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Efficacy of ketamine gargle 40 mg and benzydamine HCl 0.075% in reducing post intubation sore throat Djayanti Sari, Eko Bambang Subekti MuhdarAbubakar
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 44, No 02 (2012)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1077.07 KB)

Sore throat is a frequent complication in postoperative patients under general anesthesia whichis performed with endotracheal tube intubation. This effect occurs because of mucosal irritationand damage and airways inflammation due to a lubricant gel on laryngoscopy or an emphasis ofendotracheal tube cuff. This study was conducted to compare the efficacy of ketamine 40 mggargle with benzydamine HCl 0.075% gargle in reducing post intubation of sore throat prior tothe insertion of endotracheal tube. A prospective randomized double blind controlled clinicaltrial enrolled patients aged 18-50 years with physical status of ASA I and II whounderwent elective surgery with general anesthesia in Dr. Sardjito General Hospital, Yogyakarta.Subjects were divided into 2 groups. 50 patients of group A were given 30 mL ketamine gargle40 mg and 51 patients of group B were given 30mL benzydamine HCl gargle 0.075%. The sorethroat was measured whenever the patients were fully awake, 2 hours and 4 hours post-extubationwith Canbay score (no pain, mild pain, moderate pain and severe pain). There was a significantdifference (p<0.01) in sore throat incidence of both groups especially at fully awake and 2hours post-extubation; 20% in group A versus 66.7% in group B at fully awake and 16% ingroup A versus 58,8% in group B at 2 hours of post-extubation. However, there was not anysignificant difference in sore throat incidence of both groups at 4 hours post-extubation(p=0.394). In conclusion, giving ketamine gargle 40 mg 5 minutes before intubation is moreefficient in reducing sore throat after endotracheal tube-general anesthesia compared withbenzydamine HCl 0.075% at fully awake and 2 hours post-extubation.Keywords : endotracheal tube - sore throat - ketamine gargle - benzydamine HCl gargle

Efficacy of pethidine 0.1 and 0.2 mg/kg body weight as an adjuvant of intrathecal bupivacaine 0.5% 10 mg in preventing shivering Djayanti Sari, Nur Hesti Kusumasari IG Ngurah Rai Artika
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 04 (2013)
Publisher : Universitas Gadjah Mada

Shivering related with spinal anesthesia commonly occurs in patients. It is not only uncomfortablefor the patients, but also related to some complication. The efficacy of pethidine in the preventionof shivering is well known. The aim of this study was to compare the efficacy of intrathecalpethidine 0.1 mg/kg body weight (BW) and 0.2 mg/kg BW as shivering-prevention drug afterspinal anesthesia. This was a randomized, double-blind controlled trial study involving 196subjects between the age 18-40 years with ASA physical status I-II, gestional age 37-42 weeks,BW of 40-70 kg or Body Mass Index (BMI) <30 kg/m2, body height >145 cm who underwent acaesarean delivery section with spinal anesthesia based of World Health Organization (WHO)procedure in cesarean delivery in Dr. Sardjito General Hospital, Yogyakarta and affiliated hospital.Subjects were divided into two groups with 98 subjects of each group. Group A was given anhyperbaric 0.5% bupivacaine 10 mg and pethidine 0.1 mg/kg BW, and Group B was given anhyperbaric 0.5% bupivacaine 10 mg and pethidine 0.2 mg/kg BW in the same volume (2.5 mL).The seubjects were observed for the incidence and severity of shivering and side effects ofpehtidine. The results showed that the incidence of shivering in Group A (35.70%) was significantlygreater than in Group B (22.44%) (p<0.05). However, the onzet an duration of shivering werenot significantly different in both groups (p>0.05). Moreover, the incidence of nausea andvomiting in Group A (8.33%) was significantly lower than Group B (22.45%). In conclusion,pethidine 0.2 mg/kg BW is more effective to preven shivering than pethidine 0.1 mg/kg BWalthough the incidence of its side effects is more higher.

The droplet size changes of 1% propofol before and after the storage procedure for 6 and 24 hours periods Djayanti Sari, Basuki Rahmat Bambang Suryono S
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 44, No 01 (2012)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (326.883 KB)

Propofol (2,6-diisopropylphenol) is a popular anesthetic agent for induction and anestheticmaintenance. Propofol preparation is formulated as a lipid macroemulsion that is thermodynamicallyunstable and degraded over time, causing the enlargement of droplet size. The degradation is fasterwhen propofol emulsion preparation package has been opened. This droplet enlargement results indecreasing propofol releasing-rate and its concentration. The risk of embolism occurs whenever themean droplet size (MDS) exceeds Food and Drug Administration (FDA) limit (<0.45) and fat globulepopulation percentage >5 ïm (PFAT5) is <0.05%. In the daily practice, some propofol emulsionpreparation are often used although they are already opened and saved more than 24 hours. The aimof this study was to evaluate the droplet size changes of propofol emulsion preparation duringstorage. This was an observational study using cohort prospective design. The droplet size changesof sixteen propofol preparation samples were evaluated before and after storage procedure for 6 and24 hours in the refrigerator at the temperature of 4ÂºC. The droplet diameter was determined under alight microscope. Mean droplet size before and after storage were calculated and analyzed by oneway analysis of variance (ANOVA), followed by Tukeyâs post hoc test with 95% confidence interval(p<0.05). The droplet diameter of propofol emulsion preparation increased significantly (p<0.05)after storage procedure for 6 h (MDS value were: 247 Â± 22 nm) and 24 h (278 Â± 29 nm) comparedto before storage (225 Â± 24 nm). The PFAT5 at each interval time was 0%. There was no color andhomogeneity changing at each interval time (n=16/100% each time interval). In conclusion, there isa change of propofol emulsion preparation droplet size after storage procedure for 6 to 24 hours attemperature of 4ÂºC compared to before storage.

Cost-effectiveness comparison between caudal block and intravenous ketorolac as an early post-operative analgesic in pediatric patients underwent surgery below umbilicus segment Djayanti Sari, Juni Kurniawaty Muhdar Abubakar
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 01 (2014)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar

Post-operative pain treatment in pediatric is frequently inadequate that could lead to psychological,physiological and behavioral changes. Therefore, adequate pediatric pain management is needed.Some analgesics such as ketorolac and regional anesthesia techniques such as caudal blockhave been applied to relieve pain. Ketorolac and caudal block have its own advantages anddisadvantages. The aim of study was to compare the cost-effectiveness of ketorolac and caudalblok as a post-operative analgesic in pediatric. This was double blind randomized controlledclinical trial with parallel design conducted in Dr. Sardjito General Hospital. The subjects werechildren who underwent surgery below umbilicus segment. Seventy patients were randomlydivided into two groups with 35 patients in each group. Group I (Caudal block Group) was givencaudal block with bupivacaine 0.12% 1 mL/kg body weight (BW) whereas Group II (KetorolacGroup) was given ketorolac 0.5 mg/kg BW intravenously (IV). The patientâs pain was scored at 0,15, 30, 45 minute and 1, 2, 3 hours after the conscious patients using modified ChildrenâsHospital of Eastern Ontario Pain Scale (mCHEOPS). Furthermore, the cost-effectiveness theboth interventions was also compared. The caudal block was more effective in reducing painthan the ketorolac at minutes 0 (27/8 vs 10/25) and 15 (34/1 vs 18/17) (p<0.05). However, atthird hour the ketorolac revealed more effective than the caudal block (29/6 vs 32/3) (p<0.05).The cost of the caudal block was higher than the ketorolac (IDR 95.860 Â± 5.745 vs IDR 7.200Â± 14.886) (p <0.05). However, the length of stay after the caudal block was shorter than theketorolac (40.43 Â± 13.899 vs 48.57 Â± 14.068) (p <0.05). Morphine was more needed forrescue analgesic in the ketorolac (p < 0.05) in first hour of operation, whereas after three houroperation paracetamol was more needed in caudal block (p < 0.05). In conclusion, the caudalblock is not more cost-effective than ketorolac in reducing post-operative pain in pediatricpatients underwent surgery below umbilicus segment.

Proporsi Kejadian Awareness selama Anestesi Umum pada Pasien Pediatrik dengan Monitored Anesthesia Care (MAC) Yunita Widyastuti; Fadhilah Zulfa; Djayanti Sari
JAI (Jurnal Anestesiologi Indonesia) Vol 13, No 1 (2021): Jurnal Anestesiologi Indonesia
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v13i1.25264

Latar Belakang: Selama anestesi berlangsung, awareness intraoperatif dapat terjadi. Kejadian awareness intraoperatif pada pasien dewasa dengan anestesi umum dilaporkan sebesar 0,1%, sedangkan pada pasien pediatrik sebesar 2,7% dan 5%. Penelitian mengenai awareness intraoperatif pada pasien pediatrik dengan monitored anesthesia care (MAC) belum pernah dilakukan di RSUP Dr. Sardjito Yogyakarta.Tujuan: Mengetahui angka kejadian awareness selama anestesi umum pada pasien pediatrik dengan MACMetode: Studi observasional dilakukan pada 30 pasien pediatrik (usia 1-18 tahun) yang direncanakan akan dilakukan MAC. Kedalaman anestesi dimonitor dengan menggunakan index of consciousness (IoC) dan skor pressure, heart rate, sweating, tears (PRST)/Skor Evan. Proporsi awareness dianalisis dan dikelompokkan dalam kriteria-kriteria seperti usia, jenis kelamin, status fisik, indikasi tindakan yang dilakukan, serta medikasi yang digunakan untuk anestesi.Hasil: Pasien dengan nilai IoC positif awareness sebesar 63,3%, sedangkan pasien dengan skor PRST positif awareness sebanyak 3,33%. Penjelasan mengapa hasil dari IoC lebih besar adalah karena nilai pada IoC dapat dipengaruhi oleh nistagmus yang terjadi pada pasien-pasien yang menggunakan ketamin (15/30 (50%)).Kesimpulan: Kejadian awareness intraoperatif pada pasien pediatrik dengan prosedur MAC di RSUP Dr. Sardjito sebanyak 3,33%. Pencegahan awareness diperlukan agar awareness tidak terjadi lagi di kemudian hari.

Efficacy of ketamine gargle 40 mg and benzydamine HCl 0.075% in reducing post intubation sore throat Eko Bambang Subekti MuhdarAbubakar Djayanti Sari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 44, No 02 (2012)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1077.07 KB)

Sore throat is a frequent complication in postoperative patients under general anesthesia whichis performed with endotracheal tube intubation. This effect occurs because of mucosal irritationand damage and airways inflammation due to a lubricant gel on laryngoscopy or an emphasis ofendotracheal tube cuff. This study was conducted to compare the efficacy of ketamine 40 mggargle with benzydamine HCl 0.075% gargle in reducing post intubation of sore throat prior tothe insertion of endotracheal tube. A prospective randomized double blind controlled clinicaltrial enrolled patients aged 18-50 years with physical status of ASA I and II whounderwent elective surgery with general anesthesia in Dr. Sardjito General Hospital, Yogyakarta.Subjects were divided into 2 groups. 50 patients of group A were given 30 mL ketamine gargle40 mg and 51 patients of group B were given 30mL benzydamine HCl gargle 0.075%. The sorethroat was measured whenever the patients were fully awake, 2 hours and 4 hours post-extubationwith Canbay score (no pain, mild pain, moderate pain and severe pain). There was a significantdifference (p<0.01) in sore throat incidence of both groups especially at fully awake and 2hours post-extubation; 20% in group A versus 66.7% in group B at fully awake and 16% ingroup A versus 58,8% in group B at 2 hours of post-extubation. However, there was not anysignificant difference in sore throat incidence of both groups at 4 hours post-extubation(p=0.394). In conclusion, giving ketamine gargle 40 mg 5 minutes before intubation is moreefficient in reducing sore throat after endotracheal tube-general anesthesia compared withbenzydamine HCl 0.075% at fully awake and 2 hours post-extubation.Keywords : endotracheal tube - sore throat - ketamine gargle - benzydamine HCl gargle

The droplet size changes of 1% propofol before and after the storage procedure for 6 and 24 hours periods Basuki Rahmat Bambang Suryono S Djayanti Sari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 44, No 01 (2012)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (326.883 KB)

Propofol (2,6-diisopropylphenol) is a popular anesthetic agent for induction and anestheticmaintenance. Propofol preparation is formulated as a lipid macroemulsion that is thermodynamicallyunstable and degraded over time, causing the enlargement of droplet size. The degradation is fasterwhen propofol emulsion preparation package has been opened. This droplet enlargement results indecreasing propofol releasing-rate and its concentration. The risk of embolism occurs whenever themean droplet size (MDS) exceeds Food and Drug Administration (FDA) limit (<0.45) and fat globulepopulation percentage >5 m (PFAT5) is <0.05%. In the daily practice, some propofol emulsionpreparation are often used although they are already opened and saved more than 24 hours. The aimof this study was to evaluate the droplet size changes of propofol emulsion preparation duringstorage. This was an observational study using cohort prospective design. The droplet size changesof sixteen propofol preparation samples were evaluated before and after storage procedure for 6 and24 hours in the refrigerator at the temperature of 4ºC. The droplet diameter was determined under alight microscope. Mean droplet size before and after storage were calculated and analyzed by oneway analysis of variance (ANOVA), followed by Tukey’s post hoc test with 95% confidence interval(p<0.05). The droplet diameter of propofol emulsion preparation increased significantly (p<0.05)after storage procedure for 6 h (MDS value were: 247 ± 22 nm) and 24 h (278 ± 29 nm) comparedto before storage (225 ± 24 nm). The PFAT5 at each interval time was 0%. There was no color andhomogeneity changing at each interval time (n=16/100% each time interval). In conclusion, there isa change of propofol emulsion preparation droplet size after storage procedure for 6 to 24 hours attemperature of 4ºC compared to before storage.

Efficacy of pethidine 0.1 and 0.2 mg/kg body weight as an adjuvant of intrathecal bupivacaine 0.5% 10 mg in preventing shivering Nur Hesti Kusumasari; IG Ngurah Rai Artika; Djayanti Sari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 04 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Shivering related with spinal anesthesia commonly occurs in patients. It is not only uncomfortablefor the patients, but also related to some complication. The efficacy of pethidine in the preventionof shivering is well known. The aim of this study was to compare the efficacy of intrathecalpethidine 0.1 mg/kg body weight (BW) and 0.2 mg/kg BW as shivering-prevention drug afterspinal anesthesia. This was a randomized, double-blind controlled trial study involving 196subjects between the age 18-40 years with ASA physical status I-II, gestional age 37-42 weeks,BW of 40-70 kg or Body Mass Index (BMI) <30 kg/m2, body height >145 cm who underwent acaesarean delivery section with spinal anesthesia based of World Health Organization (WHO)procedure in cesarean delivery in Dr. Sardjito General Hospital, Yogyakarta and affiliated hospital.Subjects were divided into two groups with 98 subjects of each group. Group A was given anhyperbaric 0.5% bupivacaine 10 mg and pethidine 0.1 mg/kg BW, and Group B was given anhyperbaric 0.5% bupivacaine 10 mg and pethidine 0.2 mg/kg BW in the same volume (2.5 mL).The seubjects were observed for the incidence and severity of shivering and side effects ofpehtidine. The results showed that the incidence of shivering in Group A (35.70%) was significantlygreater than in Group B (22.44%) (p<0.05). However, the onzet an duration of shivering werenot significantly different in both groups (p>0.05). Moreover, the incidence of nausea andvomiting in Group A (8.33%) was significantly lower than Group B (22.45%). In conclusion,pethidine 0.2 mg/kg BW is more effective to preven shivering than pethidine 0.1 mg/kg BWalthough the incidence of its side effects is more higher.

Cost-effectiveness comparison between caudal block and intravenous ketorolac as an early post-operative analgesic in pediatric patients underwent surgery below umbilicus segment Juni Kurniawaty; Muhdar Abubakar; Djayanti Sari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 01 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Post-operative pain treatment in pediatric is frequently inadequate that could lead to psychological,physiological and behavioral changes. Therefore, adequate pediatric pain management is needed.Some analgesics such as ketorolac and regional anesthesia techniques such as caudal blockhave been applied to relieve pain. Ketorolac and caudal block have its own advantages anddisadvantages. The aim of study was to compare the cost-effectiveness of ketorolac and caudalblok as a post-operative analgesic in pediatric. This was double blind randomized controlledclinical trial with parallel design conducted in Dr. Sardjito General Hospital. The subjects werechildren who underwent surgery below umbilicus segment. Seventy patients were randomlydivided into two groups with 35 patients in each group. Group I (Caudal block Group) was givencaudal block with bupivacaine 0.12% 1 mL/kg body weight (BW) whereas Group II (KetorolacGroup) was given ketorolac 0.5 mg/kg BW intravenously (IV). The patient’s pain was scored at 0,15, 30, 45 minute and 1, 2, 3 hours after the conscious patients using modified Children’sHospital of Eastern Ontario Pain Scale (mCHEOPS). Furthermore, the cost-effectiveness theboth interventions was also compared. The caudal block was more effective in reducing painthan the ketorolac at minutes 0 (27/8 vs 10/25) and 15 (34/1 vs 18/17) (p<0.05). However, atthird hour the ketorolac revealed more effective than the caudal block (29/6 vs 32/3) (p<0.05).The cost of the caudal block was higher than the ketorolac (IDR 95.860 ± 5.745 vs IDR 7.200± 14.886) (p <0.05). However, the length of stay after the caudal block was shorter than theketorolac (40.43 ± 13.899 vs 48.57 ± 14.068) (p <0.05). Morphine was more needed forrescue analgesic in the ketorolac (p < 0.05) in first hour of operation, whereas after three houroperation paracetamol was more needed in caudal block (p < 0.05). In conclusion, the caudalblock is not more cost-effective than ketorolac in reducing post-operative pain in pediatricpatients underwent surgery below umbilicus segment.

Care and protection for healthcare workers during a pandemic COVID-19: A descriptive qualitative study in Indonesia Mochamat Helmi; Djayanti Sari; Andreasta Meliala; Laksono Trisnantoro
International Journal of Public Health Science (IJPHS) Vol 11, No 4: December 2022
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v11i4.21771

This study aimed to explore the perspectives of care and protection of healthcare workers during the pandemic COVID-19 using a descriptive qualitative study in Indonesia. This study used a qualitative descriptive approach in COVID-19 National Referral Hospitals. The sample in this study is a medical team who actively engaged in delivering COVID-19 services. Purposive sampling was used to collect the sample. There were 45 respondents, with 22 men and 23 women taking part in this study. The qualitative data were analyzed using the content analysis. Three themes that emerge from the data analysis: health protection, legal protection, and incentive schemes. Health protection including calculation of the medical team's workload and lack of a systematic procedure for medical team quarantine. There was a lack of legal basis for medical practice in long-term disaster services. Dimension of incentive scheme, including incentives shift from rewards to demands, changes in incentive regulations, and discrepancy in incentive calculation. The medical team that provides services in a biological crisis, particularly for volunteers, must have a clear direction to follow legal protection and obvious health protection. By stressing protection and rewards for each level of the medical profession, it is hoped to boost motivation in actively participating and supporting the service of COVID-19 patients in critical conditions across Indonesia.

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