<![CDATA[Penurunan hormon kortisol pada masa intraoperatif dapat terjadi dengan menggunakan mekanisme penghambatan pada sistem saraf pusat. Anestesi spinal merupakan pilihan dalam mekanisme tersebut. Penelitian bertujuan untuk membandingkan kadar kortisol dan efek analgesia pascabedah pada anestesi spinal kombinasi Bupivakain hiperbarik 0,5% 8 mg+Klonidin 30 μg dan Bupivakain hiperbarik 0,5% 8 mg + morfin 0,1 mg pada seksio sesarea. Penelitian menggunakan uji klinis acak tersamar tunggal pada 50 pasien dengan kriteria inklusi, dibagi menjadi kelompok anestesi spinal kombinasi Bupivakain hiperbarik 0,5% 8 mg + Klonidin 30 μg (BK) n=25 dan kelompok kombinasi Bupivakain hiperbarik 0,5% 8 mg + morfin 0,1 mg (BM) n=25. Analisis statistik dengan Uji Mann-whitney dan uji-tes, dengan p<0,05 bermakna secara signifikan. Hasil penelitian menunjukkan pada kelompok BM sama efektif dengan kelompok BK dalam mencegah peningkatan kadar kortisol intraoperatif. Efek analgesia pascabedah anestesi spinal kombinasi kelompok BM lebih baik dibandingkan dengan kombinasi BK. Efek samping diantara kedua kelompok dinyatakan tidak bermakna. Kesimpulan penelitian adalah kelompok BM sama efektif dengan kelompok BK dalam mencegah peningkatan kadar kortisol saat pembedahann namun e fek analgesia pascabedah anestesi spinal kombinasi kelompok BM lebih baik dibandingkan dengan kombinasi BK.
Kata kunci: Anestesi spinal, kortisol, klonidin, morfin, seksio sesarea
The decrease of cortisol hormone level during intraoperative period may occur due to inhibitory mechanism on central nervous system. Spinal anesthesia is an option to prevent the proccess. This study aimed to compare cortisol hormone level and postoperative analgesia between spinal anesthesia combination of 0.5% hyperbaric Bupivacaine 8 mg and Clonidine 30 μg + hyperbaric 0.5 % Bupivacaine 8 mg + 0.1 mg morphine in cesarean section. The study was a single-blind randomized clinical trial in 50 patients with inclusion criteria, divided into BK group (a combination of 0.5 % Hyperbaric Bupivacaine 8 mg + 30 mg Clonidine; n=25) and BM group (a combination of 0.5 % hyperbaric Bupivacaine 8 mg + morphine 0.1 mg; n=25). Statistically analyzed using Mann-Whitney Test and t-test, with p<0.05 statistically significance. Research shows that BM group as effective as BK group in preventing the increase of cortisol level. Effect of postoperative analgesia in group BM was better than group BK. Side effects between the two groups revealed no significant difference. The conclusion of this study group BM as effective as group BK in preventing the increase of cortisol level during surgery. However, effect of postoperative analgesia in group BM was better than group BK.Key words: Cortisol, caesarean section, clonidin, morphin, spinal anesthesia.
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