Pengaruh Anestesi Umum dibanding dengan Anestesi Spinal untuk Seksio Sesarea terhadap Suhu Rektum Bayi Baru Lahir

Rahmat - Rahmat, Erwin - Pradian, Cindy Elfira Boom

Abstract


ABSTRACT

Teknik anestesi spinal dan anestesi umum keduanya mengganggu mekanisme termoregulasi. Masih kurang informasi tentang pengaruh teknik anestesi yang dipakai untuk seksio sesarea terhadap suhu tubuh bayi baru lahir. Tujuan penelitian ini untuk menentukan apakah ada perbedaan suhu rektum bayi baru lahir dengan seksio sesarea dihubungkan dengan teknik anestesi yang dipakai. Wanita hamil sebanyak 60 orang secara acak mendapat anestesi umum atau anestesi spinal. Suhu inti ibu diukur tiga kali dengan termometer membran timpani saat induksi, insisi uterus dan saat bayi lahir. Suhu rektum bayi diukur segera setelah lahir. Usia ibu, berat badan, tinggi badan, body mass index (BMI), suhu ibu sesaat sebelum induksi dan suhu ruangan tidak berbeda bermakna pada kedua kelompok. Interval waktu mulai induksi anestesi sampai bayi lahir pada kelompok anestesi spinal ratarata 18,24 menit (SD=2,862) dan kelompok anestesi umum rata-rata 6,47 menit (SD=3,082).Volume cairan pada kelompok anestesi spinal rata-rata 946,6 mL (SD=225,57) dan pada kelompok anestesi umum rata-rata 715,0 mL (SD=133,36), nilai P<0,05. Suhu rektum bayi pada kelompok anestesi spinal rata-rata 37,19oC (SD=0,256) dan pada kelompok anestesi umum rata-rata 37,59oC (SD=0,2288), nilai P<0.05. Suhu rektum bayi lebih rendah pada
kelompok anestesi spinal dibanding dengan kelompok anestesi umum, tetapi tidak mencapai batas hipotermi. Hal ini akibat pada anestesi spinal terjadi redistribusi panas dari inti ke perifer yang lebih besar, pada penelitian ini ditemukan pula pada anestesi spinal memerlukan lebih banyak cairan intravena dan Interval mulai anestesi sampai bayi lahir lebih panjang.


Kata kunci: Anestesi spinal, anestesi umum, suhu membran timpani, suhu rektum bayi, seksio sesarea


The Effect Of General Anesthesia Compared to Spinal Anesthesia in Cesarian Section on Newborn Rectal Temperature

Both spinal anesthesia and general anesthesia interfere thermoregulation mechanism. There are less information on the effect of anesthesia technique applied in cesarean section on newborn rectal temperature. The aim of the study was to determine whether there was a different rectal temperature of the newborn babies with cesarean section in related to using different anesthesia techniques. Sixty pregnant women were randomLy assigned either to general anesthesia group or spinal anesthesia group. The maternal core temperature was measured triplicately with tympanic membrane thermometer at induction, uterine incision, and birth. The rectal temperature of the
babies was promptly measured after delivery. The age, weight, height, BMI, and temperature before induction of the mothers, as well as the room temperature were non-significantly different in both groups. The mean time interval, from anesthesia induction to infant delivery in spinal anesthesia was 18.24 (SD=2.862) minutes and that in general anesthesia was 6.47 (SD=3.082). The mean fluid volume in spinal anesthesia was 946.6 (SD=225.57) mL and that in general anesthesia was 715.0 (SD=133.36) mL, with P<0.05. The mean infant rectal temperature in spinal anesthesia was 37.19 (SD=0.256) °C and that in general anesthesia was 37.59 (SD=0.2288) °C, with p<0.05. The infant rectal temperature was lower in spinal anesthesia compared to that in general anesthesia; but it did not
reach hypothermic limit. This was due to that in the spinal anesthesia, there are a greater heat redistribution from core to periphery, a need of more intravenous fluid, and a prolonged interval from anesthesia initiation to infant birth.


Key words: Cesarean section, general anesthesia, newborn rectal temperature, spinal anesthesia, tympanic
membrane temperature


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