PERBANDINGAN DAYA GUNA TIVA KONTINYU ANTARA PROPOFOL 1,5 MG/KGBB IV -KETAMIN 1 MG/KGBB IV DENGAN PROPOFOL 1,5 MG/KGBB IV- FENTANYL 2 Î1⁄4G/KGBB IV DALAM MENCAPAI BISPECTRAL 40-60 PADA MOW
| Main Authors: | , Antonius Silalahi, , Dr. Calcarina Fitriani RW, Sp.An., KIC, |
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| Format: | Thesis NonPeerReviewed |
| Terbitan: |
[Yogyakarta] : Universitas Gadjah Mada
, 2012
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| Subjects: | |
| Online Access: |
https://repository.ugm.ac.id/101117/ http://etd.ugm.ac.id/index.php?mod=penelitian_detail&sub=PenelitianDetail&act=view&typ=html&buku_id=57252 |
Daftar Isi:
- Background: The purpose of modern anesthesia is to ensure adequate depth of anesthesia to prevent accidental awareness. When anesthesia is less deep, partial limb movement will occur and also respiratory pattern will change to a deep and rapid breathing.To know the depth of anesthesia,it may be done in two ways, clinical and supporting method. Clinically, depth of anesthesia can be notified by monitoring respiratory rate, moving extremity, heart rate and blood pressure, while in supporting method is using Bispectral Index score (BIS). The purpose of this study is to evaluate the effectiveness anesthesia in propofol 1.5 mg/kg + ketamine 1 mg/kg iv and propofol 1.5 mg/kg + fentanyl 2 ug/kg iv application during MOW operation with TIVAcontinues using BIS as depth monitor. Method: using double blind randomized clinical trials. The number of study subjects were 48 patients, divided into two groups each of 24 patients. Group Areceived induction of propofol 1.5 mg/kg + ketamine 1 mg/kg iv followed by maintenance of propofol 4 mg/kg/hour + ketamine 1 mg/kg/ hr iv and group B received the induction of propofol 1.5 mg/kg + fentanyl 2 ug/kg iv followed by maintenance with propofol 4 mg/kg/hour IV + fentanyl 2 ug/kg/hour iv. The measurements are performed on systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, bispectral, and the patients were maintained in BIS 40-60, whenever the BIS >60, patients where given rescue propofol to maintain the BIS. Total rescue and total propofol for maintanance requirement alone recorded, as well aside effects from both research groups. Data were analyzed by paired sample t-test and Independent t-test with degrees of significance p <0.05 Result: Continuous TIVA using a combination of propofol-ketamine is more effectiveness compared with a combination of propofol-fentanyl. Propofol rescue in propofolketamine group (78,75± 23,831), and propofol-fentanyl group (105,00 ± 27,663), statistically significant (p < 0,05). Meanwhile total dose of propofol maintenance in propofol-ketamine group is 106,75 ± 15,422, compared group receiving propofol-fentanyl is 108,50 ± 13,465, statistically unsignificant (p > 0,05). Total dose of propofol used in propofol-ketamine group was 264,88 ± 30,035, compared to propofol-fentanyl group was 295,79 ± 41,359, statistically significant (p<0,05). Patient movement in a first incision occured less in group receiving propofol-ketamine that is 25%, propofol-fentanyl come are to 62,5% (p<0,05). Cardiovascular was more stable in group propofol-ketamin compared with group receiving propofol-fentanyl, though statistically unsignificant (p>0,05). Summary: Combination of propofol 1.5 mg/kg + ketamine 1 mg/kg iv more effectiveness compared with a combination of propofol 1.5 mg/kg + fentanyl 2 ug/kg iv in TIVA for tubectomy.