Efektivitas Nitrogliserin Terhadap Tekanan Darah Rerata Dan Fromme-Boezaart Score Pada Pasien Yang Menjalani Operasi Timpanoplasti
DOI:
https://doi.org/10.59680/anestesi.v4i3.2497Keywords:
Controlled Hypotension, Fromme–Boezaart, MAP, Nitroglycerin, TympanoplastyAbstract
Background: Nitroglycerin is a vasodilator commonly used to achieve controlled hypotension during tympanoplasty. Reducing mean arterial pressure (MAP) may decrease intraoperative bleeding and improve surgical field quality, as assessed by the Fromme-Boezaart score.Objective: To evaluate the effectiveness of nitroglycerin in reducing MAP and improving the Fromme-Boezaart score in patients undergoing tympanoplasty.Methods: This pre-post experimental study included 15 patients undergoing elective tympanoplasty at Prof. Dr. R. D. Kandou General Hospital, Manado. Nitroglycerin was administered intravenously using a syringe pump at 0.5-2 mcg/kg/min and titrated to achieve controlled hypotension. MAP was measured before and after nitroglycerin administration, surgical field quality was assessed using the Fromme-Boezaart score, and cognitive function was evaluated using the Mini Mental State Examination (MMSE). Data were analyzed using paired t-test, Spearman correlation, Kruskal-Wallis test, and Wilcoxon Signed Rank Test.Results: Mean MAP decreased significantly from 94.87 +/- 3.16 mmHg to 75.47 +/- 3.58 mmHg after nitroglycerin administration, with a mean reduction of 19.40 +/- 2.75 mmHg (p < 0.001). A strong negative correlation was observed between Delta MAP and the Fromme-Boezaart score (r = -0.955; p < 0.001), indicating that greater MAP reduction was associated with better surgical field quality. MMSE scores decreased from 29.53 +/- 0.64 to 27.47 +/- 0.64 (p < 0.001), but remained within the normal cognitive range.Conclusion: Nitroglycerin effectively reduces MAP and improves surgical field quality during tympanoplasty without clinically significant cognitive impairment.
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