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Pemberian Strepsils® Sebagai Lozenge Praoperasi untuk Mengurangi Nyeri Tenggorok Pascaintubasi Pipa Endotrakeal Reko Priyonggo; - Suwarman; Abdul Muthalib Nawawi
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Nyeri tenggorok pascaoperasi atau post operative sore throat (POST) terjadi karena iritasi dan inflamasi lokal di daerah faring, laring, dan trakea akibat trauma pemasangan pipa endotrakeal. Penelitian ini bertujuan mengetahui efek tablet hisap Strepsils® untuk mengurangi POST pada pasien yang dilakukan anestesi umum dengan intubasi pipa endotrakeal. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan Oktober–November 2013, terhadap 66 pasien status fisik American Society of Anesthesiologist (ASA) I–II secara prospektif single blind randomized controlled trial. Pasien dibagi menjadi dua kelompok, yaitu kelompok I, sebanyak 33 orang mendapatkan Strepsils® dan kelompok II, sebanyak 33 orang mendapatkan plasebo. Pasien diminta untuk mengulum permen sebelum induksi. Data dianalisis dengan uji-t, uji chi-kuadrat, dan Uji Mann-Whitney. Keluhan POST lebih banyak terjadi pada kelompok II dibandingkan dengan kelompok I. Secara statistik pada T0 didapatkan hasil perbedaan yang bermakna (p<0,05). Pada kelompok II, POST dengan skor 1 sebesar 14 (42%) kasus, dibandingkan dengan kelompok I sebesar 3 (9%) kasus dan tidak ada skor 2. Pada T2 didapatkan hasil perbedaan bermakna (p<0,05), POST sebesar 11 (33%) pada kelompok II, sedangkan kelompok I didapatkan 2(6%) kasus. Pada T4 didapatkan perbedaan tidak bermakna (p>0,05), POST pada kelompok II sebesar 3 (9%) kasus, sedangkan kelompok I skor 1 sebesar 1 (3%) kasus. Simpulan, pemberian Strepsils® praoperasi dengan anestesi umum mengurangi kejadian dan derajat POST.Kata kunci: Analgetik, antiinflamasi, Strepsils®, post operative sore throat Strepsils® as Pre-operative Lozenge to Attenuate Post-endotracheal Tube Intubation Related Sore Throat AbstractPost- operative sore throat (POST) is caused by local inflammation and irritation at pharynx and larynx due to traumatic endotracheal tube installation. Sixty six patients, ASA I–II, who underwent elective surgery under general anesthesia and installation of endotracheal tube were enrolled in this single blind randomized controlled trial. Patients were randomly allocated into two groups of 33 subjects: receiving Lozenge and receiving placebo. Designated as Group I (Strepsils® group) and Group II (Placebo group). Patients were asked to suck the candy slowly in the mouth before the induction of anesthesia. Data were analyzed with t-test, Chi-square test and Mann-Whitney test using SPSS ver. 13 program for Windows. The results were POST 9.1% and 42.4% at T0, 6.1% and 33.3% at T2 for Strepsils® and Placebo groups, respectively, which were statistically significant (p<0.05). In T4 and T24, non-significant differences were found (p>0.05). In conclusion, dissolving Strepsils® slowly in the mouth before induction of anesthesia pre-operatively reduces POST following general anesthesia.Key words: Analgetic, antiinflammatory, Strepsils®, post operative sore throat DOI: 10.15851/jap.v2n3.334

Scalp Nerve Block pada Kraniotomi Evakuasi Pasien Moderate Head Injury dengan Subdural Hemorrhage dan Intracerebral Hemorrhage Frontotemporoparietal Dekstra Mencegah Stress Response Selama dan Pascabedah Mariko Gunadi; - Suwarman
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Insisi kulit dan kraniotomi selama operasi intrakranial merupakan stimulus berbahaya yang dapat menghasilkan stress response yang menyebabkan peningkatan tekanan intrakranial. Scalp nerve block efektif dalam mengurangi stress response ini, selain itu juga dapat digunakan sebagai analgetik pascabedah. Seorang laki-laki usia 22 tahun dengan moderate head injury, subdural hemorrhage, dan intracerebral hemorrhage at regio fronto-temporo-parietal dextra dilakukan kraniotomi evakuasi dalam combined scalp nerve block - general anesthesia di Rumah Sakit Dr. Hasan Sadikin Bandung pada tanggal 14 Agustus 2012. Setelah dilakukan induksi dan sebelum insisi dilakukan scalp nerve block dengan bupivakain 0,5%. Hemodinamik (tekanan darah dan denyut jantung) setelah insisi kulit dan kraniotomi, serta glukosa darah pascabedah tidak menunjukkan perubahan yang signifikan. Analgetik pascabedah baru diberikan setelah 8 jam sejak dilakukan blok. Hasil ini menunjukkan scalp nerve block menggunakan bupivakain 0,5% mampu menumpulkan stress response dan dapat digunakan sebagai analgetik pascabedah.Kata kunci: Kraniotomi evakuasi, scalp nerve block, stress responseScalp Nerve Block in Craniotomy Evacuation on a Patient with Moderate Head Injury with Subdural Hemorrhage and Right Frontotemporoparietal Intracerebral Hemorrhage Prevents Intra and Post Operative Stress ResponseAbstractSkin incision and craniotomy are recognized as an acute noxious stimulation during intracranial surgery which may result in stress response causing an increase in intracranial pressure. Scalp nerve block may be effective in reducing stress response. It can also be used to provide post-operative analgesia. A twenty two years old male with moderate head injury, subdural hemorrhage, intracerebral hemorrhage at right fronto-temporo-parietal region underwent evacuation craniotomy with combined scalp nerve block and general anesthesia at Dr. Hasan Sadikin Hospital Bandung on August 14th 2012. After induction and before incision of the skin, a scalp nerve block was performed using 0.5% bupivacaine. Hemodynamic (blood pressure and heart rate) changes after incision of the skin and craniotomy were not significant, and so was post-operative blood glucose concentration. Post-operative analgetic was given eight hours after the block. The result demonstrates that scalp nerve block using 0.5% bupivacaine successfully blunts stress response and can be used as post-operative analgesia.Keywords: Craniotomy evacuation, scalp nerve block, stress response DOI: 10.15851/jap.v1n3.199

Gambaran Pola Kuman pada Bilah Laringoskop di Ruang Operasi Rumah Sakit Dr. Hasan Sadikin Bandung Edwin Haposan Martua; - Suwarman; Ike Sri Redjeki
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Kebiasaan cara membersihkan bilah laringoskop dapat menyebabkan komplikasi karena potensial kontak dengan mikro-organisme patogen dan dapat menyebabkan infeksi nosokomial. Tujuan penelitian adalah mengetahui gambaran kuman pada bilah laringoskop dengan metode pembersihan yang dilakukan di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung. Penelitian dilakukan menggunakan metode deskriptif observasional dengan cara melakukan pemeriksaan kultur kuman pada 19 bilah laringoskop sebelum digunakan dan yang sudah dibersihkan sesudah tindakan laringoskopi, serta 14 sumber air untuk membersihkan bilah laringoskop di ruang operasi RSHS Bandung pada tanggal Desember 2014–Januari 2015. Hasil penelitian ini ditemukan gambaran pola kuman komensal pada bilah laringoskop yang digunakan sebelum tindakan laringoskopi, yaitu Bacillus spp. 10 dari 19. Ditemukan gambaran pola kuman patogen pada bilah laringoskop yang sudah dibersihkan setelah tindakan laringoskopi di ruang operasi, yaitu Candida non albicans 1 dari 19, Acinobacter baumanii dan Staphylococcus haemolyticus 1 dari 19, serta Klebsiella pneumoniae dan Pseudomonas aeruginosa 1 dari 19. Simpulan, ditemukan kuman patogen pada bilah laringoskop yang sudah dibersihkan sesudah tindakan laringoskopi dan air yang digunakan untuk membersihkan bilah laringoskop di Rumah Sakit Dr. Hasan Sadikin Bandung.Kata kunci: Bilah laringoskop, infeksi nosokomial, laringoskopi, pola kumanBacterial Mapping of Laryngoscope Blade at the Operating Theater of Dr. Hasan Sadikin General Hospital BandungAbstractThe habit of cleaning laryngoscope blades can cause complications due to potential contact with patogenic microorganisms that may cause nosocomial infections. The aim this study was to determine the microbial patterns on the laryngoscope blades cleaned using the cleaning methods applied in Dr. Hasan Sadikin General Hospital (RSHS) Bandung. This study was conducted using the descriptive observational method by taking samples of bacterial culture from 19 laryngoscope blades before laryngoscopy procedures and 19 cleaned laryngoscope after laryngoscopy, as well as from the 14 water sources that were used for cleaning laryngoscope blades in the operating theaters of RSHS Bandung in December 2014–January 2015. The results of this study revealed a commensal microbial pattern of Bacillus spp. on 10 of 19 laryngoscope blades before they were used in laryngoscopy precedures. It was revealed that among the laryngoscopes blade that had been cleaned after laryngoscopy in the operating room. 1 of 19 was found to have a non-Candida albicans pattern, 1 of 19 had Acinobacter baumannii and Staphylococcus haemolyticus pattern, and 1 of 19 had Klebsiella pneumoniae and Pseudomonas aeruginosa pattern. Hence, it can be concluded that pathogenic germs are found in laryngoscope bplades that have been cleaded after laryngoscopy and water that is used to clean them in Dr. Hasan Sadikin General Hospital Bandung.Key words: Bacterial mapping, direct laryngoscopy, laryngoscope blades, nosocomial infections DOI: 10.15851/jap.v4n3.899

Penatalaksanaan Anestesi Pasien Transposition of the Great Arteries pada Operasi Mouth Preparation Ade Arya Nugraha; - Suwarman; Ardi Zulfariansyah
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Transposition of the great arteries (TGA) disebabkan kegagalan pemisahan trunkus arteriosus, sehingga aorta keluar dari bagian anterior ventrikel kanan dan arteri pulmonal keluar dari ventrikel kiri. TGA termasuk kelainan jantung bawaan tipe sianotik. Seorang anak perempuan berusia 4 tahun datang untuk perawatan dan pencabutan gigi sebagai persiapan untuk operasi koreksi TGA di Rumah Sakit Dr. Hasan Sadikin Bandung pada Januari 2014. Anamnesis didapatkan riwayat kebiruan sejak bayi dan pada pemeriksaan fisis didapatkan anak yang tampak sianosis, SpO2 70–80%, murmur sistol, dan jari tabuh. Pada pemeriksaan ekokardiografi didapatkan kelainan TGA. Manajemen anestesi pada pasien ini dilakukan dengan menggunakan ketamin dan vekuronium untuk induksi serta pemeliharaan dengan O2 dan air, serta sevofluran. Manajemen anestesi dilakukan dengan target mencegah penurunan miring systemic vascular resistance (SVR) dibandingkan dengan pulmonary vascular resistance (PVR). Simpulan, prinsip pengelolaan perioperatif pembedahan nonkardiak pada pasien TGA adalah menjaga agar tidak terjadi penurunan SVR dan peningkatan PVR.Kata kunci: Kelainan jantung kongenital sianotik, pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), transposition of the great arteries (TGA)Management of Anesthesia in Patients Transposition of the Great Arteries which Undergo Mouth PreparationTransposition of the great arteries (TGA) results from failure of the truncus arteriosus to spiral, so that the aorta arises from the anterior portion of the right ventricle and the pulmonary artery arises from the left ventricle. TGA which is the type of cyanotic congenital heart disease. A girl of 4 years came for treatment and tooth extraction as preparation for the surgical correction of TGA at the Dr. Hasan Sadikin Hospital –Bandung within January 2014. Patient with a history of blue when she was a baby and on physical examination found the child looking cyanosis, SpO2 70–80%, sistolic murmur and clubbing finger. Abnormalities on echocardiography obtained TGA. Anesthetic management of this patients was performed using ketamine and vecuronium for induction and maintenance with O2, N2O, and sevoflurane. Cyanotic attacks can occur preoperative, intraoperative, and post operative, which was treated by increasing systemic vascular resistance (SVR) compared to pulmonary vascular resistance. In conclusions, perioperative management principal for non cardiac surgery on transposition of the great arteries (TGA) is to keep SVR from decline and increase on PVR.Key words: Cyanotic congenital heart defects, pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), transposition of the great arteries (TGA) DOI: 10.15851/jap.v2n2.320

Gambaran Jenis Bakteri pada Ujung Kateter Epidural di Rumah Sakit Dr. Hasan Sadikin Bandung Indra Nur Hidayat; - Suwarman; Eri Surahman
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Analgesia epidural merupakan metode yang efektif untuk tatalaksana pengelolaan nyeri pascaoperatif. Meskipun jarang, infeksi dapat terjadi setelah proses pemasangan kateter epidural. Penelitian ini bertujuan untuk mengetahui apakah ada bakteri pada ujung kateter epidural dan bakteri apa yang tersering pada ujung kateter epidural. Penelitian ini adalah penelitian deskriptif prospektif yang dilakukan terhadap 52 orang pasien yang menjalani anestesi epidural dan digunakan sebagai analgetik epidural selama bulan Februari 2014 di Rumah Sakit Dr. Hasan Sadikin Bandung. Anastesi epidural dipasang dengan tindakan aseptik dan antiseptik sebelum operasi dan kemudian digunakan sebagai analgetik epidural setelah hari ketiga kateter epidural dicabut dengan tindakan antiseptik dan aseptik sebelumnya kemudian dibuat apus mengunakan swab steril dan diperiksakan kultur bakteri di laboratorium mikrobiologi, Patologi Klinik di Rumah Sakit Dr. Hasan Sadikin Bandung. Hasil penelitian ini didapatkan 14 dari 52 kateter epidural yang dipasang pada bulan Februari 2014 terkontaminasi oleh bakteri. S. epidermidis, S. hominis, dan Acinetobacter baumannii merupakan bakteri yang ditemukan pada ujung kateter epidural. Simpulan, didapatkan hasil 26% dari 52 ujung kateter yang digunakan sebagai analgetik epidural terkontaminasi oleh bakteri. Bakteri yang tersering yang ditemukan di dalam rongga epidural adalah Staphylococcus epidermidis diikuti oleh Staphylococcus hominis dan Acinetobacter baumannii.Kata kunci: Analgesia epidural, kultur bakteri, ujung kateter epiduralBacterial Profile of Epidural Catheters Tips in Dr. Hasan Sadikin General Hospital BandungAbstractEpidural analgesia is an effective method for post-operative pain management. Although rare, the infection may occur after an epidural catheter insertion process. There are very few reported cases; however some cases of infection, such as epidural abscess, is are serious and life threatening cases if not diagnosed early and treated well. The aim of this study was to prove the presence of bacterial contamination on epidural catheters tips and to describe the kind of bacteria found. This descriptive prospective study was conducted on 52 patients who used epidural anesthesia and epidural analgesics during the month of February 2014 in Dr Hasan Sadikin Hospital General Bandung. Epidural anesthesia was performed using antiseptic and aseptic procedures before the surgery, then used as epidural analgesia. After the third day, the catheter was removed using aseptic and antiseptic procedures and the tip catheter was smeared by a sterile swab. Cultures were then grown and examined at the microbiology laboratory of the Clinical Phatogology Department of Dr. Hasan Sadikin General Hospital Bandung. It was revealed that 14 of 52 epidural catheters placed during the month of February 2014 were contaminated by bacteria. S. epidermidis, S. hominis, and Acinetobacter baumannii were found on epidural catheter tips. It is concluded in this study that 26.3% of 52 catheter tips used as an epidural analgesic were contaminated by bacteria. The most common bacteria found in the epidural space is Staphylococcus epidermidis, followed by Staphylococcus hominis and Acinetobacter baumannii.Key words: Analgetic epidural, bacterial cultur, epidural catheter tip DOI: 10.15851/jap.v3n1.377

Perbandingan Pengaruh Nifedipin 20 mg per Oral 2 Jam Preoperasi dengan Plasebo terhadap Suhu Inti pada Pasien yang Menjalani Operasi Modified Radical Mastectomy dengan Anestesi Umum Saleh Trisnadi; - Suwarman; Abdul Muthalib Nawawi
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Upaya pencegahan hipotermia dapat dilakukan dengan mengurangi perbedaan antara suhu inti dan perifer sebelum dilakukan pembedahan dengan pemberian vasodilator. Tujuan penelitian ini untuk mengetahui efek penggunaan antara nifedipin 20 mg dan plasebo per oral 2 jam preoperasi selama operasi modifikasi mastektomi radikal terhadap penurunan suhu tubuh. Penelitian menggunakan metode prospektif, terkontrol, tersamar, buta ganda pada 30 pasien berusia 18–60 tahun, status fisik American Society Of Anesthesiologist (ASA) I dan II, yang menjalani operasi modifikasi mastektomi radikal di Rumah Sakit Dr. Hasan Sadikin Bandung pada Juni sampai Agustus 2012. Secara acak dibagi menjadi 2 kelompok, yaitu kelompok yang mendapat nifedipin 20 mg per oral 2 jam preoperasi dengan plasebo. Dilakukan pencatatan suhu timpani setiap 10 menit dari awal induksi hingga akhir anestesi. Data hasil penelitian diuji secara statistik dengan Uji Mann-Whitney. Suhu inti rata-rata pada kelompok nifedipin adalah 36,37 oC lebih besar dibandingkan dengan kelompok kontrol yaitu 35,61 oC dengan perbedaan bermakna (p<0,05). Simpulan penelitian ini menunjukkan bahwa penggunaan obat nifedipin dapat mencegah hipotermia selama operasi dibandingkan dengan plasebo (kontrol).Kata kunci: Nifedipin, suhu inti tubuh, vasodilatorEffect of 20 mg Nifedipine Orally 2 Hours Before the Operation on Core Temperature in Patients Undergoing Modified Radical Mastectomy Surgery with General AnesthesiaStrategy of prevention the initial redistribution hypothermia is based on the reduction of the heat gradient between the core and perifer before surgery by administering vasodilators. The purpose of this study was to asses the effect of oral nifedipine 20 mg 2 hours before anesthesia in preventing hypothermia in patients undergoing modified radical mastectomy under general anesthesia and to compare the decreased rate of body temperature oral nifedipine with placebo. The research was done with the prospective method, randomized double-blind controlled study in 30 patients aged 18–60 yrs, American Society of Anesthesiologist (ASA) physical status I-II, underwent modified radical mastectomy surgery, were randomly divided into two groups at Dr. Hasan Sadikin General Hospital Bandung during June until August 2012. One group was given oral nifedipine 20 mg 2 hours before general anesthesia and the other group was given placebo. Tymphani temperature was recorded during anesthesia every 10 minutes. Research data was tested statistically by the Mann-Whitney test. The average core temperature in the nifedipine was 36.37 ° C which was higher than the control group 35.61 ° C (p<0.05). It can be concluded that the use of nifedipine can prevent intraoperative hypothermia.Key words: Core temperature, nifedipine, vasodilator DOI: 10.15851/jap.v2n2.306

Perbandingan Klonidin 0,5 mg/kgBB Intravena dengan Tramadol 0,5 mg/kgBB Intravena Sebagai Profilaksis Kejadian Menggigil Pascaanestesia Spinal pada Seksio Sesarea Lira Panduwaty; - Suwarman; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Menggigil merupakan komplikasi yang sering terjadi pascaanestesi spinal, akibat gangguan kontrol termoregulasi. Klonidin merupakan agonis adrenergik α2 yang memiliki efek antihipertensi, analgetik, sedasi, dan antimenggigil. Tujuan penelitian ini untuk menilai perbandingan klonidin 0,5 μg/kgBB dengan tramadol 0,5 mg/kgBB dalam menurunkan kejadian menggigil pada pasien yang menjalani seksio sesarea dengan anestesi spinal. Metode penelitian adalah uji klinis acak terkontrol tersamar ganda pada 58 pasien yang menjalani operasi seksio sesarea di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Januari−April 2014, usia 18−45 tahun, status fisik menurut American Society of Anesthesiologist (ASA) II dan dibagi secara acak menjadi 2 kelompok, yaitu kelompok yang menerima klonidin 0,5 μg/kgBB intravena dan kelompok tramadol 0,5 mg/kgBB intravena sebelum dilakukan anestesi spinal dengan bupivakain 12,5 mg. Analisis statistik menggunakan uji-t, uji chi-kuadrat, dan Uji Eksak Fisher. Hasil penelitian menunjukkan kejadian menggigil pada kelompok klonidin lebih sedikit bila dibandingkan dengan kelompok tramadol, baik di kamar operasi (3,44% vs 10,34%) maupun di ruang pemulihan (3,44% vs 17,24%). Simpulan dari penelitian ini menunjukkan bahwa pemberian klonidin 0,5 μg/kgBB intravena sebelum anestesi spinal pada seksio sesarea mengurangi kejadian menggigil dan efek samping.Kata kunci: Klonidin, menggigil, pascaanestesi spinal, tramadol Comparison of Intravenous 0.5 mg/kgBW Clonidine Intravenous and 0.5 mg/kgBW Tramadol as Post Spinal Anesthesia Shivering Prophylactic Agent in Caesarean SectionAbstract Shivering, as a result of impaired thermoregulatory control, is known as a frequent complication of post-spinal anesthesia. Clonidine is an α2-adrenergic agonist that has anti-hypertensive, analgesic, sedation and anti-shivering effects. The purpose of this study is to compare the use of 0.5 μg/kgBW clonidine with 0.5 mg/kgBW tramadol in reducing the incidence of shivering in patients undergoing cesarean section with spinal anesthesia. The method applied was the double-blind randomized controlled clinical trial in 58 patients undergoing caesarean surgery at the Dr. Hasan Sadikin General Hospital Bandung in the period of January−April 2014, age 18−45 years, American Society of Anesthesiologist (ASA) physical status II, and divided into two groups; a group receiving 5 μg/kgBW intravenous clonidine and a group receiving 0.5 mg/kgBW intravenously tramadol prior to spinal anesthesia with bupivacaine 12.5 mg. The statistical analyses used were the t test, chi-square test and Fisher’s Exact test. The incidence of shivering were less in the clonidine group compared to the tramadol group in operating theatre (3.44% vs 10.34) and recovery room (3.44% vs 17.24%). The conclusion of this study showed that the administration of 0.5 μg/kgBW clonidine intravenously before spinal anesthesia for cesarean section reduces the incidence of shivering and side effects.Keywords: Clonidine, post spinal anesthesia, shivering, tramadol DOI: 10.15851/jap.v3n1.378

Perbandingan Ketepatan Pengukuran Tekanan Balon Pipa Endotrakeal setelah Intubasi antara Metode Palpasi pada Pilot Balon dan Teknik Melepas Spuit secara Pasif Gunawan Mutiara; - Suwarman; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Metode palpasi pada pilot balon merupakan teknik yang tidak akurat untuk menentukan tekanan balon pipa endotrakeal (endotracheal tube/ETT). Tujuan penelitian ini membandingkan ketepatan pengukuran tekanan balon ETT antara metode palpasi pada pilot balon (MP) dan teknik melepas spuit secara pasif (MSP). Penelitian dilakukan pada bulan Juni 2014 di Rumah Sakit Dr. Hasan Sadikin Bandung, menggunakan metode kuantitatif eksperimen dengan rancangan uji acak silang tersamar tunggal. Subjek penelitian adalah 94 orang pasien berusia 18−65 tahun dengan status fisik American Society of Anesthesiologists (ASA) I–III, yang menjalani pembedahan dengan anestesi umum secara intubasi endotrakeal. Saat akan dilakukan intubasi, balon ETT dikembangkan dengan dua teknik yang berbeda kelompok metode palpasi (n=48) dan kelompok teknik melepas spuit secara pasif (n=46). Data hasil penelitian dianalisis menggunakan uji-t tidak berpasangan dan uji chi-kuadrat. Hasil penelitian didapatkan tekanan rata-rata pada kelompok MP 57,7±26,0 cmH2O dan MSP 28,7±4,5 cmH2O, sedangkan untuk ketepatan pengukuran pada kelompok MSP 56,5% dan kelompok MP 6,2% (p<0,001). Simpulan penelitian ini menunjukkan bahwa metode palpasi merupakan teknik pengukuran tekanan balon ETT yang tidak adekuat.Kata kunci: Metode palpasi pada pilot balon, teknik melepas spuit secara pasif, endotracheal tubeComparison between Pilot Balloon Palpation Method and Passive Release Technique on the Accuracy of Measurements of Endotracheal Tube Cuff Pressure Estimation of cuff pressure by palpating the pilot balloon is not accurate to determine the cuff pressure of endotracheal tube (ETT). Hence, this study we conducted to compare the accuracy of indirect measurements between pilot balloon palpation method (MP) and passive release technique (MSP). This was a single blind randomized crossover study performed in june 2014 at Dr. Hasan Sadikin General Hospital Bandung, in which patients received each technique and as a control group. Subjects were 94 patients aged 18−65 years old with American Society of Anesthesiologists (ASA) physical status I−III who underwent surgery requiring tracheal intubation. These subjects were randomized into two groups. After induction of anesthesia, the cuff was inflated with two different techniques: pilot balloon palpation technique (n=48) and passive release technique (n=46). Data were statistically analyzed using independent t-test and chi-square test. The mean cuff pressures of group MP was 57.7±26.0 cmH2O and for group MSP was 28.7±4.5 cmH2O, whereas the precision of measurements in the MSP group was 56.5% and 6.2% in the MP group (p<0.001). It is conclude that the palpation method for cuff inflation are inadequate. Therefore, it is suggested that the endotracheal tube cuff pressure must be kept within the optimal range using a standard manometer. Key words: Endotracheal cuff pressure, passive release technique, pilot balloon palpation method DOI: 10.15851/jap.v3n3.608

Hubungan antara Durasi Puasa Preoperatif dan Kadar Gula Darah Sebelum Induksi pada Pasien Operasi Elektif di Rumah Sakit Dr. Hasan Sadikin Bandung Budi Hartanto; - Suwarman; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Puasa preoperatif merupakan keharusan sebelum dilakukan tindakan anestesi. Alasan utamanya adalah untuk mengurangi volume lambung, tingkat keasaman lambung, dan mengurangi risiko aspirasi paru. Namun, puasa preoperatif sering kali lebih lama daripada yang direkomendasikan karena berbagai sebab. Tujuan penelitian ini mengetahui durasi puasa preoperatif pada pasien operasi elektif dan hubungan antara durasi puasa preoperatif dan kadar gula darah sebelum induksi pasien operasi elektif di Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian observasional dilakukan selama 1–31 Juni 2014 dengan melakukan wawancara pasien sebelum induksi anestesi dan pengukuran kadar gula darah menggunakan glukometer. Analisis korelasi menggunakan Uji Mann-Whitney. Hasil penelitian pada 371 pasien didapatkan lama puasa dari makanan padat, durasi minimum adalah 4 jam, maksimum 20,5 jam, dan rata-rata 10,42 jam. Pada puasa dari minuman, durasi puasa minimum adalah 2 jam, maksimum 18 jam dengan rata-rata 8,06 jam. Terdapat 8 pasien dengan kadar gula darah kurang dari 70 mg/dL dengan rentang kadar gula darah 59–70 mg/dL dan rentang durasi puasa 6–18 jam. Tiga di antaranya orang lanjut usia di atas 60 tahun. Sebanyak 253 pasien berpuasa makanan padat >8 jam dan 357 pasien berpuasa minuman >2 jam. Simpulan, tidak terdapat hubungan antara durasi puasa dan kadar gula darah sebelum induksi.Kata kunci: Durasi puasa preoperatif, kadar gula darah, operasi elektifCorrelation between Preoperative Fasting Duration and Blood Glucose Level before Induction in Elective Surgery Patients in Dr. Hasan Sadikin General Hospital BandungPreoperative fasting is a requisite before anesthesia. The main reason for preoperative fasting is to reduce gastric volume and acidity and, thus, decrease the risk of pulmonary aspiration. However, preoperative fasting is usually prolonged beyond the recommended time for various reasons. Despite the many adverse effects of prolonged fasting, patients sometimes fast for a prolonged time when the surgery is delayed for different reasons. The aim of this study was to assess the duration of preoperative fasting for elective surgery and its correlation with blood glucose after preoperative fasting in Dr. Hasan Sadikin General Hospital Bandung. An observational study was conducted from 1- 31 June 2014. Patients were interviewed before induction, and blood glucose level was measured using a glucometer. A correlation analysis was performed using Mann-whitney test. All 371 elective surgery patients admitted during the study period were included. The minimum, maximum, and mean fasting hours for food were 4, 20.5, and 10.42, respectively. The minimum, maximum, and mean fasting hours for fluid were 2, 18, and 8.06, respectively. Only 8 patients had blood a glucose level below 70 mg/dL with blood glucose levels range from 59 to 70 mg/dL and duration of fasting range from 6 to 18 hours. Three of elderly patients, who was above 60 years old, participated in this study. There were 253 patients (68.2%) fasted from solid food more than 8 hours and there were 357 (96.2%) fasted from clear fluid more than 2 hours. It is concluded that there is no correlation between duration of fasting and blood sugar level before induction.Key words: Duration of preoperative fasting, elective surgery, blood glucose level DOI: 10.15851/jap.v4n2.822

Perbandingan Numeric Rating Scale antara Infiltrasi Analgesia Tramadol 1 mg/kgBB dan Bupivakain 0,25% Pascaoperasi Hernia Inguinalis Reponibel Dadang Mulyawan; - Suwarman; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 2, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Pencegahan dan penatalaksanaan nyeri akut pascaoperasi merupakan faktor yang menentukan untuk mengurangi kemungkinan terjadinya nyeri kronik. Penelitian ini bertujuan untuk membandingkan tramadol 1 mg/kgBB dengan bupivakain 0,25% yang diberikan secara infiltrasi subkutan sebelum penutupan kulit terhadap nyeri pascaoperasi hernia inguinalis reponibel. Penelitian dilakukan terhadap 32 orang yang terbagi secara acak ke dalam 2 kelompok dengan usia 18–65 tahun, status fisik American Society of Anesthesiologist (ASA) I–II yang menjalani operasi hernia inguinalis reponibel secara uji acak terkontrol buta ganda dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Juni 2012. Penilaian skala nyeri dilakukan pada jam ke-0, 1, 2, 3, 4, 5, 6, 8, 10, dan selanjutnya sampai tercapainya nilai NRS>4. Analisis statistik menggunakan independent t-test dan chi-kuadrat. Hasil penelitian ini mendapatkan nilai NRS kelompok tramadol yang lebih rendah pada jam ke-3 dan jam ke-4 dibandingkan dengan kelompok bupivakain. Pada kelompok tramadol ditemukan durasi analgesi yang lebih panjang daripada kelompok bupivakain dengan perbedaan bermakna (p<0,05). Simpulan penelitian ini adalah pemberian infiltrasi subkutan tramadol 1 mg/kgBB menurunkan nilai NRS lebih baik daripada bupivakain 0,25% pascaoperasi hernia inguinalis reponibel dan durasi analgesi yang lebih panjang tanpa ada perbedaan efek samping yang bermakna.Kata kunci: Bupivakain, infiltrasi subkutan, numeric rating scale, nyeri pascaoperasi, tramadolNumeric Rating Scale Comparison between 1 mg/kgBW Tramadol and 0.25% Bupivacaine Infiltration Analgesia after Reducible Inguinal Hernia SurgeryPrevention and management of acute postoperative pain is an essential factor contributing to the likelihood of chronic pain development. The objective of this study is to compare 1 mg/kgBW tramadol and 0.25% bupivacaine administered as a subcutaneous infiltration prior to wound closure for post operative pain after reducible inguinal hernia surgery. Study was conducted on 32 patients (18–65 years) ASA I–II who underwent reducible inguinal hernia surgery at Dr. Hasan Sadikin Hospital Bandung during June 2012. Pain scale assessment was done using a numeric rating scale (NRS) and were recorded at 0, 1, 2, 3, 4, 5, 6, 8, 10, hours and thereafter until it reaches the value of NRS >4. NRS on the tramadol group was significantly lower during the 3rd and 4th hour compared to the bupivacaine group. Duration of analgesia was longer in the tramadol compared to bupivacaine group. In conclusions, the subcutaneous infiltration of tramadol 1 mg/ kgBW is better compared to bupivacaine 0.25% in reducing postoperative NRS value in reducible inguinalhernia surgery and provides a longer duration of analgesia, with no significant differences in side effects.Key words: Bupivacain, post operative pain, subcutaneous infiltration, tramadol, visual analogue scale DOI: 10.15851/jap.v2n1.235

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