukan penelitian terhadap mula, lama kerja blokade sensorik-motorik. Analisis data menggunakan SPSS® versi 20.0. Mula dan lama kerja blokade sensorik kelompok sufentanil secara statistik lebih bermakna daripada kelompok NaCl (p<0,001), sedangkan mula dan lama kerja blokade motorik tidak memiliki perbedaan bermakna secara statistik. Penambahan sufentanil 10 μg pada anestesi epidural levobupivakain 0,5% 15 mL mempercepat mula dan memperpanjang durasi kerja blokade sensorik. Kata kunci: Anestesi epidural, levobupivakain, sufentanil Although levobupivacaine has better safety profile than racemic bupivacaine, it has a slow onset of action and limited blockade duration. Combination of lipophilic opioid sufentanil-levobupivakain will provide synergetic effects that improve the shortcomings, but lack of research to support this. The aim of this study is to evaluate the efficacy of additional 10 μg sufentanyl to 15 mL 0.5% levobupivacaine epidural anesthesia toward sensory-motoric blockade onset and duration. Randomized controlled trials double blind study (RCT) has been conducted to 44 patients (divided into 2 groups : group I (sufentanil 10 μg), group II (2 mL NaCl0.9%)) underwent lower extremity surgery with epidural anesthesia 15 mL 0,5% levobupivakain in Dr. Mohammad Hoesin central hospital from May–August 2013 that met inclussion criteria. Onset and duration of action sensory-motoric blockade were studied. Data analysis using SPSS® version 2.0. The onset and the duration of sensory blockade in sufentanil group is statistically significant than NaCl group (p<0.001). However the onset and duration of motoric blockade are not statistically significant. The addition of 10 μg sufentanil to 15 mL of 0.5% levobupivacaine epidural anesthesia hasten the onset and prolong the duration of sensory blockade. Key words: Epidural anesthesia, levobupivacaine, sufentanyl Reference Bajwa SJS, Kaur J. Clinical profile of levobupivacaine in regional anesthesia: a systematic review. 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