Perbandingan Anestesi Spinal Bupivakain Low Dose dan Conventional Dose dalam Mencapai Adekuasi Blok Sensorik untuk Prosedur Seksio Sesarea: Penelitian Noninferioritas Acak Tersamar Tunggal
Abstract
Latar belakang: Anestesi spinal merupakan teknik pilihan untuk seksio sesarea. Penggunaan bupivakain dosis rendah kombinasi opioid diharapkan dapat mengurangi terjadinya hipotensi pascaanestesi spinal, meningkatkan mobilisasi dini, pelepasan kateter urin dini. Besarnya dosis bupivakain yang adekuat masih menjadi perdebatan
Tujuan: Penelitian ini bertujuan untuk membandingkan adekuasi blok sensorik anestesi spinal bupivakain dosis konvensional dan dosis rendah pada prosedur seksio sesarea elektif.
Subjek dan Metode: Penelitian non-inferioritas acak tersamar tunggal dilakukan di dua institusi terhadap 56 pasien seksio sesarea elektif yang dibagi menjadi 2 kelompok: kelompok LDFM mendapatkan bupivakain dosis rendah (6,5mg) kombinasi dua opioid (fentanil 25mcg dan morfin 80mcg) dan kelompok CDF menggunakan bupivakain dosis konvensional (10 mg) kombinasi fentanil (25mcg). Blok sensorik dinilai adekuat jika pasien tidak diperlukan analgetik tambahan intraoperatif dalam 90 menit pascaobat anestesi spinal diinjeksikan
Hasil: Sebanyak 3 pasien pasien memerlukan analgetik tambahan intraoperatif (2 pasien CDF dan 1 pasien LDFM). Tingkat keberhasilan blok adekuat tercapai pada 96,4% dalam kelompok LDFM dan 92,6% dalam kelompok CDF, dengan perbedaan proporsi sebesar 3,8% (95% CI -8,3% hingga 15,9%). Hasil ini memenuhi kriteria noninferioritas.
Simpulan: Bupivakain hiperbarik low dose kombinasi dengan dua opioid mampu memberikan blok sensorik intraoperatif adekuat non inferior terhadap bupivakain hiperbarik conventional dose kombinasi
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Jurnal Anestesi Obstetri Indonesia
