Perbandingan Dosis Atracurium 0,25 Mg/Kgbb dan 0,5 Mg/Kgbb terhadap Kepuasan Operator dan Lama Waktu Pulih pada Operasi Katarak Anak dengan Anestesi Umum di RS Mata Sabang Merauke Eye Center Medan

Abstract

Background: Pediatric cataract surgery requires a stable and motionless eyeball to ensure optimal surgical outcomes. Due to the lack of cooperation from pediatric patients, general anesthesia is the preferred method. Atracurium, a non-depolarizing neuromuscular blocking agent, is commonly used to achieve skeletal muscle relaxation, including ocular muscles. However, the optimal dosage of atracurium that provides favorable surgical conditions without prolonging postoperative recovery remains under debate. Objective: To compare the effects of atracurium at doses of 0.25 mg/kgBW and 0.5 mg/kgBW on operator satisfaction and recovery time following pediatric cataract surgery at Sabang Merauke Eye Center Hospital, Medan. Methods: This study was a double-blind randomized experimental design with a cross-sectional approach. A total of 80 pediatric patients undergoing cataract surgery were randomly assigned to two treatment groups (40 subjects each), receiving either 0.25 mg/kgBW or 0.5 mg/kgBW of atracurium intravenously. Primary outcome measures included operator satisfaction and patient recovery time, assessed using the Modified Aldrete Score. Statistical analysis was performed using Fisher’s exact test and independent t-test, with a significance level set at p < 0.05. Results: Operator satisfaction was reported at 100% in both groups, with no statistically significant difference (p = 1.000). However, a statistically significant difference in recovery time was observed: patients in the 0.25 mg/kgBW group reached a Modified Aldrete Score ≥9 in an average of 3 minutes 29 seconds, compared to 4 minutes 08 seconds in the 0.5 mg/kgBW group (p = 0.001). Conclusion: Although both doses of atracurium yielded equal levels of operator satisfaction, the lower dose of 0.25 mg/kgBW resulted in significantly faster recovery. Therefore, the lower dose may be considered a more efficient choice for pediatric cataract surgery, particularly in the context of postoperative recovery optimization. Keywords: Atracurium, pediatric cataract surgery, general anesthesia, operator satisfaction, Modified Aldrete Score.