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Perbandingan antara Penggunaan Asam Amino dan Ringer Laktat terhadap Penurunan Suhu Inti Pasien yang Menjalani Operasi Laparotomi Ginekologi dengan Anestesi Umum Agung Hujjatulislam; Erwin Pradian; Ike Sri Redjeki
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Pemberian asam amino intravena merangsang metabolisme oksidatif sekitar 20% dan mengurangi komplikasi hipotermia pascaoperasi. Tujuan penelitian ini mengetahui efek penggunaan asam amino preoperatif terhadap suhu inti tubuh. Penelitian menggunakan metode kuantitatif intervensi dengan rancangan uji klinis acak terkontrol buta tunggal pada 40 orang pasien berusia 18−57 tahun dengan status fisik American Society of Anesthesiologists (ASA) I dan II yang menjalani operasi laparotomi ginekologi di Rumah Sakir Dr. Hasan Sadikin Bandung periode Febuari–Mei 2014. Subjek dibagi menjadi 2 kelompok secara acak, yaitu kelompok yang mendapat asam amino 2 mL/kgBB/jam selama 2 jam preoperasi dan kelompok kontrol yang mendapat infus Ringer laktat. Pencatatan suhu timpani dilakukan setiap 10 menit dari awal induksi hingga akhir anestesi. Data hasil penelitian diuji dengan Uji Mann-Whitney. Hasil penghitungan statistika, didapatkan suhu inti rata-rata selama anestesi pada kelompok asam amino bermakna lebih tinggi dibanding dengan kelompok kontrol (p<0,05). Penurunan suhu rata-rata pada kelompok kontrol (0,11C) bermakna, lebih besar dibanding dengan kelompok asam amino (0,08C; p<0,05). Simpulan, pemberian cairan asam amino dua jam preoperasi dapat mencegah penurunan suhu yang lebih besar dibanding dengan kelompok kontrol selama operasi ginekologi laparotomi.Kata kunci: Asam amino, hipotermia, suhu inti tubuh Comparison between Amino Acids and Ringer Lactate Infusion on Body Core Temperature Decline in Patients Undergo Gynaecological Laparotomy Surgery under General AnesthesiaIntravenous administration of amino acids stimulates about 20% oxidative metabolism and reduces postoperative complications of hypothermia. The aim of this study was to determine the effects of preoperative amino acid infusion to core temperature. This was an observational analytic study with cross-sectional design to compare the reliability using the inter-rater reliability method. Subjects were 40 patients aged 18−57 years old with physical status ASA I and II who underwent gynaecological laparotomy at Dr. Hasan Sadikin General Hospital Bandung during February–May 2014. Subjects were devided randomly into 2 groups; one group was given 2 mL/kgBW/hour amino acid infusion for 2 hours before laparotomy and another group was the control group given ringer lactate infusion. Tympani membrane temperature was taken every 10 minutes throughout the anesthetic procedure. Data were statistically analyzed using Mann-Whitney test.The result of this study was the average of core temperature during anesthesia in amino acid group was significantly higher than control group (p<0.05). The average of temperature decline in the control group (0.11oC) was significantly higher (p<0.05) than the amino acid group (0.08oC). This study concludes that amino acid infusion two hours before surgery will prevent greater decrease in temperature compared to the control group during gynecological laparotomy surgery.Key words: Amino acids, body core temperature, hypothermia DOI: 10.15851/jap.v3n3.606

Perbandingan Anestesi Spinal Menggunakan Ropivakain Hiperbarik 13,5 mg dengan Ropivakain Isobarik 13,5 mg terhadap Mula dan Lama Kerja Blokade Sensorik Hunter D. Nainggolan; Iwan Fuadi; Ike Sri Redjeki
Jurnal Anestesi Perioperatif Vol 2, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Penyebaran obat anestesi lokal pada anestesi spinal terutama ditentukan oleh barisitas dan posisi. Penelitian ini bertujuan membandingkan mula dan lama kerja blokade sensorik antara anestesi spinal menggunakan ropivakain hiperbarik 13,5 mg dan ropivakain isobarik 13,5 mg. Penelitian dilakukan dengan uji acak terkontrol buta ganda mengikutsertakan 32 pasien usia 50–70 tahun, ASA I–II yang menjalani transurethral resection of prostate (TURP) dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin Bandung pada April– Juli 2012. Data hasil penelitian dianalisis menggunakan Uji Mann-Whitney dengan tingkat kepercayaan 95% dan dianggap bermakna bila p<0,05. Hasil penelitian didapatkan mula kerja blokade sensorik pada ropivakain hiperbarik 5,00 (SB 1,03) menit lebih cepat secara bermakna dibandingkan dengan ropivakain isobarik 10,25 (SB 1,23) menit dan terdapat perbedaan lama kerja blokade sensorik secara bermakna, dengan lama kerja ropivakain hiperbarik adalah 89,38 (SB 5,12) menit dibandingkan dengan ropivakain isobarik 125,94 (SB 7,57) menit. Simpulan penelitian ini adalah anestesi spinal menggunakan ropivakain hiperbarik menghasilkan mula kerja blokade sensorik yang lebih cepat dan lama kerja blokade sensorik yang lebih pendek bila dibandingkan dengan ropivakain isobarik pada pasien yang menjalani operasi TURP.Kata kunci: Anestesi spinal, barisitas, lama kerja, mula kerja, ropivakain, transurethral resection of prostateComparison of Onset and Sensory Blockade Duration of Spinal Anesthesia between 13.5 mg Hyperbaric Ropivacaine and 13.5 mg Isobaric RopivacaineThe spread of the local anesthetic drug in spinal anesthesia is primarily determined by baricity and position. The aim of this study was to compare the onset and duration of sensoric blockade in spinal anaesthesia using 13.5 mg hyperbaric ropivacaine and 13.5 mg isobaric ropivacaine. This was a double blind randomized trial involving 32 patients aged between 50–70 years with ASA I–II whom underwent TURP surgery with spinal anesthesia at Dr. Hasan Sadikin Hospital Bandung within April–July 2012. Data was analyzed using Mann-Whitney Test with level of confidence 95% and p<0.05 was significant. The result showed that onset of sensory blockade in hyperbaric ropivacaine 5.00 (SB 1.03) minutes was significantly faster compared to isobaric ropivacaine 10.25 (SB 1,23) minutes and there was significant difference on sensory blockade duration, where hyperbaric ropivacaine 89.38 (SB 5.12) minutes was shorter than isobaric ropivacaine 125.94 (SB 7.57) minutes. The conclusions of this study shown spinal anesthesia using hyperbaric ropivacaine produced faster onset and shorter duration of sensory block compared to isobaric ropivacaine in TURP surgery.Key words: Baricity, duration, onset, spinal anesthesia, ropivacaine, transurethral resection of prostate DOI: 10.15851/jap.v2n1.232

Korelasi antara Lama Pintas Jantung Paru dan Lama Bantuan Ventilasi Mekanis pada Pasien Pascabedah Pintas Arteri Koroner di Unit Perawatan Intensif Jantung Rumah Sakit Dr. Hasan Sadikin Bandung Tias Diah Setiari; Reza Widianto Sudjud; Ike Sri Redjeki
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Pintas jantung paru (PJP) diperlukan untuk sebagian besar prosedur bedah pintas arteri koroner (BPAK). Fungsi paru dan oksigenasi menurun sekitar 2–90% pada pasien pascabedah jantung dengan PJP. Ketergantungan terhadap ventilator setelah BPAK secara signifikan berhubungan dengan morbiditas dan mortalitas. Tujuan penelitian ini adalah mengorelasikan waktu PJP dengan lama bantuan ventilasi mekanis pada pasien BPAK. Penelitian ini merupakan analisis kohort retorospektif pada 43 pasien yang menjalani BPAK dengan PJP yang dirawat di Unit Perawatan Intensif Jantung Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Januari 2014 sampai Juni 2015. Lama PJP dibagi menjadi ≤90 menit dan >90. Lama bantuan ventilasi mekanis terbagi menjadi ≤12 jam dan >12 jam. Parameter yang dicatat pada penelitian ini adalah usia, berat badan, tinggi badan, indeks massa tubuh, lama PJP, waktu klem aorta, dan lama bantuan ventilasi mekanis. Analisis stastistik menggunakan uji korelasi Lambda, signifikan jika nilai p<0,05. Penelitian ini menunjukkan korelasi yang cukup kuat antara waktu PJP dan lama bantuan ventilasi mekanis setelah BPAK dengan korelasi positif (0,545) dan signifikan (p<0,05). Simpulan penelitian ini adalah semakin lama waktu PJP berkorelasi dengan memanjangnya lama bantuan ventilasi mekanis. Kata kunci: Bedah pintas arteri koroner, pintas jantung paru, ventilasi mekanis Correlation between Cardiopulmonary Bypass Time and Duration of Mechanical Ventilation after Coronary Artery Bypass Graft at Cardiac Intensive Care Unit of Dr. Hasan Sadikin General Hospital BandungCardiopulmonary bypass (CPB) is necessary for majority of procedures in coronary artery bypass grafting (CABG) surgery. Lung function and oxygenation are impaired in 20% to 90% of CPB cardiac surgery patients. Ventilator dependency following CABG is often associated with significant morbidity and mortality. This study aims to correlate the CPB time and duration of mechanical ventilation after coronary artery bypass graft. This was a retrospective analysis cohort study on 43 consecutive patients undergoing CABG on CPB who admitted to cardiac intensive care unit between January 2014 and June 2015 in Dr. Hasan Sadikin General Hospital Bandung. The CPB time divided into <90 minutes and ≥90 minutes. Duration of mechanical ventilation was defined as ≤12 hours and ≥12 hours ventilation. Parameters recorded in this study were age, weight, height, body mass index, CPB time, aortic cross-clamp time and duration of mechanical ventilation. Statistical analysis was performed using Lambda correlation, significanti if p value <0.05. This study showed moderate correlation between CPB time and duration of mechanical ventilation after CABG surgery with a positive (0.545) and significant correlation (p<0.05). Conclusion of this research is longer CPB timed correlated with prolonged mechanical ventilationKey words: Cardiopulmonary bypass time, coronary artery bypass grafting, mechanical ventilation

Perbandingan Pengaruh Premedikasi per Rektal antara Klonidin 5 μg/ kgBB dan Ketamin 10 mg/kgBB pada Anak Usia 2–5 Tahun pada Skala Pemisahan Prabedah dan Skala Kemudahan Induksi Mira Rellytania Sabirin; Ezra Oktaliansah; Ike Sri Redjeki
Jurnal Anestesi Perioperatif Vol 2, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Premedikasi pada anak berguna untuk menurunkan kecemasan prabedah dan memudahkan induksi. Penelitian ini bertujuan untuk mengetahui efektivitas klonidin 5 µg/kgBB dibandingkan dengan ketamin 10 mg/kgBB per rektal sebagai premedikasi pada anak. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada November 2011–Februari 2012 menggunakan uji klinis terkontrol samar buta ganda pada 32 pasien pediatrik usia 2–5 tahun yang akan menjalani operasi elektif dan mendapatkan klonidin 5 µg/kgBB atau ketamin 10 mg/kgBB per rektal 45 menit sebelum induksi anestesi. Kualitas skala pemisahan dari orangtua dan skala kemudahan induksi saat pemasangan sungkup muka selama pemberian inhalasi isofluran dianalisis memakai Uji Mann-Whitney dengan tingkat kepercayaan 95%, dianggap bermakna bila p<0,05. Klonidin 5 µg/kgBB memberikan kualitas yang efektif dan baik dalam hal pemisahan dan penerimaan pemasangan sungkup saat induksi dibandingkan dengan ketamin 10 mg/kgBB dengan perbedaan bermakna (p<0,001). Data ini menunjukkan bahwa klonidin 5 µg/kg rektal merupakan pilihan obat premedikasi alternatif yang efektif dan aman untuk diberikan kepada pasien pediatrik.Kata kunci: Klonidin rektal, ketamin rektal, premedikasi, skala kemudahan induksi, skala pemisahanComparison Between Premedication using Clonidine 5 μg/kgBW and Ketamine 10 mg/kgBW per Rectal in Children Aged 2–5 Years to Preoperative Separation Scale and Acceptance of Mask for Induction ScalePremedication in children is used to reduce pre operative anxiety and to facilitate induction. This study was designed to investigate the efficacy of rectal clonidine 5 µg/kgBW in comparison with rectal ketamine 10 mg/kgBW as a premedication in children. The study was conducted at Dr. Hasan Sadikin Hospital Bandung during the period November 2011–February 2012 with a double-blind randomized clinical controlled trials on 32 paediatric patients aged 2–5 years undergoing elective surgery and received either clonidine 5 µg/kgBW or ketamine 10 mg/kgBW rectally 45 min before induction of anesthesia. The quality of separation scale from the parent and the acceptance of mask for induction scale application during inhalation isoflurane were analyzed using Mann Whitney Test with 95% confidence interval, p value <0.05 is considered as statistically significant. Clonidine 5 µg/kgBW provide effective and good qualities of separation and acceptance of mask for induction compared to ketamine 10 mg/kgBW. These data indicate that rectal clonidine 5 µg/kgBW is effective and safe as an alternative drug for premedication in paediatric patients.Key words: Acceptance of mask for induction scale, clonidine, premedication, rectal, separation scale DOI: 10.15851/jap.v2n1.230

Gambaran Pengetahuan Klinisi Ruang Rawat Intensif mengenai Ventilator Associated Pneumonia (VAP) Bundle di Ruang Rawat Intensif RSUP Dr. Hasan Sadikin Bandung M. Fajar Sadli; Doddy Tavianto; Ike Sri Redjeki
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Ventilator associated pneumonia (VAP) merupakan infeksi yang terjadi pada pasien yang terintubasi ≥48 jam di ruang rawat intensif. Penanganan VAP merupakan tantangan utama akibat morbiditas dan mortalitas yang tinggi.Ventilator associated pneumonia bundle (VAPb) telah terbukti dapat menurunkan angka kejadian VAP sehingga pengetahuan dokter dan perawat mengenai VAPb menentukan keberhasilan pencegahan VAP di ruang rawat intensif. Tujuan penelitian ini mengetahui pengetahuan dokter dan perawat mengenai VAPb di ruang rawat intensif RSUP Dr. Hasan Sadikin Bandung. Data diambil dari bulan November–Desember 2016. Penelitian deskriptif dengan desain potong lintang ini menggambarkan pengetahuan mengenai VAPb dari dokter residen Departemen Anestesi dan Terapi Intensif dan perawat di ruang rawat intensif RSUP Dr. Hasan Sadikin Bandung. Responden terdiri atas 79 dokter dan 88 perawat. Tingkat pengetahuan VAPb diuji menggunakan 20 pertanyaan kuesioner. Responden perawat terbanyak berjenis kelamin perempuan (74%), berusia ≥30 tahun (92%), status pendidikan diploma III (65%), lama kerja >5 tahun (76%), dan bekerja di Intensive Care Unit (ICU) (32%). Responden dokter terbanyak berjenis kelamin laki-laki (71%), berusia ≥30 tahun (83%), dan telah menyelesaikan stase ICU (61%). Simpulan, nilai kuesioner perawat dan dokter rata-rata berturut-turut 73,63 dan 73,16. Kata kunci: Klinisi ruang rawat intensif, tingkat pengetahuan, ventilator associated pneumonoia bundle Description of Intensive Care Clinician Knowledge about Ventilator Associated Pneumonia (VAP) Bundle in the Intensive Care Unit of Dr. Hasan Sadikin Hospital BandungVentilator associated pneumonia (VAP) is an infection that occurs in patients who are intubated ≥48 hours in intensive care. Management VAP is a major challenge due to the high morbidity and mortality. Ventilator associated pneumonia bundle (VAPb) has been shown to reduce the incidence of VAP, so knowledge of doctors and nurses about VAPb determine the success of preventing VAP in intensive care. This study aims to know the description of intensive care clinician knowledge about ventilator associated pneumonia bundle in the intensive care of Dr. Hasan Sadikin General Hospital Bandung. Data were collected from November–December 2016. Descriptive study with cross-sectional design depicts VAPb knowledge of resident physicians Department of Anesthesia and Intensive Therapy and nurses in the Intensive Care Department of Dr. Hasan Sadikin Hospital. Respondents consisted of 79 doctors and 88 nurses. The level of knowledge VAPb tested using a 20 question questionnaire. Most nurse respondents were female (74%), aged ≥30 years (92%), educational status diploma III (65%), length of employment >5 years (76%), and work in Intensive Care Unit (ICU) (32%). Most physician respondents were male sex (71%), aged ≥30 years (83%), and had completed stase ICU (61%). In conclution, the mean value of the questionnaire nurses and doctors respectively 73.63 and 73.16. Key words: Intensive care clinician, level of knowledge, ventilator associated pneumonoia bundle

Efek Pemberian Magnesium Sulfat Intravena Perioperatif terhadap Nilai Visual Analog Scale (VAS) dan Kebutuhan Analgetik Pascabedah pada Pasien yang Menjalani Pembedahan Abdominal Ginekologi dengan Anestesi Umum Dhany Budipratama; U. Kaswiyan; Ike Sri Redjeki
Jurnal Anestesi Perioperatif Vol 1, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Magnesium sulfat sebagai antagonis reseptor N-methyl-D-aspartate (NMDA) dan penghambat saluran kalsium, memiliki efek antinosiseptif dan antihiperalgesia. Penelitian dilakukan secara acak, terkontrol, buta ganda bertujuan untuk menilai efek pemberian bolus magnesium sulfat intravena terhadap nilai visual analog scale (VAS) dan jumlah kebutuhan analgetik petidin pada 30 pasien wanita dengan status fisik ASA I–II, usia 18–60 tahun, yang akan menjalani operasi abdominal ginekologi elektif dengan anestesi umum di ruang operasi bedah sentral Rumah Sakit Dr. Hasan Sadikin Bandung pada Juni–September 2011. Subjek penelitian dibagi menjadi dua kelompok yang akan mendapat bolus dan rumatan MgSO4 intravena (grup M) atau NaCl 0,9% (grup S). Hasil penelitian menunjukkan nilai VAS dan jumlah pemberian analgetik petidin pada grup M secara statistik lebih rendah dibandingkan dengan grup S (p<0,05). Simpulan penelitian adalah pemberian bolus magnesium sulfat intravena perioperatif mampu menunjukkan nilai VAS saat mobilisasi pascabedah yang lebih rendah serta mengurangi kebutuhan analgetik pertolongan petidin pada pasien pascabedah abdominal ginekologi dalam anestesi umum.Kata kunci: Analgetik pascabedah, magnesium sulfat, nilai VAS saat mobilisasi, operasi abdominal ginekologiThe Effect of Perioperative Magnesium Sulphate Infusion on VAS (Visual Analog Scale) Scores and Postoperative Analgesic Requirements in Patients Undergoing Gynaecological Abdominal Surgery with General AnaesthesiaMagnesium sulphate is N-methyl-D-aspartate (NMDA) receptor antagonist and calcium channel blocker with antinociceptive and antihyperalgesia effects. A randomized, double blind, controlled study was conducted to evaluate the effect of perioperative magnesium sulphate infusion on visual analog scale (VAS) scores and cumulative rescue analgesic petidin consumption in 30 ASA physical status I–II female patients, aged 18– 60 years, scheduled for gynaecological surgery under general anaesthesia in central operating theatre Dr. Hasan Sadikin Hospital-Bandung within June–September 2011. Subjects were divided into two groups that received either intravenous bolus and maintenance of MgSO4 (M group) or 0.9% normal saline (S group). The results showed that postoperative VAS score during movement and the number of analgesic pethidin were significantly lower in M group compared to S group (p<0.05). In conclusions, intravenous bolus of magnesium sulphate perioperative are able to demonstrate the lower value of VAS during mobilization and reducing the amount of analgesic rescue petidin postoperative abdominal gynaecological surgery. Key words: Abdominal gynaecological surgery, magnesium sulphate, VAS scores during movement DOI: 10.15851/jap.v1n2.122

Perbandingan Efek Anestesi Spinal dengan Anestesi Umum terhadap Kejadian Hipotensi dan Nilai APGAR Bayi pada Seksio Sesarea Lasmaria Flora; Ike Sri Redjeki; A. Himendra Wargahadibrata
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Teknik anestesi spinal atau anestesi umum pada seksio sesarea menyebabkan penurunan tekanan darah berbeda, demikian pula nilai APGAR bayi. Tujuan penelitian ini untuk mengetahui kejadian hipotensi, nilai APGAR 1 menit dan 5 menit antara tindakan anestesi spinal dan anestesi umum. Penelitian dilakukan dengan cara randomized cross sectional pada 70 pasien di Rumah Sakit Dr. Hasan Sadikin Bandung pada Februari–Maret 2011. Setelah dilakukan randomisasi, pasien dibagi dalam dua kelompok, yaitu kelompok I (anestesi spinal) dan kelompok II (anestesi umum). Data kejadian hipotensi dianalisis dengan uji chi-kuadrat, untuk nilai APGAR menggunakan Uji Mann-Whitney. Hasil penelitian menunjukkan kejadian hipotensi 57,1% pada kelompok anestesi spinal, sedangkan kelompok anestesi umum hanya 5,7% (p<0,001). Nilai APGAR rata-rata 1 menit pada kelompok anestesi spinal 8, sedangkan pada kelompok anestesi umum 7,06. Berdasarkan Uji Mann Whitney didapatkan p<0,001. Nilai APGAR rata-rata 5 menit pada kelompok anestesi spinal 9,71, sedangkan pada kelompok anestesi umum 9,31 (p=0,015). Simpulan penelitian ini adalah angka kejadian hipotensi lebih tinggi pada anestesi spinal daripada anestesi umum. Nilai APGAR bayi 1 menit dan 5 menit lebih tinggi pada anestesi spinal dibandingkan dengan anestesi umum.Kata kunci: Anestesi spinal, anestesi umum, hipotensi, nilai APGAR, seksio sesarea Comparison of Effects between Spinal Anesthesia and General Anesthesia on Hypotension and APGAR Scoring Values of Caesarean Section BabiesTechnique of spinal anesthesia or general anesthesia on cesarean section causes decreasing in different blood pressure and APGAR score. The purpose of this study was to identify the difference of hypotension, APGAR score 1 minute and 5 minutes on the action of spinal anesthesia and general anesthesia. A randomized cross sectional was conducted on 70 patients at Dr. Hasan Sadikin Hospital Bandung during February–March 2011. Patients were divided into two groups: group I (spinal anesthesia) and group II (general anesthesia). The data of hypotension was analyzed with chi square test, for the APGAR score with Mann Whitney test. Result of the study showed that the case of hypotension was got 57.1% for the group of spinal anesthesia whereas the group of general anesthesia only 5.7% (p<0.001). The mean of APGAR score 1 minute for the group spinal anesthesia was 8 whereas the group of general anesthesia was 7.06. According to Mann Whitney test got p<0.001. The mean of APGAR score 5 minutes for the group spinal anesthesia was 9.71, whereas the mean for the group of general anesthesia was 9.31. According to Mann Whitney test got p=0.015. The conclusion of the this study is the case of hypotension value is higher for the spinal anesthesia compared to general anesthesia. APGAR score 1 minute and 5 minutes are higher for spinal anesthesia compared to general anesthesia.Key words: APGAR score, caesarean section, general anesthesia, hypotension, spinal anesthesia DOI: 10.15851/jap.v2n2.304

Perbandingan antara Sevofluran dan Enfluran terhadap Kontraksi Uterus, Jumlah Perdarahan, dan Skor APGAR pada Seksio Sesarea Elektif RR. Pramada Resvita; Ike Sri Redjeki; Tatang Bisri
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Anestetika volatil memiliki sifat fisikokimia yang berbeda-beda yang akan memberikan pengaruh berbeda juga terhadap kontraksi uterus, jumlah perdarahan dan skor APGAR. Tujuan penelitian ini adalah menilai perbedaan pengaruh antara sevofluran dan enfluran terhadap kontraksi uterus, jumlah perdarahan, dan skor APGAR. Penelitian ini adalah randomized controlled trial (RCT) pada 36 pasien seksio sesarea elektif di Rumah Sakit Melinda pada Juni–Agustus 2011. Pasien dibagi dalam dua kelompok: kelompok I (sevofluran) dan kelompok II (enfluran). Analisis data hasil penelitian dilakukan dengan melakukan uji-t, Fisher’s Exact Test, dan Uji Mann-Whitney. Hasil penelitian menunjukkan bahwa kontraksi uterus lebih baik pada kelompok sevofluran (p<0,05) dan jumlah perdarahan lebih sedikit pada kelompok sevofluran (p<0,05). Tidak didapatkan perbedaan yang signifikan untuk skor APGAR (p>0,05). Simpulan penelitian ini adalah kontraksi uterus pada seksio sesarea dengan sevofluran lebih baik dibandingkan dengan enfluran dan jumlah perdarahan lebih sedikit pada sevofluran. Skor APGAR pada kedua kelompok tidak menunjukkan perbedaan.Kata kunci: Enfluran, jumlah perdarahan, kontraksi uterus (LAS), seksio sesarea, sevofluran, skor APGARComparison between Sevoflurane and Enflurane Effects on Uterine Contraction, Amount of Bleeding, and APGAR Score in Elective Caesarean SectionAbstractDifferent volatile agents with different physicochemical properties affect uterine contraction, amount of bleeding, and APGAR score in different ways. The objective of this study was to evaluate the effects of different volatile agents, i.e., sevoflurane and enflurane, on uterine contraction, amount of bleeding, and APGAR score. A randomized controlled trial (RCT) was conducted on 36 patients undergoing elective caesarean section. These patients were randomly divided into two groups, group I (sevoflurane) and group II (enflurane). The data were analyzed using t-test, Mann-Whitney, and fisher exact tests. The result of this study showed that there was a significant difference in the strength of uterine contraction among the sevoflurane group and the enflurane group (p<0.05) and also a significant difference in the amount of bleeding among the two groups (p<0.05), with better results seen ion the sevoflurane group. However, there was no significant difference found oin the APGAR score among the two groups. It is concluded in this study that sevoflurane gives better results in terms of uterine contraction with less bleeding compared to the enflurane group. No difference is found in the APGAR score in sevoflurane and enflurane groups.Key words: Amount of bleeding, APGAR score, caesarean section, enflurane, sevoflurane, uterine contraction (LAS) DOI: 10.15851/jap.v3n1.381

PENDEKATAN STEWART DALAM pH DARAH YANG MENDASARI ASIDOSIS METABOLIK Efrida Efrida; Ida Parwati; Ike Sri Redjeki
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i2.1061

Metabolic acidosis is the most frequent acid-base disorder in patients of the Intensive Care Unit. By conventional approach based onpH value, [HCO3–], and base deficit (BD) from blood gas analyzer (BGA) measurement are often inappropriate with the clinical stateand inadequate in explaining the mechanism of the metabolic acidosis. The Stewart approach states that the blood pH is determinedby a strong ion difference (SID), the carbon dioxide tension (pCO2), the total concentration of non-volatile weak acid. The Stewartapproach may give a better understanding of the mechanisms that underlie the metabolic acidosis. The purpose of this study is to knowthe correlation of blood pH value measurement from BGA and calculation based on Stewart approach and identifying the mechanismsthat underlie a metabolic acidosis. In this study an analytic observational cross-sectional method was used. The examined subjectsconsisted of 71 patients who were admitted with a metabolic acidosis at the ICU from July up to August 2007. All patients were measuredfor their blood pH, pCO2, [HCO3–], BD, sodium, potassium, calcium, magnesium, chloride, lactate, albumin, and phosphate. The resultwas reported as the mean and standard deviation. The data were analyzed by Pearson’s correlation test and linier multiple regression.Statistical significance was determined at p < 0.05. The mean values of blood pH measurement from BGA and blood pH calculationbased on the Stewart approach were 7.33 (0.11) and 7.49 (0.11) (r = 0.681; p < 0.001). Most patients had two underlying mechanisms ofmetabolic acidosis. Hyperlactatemia was present in 61.8%, hyperchloremia was present in 58.2% of patients. Based on this study so far,by using the Stewart approach there is an excellent and significant correlation between the blood pH measurement from BGA and bloodpH calculation. Hyperlactatemia and hyperchloremia are the main causes of the metabolic acidosis in patients of the ICU ward.

PERBANDINGAN PENGARUH WATER SPRAY DAN FAN COOLING MENGGUNAKAN AIR HANGAT DENGAN AIR SUHU RUANGAN TERHADAP PENURUNAN SUHU TUBUH Efris Kartika Sari; Ike Sri Redjeki; Windy Rakhmawati
Journal of Nursing Science Update (JNSU) Vol. 1 No. 2 (2013)
Publisher : Department of Nursing, Faculty of Health Sciencce, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (281.772 KB)

Penatalaksanaan demam pada pasien sakit kritis dibutuhkan untuk meminimalkan stres metabolik dan meningkatkan oksigenasi jaringan. Penelitian ini bertujuan membandingkan pengaruh water spray dan fan cooling yang menggunakan air hangat dengan air suhu ruangan terhadap waktu dan besarnya penurunan suhu tubuh pasien demam yang mendapat terapi acetaminophen, di ruang rawat intensif RSUP dr. Hasan Sadikin Bandung. Desain penelitian adalah pretest-posttest control group design. Subjek dibagi secara acak ke dalam kelompok perlakuan dan kontrol yaitu: 1) 500 mg acetaminophen dan water spray dan fan cooling dengan air hangat (n= 14), 2) 500 mg acetaminophen dan water spray dan fan cooling dengan air suhu ruangan (n= 14). Terapi diterapkan selama 60 menit. Hasilnya kelompok perlakuan menunjukkan penurunan suhu tubuh sebesar 0,5oC lebih cepat (30 menit) daripada kelompok kontrol (60 menit). Hasil uji Independent Samples T Test juga menunjukkan perbedaan rata-rata nilai suhu tubuh yang bermakna (p < 0,05), dengan rata-rata penurunan suhu tubuh pada kelompok perlakuan yaitu 0,8oC, dan kontrol 0.5oC. Oleh karena itu, water spray dan fan cooling sebagai terapi pendukung (komplementer) hendaknya diterapkan dengan menggunakan air hangat. Â Kata kunci: demam, water spray dan fan cooling, air hangat, air suhu ruangan.

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