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Perbandingan Kejadian Agitasi Pada Pasien Dewasa Bedah Rawat Jalan Yang Menjalani Anestesi Umum Dengan Menggunakan Desfluran Atau Sevofluran (The Comparative of Agitation Incidency In Adult One Day Surgery With General Anesthesia Desflurane Or Sevoflurane)

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Background and Objective: Postoperative agitation is a problem that sometimes occurs in patients who underwent general anesthesia. There is still controversy about the relative advantages of the use of perioperative desflurane or sevoflurane inhalation as maintenance of anesthesia in ambulatory surgical patients. This study aims to determine the comparative magnitude of the incidence of postoperative agitation in patients with ambulatory surgery performed under general anesthesia using sevoflurane or desflurane.

Subject and Method: Experimental studies with a prospective single blind randomized controlled trial, conducted in 94 surgical patients ASA I outpatients who received general anesthesia. Subjects were randomly selected and divided into two groups: group desfluran receive maintenance anesthesia with sevoflurane group received desflurane and sevoflurane. The two groups in induction with propofol 2 mg / kg, fentanyl 2pg/kgbb, atrakurium 0.1 mg / kg, then do the installation of LMA (Laryngeal Mask Airway). For maintenance of anesthesia, subjects were randomly selected to get desflurane or sevoflurane. Standard monitoring including pulse rate, respiratory rate, noninvasive blood pressure, saturation, temperature, measured continuously with the engine monitor. Anestetika volatile suspended when the surgical procedure has been completed. An assessment of agitation in patients since the LMA is released, the use of anesthetic drugs have been discontinued, and at minute 5, 10, 15, 20, 25, 30, and so on every five minutes to 120 minutes later by using the Riker sedation-agitation Scale / Riker Sedation-Agitation Scale. In the recovery room, also performed hemodynamic data recording, the patient's VAS assessment, provision of additional analgesic and Modified Aldrete Score.

Result: Results found 7 patients experienced postoperative agitation desflurane group of 47 samples (14.9%), whereas only 5 patients with agitation of 47 samples sevoflurane group (10.6%). Although the frequency of occurrence of postoperative agitation in desflurane group larger than the sevoflurane group, but the difference was not statistically significant. There were no significant differences in hemodynamic data from both treatment groups during the observation period of anesthesia recovery. There was no statistically significant differences in terms of comparison longer wake up, wake up faster desflurane group compared with the sevoflurane group. Desflurane group more quickly achieve a score of 10 from the scoring modification aldrete compared with sevoflurane group.

Conclusion:The comparative magnitude of the incidence of Vtation in the group that performed under general anesthesia using desflurane with the use of sevoflurane groups was statistically no significant difference. Percentage of agitation in the two groups can be said is not very high numbers, so desflurane and sevoflurane are both used for outpatient surgery patients.

Keywords: agitation, Riker sedation-agitation scale, desflurane, sevoflurane

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Jurnal Neuroanastesia Indonesia, 02 (01) 2013 : 1-

Publisher

Bandung : Indonesian Society of Neuroanesthesia & Critical Care INA_SNACC., 2013

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9p

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2088-9670

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