Profil Pemberian Cairan Perioperatif serta Pengaruhnya terhadap Keseimbangan Asam Basa, Elektrolit, dan Kadar Glukosa Darah
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Latar belakang. Pemberian cairan intravena perioperatif yang tidak tepat dapat menimbulkan komplikasi asidosis metabolik, hiponatremia, hipoglikemi, atau hiperglikemia.
Tujuan. Mengetahui profil pemberian cairan perioperatif serta pengaruhnya terhadap keseimbangan asam basa, elektrolit dan gula darah serum.
Metode. Studi deskriptif kohort prospektif pada anak yang menjalani tindakan bedah elektif di RSCM. Pada subyek dilakukan pemeriksaan laboratorium sesaat sebelum dan setelah tindakan bedah, serta 6 jam setelah pemberian cairan postoperatif.
Hasil. Terdapat 61 subyek, 65,6% tidak mendapat cairan preoperatif. Cairan terbanyak digunakan intraoperatif adalah ringer asetat malat (RAM) (77%) dan untuk postoperatif adalah kristaloid hipotonik (83,6%). Jumlah cairan preoperatif dan postoperatif sebagian besar sesuai formula Holliday-Segar. Subyek yang mendapat cairan preoperatif D10 1/5 NS + KCl (10) lebih banyak mengalami hiponatremia (13,4% vs 5%) dan gangguan kadar gula darah (20% vs 0%) dibandingkan dengan yang tidak mendapat cairan. Asidosis metabolik kelompok cairan intraoperatif RAM (36,2%) maupun Ringer asetat (36,4%). Hiponatremia pasca cairan postoperatif 57,1% subyek yang tidak mendapat cairan, 44,4% pada kelompok KA-EN3B®, dan 21,9% pada kelompok D10 1/5 NS + KCl (10). Hiperglikemia 15,6% subyek yang mendapat D10 1/5 NS + KCl (10).
Kesimpulan. Pemberian cairan perioperatif di RSCM bervariasi. Angka kejadian hiponatremia pasca pemberian kristaloid hipotonik 13,4%-44,4%. Hiponatremia dan gangguan kadar gula darah terjadi pada subyek yang mendapat cairan D10 1/5 NS + KCl (10).Â
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DOI: http://dx.doi.org/10.14238/sp17.5.2016.335-342
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