Perbandingan Pemberian Kombinasi Ketamin 0,2 Mg/KgBB dan NaCl 0,9 % dengan NaCl 0,9 % terhadap Penambahan Uterotonika pada Pasien Sectio Caesarean dengan Spinal Anestesi di RSU Prof Chairuddin P Lubis Universitas Sumatera Utara

Abstract

Background: The increasing incidence of caesarean sections is associated with increased morbidity and mortality, with 19% of these due to post partum hemorrhage. Uterine atonicity is the most common cause of post-partum bleeding. The use of oxytocin as a first-line drug is associated with some side effects and approximately 10-40% of women undergoing caesarean section require additional uterotonic agents. The use of low-dose ketamine as an additional uterotonic agent is based on its similar action to oxytocin. However, other experimental research regarding the effects of ketamine on uterotonic effects and intraoperative caesarean section bleeding is still very limited Objective: To determine the comparison of administering low doses of ketamine to changes in hemoglobin values and the number of uterotonics in caesarean section patients with spinal anesthesia. Methods: The research design is randomized clinical trial with a double blind method. After obtaining approval from the Ethics Committee of the Faculty of Medicine, Universitas Sumatera Utara Medan, 24 research samples were collected which after fulfilling the inclusion criteria were divided randomly into 2 groups. Group A received 0.2 mg/KgBW ketamine and group B received 2 ml of 0.9% Nacl. The research data obtained was tested using SPSS. Results: The hemoglobin (T0) value in subjects who received oxytocin + ketamine 0.2 mg/KgBW had a mean ± SD value of 11.9 ± 0.46; Hemoglobin value (T1) has a mean ± SD value of 10.7 ± 0.54. The hemoglobin (T0) value in subjects who received oxytocin + NaCl 0.9% 2 ml showed a mean ± SD value of 12.1 ± 0.56. The hemoglobin value (T1) shows a mean ± SD value of 10.6 ± 0.50. The administration of additional uterotonics was more in the control group but this was not statistically significant. Conclusion: Administration of low doses of ketamine is superior to placebo in reducing bleeding in caesarean section patients