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Yunita Widyastuti
Department Of Anesthesiology And Intensive Care, Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Religion Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Decision Sciences, Operations Research & Management Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : Jurnal Kesehatan Andalas

 1 
Perbandingan Insidensi Hipotensi Saat Induksi Intravena Propofol 2 Mg/Kg Bb Pada Posisi Supine dengan Perlakuan dan Tanpa Perlakuan Elevasi Tungkai Beni Indra; Untung Widodo; Yunita Widyastuti
Jurnal Kesehatan Andalas Vol 5, No 1 (2016)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v5i1.476

Abstract

Abstrak          Penggunaan Propofol untuk induksi pada general anestesi dapat menyebabkan  hipotensi akibat vasodilatasi arteri dan vena terutama vena kapasitan ditungkai. Manuver elevasi tungkai dapat mempertahankan stabilitas hemodinamik dengan meningkatkan aliran balik vena ke jantung dan mengurangi penumpukan darah di vena kapasitan tungkai. Penelitian ini dirancang dengan menggunakan cara Open Randomized Control Trial. Subyek penelitian adalah 184 sampel pasien dewasa ASA I-II yang menjalani operasi elektif dengan menggunakan general anestesi dengan induksi propofol. Kelompok sampel penelitian dibagi dalam dua kelompok masing-masing berjumlah 92 orang. Setelah prabeban cairan RL 10 cc/kgbb dan pemberian fentanyl 2 mcg/kgbb dan midazolam 0,05 mg/kgbb maka kelompok A dilakukan elevasi tungkai 45º satu menit sebelum induksi propofol dan dipertahankan sampai penelitian selesai. Sedangkan kelompok B tidak dilakukan elevasi tungkai. Data yang dikumpulkan dianalisa dengan uji t tes. Untuk data proporsi dilakukan analisa dengan tes chi-square. Dari data demografi tidak didapatkan perbedaan yang bermakna secara statistik (p>0,05) antara kedua kelompok penelitian kecuali untuk BMI (p<0,05). Insidensi hipotensi  menit pertama pasca induksi propofol pada kelompok A (elevasi tungkai) secara signifikan lebih rendah (12%) dibanding kelompok kontrol B  (27,2%) (p=0,016; p < 0,05). Pada menit ketiga pasca induksi juga didapatkan insidensi hipotensi kelompok A  (15,2%) signifikan lebih rendah dibanding kelompok B (23,9%) (p= 0,014; p < 0,05). Elevasi tungkai 45 derajat efektif dalam menurunkan insidensi hipotensi pasca induksi propofol.  Kata kunci: propofol, hipotensi, elevasi tungkai AbstractThe induction of general anaesthesia with propofol may induce of considerable degree of hypotension that has been atributed to decrease in systemic vascular resistance  caused by combination of venous and arterial vasodilatation. It will produce a shifting  of blood to venous reservoir, especially capacitance venule of legs. Leg elevation can provide hemodynamic stability by increases cardiac preload and recruits blood contained in the venous reservoir. This is Open Randomized Control Trial include 184 elective surgery patients with American Society of Anaesthesiologist (ASA) physical status I and II. Anesthesia  was induced with propofol. Patients were randomly allocated into two groups with 92 patients in each. All the patients received Ringer’s Lactate (10 ml/kg) and premedicated with fentanyl (2 mcg/kg) and midazolam (0,05 mg/kg) before induction of anesthesia. Group A was performed passive leg raising 45 degree 1 minute before injection of propofol until  the end of study and group B (control) did not receive any maneuver. Parametric data were analyzed with t-test and categorical data was done by using Chi-square test. A p value of less than 0,05 was consider significant. Demografic characteristics (age, sex, body weight and height) and  baseline haemodynamic parameters of the patients were similar in two groups (p > 0.05) except for BMI (p < 0.05) . The incidence of hypotension was significantly lower in group A (12 %, ) than group  B (27,2%) at the first minute after propofol  injection, p value = 0.016 (p < 0,05). In the third minute, incidence of hypotension was also significantly lower in group A (15,2%) than group B (23,9%), p value = 0,014 (p < 0,05). Leg elevation maneuver 45º significantly decrease incidence of hypotension after propofol induction. Keywords: Propofol, hypotension, leg elevation
Co-Authors . Supomo Adhinugroho, Sudjati Adi, Danis Woro Kuncoro Akhmad Yun Jufan Alqustar, Adam Amelia Ananda Putri Lestari Anggraini, Diana Arifin, Achmad Reza Atmanagara, Dikho Atmojo, Danang Dwi Beni Indra, Beni Bhirowo Yudo Pratomo Budi Yuli Setianto Calcarina Fitriani Retno Wisudarti Cindy Elfira Boom Cornelia Ancilla Darwito, Darwito Denaldi Rananda Saputra Djajantisari Djayanti Sari Ekuarianto, Donny Erwin Kusumastuti Fadhilah Zulfa Fadinie, Wulan Fauzan Imani Ardanto Fauzi, Rizqi Ahmad Febrianti, Skolastika Rani Firman Ardiansyah Getar M, Geza Getar M Givano, Muhamad Randy Gunawan, Fanny Handayani, Donna Hartono, Dedy hendra, hendra hermawan Hernandes, Crodia Hernawan, Agung Diky Hidayat, Fachsyar Ika Puspitasari Ilman, Pesiar Iwan Purnawan Iwan Purnawan Juni Kurniawaty Muhdar Abubakar Djayanti Sari Khoeri, Fatkhur Roofi Krisdiyantoro, Nova Kurniawan, Novianto Mahmud Mahmud Muhammad Brian Ristianto Muhammad Mufti Sofyanoor Napitu, Annika Ngahu, Robby Mesakh Novianto Kurniawan Nugraha, Achmad Fauzani Nur Azza, Kamala Kan Prakosa, Nur Hamam Primastuti, Githa Rizki Priyadi Nugraha P Probosuseno Probosuseno Probosuseno, P Ramsi, Irhash Faisal Ratih Kumala Fajar Apsari Rayhandika Ridha, Ihsanur Rizki, Gilar Romeo Putra Dirama Rumpoko, Triaji Mudo Ruth Sally Sarosa, Pandit SATRIYAS ILYAS Siti Helmyati Sri Rahardjo Sri Setiyarini SRI SETIYARINI, SRI Sudadi Suhanda, Rellig Maret Susi Handayani Taneo, Desy Chery Marlyn Tjokronolo, Yudistira Tomo, Wahyu Kartiko Untung Widodo Untung Widodo, Untung Wardhana, Ardyan Prima Wikantama, Aswin Wisudarti, Calcarina Fitri Retno YP, Bhirowo Yusmein Uyun Zahroh Shaluhiyah