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All Journal Majalah Kedokteran Bandung Jurnal Anestesi Perioperatif Bali Journal of Anesthesiology Majalah Anestesia dan Critical Care Jurnal Anestesi Obstetri Indonesia Interdisciplinary Social Studies Journal of Applied Nursing and Health Jurnal Neuroanestesi Indonesia Acta Medical and Health Sciences (AMHS)
Tatang Bisri
Departemen Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung
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Korelasi antara Panjang Garis Sternoakromion dan Titik Penyuntikan Blokade Pleksus Brakialis pada Anestesi Vertical Infraclavicular Block Menggunakan Pencitraan Ultrasonografi pada Pria Dewasa Yadi, Dedi Fitri; Redjeki, Ike Sri; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 4, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (520.913 KB) | DOI: 10.15851/jap.v4n1.739

Abstract

Anestesi regional untuk operasi di daerah lengan bawah dapat dilakukan blokade pleksus brakialis vertikal infraklavikula. Penelitian ini bertujuan menemukan korelasi antara panjang garis sternoakromion dan letak penyuntikan menggunakan pencitraan ultrasonografi untuk vertical infraclavicular block (VIB) pada pria dewasa. Penelitian potong lintang dengan mengukur titik tengah garis antara fosa jugularis dan akromion pada 48 pria dewasa. Pencitraan ultrasonografi dilakukan menggunakan probe linear untuk menentukan letak penyuntikan. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung periode Oktober 2011–Januari 2012. Hasil pengukuran didapatkan panjang garis sternoakromion kanan rata-rata 18,35±1,16 cm. dan kiri 18,39±1,22 cm. Titik tengah sternoakromion kanan rata-rata 9,18±0,59 cm dan kiri 9,19±0,61 cm. Jarak letak titik penyuntikan menggunakan ultrasonografi kanan 9,41±0,7 cm dan kiri 9,46±0,72. Terdapat korelasi positif (r kanan=0,874 dan r kiri=0,862) antara garis sternoakromion dan jarak letak titik penyuntikan menggunakan pencitraan ultrasonografi.Kata kunci: Blokade vertikal infraklavikular, letak penyuntikan blokade infraklavikular, pencitraan ultrasonografi Correlation between the Sternoacromion Line Length and Plexus Brachialis Vertical Infraclavicular Block Injection Site Using Ultrasonography Scan on Adult MalesAbstractSurgery on the lower part of the arm can be managed by brachial plexus vertical infraclavicular block. Needle placement for vertical infraclavicular block is not always at the midpoint of the sternoacromion line. The aim of this study was to find the correlation between sternoacromion length and needle placement using ultrasond scan for vertical infraclavicular block on adults males. This was a cross sectional study measuring the midlle point of sternoacromion line on 48 adult male volunteers whom never had any injury or operation on shoulder areas. Linear probe ultrasound was used to determine the needle placement. This study was conducted in Dr. Hasan Sadikin General Hospital Bandung within the period of October 2011–January 2012. Pearson correlation test and linear regression were used to analyze the data. Result of this study showed an average right strernoacromion length of 18.35±1.16 cm, an average left sternoacromion leght of 18.39±1.22 cm, an average midpoint right sternoacromion of 9.18±0.59 cm, and an average midmpoint left sternoacromion of 9.19±0.61. The average ultrasound right point was 9.41 cm and 9.46 cm for the left point. Hence, thereare significant correlations (r right=0.874, r left=0.862) between sternoacromion length and ultrasound injection point for vertical infraclavicular block.Key words: Injection site for infraclavicular block, ultrasound scan, vertical infraclavicular block DOI: 10.15851/jap.v4n1.739
Perbandingan Kombinasi Bupivakain 0,5% Hiperbarik dan Fentanil dengan Bupivakain 0,5% Isobarik dan Fentanil terhadap Kejadian Hipotensi dan Tinggi Blokade Sensorik pada Seksio Sesarea dengan Anestesi Spinal Okatria, Ahmado; Oktaliansah, Ezra; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Anestesi spinal mejadi teknik pilihan untuk seksio sesarea karena lebih aman dan efisien dibanding dengan anestesi umum. Anestesi spinal pada wanita hamil menyebabkan hipotensi lebih berat dan cepat. Hipotensi berhubungan dengan ketinggian blokade simpatis yang dipengaruhi oleh barisitas anestetik lokal. Tujuan penelitian ini adalah membandingkan kejadian hipotensi dengan tinggi blokade sensorik antara kombinasi bupivakain 0,5% hiperbarik 12,5 mg dan fentanil 25 µg dengan bupivakain 0,5% isobarik 12,5 mg-fentanil 25 µg pada anestesi spinal untuk seksio sesarea. Penelitian dilakukan di Central Operating Theatre (COT) Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan April‒Mei 2015 dengan uji klinis acak tersamar ganda terhadap 40 pasien yang menjalani seksio sesarea dengan status fisik American Society of Anesthesiologist (ASA) II. Kejadian hipotensi dan tinggi blokade sensorik dinilai setelah pemberian anestesi spinal. Data penelitian dianalisis menggunakan uji-t, Mann-Whitney, dan chi-kuadrat. Hasil penelitian bermakna jika nilai p<0,05. Kejadian hipotensi antara kelompok hiperbarik dan isobarik adalah 75% vs 100% (p=0,017). Tinggi blokade sensorik rata-rata antara kedua kelompok di T6 vs T4 (p=0,000). Kejadian hipotensi dan blokade sensorik lebih tinggi pada kombinasi bupivakain 0,5% isobarik 12,5 mg dan fentanil 25 µg dibanding dengan bupivakain 0,5% hiperbarik 12,5 mg dan fentanil 25 µg.Kata kunci: Anestesi spinal, bupivakain hiperbarik, bupivakain isobarik, seksio sesareaComparison between Combination of Hyperbaric 0.5% Bupivacain with Fentanyl and 0.5% Isobaric Bupivacain with Fentanyl Use on Incidence of Hypotension and Sensoric Blockade Level in Caesarian Section with Spinal AnesthesiaSpinal anesthesia technic has been the technic of choice for caesarean section due to its safety and efficiency compared to general anesthesia. Spinal anesthesia in pregnancy causes hypotension in a heavier and more rapid manner. Hypotension is associated with the height of the sympathetic block influenced by the baricity of the local anesthetics. This study aimed to compare hypotension incidence and sensory blockade height between combination of 12.5 mg 0.5% hyperbaric bupivacaine with 25 µg fentanyl and 12.5 mg 0.5% isobaric bupivacaine with fentanyl 25 µg in spinal anesthesia for caesarean section. The study was performed at the central operating theatre (COT) of Dr. Hasan Sadikin General Hospital during April‒May 2015 using double blind randomized control trial method on 40 patients underwent caesarean section with American Society of Anesthesiologist (ASA) II physical status. The hypotension incidence and sensory blockade height were assessed after spinal anesthesia and measured by t-test, Mann Whitney, and Chi-square tests. Significancy was declared when p value <0.05. The hypotension incidence between the hyperbaric and isobaric groups were 75% vs. 100% (p value=0.017). The mean sensory blockade height was at T6 vs. T4 (p value=0.000). The hypotension incidence and sensory blockade are significantly higher in isobaric 12.5 mg 0.5% bupivacainewith 25 µg fentanyl compared to those in 12.5 mg hyperbaric 0.5% bupivacaine with fentanyl 25 µg.Key words: Caesarean section, hyperbaric bupivacaine, isobaric bupivacaine, spinal anesthesia  DOI: 10.15851/jap.v4n2.820
Perbandingan Pemberian Deksametason 10 mg dengan 15 mg Intravena sebagai Adjuvan Analgetik terhadap Skala Nyeri Pascabedah pada Pasien yang Dilakukan Radikal Mastektomi Termodifikasi Erlangga, M. Erias; Sitanggang, Ruli Herman; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Deksametason merupakan kortikosteroid yang memiliki efek anti-inflamasi paling kuat. Penelitian ini bertujuan membandingkan deksametason 10 mg dengan deksametason 15 mg intravena prabedah terhadap nyeri pascabedah dan kebutuhan analgetik opioid. Penelitian ini merupakan uji acak terkontrol buta ganda pada 60 wanita dengan status fisik American Society of Anesthesiologist (ASA) I–II yang menjalani pembedahan radikal mastektomi termodifikasi dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung periode Desember 2013–April 2014. Pasien dibagi menjadi dua kelompok, yaitu 30 orang menerima deksametason 10 mg dan 30 orang menerima deksametason 15 mg yang diberikan 30 menit prabedah. Penilaian skala nyeri menggunakan nilai numeric rating scale (NRS) pada saat istirahat dan mobilisasi, pada jam ke-1, 2, 4, 12, dan 24 pascabedah. Pemberian analgetik tambahan opioid dilakukan bila nilai NRS>3. Analisis statistika data hasil penelitian menggunakan uji-t, chi-kuadrat, dan Mann-Whitney. Hasil penelitian menunjukan nilai NRS saat istirahat pada kelompok deksametason 10 mg dengan deksametason 15 mg tidak berbeda bermakna (p>0,05), sementara nilai NRS saat mobilisasi pada kelompok deksametason 10 mg lebih tinggi dibanding dengan kelompok deksametason 15 mg (p<0,05). Pemberian analgetik tambahan pascabedah tidak terdapat perbedaan secara bermakna antara kedua kelompok (p>0,05). Simpulan penelitian ini adalah pemberian deksametason 15 mg dapat diberikan karena mempunyai efek analgesia yang lebih baik.Kata kunci: Deksametason, numeric rating scale, nyeri pascabedahComparison between 10 mg and 15 mg of Intravenous Dexamethasone as Analgesia Adjunct on Post Operative Pain in Patients Undergo Modified Radical Mastectomy Dexamethasone is a glucocorticoid with the strongest anti-inflammatory property. The aim of this study was to compare the effect of 10 mg and 15 mg of intravenous dexamethasone on post operative pain and opioid analgetic need. This was a randomized double-blind study involving 60 females with physical status ASA I–II whom underwent modified radical mastectomy under general anesthesia at Dr. Hasan Sadikin General Hospital during December 2013–April 2014. Patients were divided into 2 groups where 30 patients received 10 mg dexamethasone and 30 patients received 15 mg dexamethasone 30 minutes prior to surgery. Pain assessment was performed using numeric rating scare (NRS) at rest and during activity, documented on the 1st, 2nd, 4th, 12th and 24th hour post operative. Additional analgesia was given if NRS >3. Data were analyzed statistically using Student’s t test, chi-square and Mann Whitney U test. Result showed that the difference between NRS at rest for 10 mg and 15 mg dexamethasone (p>0.05) was not significant, while the difference in NRS during activity at all time measurements were statistically significant (p<0.05). There was no statistical significant difference in additional opioid administered between the two groups (p>0.05). This study concludes that 15 mg dexamethasone has a better analgesia effect to reduce analgesic dose.Key words: Dexamethasone, numeric rating scale, post operative pain DOI: 10.15851/jap.v3n3.607
Perbandingan Pemberian Kombinasi Haloperidol 0,5 mg dan Deksametason 5 mg dengan Ondansetron 4 mg terhadap Kejadian Mual Muntah Pascaoperasi Modified Radical Mastectomy dengan Anestesi Umum Rahmadsyah, Teuku; Fuadi, Iwan; Bisri, Tatang
Majalah Anestesia dan Critical Care Vol 34 No 1 (2016): Februari
Publisher : Perdatin Pusat

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Mual muntah pascaoperasi dapat meningkatkan morbiditas dan memperpanjang masa rawat pascaoperasi.Haloperidol adalah obat tranquilizer major golongan dari butirofenon yang mempunyai efek reseptor D2 antagonis.Penggunaan kombinasi haloperidol dan deksametason sebagai antiemetik profilaksis dapat menguntungkan.Penelitian ini bertujuan untuk membandingkan kombinasi haloperidol 0,5 mg dan deksametason 5 mg denganondansetron 4 mg terhadap kejadian mual muntah pascaoperasi pada operasi modified radical mastectomy.Penelitian dilakukan terhadap 42 wanita (kurang dari 50 tahun) status fisik ASA I-II yang menjalani operasimodifikasi mastektomi radikal secara uji acak terkontrol buta ganda dalam anestesi umum. Pasien dibagi menjadidua kelompok yaitu 21 orang menerima haloperidol 0,5 mg ditambah deksametason 5 mg dan 21 orang menerimaondansetron 4 mg yang diberikan setelah intubasi dilakukan. Pasien diberikan analgetik ketorolak dan petidinintravena secara kontinu pascaoperatif. Evaluasi yang dinilai adalah tekanan darah, laju nadi, dan saturasioksigen. Hasil dari penelitian menunjukan terdapat kecenderungan keluhan mual muntah pascaoperasi lebihbanyak terjadi pada kelompok ondansetron 4 mg (38,1%) dibanding dengan kelompok kombinasi haloperidol0,5 mg dan deksametason 5 mg (4,8%). Pada analisis statistik yang dilakukan dengan uji Chi-Square didapatkanhasil perbedaan yang bermakna (p kurang dari 0,05). Simpulan dari penelitian ini adalah pemberian kombinasihaloperidol 0,5 mg dan deksametason 5 mg intravena lebih baik dibandingkan dengan ondansetron 4 mg intravenadalam menurunkan kejadian mual muntah pascaoperasi modified radical mastectomy. Kata kunci: deksametason, haloperidol, modified radical mastectomy, mual muntah, ondansetron Postoperative nausea and vomiting can lead to increase morbidity and lengthened postoperative hospital stay.Haloperidol is a major tranquilizer with a D2 receptor antagonist effect. A combination of haloperidol anddexamethasone is also effective to prevent postoperative nausea and vomiting, which offers beneficial effectssuch as lower cost, longer duration and are easy to find. The aim of this study is to compare a combination ofhaloperidol 0,5 mg and dexamethasone 5 mg with ondansetron 4 mg in managing postoperative nausea andvomiting following modified radical mastectomy. The study was done by conducting a double blind randomizedcontrolled trial of 42 subjects, women aged under 50 years old, who underwent modified radical mastectomy undergeneral anesthesia, with physical status ASA I-II. Patients were divided into two groups: 21 patients receivedcombination of haloperidol 0,5 mg and dexamethasone 5 mg, and 21 patients received ondansetron 4 mg, afterintubation. Intravenous ketorolac and pethidine were given as postoperative analgesia. Blood pressure, heartrate, oxygen saturation and length of surgery was recorded.The result of this study was postoperative nausea andvomiting occurs more frequent in the ondansetron 4 mg group (38,1%) compared to combination of haloperidol0,5 mg and dexamethasone 5 mg group (4,8%). In statistical analysis performed with Chi-Square test showedthere was significant difference between the two groups (p&lt;0,05). As a conclusion of this study is intravenouscombination of haloperidol 0,5 mg and dexamethasone 5 mg better than ondansetron 4 mg in lowering theincidence of postoperative nausea and vomiting after modified radical mastectomy. Key words: Dexamethasone, haloperidol, modified radical mastectomy, nausea and vomiting, ondansetron Reference Daabiss MA. Ephedrine-dexamethasone combination reduces postoperative nauseaand vomiting in patients undergoing laparoscopic cholecystectomy. Internet Anesthesiol. 2008;18(1):1092 ̶ 100. Habib AS, Gan TJ. Evidence-based management of postoperative nausea and vomiting. Can J Anesth. 2004;51:326 ̶ 41. Watcha MF, White PF. Postoperative Nausea and Vomiting, lts Etiology, Treatment, and Prevention. Anesthesiology. 1992;77:162–84. Gan TJ. Risk factors of postoperative nausea and vomiting. Anaesth Analg. 2006;102:1884 ̶ 98. Islam S, Jain PN. Postoperative nausea and vomiting (PONV): a review article. Indian J Anesth. 2004;48:253 ̶ 8. Sinclair DR, Chung F, Mezei G. Can postoperative nausea and vomiting be predicted? Anesthesiology. 1999;91:109 ̶ 18. Ho KY, Chiu JW. Multimodal antiemetic therapy and emetic risk profiling. Ann Acad Med Singapore. 2005;34:196 ̶ 205. Matthew TV, Chan, Chui PT, Ho WS, King WK. Single dose tropisetron for preventing post operative nausea and vomiying after breast surgery. Anesth Analg. 1998;87:931 ̶ 5. McQuaid KR. Drugs used in the treatment of gastrointestinal diseases. Dalam: Basic &amp; clinical pharmacology. Edisi ke-9. Boston: The McGraw-Hill Companies. 2004. hlm. 1045 ̶ 60. Raman S, Kaul TK, Anju G, Aprajita S. Postoperative nausea and vomiting. Anesth Clin Pharmacology. 2007;23:341 ̶ 56. Ku CM, Ong BC. Postoperative nausea and vomiting: a review of current literature. Singapore Med J. 2003;44(7):366 ̶ 74. Splinter WM, Roberts DJ. Dexamethasone decreases vomiting by children after tonsillectomy. Anesth Analg. 1996;83:913 ̶ 6. O’Brien C. Nausea and vomiting. J Can Family Physician. 2008;54:861 ̶ 3. Zarate E, et.al. A Comparison of The Cost and Efficacy of Ondansetron versus Dolasetron for Antiemetic Prophylaxis. Anaesth Analg. 2000;90:1352 ̶ 8. Rosow CE, et.al. Haloperidol versus Ondansetron for Prophylaxis of Post operative Nausea and Vomiting. Anesth Analg. 2008; 106:1407 ̶ 9. Azwar. Pencegahan mual dan muntah pascaoperasi pada anestesi umum: Perbandingan haloperidol 1mg iv dengan ondansetron 4 mg iv [Jakarta: Universitas Indonesia. 2009. Adipraja K, Himendra A, Bisri T. Pengaruh premedikasi haloperidol (serenace®) terhadap efek samping ketamine pada penderita rawat Intensif Fakultas Kedokteran UNPAD/RSHS Bandung. 1992; hlm. 1 ̶ 9. Smith JC, Wright EL. Haloperidol: An Alternative Butyrophenon for Nausea and’ Vomiting Prophylaxis in Anesthesia. AANA journal. 2005;75:273 ̶ 5. Digregio GJ. Anti Psichotic Drugs and Lithium. Dalam: Basic Pharmacology in Medicine. Edisi ke-3. New York: Mc Graw-Hill. 1990. hlm. 261 ̶ 2. Moorselli PL. Haloperidol: Clinical Pharmacokinetics and Significance of Theurapeutic Drug Monitoring. Dalam: Theurapeutic Drug Monitoring. Churchill Livingstone. 1981. hlm. 296 ̶ 301. Khan MP, Singh V, Kumar M, Singh B, Kapoor R, Bhatia VK. Prophylactic antiemetic therapy using combinations of granisetron, dexamethasone and droperidol in patients undergoing laparoscopic cholecystectomy. The Internet Journal of Anesthesiology. 2009;21(1):1092 ̶ 102.
Comparison of Agitation Incidence in Adult Ambulatory Patients who Underwent Surgery by General Anesthesia Using Desflurane or Sevoflurane Putri, Andika C.; Nawawi, A. Muthalib; Bisri, Tatang
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
Publisher : Perdatin Pusat

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Postanesthesia agitation is a problem that sometimes occurs in patients who underwent general anesthesia. Thisstudy aims to compare the magnitude of the incident postanesthesia agitationin patienambulatory surgery performedunder general anesthesia with desflurane or sevoflurane use. Research single blinde randomized controlled trial in94 ambulatory surgical patients ASA I. Subjects divided into two groups: group I received desfluran and group IIreceived sevoflurane. Both groups at induction with propofol 2 mg/kg, fentanyl 2 μg/kgBW, atrakurium 0,1 mg/kg, then do laringeal mask airway (LMA) installation. Agitation in patiens assesed since the LMA is removed,the use of anesthetic drugs has beeb stoped, then at minute 5, 10, 15, 20, 25, 30, every five minutes after usingagitation-sedation scale riker. Statistic analysis using Chi-square and Mann-Whitney Test. The results obtainedindicate that the ratio of the incidence of agitation in the recovery room between the desflurane with sevofluranegroups were not statistically significant. Obtained 7 patients experiencing agitation pascaanestesi desflurane groupof 47 samples (14.9%), whereas only 5 patients with agitation of 47 samples sevoflurane group (10.6%). Onepatient from group desflurane assessed his agitation scale 6 (very agitated). The result of comparative magnitudeof the incidence of agitation in the group performed under general anesthesia using desflurance with sevofluranegroup using there is not a statistically significant difference.
Perbandingan Kejadian Post Dural Puncture Headache pada Pasien Seksio Sesarea dengan Anestesi Spinal Menggunakan Teknik Median dan Paramedian , Rizki; , Suwarman; Bisri, Tatang
Majalah Anestesia dan Critical Care Vol 32 No 2 (2014): Juni
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spinal (LCS) berpengaruh terhadap timbulnya PDPH. Berbagai faktor yang memengaruhi insidensi kejadian PDPH, meliputi jenis kelamin, usia, kehamilan, riwayat PDPH sebelumnya, ukuran dan bentuk jarum, arah jarum, jumlah percobaan tusukan, teknik penusukan median atau paramedian, dan keahlian ahli anestesi. Tujuan penelitian adalah membandingkan kejadian PDPH wanita hamil yang dilakukan seksio sesarea dengan anestesi spinal menggunakan teknik median dan paramedian di RS Dr. Hasan Sadikin Bandung, periode Maret–April 2014. Penelitian ini dilakukan secara uji klinis acak terkontrol tersamar tunggal terhadap 44 pasien wanita hamil aterm dengan status fisik American Society of Anesthesiologists (ASA) I dan II yang menjalani seksio sesarea dengan anestesi spinal. Subjek dibagi menjadi dua, kelompok paramedian (P) dan kelompok median (M). Kelompok P dilakukan penusukan menggunakan teknik paramedian dan kelompok M menggunakan teknik median dengan m jarum spinal ukuran 25-gauge tipe Quincke. Data hasil penelitian dianalisis menggunakan metode chi-kuadrat Hasil penelitian menunjukkan tidak ada perbedaan yang bermakna pada kedua kelompok (p=0,351), terdapat 2 kejadian (9%) PDPH pada kelompok median (n=22) dan tidak ditemukan kejadian pada kelompok paramedian (n=22). Simpulan penelitian ini adalah tidak ada pengaruh teknik penusukan menggunakan teknik paramedian atau median terhadap kejadian PDPH pada wanita hamil yang dilakukan seksio sesarea Kata kunci: Anestesi spinal, teknik paramedian, post dural puncture headache, teknik median Post dural puncture headache (PDPH) is an iatrogenic complication of spinal anesthesia. Cerebro spinal fluid (LCS) leak have effect on the incidence of PDPH. Various factors affect the incidence of PDPH include gender, age, pregnancy, history of previous PDPH, the size and shape of the needle, the needle direction, the number of attempted punctures, median or paramedian puncture technique, and skill of the operator. The purpose of this study was to compare the incidence of PDPH in pregnant women who performed caesarean section under spinal anesthesia using median and paramedian techniques in Dr. Hasan Sadikin Hospital Bandung at April-May 2014. This research was conducted in single-blind randomized controlled clinical trial on 44 at term pregnant women with American Society of Anesthesiologists (ASA) physical status I and II undergoing cesarean section with spinal anesthesia. Subjects were divided into two groups paramedian (P) and the median (M). Group P performed using paramedian puncture technique and M groups using the median technique. Both of technique using a 25- gauge Quincke needle. The data were analyzed using chi-square method The results of this study showed no significant difference in both groups (p=0.351) , with 2 incidences of PDPH (9 % ) in the group median (n=22) and not found in the paramedian group (n=22). Conclusions there is no difference between median and paramedian techniques on the incidence of PDPH in pregnant women who performed caesarean section. Key words: Median, paramedian, post dural puncture headache, spinal anesthesia Reference Paech MJ, Whybrow T. The prevention of anaesthesiology. Asean J Anaesth.2007;8:86–95. Amorim JA, Gomes de Barros MV, Valenca MM. Post-dural (post-lumbar) puncture headache: risk factors and clinical features. Cephalalgia. 2012 Sep;32(12):916−23. Singh J, Ranjit S, Shrestha S, Limbu T, Marahatta SB. Post dural puncture headache. J Inst Med. 2010;32(2):30−2. Mosaffa FK, Madadi F, Khoshnevis SH, Besheli LD, Eajazi A. Post-dural puncture headache: a comparison between median and paramedian approaches in orthopedic patients. Anesth Pain. 2011;1(2):66–9. Wu CL, Christo P, Richman JM, Hsu W. Postdural puncture headache: an overview. Int J Pain Med Pall Care. 2004;3(2):53–9. Turnbull DK, Shepherd DB. Postdural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth. 2003 Nov;91(5):718−29. Ghaleb A, Khorasani A, Mangar D. Postdural puncture headache. Intern J General Med. 2012;5:45–51 Vallejo MC, Mandell GL, Sabo DP, Ramanathan S. Postdural puncture headache: a randomized comparison of five spinal needle in obstetric patients. Anesth Analg. 2000;91:916−20. Lybecker H, Moller JT, May O, Nielsen HK. Incidence and prediction of post dural puncture headache: a prospective study of 1021 anesthesia. Anesth Analg. 1990;70:389–94. Haider SZ, Aziz MA., Qasim M. Post dural puncture headache - a comparison of midlineand paramedian approaches. Biomedica. 2005;21:90−2. Valenca MM, Amorim JA, Moura TP. Why don't all individuals who undergo dura mater/arachnoid puncture develop postdural puncture headache? Anesth Pain. 2012;1(3):207–9. Choi PT, Galinski SE, Takeuchi L, Lucas S, Tamayo C, Jadad AR. PDPH is a common complication of neuraxial blockade in parturients: a meta-analysis of obstetrical studies. Canadian J Anesth. 2003;50(5):460–9. Jabbari A, Alijampour E, Mir M, Hashem NB, Rabiea SM, Rupani MA. Post spinal puncture headache, an old problem and new concepts: review of articles about predisposing factors. Caspian J Intern Med. 2013;4(1):595–602. Kempen P, Mocek C. Bevel direction, dura geometry, and hole size in membrane puncture: laboratory report. Reg Anesth. 1997;22(3):267–72. Fink BR, Walker S. Orientation of fibers in human dorsal lumbar dura mater in relation to lumbar puncture. Anesth Analg. 1989 Dec;69(6):768–72. Hatfalvi B. Postulated mechanisms for postdural puncture headache and review of laboratory models. Clinical experience. Reg Anesth. 1995;20(4):329−36.
Pengaruh Pemberian Lidokain 2% sebelum Ekstubasi terhadap Penurunan Kejadian Batuk saat Proses Ekstubasi Suryaningrat, IGB; Bisri, Tatang; Oktaliansah, Ezra
Majalah Anestesia dan Critical Care Vol 32 No 3 (2014): Oktober
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Batuk saat ekstubasi pada pasien dengan anestesi umum dan endotrakeal merupakan masalah klinis yang dihadapi. Angka kejadian berkisar 38%−96%. Pemberian lidokain sebelum ekstubasi secara laringotracheal instilation of topical anesthesia endotracheal tube (ETT LITA) dapat mengurangi kejadian batuk saat ekstubasi. Tujuan penelitian adalah menilai efek pemberian lidokain 2% 1,25 mg/kgBB endotrakeal sebelum ekstubasi terhadap kejadian batuk saat ekstubasi. Penelitian kuantitatif intervensi dengan uji klinis acak terkontrol buta tunggal dengan subjek penelitian: 50 pasien laki-laki, usia 18−60 tahun, status fisik American Society of Anesthesiologists I dan II, operasi elektif dengan endotrakeal. Subjek dibagi menjadi 2 kelompok, yaitu kelompok I yang mendapat lidokain 2% 1,25 mg/kgBB endotrakeal 5 menit sebelum ekstubasi dan kelompok kontrol yang tanpa perlakuan. Data diuji dengan uji chi-kuadrat dan uji t. Penelitian dilakukan periode Februari−April 2014 di Rumah Sakit Dr. Hasan Sadikin Bandung. Kejadian batuk rata-rata saat ekstubasi pada kelompok lidokain lebih rendah dibanding dengan kelompok kontrol dengan hasil yang bermakna (p&lt;0,05). Derajat batuk 5 menit pascaekstubasi antara kedua kelompok menunjukkan berbeda bermakna (p=0,00046). Simpulan penelitian ini menunjukkan bahwa pemberian lidokain 2% 1,25 mg/kgBB endotrakeal sebelum ekstubasi dapat menurunkan kejadian batuk saat ekstubasi. Kata kunci: Anestesi umum, batuk, ekstubasi, lidokain endotrakeal Cough during extubation under general anesthesia with endotracheal intubation is a clinical problem that encountered. The Incidence rates ranged from 38%−96%. Lidocaine spray given before extubation through instillation process into the laringotracheal instilation of topical anesthesia endotracheal tube (ETT LITA) significantly lower the incidence of coughing during extubation. The goal of this research is to see the effect of lidocaine 2%, 1,25 mg/kgbw through endotracheal before extubation toward cough incidence during extubation of endotracheal tube process. In our prospective, single-blind randomized controlled clinical trial, we enrolled 50 male patients aged 18−60 years, ASA physical status I and II underwent elective surgery with generalwith endotracheal tube insertion. The subject was then divided into 2 groups, first group had lidocaine 2% 1,25 mg/kgBW endotracheal 5 minute before extubation and the control group without any intervention. The data result was tested statistically with chi-square and t-test. This study was conducted from February ̶ April 2014 in the operating room Dr. Hasan Sadikin Hospital, Bandung.Tthe statistic result, cough incidence was found at extubation process in the group that had lidocain 2% 1.25 mg/kgbw is lower than control group with significant result (p&lt;0.05). the cough degree 5 minutes post extubation in the grup that had lidocain 2% 1.25 mg/kgbw compare to control group in significantly different (p=0.00046). The conclusion is shows lidocaine 2% 1.25 mg/kgbw effect through endotracheal before extubation significantly lower cough incidence throughout extubation process. Key words: Cough, endotracheal lidocaine, extubation, general anesthesia Reference Minogue SC, Ralph J, Lampa MJ. Laryngotracheal topicalization with lidocaine before intubation decreases the incidence of coughing on emergence from general anesthesia. Anesth Analg. 2004;99:1253−7. Jee D, Park SY. Lidocaine sprayed down the endotracheal tube attennuates the airwaycirculatory reflexes by local anesthesia during emergence and extubation. Anesth Analg. 2003;96(1):293−7. Ki YM, Kim NS, Lim SH, Kong MH, Kim HZ. The effect of lidocaine spray before endotracheal intubation on the incidence of cough and hemodynamics during emergence in children. Korean J Anesthesiol .2007;53:1−6. Morgan EG, Mikhail MS, Murray MJ. Management airway. Dalam: Morgan EG, Mikhail MS, Murray MJ, penyunting. Clinical anesthesiology. Edisi ke-4. New York: McGraw-Hill;2006. Hlm. 91−116. Henderson J. Airway management in adult. Dalam: Miller RD, penyunting. Miller’s Anesthesia. Edisi ke-7. Philadelphia: Elsevier Churcill Livingstone; 2010. Hlm.1573−610. Karmarkar S, Varshney S. Tracheal extubation. Continuing education in anaesthesia, Crit are &amp; Pain 2008;8(6):214−20 Gonzalez RM, Bjerke RJ, Drobycki T. Prevention of endotracheal tube-induced coughing during emergence from general anesthesia. Anesth Analg. 1994;79:792−5. Diachun CD, Tunink BP, Brock-Utne JG. Suppression of cough during emergence from general anesthesia: laryngotracheal lidocaine through a modified endotracheal tube. J Clin Anesth 2001;13:447−57 Nishino T, Hiraga K, Sugimori K. Effects of intravena lignocaine on airway reflexes elicited by irritation of the tracheal mucosa in humans anesthetized with enflurane. Br J Anaesth. 1990;64:682−7. Hamaya Y, Dohi S. Differences in cardiovascular response to airway stimulation at different sites and blockade of responses by lidocaine. Anesthesiol.2000;93(1):95−103 Orandi AN, Hajimohammadi F. Post-Intubation Sore Throat and Menstrual Cycles. Anesth Pain. 2013;3(2):243−9. Liu J, Zhang X, Gong W, Li S, Wang F, FuS, dkk. Correlations between Controlled endotracheal tube pressure and postprocedural comploication: a multicenter study. Anesth Analg 2010;111;1133−7 Jaicbandran VV, Bhanulaksmi IM, Jagadeesh V. Intracuff buffered lidocaine versus saline or air-A comparati.v.e study for smooth extubation in patients with hyperactive airways undergoing eye surgery. SAJAA .2009;15(2):114 Navarro LHC, Lima RM, Aguiar AS, Braz JR, Carness JM, Modolo NS. The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers. Rev Assoc Med Bras. 2012;58(2):248−53. Canning BJ. Anatomy and neurophysiology of the cough reflex. Chest. 2006;129:Suppl:33−47. Widdicombe JG. A brief overview of the mechanisms of cough. Dalam: Chung KF, Widdicombe JG, Boushey HA, penyunting. Cough: Causes, mechanism and therapy. Massachusetts: Blackwell Publishing: 2003.hlm.17−25.
The Effect of General Anesthesia compared to Spinal Anesthesia for Caesarean Section on Neonatal APGAR Score christiana, monica; Bisri, Tatang
Majalah Anestesia dan Critical Care Vol 33 No 2 (2015): Juni
Publisher : Perdatin Pusat

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Abstract

For the last decades, Casearean delivery cases has increased significantly. The choice of anesthesia technique for surgical procedure consider its safety for both the mother and neonates. Neonatal APGAR scoring has been used as the parameter of neonate’s well being and success of obstetric anesthesia technique. Several previous studies have recommended the excellence of regional anesthesia compared to general one. This study was conducted to compare the effect of general anesthesia to spinal anesthesia on the APGAR score of the neonates. The objective of this study is to describe the general anesthesia and spinal anesthesia effect in Caesarean delivery on AGPAR score. Rertospective study of 64 parturient patients underwent elective Caesarean section from January to June 2015. Data were obtained from medical record of Melinda Mother and Child Hospital, Bandung. Subjects were distributed into 2 groups of 32 patients each. Group I underwent general anesthesia, while the other underwent spinal anesthesia. Parameter asessments were APGAR, blood pressure, pulse, and okxygen saturation. Data recoded were analized with t test and p&lt;0.05 considered as significant. First minute APGAR scores were recorded unsignificantly higher (p=0.326) in Group I (8.87± 0.33) compared to Group II (8.78± 0.42). However, fifth minute APGAR scores were significantly (p=0.000) better in Group II (9.75±0.46) compared to Group I (9.25±0.44). Spinal anesthesia technique in caesarean section procedure had a significantly better effect on neonatal APGAR score compared to genaral anesthesia.
Sakit Kepala yang dihubungkan dengan Cedera Otak Traumatik Bisri, Dewi Yulianti; Bisri, Tatang
Majalah Anestesia dan Critical Care Vol 32 No 2 (2014): Juni
Publisher : Perdatin Pusat

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Abstract

Sakit kepala adalah salah satu keluhan yang sering setelah cedera otak traumatik (COT) dan disebut sebagai “post-traumatic headache” sakit kepala pascatrauma. Berkisar 30–90% pasien mengalami sakit kepala setelah cedera. Sakit kepala setelah COT dapat berlangsung lama, datang dan hilang dalam waktu satu tahun, menyulitkan melakukan aktivitas sehari-hari, sulit berfikir dan mengingat sesuatu. Setelah cedera kepala berat, pasien mungkin mengalami sakit kepala akibat dari operasi pada tulang kepalanya atau masih adanya kumpulan kecil darah atau cairan di ruang intrakranial. Sakit kepala bisa setelah cedera kepala ringan, sedang dan berat. Sakit kepala ini dapat disebabkan berbagai kondisi antara lain perubahan dalam otak akibat cedera, cedera leher dan tulang kepala yang belum pulih seluruhnya, tegangan dan stres, atau efek samping pengobatan. Ada beberapa tipe sakit kepala antara lain sakit kepala tipe migraine, tension, cervicogenic, dan rebound. Terapi dapat dilakukan dengan merubah pola hidup misalnya harus cukup tidur, olah raga, hindari kopi, hindari makanan tertentu yang memicu sakit kepala seperti anggur (red wine), monosodium glutamat, keju dan terapi obat-obatan misalnya asetaminophen, gabapentin, antidepresant. Akan tetapi, lebih utama adalah pencegahan dengan cara menghindari cedera otak primer, dan apabila terjadi cedera otak primer sebaiknya menghindari dan mengobati cedera otak sekunder dengan pengelolaan perioperatif yang tepat. Kata kunci: Bedah saraf, cedera otak traumatik, neuroanestesi, sakit kepala Headache is one of the most common symptoms after traumatic brain injury (TBI) and called “post-traumatic headache”. Approximately 30–90% of people having headaches. Headaches after TBI can be long-lasting, coming and going even past one year. Headaches can make it hard for you to carry out daily activities or can cause you to have more difficulty thinking and remembering things. Right after a severe TBI, people may have headaches because of the surgery on their skulls or because they have small collections of blood or fluid inside the skull. Headaches can also occur after mild, moderate and severe TBI. These headaches can be caused by a variety of conditions, including a change in the brain caused by the injury, neck and skull injuries that have not yet fully healed, tension and stress, or side effects from medication.There are many kinds of headaches,migraine headaches, tension-type headaches, cervicogenic headaches, and rebound headaches. Treatment a headache after TBI will depend on each individual case. They are lifestyle changes like get enough sleep, get daily exercise, avoid caffeine, avoid certain foods that may trigger a headache, like red wine, monosodium glutamate or certain cheeses, and medicine therapy as acetaminophen, gabapentin, antidepresant. But, more important is prevention with avoid primary brain injury and avoid and treatment secondary brain injury with adequate periopeative management. Key words: headache, neuroanesthesia, neurosurgery, traumatic brain injury Reference Levin M, Ward TN. Headache. Dalam: Silver JM, McAllister TW, Yudofsky SC, penyunting. Textbook of traumatic brain injury. Edisi ke-2. Washington: American Psychiatric Pub Inc;2011,343–50. Lew HL, Lin PH, Fuh JL, Wang SJ, Clark DJ, Walker WC. Characteristics and treatment of headache after traumatic brain injury: A focused review. Am J Phys Med Rehabil 2006;85(7):619–27. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro C A. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med 2008;358(5):453–63. Mihalik JP, Stump JE. Collins MW, Lovell MR, Field M, Maroon JC. Posttraumatic migraine characteristics in athletes following sports-related cocussion. J Neurosurg 2005;102(5):850–55. Hofman JM, Lucas S, Dikmen S, Braden CA, Brown AW, Brunner R, dkk. Natural history of headache after traumatic brain injury. Journal of Neurotrauma 2011;28:1719–25. Walker WC, Seel RT, Curtiss G, Warde DL. Headache after moderate and severe traumatic brain injury: a longitudinal analysis. Arch Phys Med Rehabil 2005;86:1793–800. Sherman KB, Goldberg M, Bell KR. Traumatic brain injury and pain. Phys Med Rehabil Clin N Am. 2006;17:473–90. De Lima Martin HA, Ribas VR, Martins BBM, Ribas RMG, Valenca MM. Posttraumatic headache. Arq Neuropsiquiatr 2009;67(1):43–45. McAllister TW. Mild brain injury. Dalam: Silver JM, McAllister TW, Yudofsky SC, Penyunting. Textbook of traumatic brain injury. Edisi ke-2. Washington: American Psychiatric Pub Inc;2011. hlm. 239–57. Lew Hl, Lin Pri, Fuh JL, Wong SJ, Clark DJ, Walker WC. Characteristic and treatment of headache after traumatic Broun Injury: a focused review. Am J Phys Med Rehabil. 2006;85(7):619–27
Pengaruh Magnesium Sulfat Intravena terhadap Kebutuhan Fentanil dan Propofol Intraoperatif pada Pasien yang Dilakukan Histerektomi dengan Anestesi Umum Thayeb, Srilina; Bisri, Tatang; Oktaliansah, Ezra
Majalah Anestesia dan Critical Care Vol 32 No 3 (2014): Oktober
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Abstract

Pemberian adjuvan analgetik dan sedatif intraoperatif bisa mengurangi pemakaian fentanil dan propofol sehingga akan mengurangi efek samping. Magnesium sulfat (MgSO4) mempunyai efek analgetik dan sedatif dengan bekerja sebagai antagonis reseptor N-Methyl D-Aspartat (NMDA) dan menghambat saluran kalsium (Ca-channel blocker). Penelitian ini bertujuan untuk mengetahui efektivitas pemberian MgSO4 untuk mengurangi penggunaan fentanil dan propofol intraoperatif. Penelitian dilakukan di Central Operating Theatre (COT) Rumah Sakit Dr. Hasan Sadikin Bandung sejak bulan Agustus−Oktober 2013 dengan uji klinis acak tersamar ganda pada 58 pasien yang menjalani histerektomi dengan anestesi umum. Pasien dibagi dalam 2 kelompok, masing-masing 29 orang. Kelompok MgSO4 mendapatkan MgSO4 30 mg/kgBB sebelum induksi anestesi dilanjutkan 10 mg/kgBB/jam sampai akhir operasi. Kelompok kontrol mendapatkan NaCl 0,9% dengan jumlah yang sama. Anestesi yang adekuat dinilai dengan patient response to surgical stimulus (PRST) dan bispectral index (BIS). Data hasil penelitian diuji dengan uji-t dan Uji Mann-Whitney. Hasil penelitian didapatkan bahwa dengan pemberian MgSO4 untuk mempertahankan nilai BIS 40−60 dan PRST 2−4 menggunakan fentanil dan propofol yang lebih sedikit dibanding dengan kelompok kontrol, dengan pebedaan sangat bermakna (p&lt;0,01). Simpulan penelitian ini adalah pemakaian MgSO4 bisa mengurangi kebutuhan fentanil dan propofol intraoperatif. Kata kunci: Bispectral index, fentanil, propofol, patient response to surgical stimulus Administration of intraoperative analgetic adjuvant will reduce major fentanyl requirement dose, in consideration of increasing fentanyl dose denotes more side effects. Magnesium sulphate (MgSO4 )acts as NMDA receptor – antagonist and blocks calcium channel (Ca channel blocker) and give effect analgesia and anesthesia. The aim of this study is to understand effectiveness of magnesium sulphate administration to reduce fentanyl and propofol requirement intraoperative.This study was conducted with double blind randomized controlled trial method to 58 patients who underwent hysterectomy in general anesthesia and divided into two groups of 29 persons .The MgSO4 group was administered 30mg/kgBW MgSO4 intravenously before induction and 10 mg/kgBW during surgery. The NaCl group was administered NaCl 0,9% intravenous. In both groups, PRST and BIS was assessed. This test results in administration of magnesium sulphate to maintain BIS score 40−60 and PRST 2–4 could reduce dose fentanyl and propofol requirement dose the lower in magnesium group (p&lt;0,01). The Conclusion of this study is there is MgSO4 can reduce fentanyl and propofol intraoperatif. Key words: Bispectral index, fentanyl, propofol, patient response to surgical stimulus Reference Chin KJ, Yeo SW. Bispectral index values at sevoflurane concentrations of 1% and 1.5% in lower segment cesarean delivery. Anesth Analg. 2004;98:1140–4. Barbosa FT, Barbosa LT, Jucá MJ, Cunha RMd. Applications of magnesium sulfate in obstetrics and anesthesia. Rev Bras Anestesiol. 2010;60:481–97. Nurrochmad A, Masahiko O, Narita M, Suzuki T. The advantages of fentanyl for the treatment of pain: studies of pharmacological profiles and fentanyl related side effects. Majalah Farmasi Indonesia. 2004;15:185. Ray M, Bhattacharjee DH, Hajra B, Pal R, Chatterjee N. Effect of clonidine and magnesium sulphate on anaesthetic consumption, haemodynamics and postoprative recovery: a comparative study. Indian J Anaesth.2010;54:137–41. Kothari D, Mehrotra A, Choudhary B, Mehra A. Effect of intravenous magnesium sulfate and fentanyl citrate on circulatory changes during anaesthesia and surgery: a clinical study. Br J Anesth.2008;52:800–4. Na HS, Lee JH, Hwang JY, Ryu JH, Han SH, Jeon YT, dkk. Effect of magnesium sulphate on intraoperative neuromuscular blocking agent requrements and postoperative analgesia in children with cerebral palsy. Br J Anesth. 2010;104:344–50. Jee H, Lee D, Yun S, Lee C. Magnesium sulphate attenuates arterial pressure increase during laparoscopic cholecystectomy. Br J Anesth. 2009;103:484–9. Lee DH, Kwon IC. Magnesium sulphate has beneficial effects as an adjuvant during general anaesthesia for caesarean section. Br J Anesth.2009;103:861–6. Choi JC, Yoon KB, Um DJ, Kim C, Kim JS, Lee SG. Intravenous magnesium sulfate administration reduces propofol infusion requirements during maintenance of propofol–N2O anesthesia. Anesthesiology 2002;97:1137–41. Levaux CB, Dewandre PY. Effect of intraoperative magnesium sulphate on pain relief and patient comfort after major lumbar orthopedic surgery. Anaesthesia 2003;58:131–5. Širvinskas E, Laurinaitis R. Use of magnesium sulfate in anesthesiology. Medicina.2002;38:695. Dube LG, JC. The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review. Can J Anesth. 2003;50:732–46. Rao M. Acute postoperative pain. Indian JAnaesth 2006;50:340–4. Koinig H, Wallner T, Marhofer P, Andel H, Rauf KH, Mayer N. Magnesium sulfate reduces intra and postoperative analgesic requirements. Anesth Analg. 1998;87:206–10. Morgan JM, Murray MJ. Pain management. Dalam: Morgan JM, Murray MJ, penyunting. Clinical Anesthesiology. Edisi ke-4. New York: McGraw Hill Companies; 2006. Hlm.359–411. Seyhan TO, Tugrul M, Sungur MO, Kayachan S, Telci L, Pembeci K, dkk. Effect of three diffrent dose regimens of magnesium on propofol requirements, haemodynamic variables and postoperative pain relief in gynaecological surgery. Br J Anaesth. 2006;96:247–52.
Co-Authors , Rizki , Suwarman - Irwan, - A. Himendra Wargahadibrata A. Muthalib Nawawi Agus Junaidi Aini, Quratul Akbar, Ieva B Alifahna, Muhammad Rezanda Andie Muhari Barzah, Andie Muhari Ardi Zulfariansyah Arief Kurniawan Bambang Suryono, Bambang Christanto, Sandhi Christanto, Sandhi christiana, monica Dedi Fitri Yadi Dewi Yulianti Bisri Diana C. Lalenoh, Diana C. Diana Lalenoh Erias, Muhammad Erwin Pradian Ezra Oktaliansah Firdaus, Riyadh Firdaus, Riyadh Fithrah, Bona Akhmad Fithrah, Bona Akhmad Fitri Sepviyanti Sumardi Giovanni, Cindy Giovanni, Cindy Hamzah, Hanzah Hermawanto, Agung Hindun Saadah, Hindun Ida Bagus Krisna Jaya Sutawan Ieva B. Akbar Ike Sri Redjeki Indrayani, Ratih Rizki Iwan Abdul Rachman Iwan Fuadi Jasa, Zafrullah Khany Kusuma Harimin, Kusuma Laksono, Buyung Hartiyo Lalenoh, Diana Christine Lalenoh, Diana Christine Limawan, Michaela Arshanty M. Dwi Satriyanto M. Erias Erlangga, M. Erias M. Sofyan Harahap Mariko Gunadi Martinus, Fardian Martinus, Fardian MM Rudi Prihatno, MM Rudi Muh. Rumli Ahmad Muhamad Adli Boesoirie, Muhamad Adli Muhammad Habibi Ningsih, Diana Fitria Ningsih, Diana Fitria Noer Rochmah, Elly Nugraha, Ade Aria Nugraha, Ade Aria Nuryanda, Dian Oetoro, Bambang J. Oetoro, Bambang J. Okatria, Ahmado Pontjosudargo, Fransiska Ambarukmi Priyadi, Hendri Putri, Andika C. Putu Pramana Suarjaya Radian Ahmad Halimi Rahmadsyah, Teuku Rahordjo, Sri Rasman, Marsudi Rasman, Marsudi Reza Widianto Sudjud Rose Mafiana Rovina Ruslami, Rovina Ruby Satria Nugraha Ruli Herman Sitanggang Saleh, Siti Chasnak Saleh, Siti Chasnak Saputra, Tengku Addi Saputra, Tengku Addi SATRIYAS ILYAS Septiani, Gusti Ayu Pitria Soefviana, Stefi Berlian Sri Rahardjo Stella, Angela Subekti, Bambang Eko Subekti, Bambang Eko Suryaningrat, IGB Susanto, Bahtiar Sutanto, Sigit Sutanto, Sigit Suwarman Suwarman, Suwarman Suwarman, S Suwarman, S Syafruddin Gaus Thayeb, Srilina Theresia C. Sipahutar Theresia Monica Rahardjo Uhud, Akhyar Nur Widiastuti, Monika - Wirawijaya, Dear Mohtar Wirawijaya, Dear Mohtar Wirawijaya Wullur, Caroline Wullur, Caroline Yunita Susanto Putri Zaka Anwary, Army