<![CDATA[Fentanil merupakan analgetik opioid yang hampir selalu digunakan sebagai ko-induksi di ruang operasi. Namunpenggunaan fentanil intravena bisa menimbulkan batuk yang dikenal juga sebagai fentanyl-induced cough (FIC).Batuk merupakan hal yang tidak diinginkan saat induksi karena bisa menyebabkan peningkatan tekanan intrakranial,tekanan intraokular dan tekanan intra-abdominal. Kejadian FIC salah satunya dihubungkan dengan kecepatanpenyuntikan fentanil. Penelitian ini bertujuan untuk membandingkan antara kecepatan penyuntikan fentanil 5 detikdan 20 detik terhadap angka kejadian dan derajat FIC pada pasien ras Melayu yang menjalani anestesia umum diRumah Sakit Cipto Mangunkusumo. Penelitian ini merupakan uji klinis acak tersamar ganda terhadap 124 pasienras Melayu yang menjalani operasi dengan anestesia umum di Rumah Sakit Cipto Mangunkusumo. Subjek dibagimenjadi 2 kelompok (kelompok kecepatan 5 detik dan kecepatan 20 detik). Pasien secara acak diberikan fentanil 2mcg/kgBB sebagai co-induksi dengan kecepatan penyuntikan 5 detik atau 20 detik. Insiden dan derajat FIC dicatatpada masing-masing kelompok. Derajat FIC dibagi berdasarkan jumlah batuk yang terjadi, yaitu ringan (1–2 kali),sedang (3–5 kali) dan berat ( >5 kali). Analisis data dilakukan dengan uji Chi-square dan uji Kolmogorov-Smirnovsebagai uji alternatif. Insiden FIC pada kelompok 20 detik lebih rendah secara bermakna dibandingkan kelompok5 detik, 8,07% vs 29,03% (p<0,05). Derajat FIC antara kedua kelompok secara statistik tidak berbeda bermakna(p>0,05). Insiden dan derajat FIC lebih rendah pada kelompok 20 detik dibanding dengan kelompok 5 detik padapenggunaan fentanil 2 mcg/kgBB sebagai co-induksi.
Kata kunci: Fentanil, fentanyl-induced cough (FIC), kecepatan penyuntikan
Fentanyl, an analgesic opioid, is commonly used by anaesthesiologists in the operating room as co-induction.However, co-induction of intravenous fentanyl bolus is associated with coughing, known as fentanyl-inducedcough (FIC). Coughing during anesthesia induction is undesirable as it is associated with increased intracranial,intraocular, and intraabdominal pressures. Incidence of FIC is associated with injection rate of fentanyl. Thisstudy compared the incidence and severity of FIC between 5 seconds and 20 seconds fentanyl injection rate inMelayan race patients in Cipto Mangunkusumo hospital. This was a double blind randomized study in Melayanrace patients that underwent operations with general anesthesia at Cipto Mangunkusumo hospital. 124 subjectswere included in the study and divided into 2 groups (5 seconds and 20 seconds group). Subjects were randomizedto receive co-induction fentanyl 2 mcg/kgBW with either 5 second or 20 seconds injection rate. The incidenceand severity of FIC were recorded in each group. Based on the number of coughs observed, cough severity wasgraded as mild (1–2), moderate (3–5), or severe (>5). Data was analyzed by Chi-square and Kolmogorov-Smirnovtest. The incidence of FIC was significantly lower in the 20 seconds group than in the 5 seconds group, 8,07%vs 29,03% (p<0,05). The severity of FIC wast statistically not significant in both groups (p>0,05). Incidence andseverity of FIC was lower in the 20 seconds group compared with the 5 seconds group in co-induction usingfentanyl injection 2 mcg/kgBW.
Key words: Fentanyl, fentanyl-induced cough (FIC), rate of injection
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