Abstract
Simetikon adalah salah satu agen anti busa yang banyak digunakan untuk menghilangkan gelembung dan meningkatkan kenyamanan pasien. Namun penggunaan premedikasi pada esofagogastroduodenoskopi dengan sedasi masih sangat jarang digunakan karena risiko aspirasi. Larutan natrium bikarbonat dikombinasikan dengan simetikon dapat mencegah terbentuknya gelembung busa dengan menetralkan asam lambung. Penelitian ini bertujuan untuk melihat efek premedikasi simetikon terhadap visibilitas mukosa saluran cerna, kebutuhan penyiraman air, dan lama tindakan dibandingkan dengan tanpa premedikasi pada tindakan esofagogastroduodenoskopi yang dilakukan dengan sedasi. Penelitian intervensi double-blind randomized control trial yang dilakukan di Instalasi Endoskopi RSUD dr. Zainoel Abidin Banda Aceh dari 1 Juli sampai 30 September 2022. Kelompok I (kontrol) mendapatkan air hangat sebanyak 100 ml. Kelompok II (percobaan) mendapatkan simetikon 40 mg tablet kunyah dan 100 ml natrium bikarbonat 5% diberikan 2 jam sebelum tindakan. Sampel berjumlah 137 orang yang terdiri dari 73 pada kelompok I dan 64 pada kelompok II. Visibilitas mukosa pada kelompok II lebih baik dibandingkan kelompok I (p 0.000). Durasi tindakan pada kelompok II lebih cepat (4.77±0.63) dibandingkan kelompok I (5.25±1.43) (p 0.013) dan jumlah cairan yang dibutuhkan lebih sedikit pada kelompok II (12.61±15.9) dibandingkan pada kelompok I (61.96±57.47) (p 0.000). Pemberian simetikon dan natrium bikarbonat 2 jam sebelum tindakan esofagogastroduodenoskopi dengan sedasi dapat meningkatkan visibilitas mukosa, mengurangi kebutuhan penyiraman air dan mempercepat durasi tindakan serta tidak terjadi aspirasi pneumonia
References
Daftar Pustaka
Chen X, Dai N, Deng Y, Sun X, Zhang M, Pan J, et al. Premedication with reformulated simethicone and sodium bicarbonate improves mucosal visibility during upper gastrointestinal endoscopy: a double-blind, multicenter, randomized controlled trial. BMC Gastroenterol [Internet]. BioMed Central; 2021;21(1):1–10. Available from: https://doi.org/10.1186/s12876-021-01623-w
Trial P, Keeratichananont S, Sobhonslidsuk A, Achalanan N, Kitiyakara T, Soonthornpun S, et al. Visibility Prior to Esophagogastroduodenoscopy : A Prospective , Narrow Band Imaging ( NBI ) in Differentiating Neoplastic from An Adequate Level of Training for Technical Competence in Diagnostic Unsedated Transnasal Endoscopy : A Prospective Interobserv. 2009;69(5):2009.
Wu L, Cao Y, Liao C, Huang J, Gao F. Systematic review and meta-analysis of randomized controlled trials of Simethicone for gastrointestinal endoscopic visibility. Scand J Gastroenterol. 2011;46(2):227–35.
Monrroy H, Vargas JI, Glasinovic E, Candia R, Azúa E, Gálvez C, et al. Use of N-acetylcysteine plus simethicone to improve mucosal visibility during upper GI endoscopy: a double-blind, randomized controlled trial. Gastrointest Endosc [Internet]. American Society for Gastrointestinal Endoscopy; 2018;87(4):986–93. Available from: https://doi.org/10.1016/j.gie.2017.10.005
Chen X. Prevention of White Flocculate Precipitation with Simethicone During Upper Gastrointestinal Endoscopy : A Double ‐ Blinded , Multi ‐ Center , Randomized Study. :1–15.
Zhang LY, Li WY, Ji M, Liu FK, Chen GY, Wu SS, et al. Efficacy and safety of using premedication with simethicone/Pronase during upper gastrointestinal endoscopy examination with sedation: A single center, prospective, single blinded, randomized controlled trial. Dig Endosc. 2018;30(1):57–64.
Bhandari P, Green S, Hamanaka H, Nakajima T, Matsuda T, Saito Y, et al. Use of gascon and pronase either as a pre-endoscopic drink or as targeted endoscopic flushes to improve visibility during gastroscopy: A prospective, randomized, controlled, blinded trial. Scand J Gastroenterol. 2010;45(3):357–61.
Manfredi G, Bertè R, Iiritano E, Alicante S, Londoni C, Brambilla G, et al. Premedication with simethicone and N-acetylcysteine for improving mucosal visibility during upper gastrointestinal endoscopy in a Western population. Endosc Int Open. 2021;09(02):E190–4.
Mahawongkajit P, Kanlerd A. A prospective randomized controlled trial comparing simethicone, N-acetylcysteine, sodium bicarbonate and peppermint for visualization in upper gastrointestinal endoscopy. Surg Endosc [Internet]. Springer US; 2021;35(1):303–8. Available from: https://doi.org/10.1007/s00464-020-07397-8
Elvas L, Areia M, Brito D, Alves S, Saraiva S, Cadime AT. Premedication with simethicone and N-acetylcysteine in improving visibility during upper endoscopy: A double-blind randomized trial. Endoscopy. 2017;49(2):139–45.
Woo JG, Kim TO, Kim HJ, Shin BC, Seo EH, Heo NY, et al. Determination of the optimal time for premedication with pronase, dimethylpolysiloxane, and sodium bicarbonate for upper gastrointestinal endoscopy. J Clin Gastroenterol. 2013;47(5):389–92.
Chang WK, Yeh MK, Hsu HC, Chen HW, Hu MK. Efficacy of simethicone and N-acetylcysteine as premedication in improving visibility during upper endoscopy. J Gastroenterol Hepatol. 2014;29(4):769–74.
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