PERBANDINGAN SUHU INTI, KEJADIAN HIPOTERMIA, KEJADIAN SHIVERING, KADAR IL-6, IL-10, DAN RASIO IL- 10/IL-6 ANTARA UNDERBODY DENGAN OVERBODY RESISTIVE WARMING DAN SELIMUT HANGAT PADA OPERASI UROLOGI DENGAN ANESTESI SPINAL

Yoshie Patricia; Putu Pramana Suarjaya; Dewa Ayu Mas Shintya Dewi; Gede Budiarta; Tjokorda Gde Agung Senapathi

doi:10.31004/prepotif.v9i2.46774

Authors

Yoshie Patricia Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
Putu Pramana Suarjaya Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
Dewa Ayu Mas Shintya Dewi Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
Gede Budiarta Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali
Tjokorda Gde Agung Senapathi Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital Bali

DOI:

https://doi.org/10.31004/prepotif.v9i2.46774

Keywords:

hipotermia, interleukin-10, interleukin-6, operasi urologi, overbody resistive warming, resistive warming, shivering, underbody resistive warming

Abstract

Hipotermia merupakan salah satu komplikasi yang sering terjadi selama operasi, terutama pada tindakan dengan anestesi spinal yang mengganggu mekanisme termoregulasi akibat blok saraf eferen, sehingga panas tubuh berpindah dari inti ke perifer. Pada operasi urologi, penggunaan cairan irigasi semakin memperberat terjadinya hipotermia. Resistive warming (RW) adalah metode pemanasan aktif yang bertujuan mengurangi perbedaan suhu antara inti dan perifer. Penggunaan RW secara overbody (OB) dan selimut hangat (SH) lebih umum dipakai selama perioperatif, namun penggunaan underbody (UB) RW masih jarang diteliti, meskipun memiliki keuntungan tidak mengganggu akses kerja tenaga medis. Hipotermia intraoperatif dapat menyebabkan shivering, meningkatkan morbiditas kardiovaskular, dan memicu respons inflamasi dengan peningkatan IL-6 serta penurunan IL-10, yang berpotensi menyebabkan infeksi, demam, dan urosepsis pasca operasi. Penelitian ini merupakan non-blind randomized clinical trial pada 42 pasien operasi urologi yang dibagi menjadi tiga kelompok: UB, OB, dan SH. Suhu inti dicatat setiap 15 menit, dan kadar IL-6 serta IL-10 diukur sebelum serta 6 jam setelah operasi. Hasil menunjukkan bahwa kelompok UB memiliki suhu inti lebih tinggi, insidensi hipotermia dan shivering lebih rendah, penurunan IL-6 yang signifikan, serta rasio IL-10/IL-6 yang lebih tinggi secara bermakna dibanding kelompok lainnya. Underbody RW terbukti efektif mencegah hipotermia dan respon inflamasi pascaoperasi.

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