Perbandingan Durasi Anestesi Antara Pemberian Ketamin Intratekal dan Dexmedetomidine Intratekal sebagai Adjuvant Bupivakain 0,5 % pada Anestesi Spinal untuk Operasi Ekstremitas Bawah

Abstract

Introduction: Spinal anesthesia is regional analgesia by blocking nerve cells in the subarachnoid space with a local anesthetic drug. Bupivacaine is the most common agent, however, the duration of analgesia is often short-lived. The duration can be extended by adding adjuvants such as ketamine and dexmetomidine. Dexmedetomidine induces activation of α2 agonist receptors in the spinal cord which causes a decrease in the transmission of nociceptive signals such as substance P and glutamate, while ketamine as a single anesthetic agent produces psychomimetic disturbances and inadequate analgesia, thus making ketamine and dexmetomidine an adjuvant for intrathecal bupivacaine. Objective: To analyzecomparison of the duration of anesthesia between administration of intrathecal ketamine and intrathecal dexmetomidine as an adjuvant to bupivacaine 0.5% in spinal anesthesia. Method: This study used a Randomized Clinical Trial design with double blinds. Samples were divided into: group A (adjuvant ketamine) received hyperbaric Bupivacaine 0.5% 15mg with adjuvant Ketamine 5 mg and group B (Bupivacaine) with adjuvant dexmetomidine 5 mcg. Results: There are 30 samples with a distribution of 15 samples in each group. There was a significant difference in sensory and motor duration (p<0.001). The average sensory duration in the ketamine group was 185 minutes and in the dexmetomidine group 293 minutes, while the motor duration in the ketamine group was found to be an average of 200 minutes and for dexmetomdine an average of 303 minutes. Conclusion: There was a comparison of the duration of anesthesia with adjuvant bupivacaine 0.5% in spinal where the dexmetomidine group had a longer duration of anesthesia than the ketamine group.