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All Journal Jurnal Anestesi Perioperatif The Journal of Society Medicine (JSOCMED)
Dadang Mulyawan
Instalasi Bedah Sentral Rumah Sakit Umum Daerah Cianjur,
Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1218.698 KB)

Abstract

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
Management of Peripartum Cardiomyopathy in Severe Preeclampsia Patients in ICU Mulyawan, Dadang; Pison, Osmond M.
Journal of Society Medicine Vol. 3 No. 2 (2024): February
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i2.127

Abstract

Introduction: Peripartum cardiomyopathy (PPCM) is a life-threatening cardiomyopathy with left ventricular systolic dysfunction, in late pregnancy, during delivery, or in the first months postpartum, in women who have no previously identifiable cause of heart failure. Case: A 25-year-old primigravida woman with a pregnancy of 35 weeks came to the Emergency Department (ER) with symptom of severe pre eclampsia, and pulmonary edema and later underwent a cesarean section. After surgery, the patient is admitted to the ICU , and then became worsening. Echocardiography was then performed and found a decrease in left ventricular systolic function, EF 35%, posterior anterior acinetics, mild MR. The diagnosis of PPCM was established. The therapy given is drugs and a negative fluid balance is created for this patient. On day 10, the patient showed improvement in left ventricular function with EF 48%. The patient is extubated from a mechanical ventilator and moved to the internal medicine inpatient room. Conclusion: I Early diagnosis with supporting echocardiography as well as appropriate management in PPCM cases greatly determines the success of therapy in patients in the ICU.
Perbandingan Nilai Diskriminasi Modified NUTRIC Score dan Skor APACHE II Terhadap Mortalitas 28 Hari Pada Pasien Sepsis Yang Dirawat Di ICU Mulyawan, Dadang; Pradian, Erwin; Zulfariansyah, Ardi
Jurnal Anestesi Perioperatif Vol 14, No 1 (2026)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v14n1.4027

Abstract

Introduction: Sepsis with malnutrition increases complications and mortality in ICU patients. The modified Nutrition Risk in Critically Ill (mNUTRIC) score assesses nutritional risk and predicts mortality, whereas APACHE II does not account for nutritional status. This study compared mNUTRIC and APACHE II for predicting 28–day mortality in ICU patients with sepsis. Methods: This prospective observational study was conducted from February to April 2024. Sepsis patients admitted during the study period were included. Discriminatory performance for predicting 28–day mortality was evaluated using the area under the receiver operating characteristic curve (AUROC). Comparison between scoring systems was performed using DeLong’s non–parametric test.Results: A total of 39 ICU patients were included. The mean mNUTRIC score was 4.44±2.23, and the mean APACHE II score was 17.59±5.28. The AUROC value was 0.825 for the mNUTRIC score and 0.789 for the APACHE II score. DeLong’s test showed that the mNUTRIC score had significantly better discrimination for predicting 28–day mortality than the APACHE II score (p=0.011).Discussion: mNUTRIC integrates nutritional and chronic health factors, capturing patients’ physiological reserve more comprehensively than APACHE II. Early identification of high–risk patients may guide targeted interventions and ICU resource allocation.Conclusion: The mNUTRIC score demonstrated superior discriminatory ability compared to the APACHE II score in predicting mortality among sepsis patients in the ICU. Incorporating nutritional risk assessment may improve mortality prediction and clinical decision–making in critically ill sepsis patients.
Co-Authors Ardi Zulfariansyah Erwin Pradian Pison, Osmond M. Ruli Herman Sitanggang Suwarman Suwarman