Perbandingan antara Sevofluran dan Isofluran terhadap Gangguan Fungsi Kognitif Pascabedah Tumor Otak menggunakan Mini Mental State Examination (MMSE

Caroline Wullur, Ike Sri Redjeki, Tatang Bisri

Abstract


Latar Belakang dan Tujuan: Pasien dengan tumor otak sering mengalami gangguan fungsi kognitif yang berdampak terhadap fungsi fisik, psikologis, sosial, dan vokasional. Post operative cognitive dysfunction (POCD) adalah ganggguan kognitif pascabedah yang paling sering terjadi. Anestesi umum yang digunakan dapat berpengaruh terhadap gangguan fungsi kognitif. Anestetika inhalasi sevofluran dan isofluran merupakan anestetika inhalasi yang paling sering digunakan untuk prosedur kraniotomi tumor otak. Tujuan penelitian adalah untuk mengetahui perbandingan efek antara sevofluran dan isofluran terhadap fungsi kognitif pascabedah tumor otak.

Subjek dan Metode: eksperimental acak terkontrol buta tunggal melibatkan 44 pasien dengan tumor otak yang menjalani kraniotomi tumor otak pada bulan April−Oktober 2015. Data dianalisis dengan uji-t tidak berpasangan, Chi kuadrat, Mann Whitney dan Komolgorov Smirnov, nilai p<0,05 dianggap bermakna. Fungsi kognitif diukur menggunakan uji mini mental state examination (MMSE) yang dinilai saat pre-operatif dan pascabedah pada jam ke 6, 12, 18, 24, 48, 72, 96, dan 120.

Hasil penelitian menunjukkan MMSE pascabedah pada kelompok anestetika inhalasi sevofluran lebih tinggi dibanding dengan isofluran pada 6, 12, 18, 18, 24, 48 dan 72 jam pascabedah dengan perbedaan bermakna (p<0,05).

Simpulan: Anestetik inhalasi sevofluran menimbulkan gangguan fungsi kognitif pascabedah yang lebih ringan dibanding dengan isofluran pada pasien yang menjalani kraniotomi tumor otak.

Comparison between Sevoflurane and Isoflurane on Cognitive Dysfunction Post Craniotomy Tumor Removal assessed using Mini Mental State Examination (MMSE)

Background and Objective: Patients with brain tumor often experience cognitive dysfunction that may have an impact on physical functioning, psychology, social and vocacional functioning. Post operative cognitive dysfunction (POCD) is the most common post surgical cognitive dysfunction. General anaesthesia may have an impact on POCD. Sevofluran and isoflurane are the two most commonly used inhaled anaesthetic agents for craniotomy tumor removal. The aim of this study is to compare the effects between sevoflurane and isoflurane on cognitive functions after brain tumor surgery. 

Subject and Method: This is a randomized controlled trial involving 44 ASA II patients who underwent craniotomy tumor removal under general anaesthesia between period of April−October 2015. Statistical analysis using unpaired t-test, Chi Square, Mann Whitney and Komolgorov Smirnov test with p<0,05 as statistically significant. Cognitive function was assessed using mini mental state examination (MMSE) preoperatively and postoperatively at 6, 12, 18, 24, 48, 72, 96 and 120 hour postoperative.
Result: shows that postoperative MMSE was higher in sevoflurane group compared to isoflurane on 6, 12, 18, 24, 48, 72 hours postoperatively with statistical significance (p<0,05).
Conclusion: Inhaled anaesthetic agent sevoflurane causes less postoperative cognitive disturbance compared to isoflurane on patients undergoing craniotomy tumor removal.


Keywords


Gangguan fungsi kognitif; kraniotomi tumor otak; sevofluran; isofluran; Cognitive dysfunction; craniotomy tumor removal; sevoflurane; isoflurane

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References


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DOI: https://doi.org/10.24244/jni.vol5i3.71

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