Perbedaan Efek Penambahan MgSO4 atau Fentanil terhadap Pro l Anestesi Spinal dengan Lidokain 5%

Abstrak

Pendahuluan: Anestesi spinal dengan lidokain memiliki lama kerja singkat. Penambahan MgSO4 dan fentanil dapat memperpanjang durasi blokade sensorik ataupun motorik dari lidokain. Penelitian ini bertujuan untuk menganalisis perbandingan efek penambahan MgSO4 atau fentanil pada lidokain 5% terhadap mula kerja dan lama kerja blokade sensorik dan motorik dari anestesi spinal serta efek hemodinamiknya. Metode: Double blind randomized control trial pada 36 pasien ASA I dan II yang menjalani operasi dengan anestesi spinal. Pasien dibagi menjadi kelompok M (Lidokain Hiperbarik 75 mg+MgSO4 50 mg) dan kelompok F (Lidokain Hiperbarik 75 mg+Fentanil 25 μg). Mula kerja dan lama kerja blokade sensorik dan motorik, waktu mulai regresi sensorik, data hemodinamik serta efek samping dicatat. Hasil: Penambahan MgSO4 lebih efektif memanjangkan durasi blokade motorik (137,22 vs 116,11+19,75), p=0,014. Blokade sensorik pada penambahan MgSO4 juga lebih superior meskipun tidak bermakna. Pengaruh terhadap tanda vital dan efek samping tidak bermakna. Simpulan: Lama kerja blokade motor lidokain hiperbarik lebih panjang pada penambahan MgSO4 dibandingkan penambahan fentanil, sedangkan mula kerja dan blokade sensorik tidak berbeda. Gejolak hemodinamik serta efek samping tidak berbeda bermakna antar kelompok.

Introduction: Spinal anesthesia with lidocaine has short duration of action. Addition of MgSO4 and fentanyl can prolong duration of sensory and motor blockade of lidocaine. This study compared the effects of MgSO4 or fentanyl addition to 5% lidocaine on the onset of action, duration of sensory and motor blockade, and their hemodynamics effects. Methods: Double blind randomized control trial on 36 patients with ASA I and II who underwent surgery under spinal anesthesia. Patients were divided into group M (Hyperbaric Lidocaine 75 mg + MgSO4 50 mg) and group F (Hyperbaric Lidocaine 75 mg + Fentanyl 25 μg). Onset of action and duration of sensory and motor blockade, onset of sensory regression, hemodynamic data, and side effects are recorded. Results: Duration of motor blockade was more prolonged with the addition of MgSO4 as compared with the addition Hyperbaric Lidocaine (137.22 vs 116.11 + 19.75), p = 0.014. Effect on sensory blockade was also superior but not significant. No significant effect on vital signs and side effects. Conclusion: Compared with the addition Hyperbaric Lidocaine, addition of MgSO4 to Hyperbaric Lidocaine prolonged the duration of motor blockade, but not the sensory blockade. Hemodynamic changes and side effects between groups are not significantly different.