Pengaruh Penggunaan Epidural Intraoperatif pada Jumlah Perdarahan dan Kebutuhan Transfusi Intraoperatif Pasien yang Menjalani Prosedur Reseksi Hepar dengan Anestesi Umum

Abstract

Background: Liver resection is a major surgical procedure with a high risk of intraoperative bleeding. Optimal anesthetic management, including the use of epidural, is expected to reduce blood loss through the mechanism of lowering central venous pressure and maintaining hemodynamic stability. This study aims to analyze the effect of intraoperative epidural use on the amount of bleeding and transfusion requirements in liver resection patients. Methods: This analytical retrospective study was conducted at RSUP Prof. Dr. R. D. Kandou Manado with a total of 63 subjects (July 2019 – December 2024). Subjects were divided into two groups: the General Anesthesia group (GA, n=34) and the combined General Anesthesia and Epidural group (GA+E, n=29). Data on the amount of bleeding and transfusion requirements were analyzed using the independent t-test. Results: The mean amount of intraoperative bleeding in the GA group was 975.9 ± 973.86 cc and in the GA+E group was 879.3 ±745.16 cc, indicating no statistically significant difference (p = 0.332). The mean transfusion requirement in the GA group was 1.59 ± 1.459 units and in the GA+E group was 1.69 ± 1.606 units, which also showed no significant difference (p = 0.397). Conclusion: The use of intraoperative epidural as an adjunct to general anesthesia does not significantly influence the reduction of intraoperative bleeding or blood transfusion requirements in patients undergoing liver resection.