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HERAWATI, LILIK
Departemen Ilmu Faal, Fakultas Kedokteran, Universitas Airlangga, Surabaya
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Journal : Jurnal Neuroanestesi Indonesia

 1 
Analisis Penambahan Dexmedetomidine pada Operasi Besar Tulang Belakang Elektif di RSUD Dr. Soetomo Putri Rizkiya; Nancy Margarita Rehatta; Bambang Harijono; Lilik Herawati
Jurnal Neuroanestesi Indonesia Vol 9, No 2 (2020)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (850.068 KB) | DOI: 10.24244/jni.v9i2.225

Abstract

Latar Belakang dan Tujuan: Dexmedetomidine (DEX) suatu agonis α2, telah banyak digunakan untuk mengendalikan respon stress pembedahan melalui penekanan respon simpatis dan endokrin. Studi ini bertujuan untuk menganalisis efek penambahan dexmedetomidine terhadap kadar kortisol, nadi, tekanan arteri rerata, kebutuhan penggunaan fentanyl dan isoflurane pada operasi tulang belakang.Metode: Sebuah studi randomisasi terkontrol tersamar ganda dilakukan pada pasien yang menjalani operasi besar tulang belakang elektif di RSUD Dr. Soetomo, Surabaya. Nadi, tekanan arteri rerata, kebutuhan fentanyl dan isoflurane serta perubahan kadar kortisol pre dan post-operatif dibandingkan antara pasien yang memperoleh dexmedetomidine (DEX) dan placebo (SAL).Hasil: Nadi dan tekanan arteri rerata lebih stabil pada kelompok DEX pada saat intubasi, prone positioning dan insisi. Perubahan kadar kortisol pada kelompok DEX (9,9±5,2 mcg/dl) lebih rendah dibanding kelompok SAL (11.7±8.4 mcg/dl) namun tidak berbeda bermakna secara statistik (p=0.88). Penggunaan fentanyl dan isofluran pada kelompok DEX dapat dikurangi masing-masing 50% (p=0,00) dan 30% (p=0,00). Kecepatan pulih sadar kelompok DEX lebih cepat. (p=0,001) Simpulan: Hemodinamik yang stabil, berkurangnya penggunaan opioid dan anestesi inhalasi serta proses pulih sadar yang lebih cepat pada kelompok DEX mendukung penggunaan dexmedetomidine dalam operasi besar tulang belakang. Analysis of Dexmedetomidine Addition in Elective Major Spinal Surgery in RSUD Dr. SoetomoAbstractBackground and Objective: Dexmedetomidine (DEX) an α2 agonist, is widely used to control stress response during surgery through inhibition of sympathetic and endocrine response. This study aims to analyze the effect of dexmedetomidine addition towards blood cortisol level, pulse rate, mean arterial pressure, and fentanyl and isoflurane use during major spinal surgery.Method: A randomized doubleblind controlled study was conducted on twenty patients undergoing major spinal surgery in RSUD dr. Soetomo, Surabaya. Pulse rate, mean arterial pressure, fentanyl and isoflurane used, and plasma cortisol changes were compared between patients receiving dexmedetomidine (DEX) and placebo (SAL). Results: Pulse rate and mean arterial pressure was more stable in DEX group during intubation, prone positioning and incision. Changes in cortisol level in DEX group (9.9±5.2 mcg/dl) was lower, but not statistically significant fromSAL group (11.7±8.4 mcg/dl,p=0.88). Fentanyl and isoflurane use in DEX group was reduced 50% (p=0.00) and 30% (p=0.00) respectively. Recovery time in DEX group was faster (p=0.001).Conclusion: Hemodinamik stability, reduced opioid and inhalational anesthesia use, and faster anesthesia recovery time supports dexmedetomidine as anadjunct in general anesthesia in major spinal surgery.
Co-Authors Adek Ardiansyah Aditiawarman - Ahmad Rukhani Lutfi Ahmad Rukhani Lutfi Angga Miftakhul Nizar Angga Miftakhul Nizar Anggis Putri Wijayanti Anggraeni Dyah Kumalasari Anissa Maulina Rinjani Annas, Jimmy Yanuar Anny Setijo Rahaju, Anny Setijo Ario Imandiri Ashon Sa’adi Ashon Sa’adi Bambang Harijono Bambang Purwanto Cantika Putri Melyana Chiquita Febby Pragitara Choesnan Effendi Citrawati Dyah Kencono Wungu Damayanti Tinduh David Wicaksono Dede Gantini Desi Rianti Rahmadhani Dicha Niswansyah Auliyah Dina Delvin Anggriani Dita Mega Utami Dwi Putri Rahayu Tampubolon Dwikora Novembri Utomo Eddy Rahardjo Eka Arum Cahyaning Putri Ema Qurnianingsih Endyka Erye Frety Ernawati Ernawati Ernawati Ernawati Faizah, Zakiyatul Fajar Shamsudin Fajar Syamsudin Farah Yusrania Gadis Meinar Sari Gantini, Dede Gebyar Catur Wahyuning Rohmawati Giwang Yayi Retnosari Gosy Endra Vigriawan Hanik Badriyah Hidayati, Hanik Badriyah HariSetijono Hayuris Kinandita Setiawan Herdy Sulistyono Hermina Novida Hidayat Arifin I Ketut Sudiana I'tishom, Reny Indira Syahraya Indriani, Aliza Umar Innani Wildania Husna Iqbal Laksana Irwanto, Irwanto Jimmy Yanuar Annas Junian Cahyanto Wibawa Krismaningrum, Veronika Intan Kusnanto Kusnanto Kusnanto Kusnanto Kusnanto Kusnanto Laylatul Fitriah Mukarromah Lila Tri Harjana Lina Lukitasari, M.Si M. Ali Machfud Maharani Ayuputeri Wijaya Mahmudin Aritanoga Maulana Arif Murtadho Maya Septriana Misbah Abdul Haris Nasution Alhanif Mohammad Anam Al-Ari Mohammad Anam Al-Arif Muchammad Rif’at Fawaid As’ad Muchammad Rif’at Fawaid As’ad Mufarrihul Ihsan Mufidah Sheena Andani Prastini Muhammad Miftahussurur Muhammad Zainul Arifin Nancy M. Rehatta, Nancy M. Ningrum, Astika Gita Niwanda Yogiswara Nugroho, Ardi Setyo Nuniek Nugraheni Sulistiawaty Nurcholis Majid Paulus Liben Paulus Liben Pradika Gita Baskara Prananda Surya Airlangga Purwo Sri Rejeki Purwo Sri Rejeki Purwo Sri Rejeki Purwo Sri Rejeki Purwo Sri Rezeki Putri Lisdiana Rahmawati Putri Rizkiya Raden Argarini Rehatta, Nancy Margarita Rezy Ramawan Melbiarta Rias Gesang Kinanti Rifka Kurniati Risa Etika, Risa Rivarti, Arina Windri Senja Himaya Senja Himaya Silvia Maya Ananta Siti Khaerunnisa Siti Khaerunnisa Soetojo Soetojo Sony Wibisono Sri Ratna Dwiningsih Suhartati Suhartati Sundari Indah Wiyasihati Susi Wahyuning Asih Tato Nuryanto Viskasari P. Kalanjati Wardhani, Indrayuni Lukitra Wibi Riawan Widati Fatmaningrum Widayana, Maeril Kirana Widjiati Wigati, Kristanti Wanito Windhu Purnomo Winna Adelia Amru Yudi Her Oktaviano Yusuf Salim Zulhabri Othman Zulhabri Othman