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Perbandingan Osmolaritas Plasma Setelah Pemberian Manitol 20% 3 mL/kgBB dengan Natrium Laktat Hipertonik 3 mL/kgBB pada Pasien Cedera Otak Traumatik Ringan-Sedang Budi Harto Batubara; Nazaruddin Umar; Chairul Mursin
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Terapi osmotik adalah salah satu cara penanganan pada cedera kepala traumatik untuk menurunkan tekanan intrakranial (TIK) dengan cara mengatasi edema yang terjadi. Penelitian ini dilakukan pada 30 pasien cedera otak traumatik ringan-sedang yang masuk ke UGD Rumah Sakit H. Adam Malik Medan pada Oktober–Desember 2015 yang memenuhi kriteria inklusi dan tidak termasuk eksklusi. Subjek dibagi menjadi 2 kelompok secara acak, yaitu kelompok A diberikan manitol 20% 3 mL/kgBB dan kelompok B diberikan natrium laktat hipertonik 3 mL/kgBB. Dilakukan penilaian osmolaritas sebelum perlakuan dan 60 menit setelah perlakuan dengan cara pengambilan darah, kemudian dilakukan pemeriksaan laboratorium. Data hasil penelitian diuji dengan uji T-independent dan Uji Mann-Whitney. Dari hasil penelitian didapatkan efek perubahan osmolaritas plasma setelah perlakuan tidak bermakna secara statistik (p>0,05) walaupun osmolaritas plasma akhir setelah perlakuan pada kedua kelompok berbeda bermakna (p<0,05). Volume urin lebih banyak pada kelompok manitol dan bermakna secara statistik (p<0,05), akan tetapi tidak ada perubahan hemodinamik yang bermakna. Dari hasil penelitian disimpulkan bahwa manitol lebih baik dalam hal target osmolaritas plasma pada pasien cedera otak traumatik ringan sedang.Kata kunci: Cedera otak traumatik, manitol 20%, natrium laktat hipertonik, osmolaritasPlasma Osmolarity Changes After Mannitol 20% 3 mL/kgBW and Hypertonic Sodium Lactate Solution 3 mL/kgBW Administration in Patients with Mild-Moderate Traumatic Brain InjuryAbstractOsmotic therapy is one of many modalities to manage traumatic brain injuries aimed to decrease intracranial pressure by alleviating the brain edema. A study was performed on 30 subjects with mild and moderate brain injuries admitted to the emergency department of Adam Malik General Hospital Medan during October–December 2015 who meet the inclusion and exclusion criteria. Subjects were divided randomly into 2 treatment groups, i.e. group A that received mannitol 20% 3 mL/kgBW and group B that received hypertonic natrium lactate 3 mL/kgBW. The measurement of osmolarity was performed before administration of either of mannitol and hypertonic natrium lactate and at 60 minutes after the administration by drawing the blood for blood check. . Data were statistically analyzed using T- independent test and Mann-Whitney test. Plasma osmolarity changes before and after the treatment were not statistically sifgnificant (p>0.05) for each group treatment even though post-treatment plasma osmolarity was statistically significant. Urin output in the mannitol group was higher than in the hypertonic sodium lactate group and was statistically significant (p>0.05); nevertheless, there was no significant difference in the hemodynamic change. Therefore, manitol is better than hypertonic natrium lactate for osmolarity target therapy in patients mild-moderate head injury.Key words: Hypertonic natrium lactate, mannitol 20%, osmolarity, traumatic brain injury DOI: 10.15851/jap.v4n3.677
Perbandingan Tingkat Sedasi Klonidin Syrup 2 mcg/kgBB dengan Diazepam Syrup 0.4 mg/kgBB sebagai Premedikasi pada Pasien Anak yang Menjalani Pembedahan dengan General Anestesi Vera Muharrami; A. Sani P. Nasution; Nazaruddin Umar
Jurnal Ilmu Kedokteran Vol 5, No 2 (2011): Jurnal Ilmu Kedokteran
Publisher : Fakultas Kedokteran Universitas Riau

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (74.13 KB) | DOI: 10.26891/JIK.v5i2.2011.111-117

Abstract

Introduction: Anxiety in children undergoing surgery is characterized by subjective feeling of tension, apprehension,nervousness and worry that may be expressed in various forms. Clonidine, an alpha 2-adrenoceptor agonist, has beenshown to be as a preanesthetic medication in childrens. The current study was designed to investigate the differencesof level sedation clonidine syrup and diazepam syrup as a premedicant in children.Methods: In a randomized, double-blind, controlled clinical trial, 40 children, aged 2-12 yr, undergoing electivesurgery received 2 micrograms/kg clonidine syrup or 0.4 mg/kg diazepam syrup orally. These agents were administered120 min before the estimated time of induction of general anesthesia and noted the children’s level of sedation. Thelevel of sedation were compared among the two groups. PASS <1 demanded rescue intravenous sedation.Result: Clonidine syrup 2 mcg/kgBB provided better quality of sedation after 60 min of premedicant but it wasn’tsignificant(1.8±0.92) and diazepam syrup (0.80±0.89; p>0.05) and number of patients with rescue intravenous diazepamacceptance were same both clonidine group compared to diazepam, there was no significant difference between twogroups, 10% of clonidine group patients, 10 % of diazepam group patients (p>0.05). No clinically significanthypotension or bradycardia was observed after preanesthetic medications of diazepam and clonidine syrup.Discussion: These data indicate that, even in pediatric surgery, the 2 micrograms/kg syrup clonidine is an effectivepremedication. However, the safety and optimal dose of clonidine in this setting remain to be determined.
Perbandingan efek klonidin 2g/Kg intravena dan lidokain 2% 1.5 mg/Kg intravena untuk mencegah kenaikan tekanan intra okuler (TIO) selama tindakan intubasi endotrakheal Muhammad Jalaluddin Assuyuthi Chalil; Nazaruddin Umar; Dadik Wahyu Wijaya; Aslim Sihotang
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 47, No 1 (2014): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Background: Endotracheal intubation is routinely performed during general anaesthesia in patients undergoing intraocular surgery. However, intubation is associated with an increase in intraocular pressure (IOP).Aim: To compare the effect of clonidine and lidocain to prevent the increase of IOP during endotracheal intubation. Method: Forty patients with no pre-existing eye diseaseundergoing elective non-ophthalmic surgeriesundergeneral anesthesiawererandomly allocated to two groups of 20 each.In Group A, patients received clonidine 2μg/kg/iv, and in group B lidocain2% 1.5mg/kg/iv for premedication.The hemodynamic profile (systolic and diastolic blood pressure, mean arterial pressure, heart rate) and IOP (using Schioetz tonometer) were measured before premedication (pre anesthesia), before intubation, immediately after intubation, and every 1 minute for 2 minutes.Result:There was a significant decrease in IOP and hemodynamic profile within both groups before and after endotracheal intubation compare to pre anesthesia periode (P <0.05). But the decreasewas not different between two groups (P >0.05). Conclusion: We conclude that both drugs have the same ability in blunting the hemodynamic response and attenuating the IOP, and preventing the increase in IOP caused by endotracheal intubation.Key word : clonidine, endotracheal intubation, intra-ocular pressure, lidocain