ABSTRAK
Latar belakang :TNF-α merupakan faktor proinflamasi yang akan meningkat pada keadaan sepsis. Sekresi TNF-α yang berlebih memiliki efek sitotoksik, hematopoetik maupun imunologi. Deksmedetomidin dan ketamin merupakan obat yang mempuyai efek menurunkan kadar TNF-α.
Tujuan : Mengetahui perbedaan kadar TNF-α pada pemberian deksmedetomidin dan ketamin tikus wistar sepsis polimikrobial.
Metode : Penelitian ini termasuk ekperimental laboratorik dengan post test only control group design pada 33 ekor tikus wistar yang diadaptasikan selama 7 hari, setelah itu dilakukan cecal inoculum 200 mg/kgbb/hari. Setelah perlakuan selama 3 hari dan memenuhi kriteria sepsis, tikus dibagi secara acak menjadi 3 kelompok dan setiap kelompok terdiri dari 11 ekor tikus. Kelompok kontrol mendapatkan Nacl 0,9 % 0,5ml/6jam. Kelompok deksmedetomidin mendapatkan deksdemetomidin10 mcg/kg/6jam intravena. Kelompok ketamin mendapatkan ketamin 5 mg/kg/6jam intravena. Pada saat observasi didapatkan kelompok kontrol 2 ekor tikus mati, kelompok deksmedetomidin 1 ekor mati, kelompok ketamin 1 ekor tikus mati, setelah 24 jam diambil sampel darah 2 ml untuk diukur kadar TNF-α. Analisa abnormalitas data dengan uji Shapiro-Wilk dan uji homogenisitas data dengan Levene Test. Analisa data dilanjutkan dengan Kruskal-Wallis dan Mann Whitney. Nilai p < 0,05 menunjukkan signifikansi statistik.
Hasil :Perbandingan kadar TNF-α pada kelompok deksmedetomidin (11,493±4,490 pg/ml) dengan kelompok kontrol (49,855±16,639 pg/ml) terdapat perbedaan bermakna dengan p=0,001. Perbandingan kadarTNF-α pada kelompok ketamin(13,741 + 2,832 pg/ml) dengan kelompok kontrol (49,855±16,639 pg/ml) terdapat perbedaan bermakna dengan p=0,001. Tetapi,  perbandingan kadarTNF-α pada kelompokdeksmedetomidin (11,493±4,490 pg/ml) dengan kelompok ketamin (13,741±2,832 pg/ml) tidak berbeda bermakna dengan p=0,353.
Kesimpulan:Terdapat perbedaan bermakna kadar TNF-α pada pemberian deksmedetomidin dan ketamin dibanding dengan kelompok kontrol pada tikus wistar sepsis polimikrobial. Tidak terdapat perbedaan bermakna kadar TNF-α pada pemberian deksmedetomidin dan ketamin tikus wistar sepsis polimikrobial.
Kata kunci : TNF-α, sepsis polimikrobial, cecal inoculum, deksmedetomidin, ketamin, tikus wistar.
ABSTRACT
Background : TNF- α is a proinflammatory factors that increase during septic condition. High secretion of TNF- α have cytotoxic effects, hematopoietic and immunology. Dexmedetomidine and ketamine is a drug that has the effect of lowering the levels of TNF- α.
Objective : To analyze the difference of dexmedetomidine and ketamine  on TNF –α in wistar rat with septic polymicrobial model.
Methods : This research was laboratory experimental with post test only control group design. 33 wistar rat were adapted for 7 days and after that cecal inoculum with 200 mg/kgBW/day. After 3 days, the wistar rat were randomly assign to 3 groups that consists of 11 rats. The first group was the control group that were given the normal saline 0.5 ml/6 hours iv. First treatment group were given dexmedetomidine 10 mcg/kgBW/6 hours iv. On the other hand, the second treatment group were given 5 mg/kgBW/6 hours of ketamine iv. After 24 hours, 2 dead rat in control group, 1 dead rat in dexmedetomidine group, 1 dead rat in ketamine group and 2 ml of blood sample were measured and analyzed for  the TNF- α level. Data abnormality analyzed with Shapiro Wilk and homogensity test were done with Levene Test. Data analysis were continued with Kruskal-Wallis dan Mann Whitney. Significance level for a result is p < 0.05.
Result : There was a significant difference of TNF-α in dexmedetomidine group (11.493 ± 4.490 pg / ml) vs control group (49.855 ± 16.639 pg/ml) with p=0.001. There was a significant difference of TNF-α in ketamine group (13.741 ± 2.832 pg/ml) vs control group (49.855 ± 16.639 pg/ml) with p=0,001. But, the dexmedetomidine group (11.493 ± 4.490 pg / ml) vs ketamine groups (13.741 ± 2.832 pg/ml) were not statistically different with p = 0.353
Conclusion : The results were shown that administration of dexmedetomidine and ketamine more significant reduced on TNF-α than control group. There are no significant difference of dexmedetomidine and ketamine on TNF-α in wistar rat with septic polymicrobial model.
Keywords : TNF- α, polymicrobial septic, cecal inoculum, dexmedetomidine, ketamine, wistar rat.