Manajemen jalan napas merupakan salah satu aspek penting dalam anestesiologi. Salah satu jenis alat bantu jalannafas yang sering digunakan adalah Laringeal Mask Airway (LMA/sungkup laring). Pemasangan sungkup laringtanpa pelumpuh otot membutuhkan kedalaman anestesi yang cukup. Trapezius squeezing test dan jaw thrustadalah dua uji klinis sederhana yang digunakan untuk menguji kedalaman anestesia. Penelitian ini bertujuan untukmembandingkan trapezius squeezing test dan jaw thrust sebagai indikator klinis menilai kedalaman anestesi padapemasangan sungkup laring dengan induksi anestesia menggunakan propofol. Sebanyak 128 pasien dirandomisasimenjadi dua kelompok yaitu kelompok 1 (kelompok jaw thrust) dan kelompok 2 (kelompok trapezius squeezingtest). Setelah premedikasi dengan midazolam 0,05 mg/kgBB dan fentanil 1 μg/kgBB, untuk induksi anestesiadiberikan propofol dosis titrasi. Manuver jaw thrust dan trapezius squeezing test dilakukan setiap 15 detik. Saatrespon motorik dari manuver hilang dilakukan pemasangan sungkup laring. Keberhasilan pemasangan padakelompok 1 dan 2 adalah 93,8% vs. 90,6% (p >0,05). Rata-rata penggunaan propofol pada kelompok 1 sebesar120,34 mg dan kelompok 2 sebesar 111,86 mg (p > 0.05). Pada kelompok 1 apnea dijumpai pada 10 pasien(15.6%) sedangkan pada kelompok 2 sebanyak 11 pasien (17.2%). Trapezius squeezing test sama baiknya denganjaw thrust sebagai indikator klinis dalam menilai kedalaman anestesia pada insersi sungkup laring.
Kata Kunci: Jaw thrust, kedalaman anestesia, propofol, sungkup laring, trapezius squeezing test
Airway management remains as one of the most important aspect in anesthesiology. Laryngeal Mask Airway(LMA) has been widely used as an airway device. Laryngeal mask insertion without muscle relaxant facilitationrequires an adequate anesthesia level. The purpose of this study was to compare trapezius squeezing test andjaw thrust maneuver as an indicator of anesthesia depth for laryngeal mask insertion, with propofol as inductionagent. There were 128 subjects who had been randomized into two groups: Group 1 (jaw thrust group) andGroup 2 (trapezius squeezing test group). All subjects received midazolam 0.05 mg/kg and fentanyl 1 μg/kg aspremedication. Propofol with titrated dose were used for anesthesia induction. Jaw thrust or trapezius squeezingtest maneuver were performed every 15 seconds in each group. When motoric responses were lost after maneuver,LMA was inserted. Succesfull LMA insertion were found in 93,8% patients (Group1) and 90,6% (Group 2) withp >0,05. Mean propofol consumptions were 120.34 mg in Group 1 and 111,86 mg in Group 2. Apnea was found in10 patients (15,6%) in Group 1 and 11 patients (17.2%) in Group 2. Trapezius squeezing test was as good as jawthrust maneuver as an adequate depth of anesthesia indicator for laryngeal mask insertion.
Keywords: Departement of anesthesia, jaw thrust, laryngeal mask, propofol, trapezius squeezing test
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