The Effect Of Giving Warm Compresses on Intestinal Motility in Patients Post Appendectomy in Sanjiwani Hospital, Gianyar (2011)
1 I Gusti Ngurah Agung Hendra Kusuma (Student of Nursing Science Departement. of STIKes Wira Medika PPNI Bali)
2 I Nyoman Dharma Wiasa SKp, SH, MM (RSUP Sanglah Hospital)
3 Ns. Ni Wayan Trisna Dewi S.Kep (Docent Nursing Science Departement. of STIKes Wira Medika PPNI Bali)
Acute appendicitis is inflammation that occurs in the appendix. Appendicitis may be caused by fekalit (mass in the stool), tumors, and foreign objects (Brunner & Suddarth, 2001). The incidence of appendicitis performed apendiktomi action in Indonesia is quite high at 27% of cases of the total population in Indonesia per year. Most patients who undergo apendiktomi surgery in hospitals Sanjiwani Gianyar performed using the technique of spinal block anesthesia. Selection of surgery technique blocks spinal anesthesia is to minimize the occurrence of nerve trauma directly, reducing the response to the stress of surgery, withhold the amount of catecholamines intra-operative on the value before surgery, and make period ileus that lasts shorter (Goodman & Gilman, 2007).
Intestinal motility is a sound passage of air and liquids created by the peristaltic. Normally the air and the liquid flowing through the intestines causing a gurgling sound or a click and gurgle that occur irregularly 5 to 35 times per minute (Potter and Perry 2005). Patients experiencing problems apendiktomi intestinal motility disorders associated with anesthesia, either general anesthesia or the anesthesia block the respective duration of the anesthetic effect depends on the patient’s condition and the dose rather than anesthesia. Gut motility disorders occur, such as a decrease in intestinal peristalsis of the normal range of 5-35 times per minute to decrease the effects of anesthesia blockade sympathetic nerve fibers originating from thoracal five (T5) until the lumbar one (L1) that causes the intestines to contract blockade weak. Intestinal motility disorders experienced by patients in addition to a decrease in peristalsis or bowel sounds, usually marked with the resulting flatulence abdominal distention or increase in intra-abdominal pressure.
The collection of data obtained from 20 sample in the third week of May to the first week of July 2011. The study was conducted by using one group pretest-posttest design that is before the intervention giving warm compress examination bowel sounds and warm compresses after giving back examination bowel sounds.
Frequency of bowel motility respondents when pretest
Frequency of bowel motility respondents posstest
Result The Effect of Giving Warm Compresses on Intestinal Motility in Patients Post Appendectomy
|The average before-after||-1,70000|
Giving a warm compress using conduction, stimulating the bowel to contract by stimulation warm at the end of the peripheral nerves found in the walls of the abdominal skin and deliver these signals to the spinal cord, then the signal is forwarded to the autonomic nervous system that is controlled by the hypothalamus and further stimulate employment rather than the sympathetic nervous system and parasympathetic nervous that of the gastrointestinal tract. The sympathetic nervous system neurotransmitter release in the form of norepineprin which serves to decrease intestinal motility work, while the parasympathetic nervous system to release neurotransmitters such as acetylcholine which serves to enhance the work of peristalsis / motility (Guyton & Hall, 2007; Ganong, 2008).
Warm compresses useful to provide a sense of comfort relaxes stiff muscles, stimulate an increase in intestinal motility weakened by the influence of narcotics or medication effects of anesthesia The influence of a warm compress against intestinal motility post apendiktomi patients with spinal block anesthesia was done with Paired Samples Test at significance level α = 0.05, the value of (p) of 0.004, which is smaller than the value (α), so that Ho rejected and Ha accepted. It showed no significant effect giving a warm compress against intestinal motility post apendiktomi patients with spinal block anesthesia
KEY WORDS: Appendictomy, intestinal motility, warm compresses