Perbandingan Pemberian Cairan Koloid Co-loading dengan Infus Efedrin terhadap Pencegahan Hipotensi akibat Anestesi Spinal pada Seksio Sesarea
Abstract
Latar Belakang: Hipotensi merupakan komplikasi anestesi spinal pada seksio sesarea karena blokade simpatis akibat vasodilatasi arteri dan vena. Pemberian koloid co-loading dapat meningkatkan volume intravaskular sedangkan infus efedrin diharapkan terjadi vasokonstriksi.
Tujuan: Untuk membandingkan pemberian efedrin dan cairan koloid co-loading dalam mencegah hipotensi akibat anestesi spinal pada seksio sesarea.
Metode: Uji terkontrol acak buta tunggal pada 42 pasien seksio sesarea dengan anestesi spinal yang dilakukan di Rumah Sakit Hasan Sadikin Bandung pada September sampai Oktober 2018. Subjek penelitian dibagi secara acak menjadi 2 kelompok yaitu kelompok pemberian infus efedrin dan kelompok pemberian koloid secara co-loading. Kelompok koloid diberikan cairan koloid sebanyak 7 mL/KgBB selama 20 menit sedangkan kelompok efedrin diberikan efedrin bolus 5 mg pada menit pertama dan kedua, kemudian 15 mg dalam infus selama 15 menit. Tekanan darah diukur setiap 1 menit selama 10 menit, kemudian setiap 3 menit sampai menit ke-45. Analisis statistik yang digunakan adalah uji T tidak berpasangan dan Mann Whitney.
Hasil: penelitian menunjukan angka kejadian hipotensi lebih sedikit pada kelompok infus efedrin (5/21) dibandingkan dengan kelompok koloid (15/21) dengan perbedaan yang bermakna (p<0,05).
Simpulan: penelitian ini menunjukan bahwa kejadian hipotensi pada pasien seksio sesarea yang dilakukan anestesi spinal lebih banyak pada kelompok koloid co-loading dibandingkan dengan kelompok infus efedrin.
Comparison of Colloid Co-loading with Ephedrine Infusion on Prevention of Hypotension Due to Spinal Anesthesia in Cesarean Section
Abstract
Background: Hypotension is a complication of spinal anesthesia in cesarean section due to sympathetic blockade that causes arterial and venodilation. Administration co-loading of colloid can increase intravascular volume, whereas administration of ephedrine infusion expected to vasoconstric.
Objective: To compare administration of co-loading colloid with ephedrine infusion on preventing hypotension due to spinal anesthesia in cesarean section.
Method: A single blind randomized controlled trial in 42 patients who underwent cesarean section under spinal anesthesia, the physical status of ASA II which was randomly divided into 2 group administering ephedrine infusion and colloid co-loading. Colloid was given 7 ml/ Kg for 20 minutes, whereas ephedrine bolus 5 mg was given in the first and second minutes, then 15 mg in infusion for 15 minutes. Blood pressure is measured every 1 minute for 10 minutes, then every 3 minutes until the 45th minute. the statistical analysis used is unpaired T test and Mann Whitney.
Results: The study showed a lower incidence of hypotension in the ephedrine infusion group (5/21) compared with the colloid group (15/21), this difference was statistically significant (p <0.05).
Conclusions: This study show that the incidence of hypotension in cesarean section patients was more in the colloid group compared to the ephedrine group.
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References
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Jurnal Anestesi Obstetri Indonesia
