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Gabapentin dan Gabapentin-Amitriptilin sebagai Adjuvan Analgetik Nyeri Kanker di Klinik Nyeri RSUP H. Adam Malik Medan Ramadhan, Muhammad; Tanjung, Qadri Fauzi; Silaen, Ester Lantika; Hamdi, Tasrif; Ihsan, Muhammad; Amelia, Rina
Majalah Anestesia & Critical Care Vol 43 No 3 (2025): Oktober
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v43i3.350

Abstract

Pendahuluan: Pasien kanker merasakan nyeri yang mempengaruhi kualitas hidup terutama pasien kanker stadium lanjut. Beberapa agen yang digunakan pada nyeri kanker adalah morfin, parasetamol, dan amitriptilin. Antidepresan, anti-epileptik, dan kortikosteroid mulai dieksplorasi untuk terapi nyeri pada penyakit non-kanker, namun penggunaannya dalam nyeri kanker masih belum dipelajari dengan baik. Beberapa studi menyimpulkan manfaat penggunaan gabapentin pada nyeri neuropatik dan nosiseptif, hingga kini belum ada studi efikasi agen tersebut pada nyeri kanker, maka penelitian terfokus kepada efikasi kombinasi antara amitriptilin dan gabapentin. Metode: Penelitian ini menggunakan Randomized Clinical Trial dengan sistem blinding. Dua kelompok sampel diobservasi sebelum pemberian (T0), hari ke-1 (T1), ke-3 (T2), dan ke-7 (T3). Kelompok A menerima gabapentin dan kelompok B menerima gabapentin dengan amitriptilin. Analisis data menggunakan uji t independen atau Mann-Whitney. Hasil: Sebanyak 62 orang dibagi menjadi 2 kelompok. Kelompok A mengalami keluhan mual, muntah, penurunan nafsu makan, dan pusing terbanyak sedangkan kelompok B mengalami keluhan sulit tidur terbanyak. Secara statistik, kelompok A maupun B mampu mereduksi skala nyeri berdasarkan skala pengukuran NRS dan pain detect (p<0,001) serta data keluhan awal dijumpai perbedaan signifikan (p<0,001). Perbedaan yang bermakna secara signifikan antara kedua regimen yang dianalisis juga tidak dijumpai dengan nilai p>0,05 pada seluruh waktu, kecuali pada variabel NRS di T3 (gabapentin (4,03±0,59)) dan kombinasi (3,53±0,82); p=0,009). Simpulan: Temuan mengindikasikan perbedaan yang signifikan mungkin baru terlihat pada hari ke-7 pasca observasi, meskipun pada dasarnya regimen kombinasi lebih efektif untuk mereduksi nyeri dibandingkan gabapentin tunggal. Kelompok kombinasi mengalami penurunan derajat nyeri yang lebih tinggi namun hanya signifikan pada waktu T3-T2 menggunakan skala NRS.
Perbandingan Tingkat Kesulitan Intubasi dengan Menggunakan Bantal dan Tanpa Bantal di Ruang Operasi RSUP H. Adam Malik Sinaga, Ade Putra Fratama; Hamdi, Tasrif; Tanjung, Qadri Fauzi
Majalah Anestesia & Critical Care Vol 43 No 3 (2025): Oktober
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v43i3.406

Abstract

Latar Belakang: Intubasi endotrakeal merupakan teknik yang cepat, sederhana, dan aman untuk mencapai tujuan manajemen jalan napas. Posisi kepala dan leher yang tepat, sering kali ditingkatkan dengan bantal kepala, sangat penting untuk laringoskopi dan intubasi trakea yang efektif, karena dapat meningkatkan sudut oksipito-atlanto-aksial dan memperbesar ruang submandibular. Metode: Penelitian cross-sectional acak di RSUP H. Adam Malik Medan ini membandingkan kesulitan intubasi dengan dan tanpa menggunakan bantal. Sebanyak 24 subjek dibagi dua kelompok, masing - masing 12 orang. Data meliputi usia, jenis kelamin, indeks massa tubuh (IMT), status ASA, skor Wilson, dan skor Cormack-Lehane. Hasil: Rata-rata usia kelompok tanpa bantal 49,4 ± 12,1 tahun dan dengan bantal 44,3 ± 14,4 tahun. Sebagian besar subjek tanpa bantal adalah laki-laki, sedangkan dengan bantal perempuan. IMT ratarata masing-masing 21,0 ± 1,65 kg/m² dan 21,8 ± 1,85 kg/m². ASA I lebih banyak pada kelompok tanpa bantal, sedangkan ASA I dan II sama pada kelompok dengan bantal. Tidak ada perbedaan signifikan karakteristik dasar kedua kelompok. Skor Wilson memprediksi intubasi mudah pada sebagian besar pasien. Skor rata-rata Wilson lebih tinggi pada kelompok tanpa bantal (15,9 ± 1,6) dibanding dengan bantal (10,8 ± 1,8; p<0,05). Skor Cormack-Lehane menunjukkan kelompok dengan bantal lebih sering pada tingkat 1 dibanding tanpa bantal yang dominan tingkat 2 (p<0,05). Simpulan: Intubasi tanpa bantal membutuhkan sedikit bantuan, sementara sebagian besar pasien yang menggunakan bantal dapat dengan mudah diintubasi. Tidak ada perbedaan yang signifikan di antara kedua kelompok.
Pelatihan Penanganan Cardiac Arrest (Henti Jantung) dengan Menggunakan Metode Bantuan Hidup Dasar (BHD) Bagi Pengemudi Ojek Online Se Kota Medan Siahaan, Dwi Lunarta D. S.; Sinatra, Jadeny; Nazma, Diani; Lubis, Andriamuri P.; Tanjung, Qodri F.; Sitepu, John Frans; Hamdi, Tasrif; Hamdani, Irfan; Chalil, M. Jalaluddin A.; Yunafri, Andri; Irina, Sinta; Zainumi, Cut M.; Fadinie, Wulan; Silaen, Ester L. R.; Simbolon, Boyke M.; Siahaan, Jekson M.; Lim, Hadyanto; Anto, Endy Juli; Tobing, Paul S. M. L.; Rimbun, Surjadi; Hutasoit, Eka Samuel P.; Tambunan, Ronald T. H.; Tarigan, Juliyanti; Stephanie S., Kezia; Natalie S., Karen
Jurnal Pengabdian Pada Masyarakat METHABDI Vol 4 No 2 (2024): Jurnal Pengabdian Pada Masyarakat METHABDI
Publisher : Universitas Methodist Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46880/methabdi.Vol4No2.pp188-193

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Cardiac Arrest is the leading cause of death in the world including Indonesia, which can occur anytime and anywhere. The causes vary, ranging from fatigue, and underlying health conditions, to traffic accidents. Basic Life Support (BLS) is the initial step that can be taken to restore respiratory and circulatory function in individuals experiencing respiratory or cardiac arrest. It is important for online motorcycle taxi drivers to possess these skills, as they often spend time on the road and interact with various people in different situations. Perhimpunan Dokter Spesialis Anesthesiology dan Terapi Intensif (PERDATIN) North Sumatra Branch concluded a series of Kursus Penyegar dan Penambah Ilmu Anestesia (KPPIA) by providing basic life support training to 521 public transport or online motorcycle taxi drivers in the city of Medan on September 29, 2024. Held at the Gedung Serba Guna of the North Sumatra Provincial Government, the participants were divided into 52 groups guided directly by anesthesiologist specialists as instructors. By providing this education and training, they can be better prepared to face emergency situations on the road, thereby enhancing safety and service for passengers
Factor Analysis of Knowledge Attitude and Characteristics of Nurses Towards Pain Management Hanim, Saodah; Nasution, Siti Saidah; Hamdi, Tasrif
Indonesian Journal of Global Health Research Vol 6 No 6 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6i6.3911

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Pain is an experience of subjective and physiological condition. Accurate pain assessment is essential and effective for the successful implementation of pain management. The inability of nurses to assess pain and poor communication between patients and nurses leads to ineffective pain management. In addition, an adequate level of knowledge and a positive attitude in caring for patients is an important component in the delivery of pain management. Objective: The purpose of this study was to analyze the factor of knowledge and attitude of nurses towards pain management at Haji Adam Malik Hospital Medan. Method: The type of research used in this study was quantitative with a survey method research design. Respondents in the study amounted to 84 nurses in the RB6. RA3, RA4 dan RA5. Bivariate Data Analysis with Chi-Square. Results: The result chi-square test analysis obtained a p-value for the variable of age (0,472). Education (0,790). Experience (),376), knowledge (0,099), and attitude (0,000). Conclusions: Attitude is the nurse's readiness or willingness to act in the assessment and reassessment of pain, managing pain, and evaluating it. Good nursing attitudes are needed to improve the implementation of pain management at the H. Adam Malik Central General Hospital, Medan.
Initial Sofa Score and Mortality of Sepsis Patients in the Intensive Care Unit of Haji Adam Malik Hospital Medan: Does It Correlate? Hanif, Raisa Syifa; Hamdi, Tasrif; Kadri, Alfansuri; Megawati, Eka Roina
Indonesian Journal of Anesthesiology and Reanimation Vol. 6 No. 2 (2024): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V6I22024.73-79

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Introduction: Sepsis is a life-threatening organ dysfunction or failure that is the primary cause of death in infectious disease. the Sepsis-3 Task Force recommends The Sequential (Sepsis-Related) Organ Failure Assessment (SOFA) Score as a means of Sepsis identification. Objective: To determine the correlation between sepsis patients’ deaths in the intensive care unit (ICU) of Haji Adam Malik Hospital Medan and their initial SOFA score. Methods: This study uses a cross-sectional study design and an observational analytical investigation. The sample for this study was sepsis patients who were treated in the ICU of Haji Adam Malik Hospital Medan in 2021-2022, and they were selected using the purposive sampling method. After calculating the Slovin formula, 61 samples are required. The researchers obtained the data from patient medical records. The analyses used are univariate and bivariate, with the Independent-T test and Fisher’s exact. Results: From 71 patients, there were 36 patients (50.7%) in the age group of 46-65 years old; 39 patients (54.9%) were male; 50 patients (70.4%) had comorbidities; and 50 patients (70.4%) had non-surgical disease. The average initial SOFA score was 9.89 ± 3.95, with mortality for sepsis patients in the ICU of 74.6%. The findings of the statistical analysis indicated a substantial difference (p<0.001) in the SOFA scores of those who survived and those who did not, as well as a significant correlation (p<0.001) between the initial SOFA score and mortality. Conclusion: There is a correlation between initial SOFA score and the mortality of sepsis patients in the ICU of Haji Adam Malik Hospital.
Anestesia pada Tindakan Dekompresi Foramen Magnum pada Pasien dengan Malformasi Arnold Chiari Umar, Nazaruddin; Prabowo, Haryo; Hamdi, Tasrif
Jurnal Neuroanestesi Indonesia Vol 2, No 2 (2013)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (200.862 KB) | DOI: 10.24244/jni.vol2i2.163

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Malformasi Arnold Chiari tipe 1 adalah pergeseran tonsil serebellum kearah kaudal kanalis spinalis tulang belakang servikal melalui foramen magnum. Siringomielia adalah gangguan degeneratif progresif yang ditandai dengan amiotropi brakhial dan kehilangan fungsi sensorik dan secara patologi dengan kavitasi bagian sentral dari medula spinalis, siringomielia pada malformasi Chiari terjadi antara level servikalis 46. Seorang laki-laki usia 29 tahun datang dengan riwayat nyeri tumpul di kedua lengan atas. Dalam perjalanannya setelah 2 tahun terjadi atropi thenar dan hipothenar dan kehilangan kemampuan motorik pada kedua lengan atas. Pemeriksaan neurologis menunjukkan gangguan sensorik pada lengan kanan dan lengan kiri. Pencitraan MRI menunjukkan herniasi tonsil ke foramen magnum dan siringomielia dari medula oblongata ke level T4. Laporan kasus ini adalah kasus langka seorang laki-laki dengan malformasi Arnold Chiari tipe 1 dengan manifestasi lambat dan siringomielia yang sukses menjalani prosedur operasi dekompresi foramen magnum dengan teknik anestesi umum.Anesthesia for Foramen Magnum Decompression in Patient with Arnold Chiari Malformation The Arnold Chiari malformation type I (Chiari malformation) is a caudal displacement of the cerebellar tonsils into the cervical spinal canal through the foramen magnum. Syringomyelia is a chronic progressive degenerative disorder characterized clinically by brachial amyotrophy and segmental sensory loss of dissociated type, and pathologicaly by cavitation of the central parts of the spinal cord, syringomyelia is often associated with Chiari Malformation type I and is commonly seen between the C-4 and C-6 levels. A 29-year-male had experienced a history of dull pain in her both arm for 2 years. Additionally, after two years hipothenar and thenar muscle became atropi and the patient lossing his upper extremity motorik ability. The neurological examination revealed sensory disturbances in his right arm,and left arm. MRI showed cerebellar tonsillar herniation into the foramen magnum and syringomyelia from the medulla oblongata to the T4 level. This report is a very rare case of an middle age male with late-onset Arnold Chiari malformation type I and syringomyelia that was successfully undergo foramen magnum decompression under general anesthesia.
Effectiveness of 0.25% vs 0.375% Ropivacaine for Incisional Infiltration in Cesarean Delivery with Spinal Anesthesia Siregar, Ahmad Habibi; Hamdi, Tasrif; Nadeak, Rommy F.; Wahyuni, Arlinda Sari
JAI (Jurnal Anestesiologi Indonesia) Vol 18, No 1 (2026): JAI (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.v0i0.67832

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Background: Postoperative discomfort subsequent to a caesarean delivery significantly influences the recuperation process and necessitates efficacious therapeutic intervention. Ropivacaine is a local anesthetic used to manage this pain, but there is limited comparison between its 0.25% and 0.375% concentrations.Objective: To evaluate the comparative efficacy of varying dosages of ropivacaine, specifically 0.25% and 0.375% concentrations, as local anesthetic infiltrates during the surgical procedure of Cesarean section incision.Methods: This randomized controlled trial (RCT) encompassed a cohort of 60 patients who underwent cesarean sections utilizing spinal anesthesia at Adam Malik Hospital, Medan, Haji Hospital Medan, Prof. Chairuddin P. Lubis USU Hospital Medan, and Putri Hijau Hospital Medan. The participants were stratified into three distinct groups: ropivacaine 0.25% (n=20), ropivacaine 0.375% (n=20), and a control group (n=20). Pain intensity was quantitatively assessed employing the numerical rating scale (NRS) at intervals of 2, 6, 12, and 24 hours postoperatively. Furthermore, the utilization of supplementary analgesics and the occurrence of adverse effects were meticulously documented. Statistical analysis of the data was conducted utilizing the Kruskal-Wallis test (p<0.05).Results: Both ropivacaine 0.25% and 0.375% groups demonstrated significantly lower NRS pain scores at 2, 6, 12, and 24 hours postoperatively compared to the control group (p<0.05). Patients receiving ropivacaine infiltration also showed a significantly reduced need for additional analgesics compared to those who did not receive ropivacaine. However, no statistically significant differences in postoperative pain scores or supplemental analgesic requirements were observed between the 0.25% and 0.375% ropivacaine groups (p>0.05).Conclusions: Both 0.25% and 0.375% ropivacaine effectively reduce postoperative pain and the need for additional analgesics compared to the control group. However, there was no significant difference between the two ropivacaine concentrations.
The Effect of Intrathecal 20 mg Ketamine on 0.5% 15 mg Bupivacaine in Spinal Anesthesia For Lower Extremity Surgery Chandra, Nopial Ade; Hamdi, Tasrif; Lubis, Andriamuri Primaputra
Journal of Anaesthesia and Pain Vol. 7 No. 1 (2026): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

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Background: Regional anesthesia is widely used in orthopedic procedures to reduce complications such as nausea, vomiting, and pulmonary aspiration. Intrathecal ketamine is known to prolong analgesia duration, but evidence remains limited. This study aimed to compare the effectiveness and side effects of combining intrathecal ketamine 20 mg with 0.5% bupivacaine 15 mg versus bupivacaine alone in spinal anesthesia for lower extremity surgery. Methods: A randomized controlled trial (RCT) was conducted at RS Haji Medan and Rumkit Tk II Putri Hijau Medan, involving 30 patients undergoing spinal anesthesia. Subjects were divided into two groups: Group A (Ketamine + Bupivacaine) and Group B (Bupivacaine only). Variables observed included onset and duration of sensory and motor blockade, sedation level, hemodynamic responses, and adverse effects. Data were analyzed using SPSS v24.0. Results: No significant differences were found in baseline characteristics between the two groups. The addition of ketamine did not significantly affect the onset or duration of sensory and motor blockade. Hemodynamic parameters such as heart rate and blood pressure remained stable in both groups. However, sedation levels were lower and the incidence of adverse effects (such as nausea, shivering, and hallucinations) was higher in the ketamine group. Conclusion: The addition of intrathecal ketamine 20 mg to bupivacaine 0.5% 15 mg slightly prolonged spinal anesthesia but was associated with an increased risk of adverse effects and lower sedation. This combination should be used cautiously in clinical practice.
Comparison between Local Infiltration Combination of 1% 200 mg Lidocaine and 10 mg Dexametason with 0.75% 150 mg Ropivacaine on Degree of Pain in Post-Caesarian Operative Wounds Simamora, Veronica; Bangun, Chrismas Gideon; Hamdi, Tasrif; Harahap, Juliandi
Jurnal Anestesi Perioperatif Vol 13, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n3.3673

Abstract

Introduction: Local anesthetic wound infiltration reduces postoperative pain, promotes early mobilization, and shortens hospital stay after cesarean section. Lidocaine is widely used, and the addition of dexamethasone may prolong its analgesic effect. Ropivacaine provides longer-lasting analgesia but is more expensive and less accessible in many hospitals. This study aimed to compare the analgesic effects of local wound infiltration using 0.75% ropivacaine 150 mg versus 1% lidocaine 200 mg combined with 10 mg dexamethasone on postoperative pain following cesarean section.Methods: This randomized, double-masked, controlled clinical trial involved 38 patients undergoing cesarean section under spinal anesthesia. Participants were randomly allocated using a computer-generated sequence to receive wound infiltration with either 1% lidocaine (200 mg) plus dexamethasone (10 mg) or 0.75% ropivacaine (150 mg). Patients and outcome assessors were blinded to group allocation. Postoperative pain intensity was assessed using the Numeric Rating Scale (NRS) at rest and during passive movement at 2, 6, 12, and 24 hours after surgery.Results: The ropivacaine group had significantly lower NRS scores at rest and during passive movement at 2, 6, and 12 hours postoperatively compared with the lidocaine–dexamethasone group (p < 0.05). At 24 hours after surgery, no significant difference in pain intensity was observed between groups (p>0.05).Conclusion: Local wound infiltration with 0.75% ropivacaine 150 mg provided superior analgesia during the first 12 hours after cesarean section compared with lidocaine combined with dexamethasone. The lidocaine–dexamethasone combination remains a practical alternative where ropivacaine is unavailable.
Relationship Between Nutritional Status and Severity of Pneumonia among Children Under Five Rizone, Alifya Shifwah; Meirina, Fathia; Hamdi, Tasrif; Aldy, Fithria
Jurnal Ilmiah Kedokteran Wijaya Kusuma Vol. 14 No. 2 (2025): SEPTEMBER 2025
Publisher : Universitas Wijaya Kusuma Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30742/jikw.v14i2.4145

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Background. Pneumonia is known as a forgotten pandemic, leading to high morbidity and mortality, especially among children under five years, with nutritional status identified as a risk factor for the disease's incidence. This study aimed to determine the relationship between nutritional status and pneumonia severity in children under five. Methods. An analytical observational study with a cross-sectional design was conducted among 122 children aged 2-59 months diagnosed with pneumonia based on medical record data from Prof. Dr. Chairuddin Panusunan Lubis Medan Hospital from February 2022 - January 2024. The data were obtained with consecutive sampling. Data were analyzed through univariate and bivariate analyses using the chi-square test with SPSS software version 27. Results. Of 122 patients, the majority of patients were aged 12-59 months (64.8%), male (56.6%), had good nutritional status (63.1%), had a high level of life outcomes (98.4%), and had pneumonia (71.4%). Bivariate analysis showed a significant relationship between nutritional status and pneumonia severity (p < 0,001); PR = 4,3023; CI = 3,449 – 20,338). But there was no relationship between age (p = 0,081; PR = 1,740; CI = 0,989 – 4,963) and gender (p = 1,000; PR = 1,02; CI = 0,468 – 2,283) with severity of pneumonia. Conclusion. There is a significant relationship between nutritional status and severity of pneumonia in children under five. Keywords: Pneumonia, severity, nutritional status, severe pneumonia, children