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All Journal International Journal of Integrated Health Sciences Jurnal Anestesi Perioperatif Medula Nusantara Medical Science Journal
Muhammad Ramli Ahmad
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health

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Perbandingan Intensitas Nyeri dan Kadar Prostaglandin Kombinasi Tramadol dan Deksketoprofen dengan Tramadol dan Parasetamol Intravena pada Pasien Bedah Ortopedi Ekstremitas Bawah Clara Valentia Josephine; Muhammad Ramli Ahmad; Hisbullah Hisbullah; Abdul Wahab
Jurnal Anestesi Perioperatif Vol 7, No 2 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2475.424 KB) | DOI: 10.15851/jap.v7n2.1691

Abstract

Analgesia multimodal adalah prinsip manajemen nyeri pascaoperasi. Penelitian ini merupakan uji klinis rancangan acak tersamar ganda. Tujuan penelitian ini membandingkan efek kombinasi analgesik tramadol dan deksketoprofen dengan tramadol dan parasetamol terhadap intensitas nyeri dan kadar prostaglandin (PGE2) di RSUP Dr. Wahidin Sudirohusodo serta Rumah Sakit Jejaring di Makassar pada bulan Juli–September 2018. Empat puluh enam pasien ASA PS I dan II yang menjalani operasi ortopedi ekstremitas bawah dibagi menjadi dua kelompok. Kelompok D adalah pasien yang menerima 50 mg tramadol dengan 50 mg deksketoprofen dan kelompok P adalah pasien yang menerima 50 mg tramadol dengan 1.000 mg parasetamol intravena. PGE2 dan intensitas nyeri dicatat selama penutupan kulit sebelum pemberian obat 8 dan 16 jam sesudahnya. Data dianalisis menggunakan Uji Mann-Whitney U dan paired t-test yang sesuai. Numeric rating scale (NRS) kelompok tramadol dan deksketoprofen lebih rendah dibanding dengan kelompok tramadol dan parasetamol dengan perbedaan bermakna (p<0,05). Kadar PGE2 menurun pada kelompok tramadol dan deksketoprofen (T1–T2 p=0,009 dan T0–T2 p=0,01), sedangkan kadar PGE2 pada kelompok tramadol dan parasetamol meningkat (T2–T1 p=0,227 dan T0–T2 p=0,706). Simpulan, kombinasi tramadol dan deksketoprofen mengurangi tingkat PGE2 dan intensitas nyeri dibanding dengan kombinasi tramadol dan parasetamol. Dexketoprofen Combination and Tramadol Paracetamol Combination in Lower Limb Orthopedic SurgeryMultimodal analgesia is one of the principles of postoperative pain management. This study aimed to compare the effect of analgesic combination of tramadol dexketoprofen and tramadol paracetamol on pain intensity and prostaglandin (PGE2) level. Forty-six ASA PS I and II patients undergoing lower limb orthopedic surgery were allocated into two groups. Group D received 50 mg tramadol with 50 mg dexketoprofen and group P received 50 mg tramadol with 1,000 mg paracetamol intravenously. The PGE2 and pain intensity were recorded during skin closure prior to drug administration, 8 and 16 hours afterwards. Data were analyzed as appropriate using Mann-Whitney U and paired t-test. The NRS of two groups were significantly different where the NRS of the Tramadol Dexketoprofen group was lower than that of the tramadol and paracetamol group (NRS T1 p=0.049, NRS T2 p=0.035). The PGE2 levels decreased in the tramadol dexketoprofen groups (T1–T2 p=0.009 and T0–T2 p=0.01), whereas PGE2 levels in tramadol paracetamol group increased (T2–T1 p=0.227 and T0–T2 p=0.706). In conclusion, tramadol dexketoprofen combination reduces the PGE2 level and pain intensity as opposed to tramadol paracetamol combination. 
Perbandingan Skor Insersi LMA antara Pemberian Petidin-propofol dan Fentanil-propofol Intravena Agussalim Ali; Syafruddin Gaus; Muhammad Ramli Ahmad
MEDULA JURNAL ILMIAH FAKULLTAS KEDOKTERAN UNIVERSITAS HALU OLEO Vol 8, No 1 (2020)
Publisher : Halu Oleo University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46496/medula.v8i1.15025

Abstract

ABSTRAKLatar Belakang Pemberian adjuvan seperti opioid, lidokain, midazolam dan pelumpuh otot dosis kecil bersama propofol mampu meningkatkan keberhasilan insersi LMA. Petidin adalah opioid yang memiliki aktivitas seperti anestetik lokal dengan harga relatif murah dibanding opioid lain.  Tujuan penelitian Membandingkan skor insersi LMA antara antara pemberian petidin-propofol intravena dengan fentanil-propofol intravena.Metode Lima puluh empat pasien ASA PS 1 dan 2 dengan rentang umur 17-60 tahun, BMI 18,5-30 kg/m2 dan mallampati I-II yang direncanakan operasi elektif dengan prosedur GA-LMA diacak kedalam 2 grup dengan menggunakan desain acak tersamar ganda. Grup P mendapatkan petidin 1 mg/kgBB 10 menit sebelum induksi dan grup F mendapatkan fentanil 1 µg/kgBB 3 menit sebelum induksi. Induksi menggunakan propofol 2 mg/kgBB selama 60 detik. Ventilasi dengan oksigen 100% melalui sungkup muka selama 60 detik dilakukan setelah refleks bulu mata hilang, selanjutnya dilakukan insersi LMA dan penilaian skor insersi LMA berdasarkan Lund & Stovener (gerakan anggota tubuh, laringospasme, menelan, batuk dan tersedak).Hasil Skor insersi LMA sangat memuaskan pada kelompok P lebih kecil dibandingkan kelompok F (29,6% vs 48,1%), namun tidak bermakna setelah uji statistik Chi-Square (p=0,264).Simpulan Skor insersi LMA dengan pemberian petidin-propofol intravena samabaiknya dengan pemberian fentanil-propofol intravena.Kata kunci :laryngeal mask airway, fentanyl, petidin, , propofol,
Multimodal Analgesic Effect on Proinflammatory and Anti-inflammatory Cytokines Serum Muhammad Ramli Ahmad; Tatang Bisri
International Journal of Integrated Health Sciences Vol 2, No 1 (2014)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1361.61 KB)

Abstract

Objective: To investigate the effect of combination epidural bupivacaine and intravenous parecoxib analgesia on  immune response in patients who underwent open reduction and internal fixation of the lower limb under epidural anesthesia.  Methods: This research was conducted using the randomized, placebo-controlled double blind trial method on 52 patients who were randomly divided into 2 groups: the Parecoxib group which received 40 mg intravenous parecoxib for 30 minutes before incision and the control group which received an equal volume of 0.9% normal saline. Both groups received epidural anesthesia and postoperative epidural 0.125% bupivacaine analgesia continously. Venous blood samples were obtained before parecoxib administration, 2 and 24 hours after the surgery. The data were analyzed using Mann Whitney U and Independent t tests (p<0.05).     Results: There was a significant difference between the two groups (p<0.05) in IL-1β, IL-6, IL-10 levels and proinflammatory to anti-inflammatory ratio, 2 hours after surgery.    Conclusions: Multimodal analgesic combination of 40 mg IV parecoxib and 0.125% bupivacaine epidural analgesia have the effect to alter and stabilize the  systemic immune response.    Keywords: Cytokines, epidural analgesia, interleukins, immune response, parecoxib, tissue damage DOI: 10.15850/ijihs.v2n1.272
Perioperative Pediatric Transfusion Strategy Ahmad Nur Islam; Elizeus Hanindito; Muhammad Ramli Ahmad; Maman Surya Permana; Hanna Aulia Namirah
Nusantara Medical Science Journal Volume 9 Issue 2, July - December 2024
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.vi.42398

Abstract

Introduction: In the modern healthcare system, blood transfusion is an essential treatment that plays a significant role in the clinical improvement of adult and pediatric patients. Given the physiological and hematological differences between children and adults, careful planning and an individualized approach are essential to maximize its effectiveness and avoid serious side effects. Method:  A thorough review of the literature was performed, utilizing PubMed, Embase, and the Cochrane Library, to gather evidence on pediatric perioperative transfusion practices. The search encompassed studies published between 2013 and 2024, employing a combination of terms and free-text keywords, as well as Boolean operators, to refine the results. Conclusion: Intraoperative blood loss in pediatric patients requires special attention with an approach that includes pre to postoperative management. This approach must be adapted to the anatomical and physiological differences of children compared to adults. Research, development of universal transfusion strategies, and education and training for medical personnel are essential to improve blood management and prevention of complications.      
Co-Authors Abdul Wahab Agussalim Ali Ahmad Nur Islam Clara Valentia Josephine Elizeus Hanindito Hanna Aulia Namirah Hisbullah Hisbullah Maman Surya Permana Syafruddin Gaus Tatang Bisri