Perbandingan Nilai SpO2 dan EtCO2 pada Anestesi Umum Intubasi dengan Teknik Low Flow Anesthesia dan High Flow Anesthesia

Abstract

Objective : To determine the safety of low flow anesthesia compared with high flow anesthesia with SpO2 and EtCO2 assessment. Methods : After getting the approval from the Ethic Committe of USU Medical School, single blind, a randomized clinical trial on 54 adult patients, 21 to 50 years, physical state ASA 1 who underwent elective surgery with general anesthesia intubation in Haji Adam Malik Medan General Hospital. The samples were divided into two groups each consisting of 27 subjects. All patients were given midazolam 0.1 mg/kgBW IV and fentanyl 2 mcg/kgBW IV. Induction with propofol 2 mg/kgBW IV, relaxation with rocuronium 1 mg/kgBW IV and intubation with ETT No. 7 or 7.5 cuff. Group A received low flow anesthesia techniques (FGF 1 liter/minute) and group B received high flow anesthesia techniques (FGF 4 liters/minute). The SpO2 and EtCO2 were observed every 10 minutes and hourly usage of isoflurane during anesthesia. Blood pressure, heart rate, respiratory rate and body temperature of the patient were also recorded. Results : This study showed that SpO2 during anesthesia at low flow anesthesia group 98.63% ± 0.39, and high flow anesthesia 98.70% ± 0.37. EtCO2 during anesthesia at low flow anesthesia group 33.73 mmHg ± 0.54, and high flow anesthesia 32.77 mmHg ± 0.39. SpO2 and EtCO2 values during anesthesia in both groups were no significant difference (p0,05). The use of isoflurane on hourly during low flow anesthesia group 4.32 ml/h ± 0.12, and the high flow anesthesia 12.92 ml/h ± 0.18. The use of isoflurane on hourly during anesthesia in both groups were significant difference (p=0,001). Conclusion : Low flow anesthesia techniques can be performed safely on SpO2 and EtCO2 of the patient.

Tujuan: Untuk mengetahui keamanan penggunaan teknik low flow anesthesia dibandingkan dengan teknik high flow anesthesia dengan penilaian SpO2 dan EtCO2. Metode: Setelah mendapat izin dari komisi etik penelitian bidang kesehatan Fakultas Kedokteran USU, Uji klinis acak tersamar tunggal pada 54 pasien dewasa, 21 sampai 50 tahun, PS-ASA 1 yang akan menjalani operasi elektif dengan anestesi umum intubasi di Rumah Sakit Haji Adam Malik Medan. Sampel dibagi menjadi dua kelompok masing-masing terdiri dari 27 orang. Semua pasien diberikan injeksi Midazolam 0,1 mg/KgBB IV dan fentanyl 2 μg/kgBB IV. Induksi dengan propofol 2 mg/KgBB IV, relaksasi dengan rocuronium 1 mg/KgBB IV dan intubasi dengan ETT No 7 atau 7,5 cuff. Kelompok A mendapat teknik low flow anesthesia (FGF 1 liter/menit) dan kelompok B mendapat teknik high flow anesthesia (FGF 4 liter/menit). Dilakukan penilaian SpO2, EtCO2 setiap 10 menit dan pemakaian isofluran perjam selama anestesi. Selain itu, tekanan darah, laju jantung, laju napas dan suhu tubuh pasien dicatat juga. Hasil: Penelitian ini menunjukkan SpO2 selama anestesi pada kelompok low flow anesthesia 98,63% ± 0,39, dan high flow anesthesia 98,70% ± 0,37. EtCO2 selama anestesi pada kelompok low flow anesthesia 33,73 mmHg ± 0,54, dan high flow anesthesia 32,77 mmHg ± 0,39. Nilai SpO2 dan EtCO2 selama anestesi pada kedua kelompok tidak terdapat perbedaan yang bermakna (p0,05). Pemakaian isoflurane perjam selama anestesi pada kelompok low flow anesthesia 4,32 ml/jam ± 0,12, dan high flow anesthesia 12,92 ml/jam ± 0,18. Pemakaian isoflurane perjam selama anestesi pada kedua kelompok terdapat perbedaan yang bermakna (p=0,001). Kesimpulan: Teknik low flow anesthesia dapat dilakukan dengan aman terhadap nilai SpO2 dan EtCO2 pasien.