Dadang Mulyawan
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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

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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.