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All Journal Indonesian Journal of Medicine Indonesian Journal of Anesthesiology and Reanimation (IJAR) Cermin Dunia Kedokteran Jurnal Komplikasi Anestesi
Putro, Bambang Novianto
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Health Professions Medicine & Pharmacology Public Health

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Perbedaan Efek Penambahan MgSO4 atau Fentanil terhadap Profil Anestesi Spinal dengan Lidokain 5% Mahardhika, Aria Windy; Santosa, Sugeng Budi; Putro, Bambang Novianto
Cermin Dunia Kedokteran Vol 46, No 4 (2019): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (552.83 KB) | DOI: 10.55175/cdk.v46i4.488

Abstract

Pendahuluan: Anestesi spinal dengan lidokain memiliki lama kerja singkat. Penambahan MgSO4 atau Fentanil dapat memperpanjang durasi blokade sensorik maupun motorik dari lidokain. Penelitian ini bertujuan untuk menganalisis perbandingan efek penambahan MgSO4 atau Fentanil pada lidokain 5% terhadap mula kerja dan lama kerja blokade sensorik dan motorik dari anestesi spinal serta efek hemodinamiknya. Metode: Double Blind Randomized Control Trial pada 36 pasien ASA I dan II yang menjalani operasi dengan anestesi spinal. Pasien dibagi menjadi kelompok M (Lidokain Hiperbarik 75 mg+MgSO450 mg) dan kelompok F (Lidokain Hiperbarik 75 mg+Fentanil 25 μg). Mula kerja dan lama kerja blokade sensorik dan motorik, waktu mulai regresi sensorik, data hemodinamik serta efek samping dicatat. Hasil: Penambahan MgSO4 lebih efektif memanjangkan durasi blokade motorik (137,22 vs 116,11+19,75), p=0,014. Blokade sensorik pada penambahan MgSO4 juga lebih superior meskipun tidak bermakna. Pengaruh terhadap tanda vital dan efek samping tidak bermakna. Simpulan: Lama kerja blokade motorik Lidokain Hiperbarik lebih panjang pada penambahan MgSO4 dibandingkan penambahan Fentanil, mula kerja dan blokade sensorik tidak berbeda. Gejolak hemodinamik serta efek samping tidak berbeda bermakna antar kelompok. Introduction: Spinal anesthesia with lidocaine has short duration of action. Addition of MgSO4 or Fentanyl can prolong duration of sensory and motor blockade of lidocaine. This study compared the effects of MgSO4 or Fentanyl addition to 5% Lidocaine on the onset of action, duration of sensory and motor blockade, and their hemodynamics effects. Methods: Double Blind Randomized Control Trial on 36 patients with ASA I and II who underwent surgery under spinal anesthesia. Patients were divided into group M (Hyperbaric Lidocaine 75 mg + MgSO4 50 mg) and group F (Hyperbaric Lidocaine 75 mg + Fentanyl 25 μg). Onset of action and duration of sensory and motor blockade, onset of sensory regression, hemodynamic data and side effects are recorded. Results: Duration of motor blockade was more prolonged with the addition of MgSO4 as compared with the addition Hyperbaric Lidocaine (137.22 vs 116.11 + 19.75), p = 0.014. Effect on sensory blockade was also superior but not significant. No significant effect on vital signs and side effects. Conclusion: Compared with the addition Hyperbaric Lidocaine, addition of MgSO4 to Hyperbaric Lidocaine prolonged the duration of motor blockade, but not the sensory blockade. Hemodynamic changes and side effects between groups are not significantly different.
SERIAL KASUS EKSTUBASI FAST-TRACK PADA BEDAH JANTUNG TERBUKA Hapsari, Paramita Putri; Pratomo, Bhirowo Yudo; Putro, Bambang Novianto
Jurnal Komplikasi Anestesi Vol 12 No 1 (2024)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v12i1.14651

Abstract

Fast-track extubation (FTE) has been shown to reduce the incidence of prolonged mechanical ventilation, resulting in shorter hospitalization, lower morbidity, mortality, and hospital costs. We present a case series of fast-track extubation involving two females aged 31 and 33 with Atrial Septal Defect (ASD) and a 33-year-old male with Ventricular Septal Defect (VSD) scheduled for defect closure. These patients were in good clinical condition with normal biventricular function and a low probability of pulmonary hypertension. The anesthesia and surgery procedures proceeded smoothly, with cardiopulmonary bypass time < 90 minutes, aortic cross-clamp time < 60 minutes, no residual shunt, acceptable lactate and blood gas analysis, stable hemodynamic with low doses of vasoactive agents, and adequate analgesia. Following the successful execution of the fast-track extubation protocol in the operating theatre, the patients were transferred to the intensive care unit (ICU) where they received postoperative management. The total ICU length of stay was < 24 hours, demonstrating the safety and efficacy of FTE for simple cardiac procedures and favourable outcomes. This approach is aimed at accelerating patient recovery, reducing complications, and enhancing overall surgical outcomes.
Comparison of The Effectiveness of Remifentanyl versus Fentanyl in Pediatric Undergoing Methotrexate Therapy Purwoko, Purwoko; Putro, Bambang Novianto; Pamungkas, Ferdy; Siswanto, Febby Gunawan
Indonesian Journal of Medicine Vol. 7 No. 1 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Anesthesia procedure is routinely performed for some painful pediatric oncologic procedures such as lumbar puncture (LP) and bone marrow examination (BME).  Several studies mentioned that fentanyl and remifentanyl are often used as anesthetic agent of this procedure, but none of them compare the recovery time of both agent. This study aims to compare the recovery time of fentanyl and remifentanyl in pediatric patients undergoing methoterexate therapy.Subjects and Method: This was a double-blind randomized controlled trial on 36 patients who underwent intratechal methotrexate chemoterapy under general anesthesia anesthesia in pediatric intervention room of Moewardi General Hospital Surakarta that met inclusion criteria. The dependent variable was recovery time and the independent variable were fentanyl and remifentanyl. The samples were divided into 2, Fentanyl (F) and Remifentanyl (R) group. Recovery time was recorded after the procedure until the subject reached Pediatric Glasgow Comma Scale (PGCS) of 15. Statistical analysis was Mann Whitney U Test using SPSS 25 for Windows.Results: The mean recovery time of F group was 373.39 ± 29.48 seconds, while R group was 124.67±11.55 seconds. There was a significant difference in recovery time between patients in the Fentanyl group and the Remifentanyl group (p= 0.000).Conclusion: Remifentanyl recovery time was significantly faster than with fentanyl in pediatric patients undergoing intrathecal methotrexate chemotherapy.Keywords: Fentanyl, Methotrexate, Outpatient anesthesia, Recovery time, RemifentanylCorrespondence: Ferdy Pamungkas. Anesthesiology Department, Moewardi General Hospital, Surakarta. Jalan Kolonel Sutarto 132 Jebres, Kecamatan Jebres, Surakarta City 57126. Central Java, Indonesia. dr.ferdypamungkas@gmail.com. +6281230269501.Indonesian Journal of Medicine (2022), 07(01): 115-121https://doi.org/10.26911/theijmed.2022.07.01.12
Effect of Snakehead Fish and Sea Cucumber Extract Administration on Mast Cell Infiltration, Interlukin-6 (IL-6), and Albumin Levels in Burns and Surgical Wounds Purwoko, Purwoko; Putro, Bambang Novianto; Hananto, Arif Zuhal Amin
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 1 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (325.679 KB) | DOI: 10.20473/ijar.V4I12022.1-5

Abstract

Introduction: Burn injury impairs almost every organ system, which causes significant morbidity and mortality. Meanwhile, the phases included in burn healing are inflammation, cell recruitment, matrix deposition, epithelialization, and tissue remodeling phase. Previous studies showed that snakehead fish and sea cucumber extract have these effects and are beneficial in burn and post-surgery wounds. Objective: This study aims to analyze the effect of snakehead fish and sea cucumber extract supplementation towards mast cell infiltration, IL-6, and albumin level in burn and post-surgery wounds. Methods: A double-blind randomized control trial was carried out at Dr. Moewardi Hospital Surakarta in November 2017 on 30 subjects, which were divided into 2 groups. Mast cell infiltration was observed on burn and post-surgery wounds colored with Toluidine Blue, while IL-6 and albumin were measured -blood, where both groups had comparable basic characteristics. Results: There was a statistically insignificant (p=0.835) higher increase in albumin level in the treatment group, while an insignificant (p=0.056) greater decrease also occur in the IL-6 level. The decrease in cell mast infiltration after treatment was also higher and not statistically significant (p=0.526). Previous studies showed that amino acids from snakehead fish play an important role in wound healing. Meanwhile, high EPA content in sea cucumber is due to its ability as an Echinodermata to regenerate tissue. It was also discovered that the results available about sea cucumber and sea snake extract on wound healing are different based on the skin condition after the use of the extracts. Conclusion: Snakehead fish and sea cucumber extract supplementation can increase albumin level, decrease IL-6 level and mast cell infiltration in burn or post-surgery wounds.
Co-Authors Bhirowo Yudo Pratomo Hananto, Arif Zuhal Amin Hapsari, Paramita Putri Mahardhika, Aria Windy Pamungkas, Ferdy Purwoko Purwoko Santosa, Sugeng Budi Siswanto, Febby Gunawan