Tesis

Perbandingan Efektivitas Teknik Syringe Recoil Dengan Teknik Konvensional Dalam Pengembangan Balon Sungkup Laring untuk Mengurangi Kejadian Nyeri Tenggorokan Pascabedah = Comparison Between Syringe Recoil and Conventional Techniques in Inflating Laryngeal Mask Airway to Reduce the Incidence of Postoperative Sore Throat.

Latar belakang. Sungkup laring merupakan alat bantu jalan napas supraglotis pada anestesia umum. Rekomendasi tekanan balon sungkup laring < 44 mmHg atau 60 cmH2O. Pengembangan balon sungkup laring yang berlebihan dapat menyebabkan komplikasi berupa nyeri tenggorokan. Diperlukan suatu teknik untuk membatasi tekanan pengembangan balon sungkup laring dan mencegah nyeri tenggorokan. Metode. Penelitian merupakan uji klinis acak tersamar tunggal dengan concealment dan 74 subjek dibagi menjadi 2 kelompok (teknik konvensional dan teknik syringe recoil). Pada kelompok teknik konvensional dilakukan pengembangan balon sungkup laring dengan volume berdasarkan ukuran sungkup menggunakan syringe 20 mL. Pada kelompok teknik syringe recoil dilakukan pengembangan sungkup laring berdasarkan teknik konvensional, kemudian sisa udara akan mendorong kembali karet di dalam syringe. Dilakukan pengukuran tekanan dengan manometer. Pascabedah dinilai nyeri menelan berupa skor VAS pada 1 jam dan 24 jam pascabedah. Hasil. Secara statistik terdapat penurunan besar tekanan balon sungkup laring secara signifikan pada kelompok syringe recoil dibandingkan kelompok konvensional (p < 0,05). Sebanyak 97,3% besar tekanan balon sungkup laring pada teknik syringe recoil berada pada tekanan sesuai rekomendasi < 60 cmH2O. Pascabedah terdapat penurunan nilai VAS 1 jam dan 24 jam secara signifikan pada kelompok syringe recoil dibandingkan kelompok konvensional (p < 0,05). Simpulan. Teknik syringe recoil lebih baik dibanding teknik konvensional dalam pengembangan balon sungkup laring untuk mengurangi kejadian nyeri tenggorokan (berupa nyeri menelan) pascabedah.
Kata kunci: sungkup laring, teknik konvensional, teknik syringe recoil, nyeri tenggorokan


Background. Laryngeal mask airway (LMA) is a supraglottic airway device in general anaesthesia. Recommended LMA cuff pressure is < 44 mmHg or 60 cmH2O. Overly pressurized cuff may cause perfusion dependent injury that comprises the larynx and surrounding pharyngeal tissue. We studied the use of the recoil of the LMA inflating syringe as an effective and practical way to limit cuff pressures at or below recommended values and prevent sore throat. Method. This was a single blind randomized clinical trial with concealment and 74 subjects were divided into 2 groups (conventional technique and syringe recoil technique). LMA cuff was attached to a three-way stopcock connected in parallel to 20 mL syringe and manometer. LMA was inserted and inflated with a volume based on the size of the mask using a 20 mL syringe. In the syringe recoil group providers open the three-way port and allowed the plunger to equilibrate with the LMA cuff pressure. The resulting cuff pressure was measured with manometer. Postoperative sore throat was assessed in VAS scores at 1 hour and 24 hours after surgery. Result. There was a statistically significant decrease in LMA cuff pressure in the syringe recoil group compared to the conventional group (p < 0.05). As much as 97.3% of the LMA cuff pressure in syringe recoil technique was at the recommended pressure < 60 cmH2O. Postoperatively, there was a significant decrease in the VAS score of 1 hour and 24 hours in the syringe recoil group compared to the conventional group (p < 0.05). Conclusions. The syringe recoil technique is better than the conventional technique in inflating LMA cuff pressure to reduce the incidence of postoperative sore throat.
Key words: laryngeal mask, conventional technique, syringe recoil technique, sore throat