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Abdul Muthalib Nawawi
Departemen Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung
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Pemberian Strepsils® Sebagai Lozenge Praoperasi untuk Mengurangi Nyeri Tenggorok Pascaintubasi Pipa Endotrakeal Priyonggo, Reko; Suwarman, -; Nawawi, Abdul Muthalib
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Nyeri tenggorok pascaoperasi atau post operative sore throat (POST) terjadi karena iritasi dan inflamasi lokal di daerah faring, laring, dan trakea akibat trauma pemasangan pipa endotrakeal. Penelitian ini bertujuan mengetahui efek tablet hisap Strepsils® untuk mengurangi POST pada pasien yang dilakukan anestesi umum dengan intubasi pipa endotrakeal. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan Oktober–November 2013, terhadap 66 pasien status fisik American Society of Anesthesiologist (ASA) I–II secara prospektif single blind randomized controlled trial. Pasien dibagi menjadi dua kelompok, yaitu kelompok I, sebanyak 33 orang mendapatkan Strepsils® dan kelompok II, sebanyak 33 orang mendapatkan plasebo. Pasien diminta untuk mengulum permen sebelum induksi. Data dianalisis dengan uji-t, uji chi-kuadrat, dan Uji Mann-Whitney. Keluhan POST lebih banyak terjadi pada kelompok II dibandingkan dengan kelompok I. Secara statistik pada T0 didapatkan hasil perbedaan yang bermakna (p<0,05). Pada kelompok II, POST dengan skor 1 sebesar 14 (42%) kasus, dibandingkan dengan kelompok I sebesar 3 (9%) kasus dan tidak ada skor 2. Pada T2 didapatkan hasil perbedaan bermakna (p<0,05), POST sebesar 11 (33%) pada kelompok II, sedangkan kelompok I didapatkan 2(6%) kasus. Pada T4 didapatkan perbedaan tidak bermakna (p>0,05), POST pada kelompok II sebesar 3 (9%) kasus, sedangkan kelompok I skor 1 sebesar 1 (3%) kasus. Simpulan, pemberian Strepsils® praoperasi dengan anestesi umum mengurangi kejadian dan derajat POST.Kata kunci: Analgetik, antiinflamasi, Strepsils®, post operative sore throat Strepsils® as Pre-operative Lozenge to Attenuate Post-endotracheal Tube Intubation Related Sore Throat AbstractPost- operative sore throat (POST) is caused by local inflammation and irritation at pharynx and larynx due to traumatic endotracheal tube installation. Sixty six patients, ASA I–II, who underwent elective surgery under general anesthesia and installation of endotracheal tube were enrolled in this single blind randomized controlled trial. Patients were randomly allocated into two groups of 33 subjects: receiving Lozenge and receiving placebo. Designated as Group I (Strepsils®  group) and Group II (Placebo group). Patients were asked to suck the candy slowly in the mouth before the induction of anesthesia.  Data were analyzed with t-test, Chi-square test and Mann-Whitney test using SPSS ver. 13 program for Windows. The results were POST 9.1% and 42.4% at T0, 6.1% and 33.3% at T2 for Strepsils®  and Placebo groups, respectively, which were statistically significant (p<0.05). In T4 and T24, non-significant differences were found (p>0.05). In conclusion, dissolving Strepsils® slowly in the mouth before induction of anesthesia pre-operatively reduces POST following general anesthesia.Key words: Analgetic, antiinflammatory, Strepsils®, post operative sore throat DOI: 10.15851/jap.v2n3.334
Perbandingan Pengaruh Nifedipin 20 mg per Oral 2 Jam Preoperasi dengan Plasebo terhadap Suhu Inti pada Pasien yang Menjalani Operasi Modified Radical Mastectomy dengan Anestesi Umum Trisnadi, Saleh; Suwarman, -; Nawawi, Abdul Muthalib
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Upaya pencegahan hipotermia dapat dilakukan dengan mengurangi perbedaan antara suhu inti dan perifer sebelum dilakukan pembedahan dengan pemberian vasodilator. Tujuan penelitian ini untuk mengetahui efek penggunaan antara nifedipin 20 mg dan plasebo per oral 2 jam preoperasi selama operasi modifikasi mastektomi radikal terhadap penurunan suhu tubuh. Penelitian  menggunakan metode prospektif, terkontrol, tersamar, buta ganda pada 30 pasien berusia 18–60 tahun, status fisik American Society Of Anesthesiologist (ASA) I dan II, yang menjalani operasi modifikasi mastektomi radikal di Rumah Sakit Dr. Hasan Sadikin Bandung pada Juni sampai Agustus 2012. Secara acak dibagi menjadi 2 kelompok, yaitu kelompok yang mendapat nifedipin 20 mg per oral 2 jam preoperasi dengan plasebo. Dilakukan pencatatan suhu timpani setiap 10 menit dari awal induksi hingga akhir anestesi. Data hasil penelitian diuji secara statistik dengan Uji Mann-Whitney. Suhu inti rata-rata pada kelompok nifedipin adalah 36,37 oC lebih besar dibandingkan dengan kelompok kontrol yaitu 35,61 oC dengan perbedaan bermakna (p<0,05). Simpulan penelitian ini menunjukkan bahwa penggunaan obat nifedipin dapat mencegah hipotermia selama operasi dibandingkan dengan plasebo (kontrol).Kata kunci: Nifedipin, suhu inti tubuh, vasodilatorEffect of 20 mg Nifedipine Orally 2 Hours Before the Operation on Core Temperature in Patients Undergoing Modified Radical Mastectomy Surgery with General AnesthesiaStrategy of prevention the initial redistribution hypothermia is based on the reduction of the heat gradient between the core and perifer before surgery by administering vasodilators. The purpose of this study was to asses the effect of oral nifedipine 20 mg 2 hours before anesthesia in preventing hypothermia in patients undergoing modified radical mastectomy under general anesthesia and to compare the decreased rate of body temperature oral nifedipine with placebo. The research was done with the prospective method, randomized double-blind controlled study in 30 patients aged 18–60 yrs, American Society of Anesthesiologist (ASA) physical status I-II, underwent modified radical mastectomy surgery, were randomly divided into two groups at Dr. Hasan Sadikin General Hospital Bandung during June until August 2012. One group was given oral nifedipine 20 mg 2 hours before general anesthesia and the other group was given placebo. Tymphani temperature was recorded during anesthesia every 10 minutes. Research data was tested statistically by the Mann-Whitney test. The average core temperature in the nifedipine was 36.37 ° C which was higher than the control group 35.61 ° C (p<0.05). It can be concluded that the use of nifedipine can prevent intraoperative hypothermia.Key words: Core temperature, nifedipine, vasodilator DOI: 10.15851/jap.v2n2.306
Perbandingan Penambahan PePerbandingan Penambahan Petidin 0,25 mg/kgBB dengan Klonidin 1 µg/kgBB pada Bupivakain 0,25% untuk Blok Infraorbital pada Labioplasti Anak terhadap Lama Analgesia Pascaoperasi Ramadani, Dewi; Fuadi, Iwan; Nawawi, Abdul Muthalib
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Nyeri pascalabioplasti dapat dicegah dengan blok infraorbital bilateral. Penelitian bertujuan membandingkan lama analgesi blok infraorbital pascalabioplasti anak antara penambahan petidin 0,25 mg/kgBB dan klonidin 1 µg/kgBB pada bupivakain 0,25% menggunakan skala nyeri skor face, leg, activity, cry, consolability (FLACC). Penelitian prospektif, uji klinis acak terkontrol tersamar tunggal dilakukan bulan Maret–September 2013 pada 30 pasien status fisik American Society of Anesthesiologist (ASA) II, usia 3 bulan–1 tahun yang menjalani labioplasti dengan blok infraorbital bilateral di Rumah Sakit Dr. Hasan Sadikin Bandung. Subjek dibagi dua kelompok, masing-masing 15 orang. Kelompok BP menerima blok infraorbital dengan adjuvan petidin dan kelompok BK dengan klonidin. Setelah induksi anestesi, dilakukan blok infraorbital sebanyak 1 mL pada tiap sisi wajah. Analisis data dengan uji t menunjukkan perbedaan lama analgesi pascaoperasi yang sangat bermakna (p<0,01) antara kelompok BP (1.828 menit) dan kelompok BK (1.072 menit). Simpulan penelitian ini adalah penambahan petidin 0,25 mg/kgBB pada bupivakain 0,25% untuk blok infraorbital labioplasti anak memberikan analgesi pascaoperasi lebih lama dibandingkan dengan klonidin 1 µg/kgBB. Kata kunci: Blok infraorbital, bupivakain, klonidin, labioplasti, petidinComparison Addition of  Pethidine 0.25 mg/kgBW  with Clonidine 1 µg/kgBW in Bupivacaine 0.25%  to Infraorbital Block in Paediatric Labioplasty for Duration Post Operative Analgesia Post operative pain for labioplasty can be prevented by bilateral infraorbital block. This study aimed to compare the effectiveness addition of pethidine 0.25 mg/kgBW and clonidine 1 µg/kgBW to bupivacaine 0.25%  for postoperative analgesia using infraorbital block in paediatric labioplasty with a pain scale score face, leg, activity, cry, consolability (FLACC). The study was a single-blind randomized controlled trial from March to September 2013 involving  30 pediatric patients, physical status American Society of Anesthesiologist (ASA) II, ages 3 months–1 year for labioplasty surgery with bilateral infraorbital block  at  Dr. Hasan Sadikin Hospital  Bandung. Subjects were grouped into two groups: 15 subjects using adjuvant pethidine 0.25 mg/kgBW (BP) and 15 subjects using adjuvant clonidine 1 ug/kgBW (BK). After induction of anesthesia, infraorbital block done 1 mL on each side of the face. Data were analyzed by t test, showed a highly significant difference (p<0.01) in BP group compared with BK, the average length of postoperative analgesia 1.828 minutes (30 hours) vs 1072 minutes (18 hours). The conclusions is the addition of pethidine 0.25 mg/kgBW in bupivacaine 0.25%  to infraorbital block in paediatric labioplasty provide postoperative analgesia longer than of clonidine 1 µg/kgBW.Key words: Bupivacaine, clonidine, infraorbital block, labioplasty, pethidine DOI: 10.15851/jap.v2n2.302
Letak Conus Medularis terhadap Vertebra Menggunakan Hasil Pencitraan Magnetic Resonance Imaging di Rumah Sakit Dr. Hasan Sadikin Bandung untuk Anestesi Spinal Nurfitriani, -; Nawawi, Abdul Muthalib; Yadi, Dedi Fitri; Anwary, Farhan
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kepentingan dari conus medularis bagi dokter spesialis anestesi adalah saat dilakukan tindakan anestesi spinal yang memiliki risiko terjadi trauma medula spinalis yang serius. Conus medularis dapat diidentifikasi melalui hasil pencitraan magnetic resonance imaging (MRI). Penelitian yang dilakukan sekarang bertujuan untuk mengetahui distribusi letak ujung conus medularis pada orang Indonesia secara observasional deskriptif dengan menggunakan hasil pencitraan magnetic resonance imaging (MRI) lumbosakral. Penelitian dilakukan melalui pemeriksaan terhadap letak ujung conus medularis secara retrospektif pada 135 hasil pencitraan MRI pasien usia 18–65 tahun dari bulan Januari 2013 hingga Maret 2014 di Departemen Radiologi Rumah Sakit Dr. Hasan Sadikin Bandung. Dari penelitian ini didapatkan letak ujung conus medularis paling banyak berada setinggi sepertiga tengah L1, dengan rentang mulai dari setinggi sepertiga tengah T12 hingga sepertiga bawah L2. Berdasarkan parameter jenis kelamin didapatkan distribusi letak conus medularis pada perempuan cenderung lebih kaudal dibandingkan dengan laki-laki.Kata kunci: Conus medularis, magnetic resonance imaging, orang IndonesiaDetermination of Conus Medullaris Position within the Vertebra using Magnetic Resonance Imaging in Dr. Hasan Sadikin General Hospital Bandung for Spinal Anesthesia PurposeAbstractThe position of conus medullaris is important to be identified by anesthesiologists during spinal anesthesia to avoid serious spinal cord trauma risk. Conus medullaris can be accurately identified through magnetic resonance imaging (MRI) images. The aim of this study was to determine the distribution of conus medullaris in Indonesians through a descriptive observation using magnetic resonance imaging (MRI) images of lumbosacral. The locations of conus medullaris were observed retrospectively on 135 MRI images scanned, aged 18–65 years, during the period of January 2013 to March 2014 at the Departement of Radiology, Dr. Hasan Sadikin General Hospital Bandung. From this study, it was revealed that the conus medullaris are mostly located at the middle third of L1, ranging from the middle third of T12 to the lower third of L2. With gender as a parameter, it was shown that the distribution of conus medullaris in women tends  to be more caudal than in men.Key words: Conus medullaris, Indonesian, magnetic resonance imaging DOI: 10.15851/jap.v2n3.333
Perbandingan Penggunaan Topikal Spray Benzidamin HCl 0,15% dan Gel Lidokain 2% pada Pipa Endotrakeal terhadap Kejadian Nyeri Tenggorok Pascaintubasi Endotrakeal Muhammad, Maulana; Fuadi, Iwan; Nawawi, Abdul Muthalib
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Nyeri tenggorok setelah operasi sering terjadi dan merupakan hal yang tidak menyenangkan setelah tindakan anestesia dengan intubasi endotrakeal. Penelitian ini dilakukan untuk mengetahui apakah penggunaan benzidamin HCl 0,15% lebih menurunkan angka kejadian nyeri tenggorok dibanding dengan lidokain gel 2% pada pasien pascaintubasi endotrakeal. Penelitian eksperimental secara randomized control trial (RCT) dilakukan pada 90 pasien dengan status fisik American Society of Anesthesiologists (ASA) I–II, usia 18–60 tahun yang menjalani operasi elektif di ruang operasi bedah sentral Rumah Sakit Dr. Hasan Sadikin Bandung pada Juni–Agustus 2014. Pasien dibagi dalam kelompok benzidamin, kelompok lidokain, dan kelompok NaCl. Selama operasi dicatat perubahan hemodinamik, tekanan balon pipa endotrakeal dipertahankan di bawah 25 mmHg, dinilai skala nyeri tenggorok pada 2 jam, 6 jam, dan 24 jam (T2, T6, T24) setelah operasi dan dilakukan uji statistik dengan uji-t, Uji Kruskal-Wallis, chi-kuadrat. Dari hasil penelitian didapatkan angka kejadian nyeri tenggorok kelompok benzidamin lebih rendah dibanding dengan kelompok lidokain pada 6 jam setelah operasi (T6) dengan perbedaan yang bermakna (p<0,05). Simpulan penelitian ini menunjukkan spray benzidamin Hcl0,15% mampu mengurangi angka kejadian nyeri tenggorok pasca-anestesia endotrakeal dibanding dengan lidokain gel 2%.Kata kunci:  Anti-inflamasi, benzidamin HCl, lidokain gel, nyeri tenggorok pascaintubasiEffectiveness of Benzydamine HCl 0.15% Spray and Lidocaine 2% Gel on Post-operative Sore Throat IncidencePostoperative sore throat is common and unpleasant after endotracheal anesthesia. This study was conducted to determine whether the use of benzydamine hcl 0.15% can further reduce the incidence of sore throat compared to lidocaine gel 2% in patients under endotracheal anesthesia. This experimental study was a randomized control trial (RCT) in 90 patients with ASA physical status I–II, aged 18–60 years who underwent elective surgery in the central surgical operating room of Dr. Hasan Sadikin General Hospital during the period of June to August 2014. Patients were divided in benzydamine group, lidocaine group, and NaCl group. The hemodynamic changes were noted during surgery. The endotracheal tube cuff pressure was maintained below 25 mmHg and a graded scale for sore throat was performed at 2 hours, 6 hours, and 24 hours (T2, T6, T24) after surgery. Statistical tests using t-test, Kruskal-Wallis, and chi-square test were conducted. From the results, the incidence of sore throat in the benzydamine HCL group was significantly lower than in the lidoccaine HCL  group at 6 hours after surgery (T6; p<0.05). It is concluded that benzydamin HCL  0.15% spray is able to reduce the incidence of postoperative sore throat when compared to lidocaine 2% gel.Key words: Anti-inflammation, benzydamine HCL, lidocaine HCL , postoperative sore throat DOI: 10.15851/jap.v3n2.579
Co-Authors - Nurfitriani Dedi Fitri Yadi Dewi Ramadani Farhan Anwary Iwan Fuadi Maulana Muhammad, Maulana Reko Priyonggo Saleh Trisnadi Suwarman Suwarman