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PERBANDINGAN PEMBERIAN DEXAMETHASONE 10 MG INTRAVENA DAN LIDOCAINE SPRAY PADA TINGKAT KENYAMANAN PASCA INTUBASI ENDOTRACHEAL TUBE DI RSUD ARIFIN ACHMAD PROVINSI RIAU Dino Irawan; Nopian Hidayat
Jurnal Kedokteran Syiah Kuala Vol 19, No 2 (2019): Volume 19 Nomor 2 Agustus 2019
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jks.v19i2.18064

Abstract

Abstrak. Penelitian ini berjudul perbandingan tingkat kenyamanan pasca pembiusan umum dengan endotracheal tube antara pemberian dexametasone intravena dan lidocaine spray di RSUD Arifin Achmad Provinsi  Riau. Tingkat kenyamanan berupa nyeri tenggorok pada pasien yang menjalani pembiusan umum dengan intubasi endotrakeal dapat dipengaruhi oleh beberapa hal yaitu obat-obatan yang diberikan, teknik insersi, tekanan cuff dan manajemen setelah insersi.Nyeri tenggorok pada pasien yang menjalani anestesi umum dengan intubasi endotrakeal pada umumnya tidak berakibat fatal dan akan menghilang dalam 48-72 jam setelah operasi tetapi hal ini dapat menyebabkan gangguan yang cukup berarti bagi pasien, menambah lama dan biaya rawatan pasien di rumah sakit serta meninggalkan kesan buruk terhadap operasi. Penelitian ini menggunakan pendekatan randomized clinical controlled trial dengan rancangan eksperimental yang dilakukan pada 104 pasien yang menjalani anestesi umum dengan endotrakeal tube di RSUD Arifin Achmad Provinsi Riau pada bulan September-Oktober 2019. Pada hasil penelitian didapatkan bahwa pemberian dexametasone intravena sebelum tindakan intubasi endotrakeal lebih efektif dalam mencegah nyeri tenggorok pasca operasi dibandingkan lidocaine spray (19.2% untuk Dexametasone intravena dan 29.8% pada Lidocaine spray). Secara statistik, perbedaan kejadian nyeri tenggorok antara kelompok Dexametasone intravena dan Lidocaine spray adalah bermakna pada skoring 1 jam post operasi (p 0.05) dan tidak bermakna pada skoring 24 jam post operasi (p0.05). Insidensi nyeri tenggorok terbanyak berdasarkan usia adalah pada kelompok usia 46-55 tahun dan 55-65 tahun, berdasarkan jenis kelamin adalah lebih banyak pada perempuan dibandingkan laki-laki, dan lebih banyak pada pasien yang mempunyai riwayat merokok. Kata kunci: nyeri tenggorok, dexametasone intravena, lidocaine spray, RSUD Arifin Achmad Provinsi Riau Abstract. This study is about the comparison of the level of comfort after general anesthesia with an endotracheal tube between administration of intravenous dexametasone and lidocaine spray in Arifin Achmad General Hospital of Riau Province. The level of comfort in the form of sore throat in patients undergoing general anesthesia with endotracheal intubation can be influenced by several things such as administration of drugs, insertion techniques, cuff pressure and management after insertion. Sore throat in patients undergoing general anesthesia with endotracheal intubation is generally not fatal and will disappear within 48-72 hours after surgery but this can cause significant disruption to the patient, increase the length and cost of patient care in the hospital and leave bad impression from surgery. This study is a randomized clinical controlled trial with an experimental design conducted on 104 patients undergoing general anesthesia with endotracheal tube at Arifin Achmad General Hospital in Riau Province in September-October 2019. The study found that administration of intravenous dexametasone before endotracheal intubation is more effective in preventing postoperative sore throat compared to lidocaine spray (19.2% for intravenous Dexametasone and 29.8% in Lidocaine spray). Statistically, the difference in the incidence of sore throat between the intravenous Dexametasone group and Lidocaine spray was significant at 1 hour postoperative scoring (p 0.05) and not significant at 24 hour postoperative scoring (p 0.05). The highest incidence of sore throat by age is in the age group 46-55 years and 56-65 years, more frequent in women than men, and more frequent in patients who have a history of smoking. Keywords: sore throat, intravenous dexametasone, lidocaine spray, Arifin Achmad General Hospital Riau Province
Anestesia Spinal Dosis Rendah untuk Seksio Sesarea pada Pasien Mitral Stenosis Berat Nopian Hidayat; Yusmein Uyun; Dewi Yulianti Bisri
Jurnal Anestesi Obstetri Indonesia Vol 2 No 2 (2019): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i2.14

Abstract

Penyakit jantung pada kehamilan meningkatkan angka morbiditas dan mortalitas ibu dan janin. Mitral stenosis adalah lesi katup jantung yang paling sering didapatkan pada wanita hamil dan hampir selalu disebabkan oleh penyakit jantung rematik. Perubahan fisiologis yang terjadi selama kehamilan dan periode peripartum dapat memperburuk gejala dan derajat penyakit jantung. Akibatnya, banyak wanita pertama kali didiagnosis penyakit jantung selama kehamilan. Seorang wanita berusia 24 tahun gravida 32–33 minggu dengan kongesti gagal jantung fungsional kelas III, mitral stenosis berat, ejection fraction (EF) 59%, regurgitasi trikuspid sedang, dan dilatasi atrium kiri menjalani seksio sesarea dengan anestesi spinal dosis rendah menggunakan bupivakaine 0,5% hiperbarik 7,5 mg ditambah fentanyl 50 mcg secara intratekal. Blok sensoris dicapai setinggi torakal 6 dalam waktu 4 menit 20 detik. Hemodinamik pasien stabil selama operasi maupun pasca operasi. Tidak diperlukan pemberian vasopresor. Pasca operasi pasien dirawat di intensive care unit (ICU) selama 3 hari dengan hemodinamik yang stabil. Laporan ini menyoroti bahwa anestesi spinal dosis rendah dapat menjadi pilihan yang baik dalam manajemen anestesi untuk seksio sesarea yang disertai dengan mitral stenosis berat. Low Dose Spinal Anesthesia for Cesarean Section with Severe Mitral Stenosis Abstract Heart disease in pregnancy increases maternal and fetal morbidity and mortality. Mitral stenosis is the most common heart valve lesion in parturient and is almost always caused by rheumatic heart disease. Physiological changes that occur during pregnancy and the peripartum period can worsen symptoms and the degree of the heart disease. As a result, many women are first diagnosed with heart disease during pregnancy. Twenty four year old woman gravida 32–33 weeks with congestive heart failure class III, severe mitral stenosis, EF 59%, moderate tricuspid regurgitation, and left atrial dilatation undergoing cesarean section with low-dose spinal anesthesia using bupivacaine 0,5% hyperbaric 7.5 mg plus fentanyl 50 mcg intrathecally. Sensory blocks were reached as high as thoracic 6th in 4 minutes and 20 seconds. The patient's hemodynamics are stable during both surgery and post surgery. Vasopressors were not needed. After surgery the patient was transferred to ICU for 3 days with stable hemodynamics. This report highlights that low-dose spinal anesthesia can be a good choice in the management of anesthesia for cesarean section accompanied by severe mitral stenosis.
Perbandingan Tingkat Kenyamanan Pasca Pembiusan Umum dengan LMA Classic dan LMA Proseal di RSUD Arifin Achmad Provinsi Riau Dino Irawan; Nopian Hidayat
Jurnal Ilmu Kedokteran Vol 18, No 1 (2024): Jurnal Ilmu Kedokteran
Publisher : Fakultas Kedokteran Universitas Riau

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26891/JIK.v18i1.2024.56-63

Abstract

Airway management during general anesthesia can be done using a triple airway maneuver or the installation of devices such as a face mask, laryngeal mask airway (LMA), and endotracheal tube/ETT. There are various types of LMA, namely classic, proseal, supreme, and various other types. Throat pain is the most common intubation complication experienced by patients after anesthesia. The incidence of throat pain can be influenced by several things, one of which is the choice of type of LMA used. This study uses an experimental design and is a randomized controlled trial. In September and October of 2019, this study was carried out at the Arifin Achmad Hospital in the Province of Riau. Patients who received LMA intubation along with general anesthesia in September and October 2019 at Arifin Ahmad Hospital comprised the research population. The findings indicated that throat pain was more common in 14 individuals (17.5%) treated with LMA Classic than in 12 patients (15%) treated with LMA Proseal. The age groups 46–55 and 55–65 have the highest incidence of throat pain, which is also more common in women, patients with a history of smoking, and patients who have been intubated for longer than an hour.