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All Journal Jurnal Ilmu Kedokteran (Journal of Medical Science) Jurnal Anestesi Perioperatif Althea Medical Journal E-Journal Widya Kesehatan dan Lingkungan Majalah Anestesia dan Critical Care Jurnal Neuroanestesi Indonesia Majalah Anestesia & Critical Care (MACC) The Journal of Society Medicine (JSOCMED) Jurnal Komplikasi Anestesi
Ezra Oktaliansah
Departemen Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung
Biochemistry, Genetics & Molecular Biology Dentistry Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Perbandingan Waktu Induksi, Perubahan Tekanan Darah, dan Pulih Sadar antara Total Intravenous Anesthesia Profopol Target Controlled Infusion dan Manual Controlled Infusion Simanjuntak, Vick Elmore; Oktaliansah, Ezra; Redjeki, Ike Sri
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Target controlled infusion (TCI) memberikan kemudahan bagi dokter anestesi dalam pelaksanaan total intravenous anesthesia (TIVA). Penelitian ini bertujuan untuk membandingkan waktu induksi, perubahan tekanan darah, dan waktu pulih sadar antara TIVA propofol TCI dan manual controlled infusion (MCI) pada ekstirpasi fibroadenoma payudara. Penelitian dilakukan terhadap 32 wanita (18–40 tahun), status fisik ASA I, yang menjalani operasi ekstirpasi fibroadenoma payudara di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Juli–September 2012, secara uji acak terkontrol buta tunggal dalam anestesi umum. Subjek dibagi menjadi dua kelompok yaitu 16 orang dilakukan anestesi umum dengan TIVA propofol TCI dan 16 orang dengan TIVA propofol MCI. Waktu induksi TCI (61,44 detik) lebih singkat daripada MCI (78,5 detik) dan perubahan tekanan darah pada TCI (15,6 %) lebih kecil daripada MCI (24,1%). Tidak berbeda bermakna (p>0,05) dalam hal waktu pulih sadar pada kedua kelompok (TCI 8,95 menit dan MCI 9,90 menit). Simpulan, TIVA propofol TCI memberikan waktu induksi yang lebih singkat dan perubahan tekanan darah yang lebih kecil bila dibandingkan dengan TIVA MCI, namun tidak didapatkan perbedaan dalam hal waktu pulih sadar.Kata kunci: Manual controlled infusion target controlled infusion, waktu induksi, waktu pulih sadar Comparison of Induction Time, Changes in Blood Pressure, and Emergence between Target Controlled Infusion and Manual Controlled Infusion of Propofol Total Intravenous AnesthesiaAbstractTarget controlled infusion (TCI) offers anesthesiologists an easier way to conduct total intravenous anesthesia (TIVA). This study was done to compare the induction time, blood pressure and recovery time between propofol TIVA with TCI and the manual controlled infusion (MCI) in patients undergoing breast fibroadenoma extirpation. This study was done on 32 women (aged 18–40 years old), ASA I physical status, who underwent breast fibroadenoma extirpation in Dr. Hasan Sadikin Hospital Bandung within July–September 2012, by single blind randomized controlled trial in general anesthesia. Subjects were allocated into 2 groups, the TCI and MCI group, each consisted of 16 women. TCI’s induction time (61.44 seconds) were much shorter compared to MCI (78.5 seconds) and the blood pressure changes, TCI (15.6%) showed smaller changes compared to MCI (24.1%). There were no significant difference (p>0.05) in the recovery time in both groups (TCI 8.95 minutes and MCI 9.90 minutes). In conclusion, propofol TIVA with TCI showed a shorter induction time and less blood pressure changes compared to MCI, but there was no significant difference in recovery time. The adverse effect of postoperative nausea and vomitting did not occur in both groups.Keywords: blood pressure changes, induction time, manual controlled infusion, recovery time DOI: 10.15851/jap.v1n3.194
Pengaruh Penambahan Petidin 0,25 mg/kgBB pada Bupivakain 0,25% untuk Blok Infraorbital terhadap Lama Analgesia Pascabedah pada Operasi Labioplasti Anak Ritonga, Anthon Vermana; Sitanggang, Ruli Herman; Oktaliansah, Ezra
Jurnal Anestesi Perioperatif Vol 1, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Nyeri pascabedah labioplasti dapat dicegah dengan regional blok infraorbital bilateral. Bupivakain 0,25% biasa digunakan untuk blok infraorbital dan penambahan petidin akan memperpanjang lama kerjanya. Penelitian telah dilakukan dengan uji klinis acak terkontrol tersamar tunggal terhadap 40 pasien ASA II usia 3 bulan–1 tahun yang menjalani operasi labioplasti di ruang operasi bedah sentral Rumah Sakit Dr. Hasan Sadikin Bandung pada Maret–Mei 2012. Setelah randomisasi secara blok permutasi, subjek dikelompokkan >menjadi dua, yaitu 20 subjek menggunakan bupivakain 0,25% 1 mL pada tiap sisi (kelompok B) dan 20 subjek menggunakan kombinasi bupivakain 0,25% dan petidin 0,25 mg/kgBB 1 mL pada tiap sisi (kelompok >BP) yang diberikan setelah induksi anestesi. Data tentang lama analgesi diuji dengan Mann-Whitney. Analisis statistik menunjukkan bahwa perbedaan lama analgesia antara kedua kelompok sangat bermakna (p<0,0001). Simpulan, peningkatan lama analgesia kombinasi bupivakain 0,25% dan petidin 0,25 mg/kg BB menghasilkan masa bebas nyeri sampai 36 jam, sedangkan pada bupivakain 0,25% lebih singkat sekitar 18 jam. Tidak dijumpai efek samping dalam penelitian ini.Kata kunci: Blok infraorbital, bupivakain, labioplasti, petidinComparison Between the Addition of Pethidine 0.25 mg/kgBW in Bupivacain 0.25% with Bupivacain 0.25% for Infraorbital Blockade in Labioplasty Surgery in Children to the Length of Post Operative AnalgesiaLabioplasty postoperative pain can be prevented by bilateral infraorbital regional block. Bupivacaine 0.25% is usually used in infraorbital block and pethidine as an adjuvant can prolong the postoperative analgesic. The research was a single-blind randomized clinical trial included 40 children ASA II aged 3 months–1 year underwent labioplasty surgery in central operating theatre Dr. Hasan Sadikin Hospital-Bandung during March–May 2012. After block of permutation randomization, the subjects were grouped into two, 20 subjects (group B) using bupivacaine 0.25% 1 mL on each side and 20 subjects (group of BP) using combination of pethidine bupivacaine 0.25% and 0.25 mg/kgBW 1 mL on each side after the induction of anesthesia. Measurement data of length of analgesia were tested with the Mann-Whitney Test. Statistical analysis showed that the difference of the length of analgesia between two groups analgesia was highly significant (p<0.0001). The conclusion of this study is that the increase of the length of analgesia in combination of bupivacaine 0.25% and pethidine 0.25 mg/kgBW produce pain-free period to 36 hours, whereas bupivacaine 0.25% is shorter, about 18 hours. The incidence of adverse effect was not found in this study.Key words: Bupivacaine, infraorbital block, labioplasty, pethidine DOI: http://dx.doi.org/10.15851/jap.v1n2.121
Perbandingan Penambahan Neostigmin 2 mg/kgBB dengan Fentanil 1 µg/kgBB dalam Bupivakain 0,125% sebagai Anestesi Kaudal terhadap Lama Analgesia Alam, Jauharul; Oktaliansah, Ezra; Boom, Cindy Elfira
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Blokade kaudal dengan injeksi tunggal sering digunakan untuk penatalaksanaan nyeri intra dan pascabedah pada pasien pediatrik. Penelitian ini bertujuan mengkaji lama analgesi setelah blokade kaudal injeksi tunggal preoperatif antara penambahan neostigmin 2 µg/kgBB dan fentanil 1 µg/kgBB dalam bupivakain 0,125% (volume 0,5 mL/kgBB) pada pasien anak yang menjalani operasi hipospadia dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Desember 2011–Februari 2012. Metode penelitian adalah penelitian eksperimental secara acak terkontrol buta ganda pada 24 anak berusia 1–7 tahun. Data pengukuran lama analgesi diperoleh dengan Children and Infant Postoperative Pain Scale (CHIPPS) yang dianalisis dengan Uji Mann-Whitney, data laju nadi dan laju napas dianalisis dengan uji-t. Hasil perhitungan statistik diperoleh lama analgesi pada kelompok BN lebih panjang mencapai 675 menit dibandingkan dengan kelompok BF 480 menit dengan hasil yang sangat bermakna (p<0,001). Simpulan penelitian ini menunjukkan bahwa penggunaan kombinasi bupivakain 0,125% dan neostigmin 2 µg/kgBB untuk blokade kaudal injeksi tunggal memberikan lama analgesia yang lebih panjang.Kata kunci: Anestesi kaudal, bupivakain, fentanil, lama analgesia, neostigminComparison between Caudal Blockade with Additional 2 µg/kgBW Neostigmine and 1 µg/kgBW Fentanyl to 0.125% Bupivacaine on the Duration of AnalgesiaAbstractSingle shot injection caudal blockade were used extensively for intra and post operative pain management in pediatric patients. The purpose of this study was to assess duration of analgesia following a single shot injection of caudal blockade with additional 2 µg/kgBW neostigmine and 1 µg/kgBW fentanyl into 0.125% bupivacaine (volume 0.5 mL/kgBW) in pediatric patients who underwent hypospadias surgery at Dr. Hasan Sadikin Hospital Bandung from December 2011 to February 2012. This experimental study was conducted using randomized control trial (RCT) method in 24 pediatric patients, aged 1–7 years. The duration of analgesia data were obtained using Children and Infant Pain Scale (CHIPPS) post operatively and analyzed using Mann-Whitney Test, whereas the heart rate and respiratory rate data were analyzed by t-test. The result of statistical analysis showed significant difference between duration of analgesia in group BN (675 minutes) compared with the BF group (480 minutes) with p<0.001. The conclusion of this study was that combination of 0.125% bupivacaine and 2 µg/kgBW neostigmine as a single shot injection in caudal blockade provides longer duration of analgesia compared to 0.125% bupivacaine and 1 µg/kgBW fentanyl combination.Key words: Bupivacaine, caudal anesthesia, duration of analgesia, neostigmine DOI: 10.15851/jap.v1n3.191
Perbandingan Insidensi Post Dural Puncture Headache (PDPH) Pascaseksio Sesarea Dengan Anestesi Spinal Antara Tirah Baring 24 Jam Dengan Mobilisasi Dini Prihartono, Mohamad Andy; Oktaliansah, Ezra; Wargahadibrata, A. Himendra
Jurnal Anestesi Perioperatif Vol 1, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Post Dural Puncture Headache (PDPH) merupakan salahsatu komplikasi iatrogenik dari anestesi spinal. Patofisiologi PDPH sampai saat ini belum jelas, namun teori yang selama ini dianut akibat penurunan volume dan tekanan CSS (Cairan SerebroSpinal). Penelitian terdahulu menyatakan PDPH dapat dicegah dengan tirah baring selama 24 jam. Beberapa penelitian terbaru membuktikan mobilisasi dini tidak meningkatkan resiko PDPH. Tujuan penelitian ini untuk membuktikan bahwa tidak ada perbedaan insidensi PDPH pada pasien yang dilakukan tirah baring selama 24 jam dengan mobilisasi dini segera setelah fungsi motorik pulih.Penelitian dilakukan dengan tipe quasi experimental dan rancangan rangkaian waktu dengan pembanding. Penelitian melibatkan 200 wanita hamil berumur 18-30 tahun, yang akan dilakukan seksio sesarea dengan anestesi spinal, kemudian dibedakan dalam dua kelompok masing-masing 100 orang. Kelompok pertama dilakukan mobilisasi dini segera setelah fungsi motorik pulih (skala Bromage 1) dan kelompok kedua mobilisasi setelah tirah baring selama 24 jam pascaseksio sesarea. Kemudian, setiap kelompok dilakukan pengamatan terhadap ada atau tidaknya PDPH sampai 2 hari pascaoperasi. Dari hasil penelitian dianalisis dengan uji statistik yaitu uji chi kuadrat dan uji Mann Whitney, di mana nilai p<0,05 dianggap bermakna. Analisis statistik menunjukkan bahwa perbandingan insidensi PDPH pada kelompok yang dilakukan mobilisasi dini (setelah fungsi motorik pulih) dan tirah baring selama 24 jam tidak bermakna (p>0,05). Pada kelompok pertama (mobilisasi dini) 100% tanpa PDPH dan kelompok kedua (tirah baring 24 jam) 99% tanpa PDPH. Simpulan dari penelitian ini adalah tidak didapatkan perbedaan insidensi PDPH pada pasien pascaseksio sesarea dengan anestesi spinal yang dilakukan tirah baring selama 24 jam dengan mobilisasi dini segera setelah fungsi motorik pulih.Kata kunci : mobilisasi dini, Post Dural Puncture Headache, seksio sesarea dengan anestesi spinal, tirah baring 24 jamComparison Of Post Dural Puncture Headache (PDPH) Incidence In Post Caesarean Section Using Spinal Anesthesia Underwent Bed Rest Position For 24 Hours Compared With Early MobilizationPost Dural Puncture Headache (PDPH) is defined as an iatrogenic complication of spinal anesthesia. The pathophysiology of PDPH remains unknown until today, but the referenced theory is due to the decrease of the LCS (Liquor Cerebrospinal) volume and pressure. The early studies confirmed that PDPH was preventable with bed rest position for 24 hour. Numerous current studies have proven that early mobilization does not increase PDPH risks. The objective of this study was to prove that there is no significant difference in PDPH incidence in bed rest patients for 24 hours compared with early mobilization patients as soon as the motoric function has been recovered. The study was conducted using quasi experimental type and control time series design. This study involved 200 pregnant women at the age of 18-30 years that were on Caesarean Section using spinal anesthesia then they were classified into 2 groups with 100 subjects, respectively. The first group was conducted early mobilization as soon as the motoric function has been recovered (using Bromage 1 scale) and the second group was conducted mobilization after bed rest 24 hours post sectio Caesarean. And then, each group was observed for the occurrence of PDPH until 2 days post surgery. The study analysis was assessed using chi square test and Mann Whitney test, which the score of p<0,05 was considered statistically significant value. Statistical analysis showed that the comparison of PDPH incidence in the early mobilization group (after motoric function had been recovered) and the bed rest for 24 hour group was not statistically significant (p>0,05). The first group (early mobilization) showed 100% of the patients without PDPH incidence and the second group (bed rest for 24 hour) showed 99% of the patients without PDPH incidence. The summary of this study revealed that there was no significant difference on PDPH incidence in post Caesarean section patients underwent spinal anesthesia with bed rest for 24 hours compared with early mobilization as soon as the motoric function had been recovered. Key words: Cesarean section with spinal anesthesia, early mobilization, Post Dural Puncture Headache, 24 hours bedrestDOI: 10.15851/jap.v1n1.155
Angka Kejadian Hipotermia dan Lama Perawatan di Ruang Pemulihan pada Pasien Geriatri Pascaoperasi Elektif Bulan Oktober 2011–Maret 2012 di Rumah Sakit Dr. Hasan Sadikin Bandung Harahap, Anggita Marissa; Kadarsah, Rudi K.; Oktaliansah, Ezra
Jurnal Anestesi Perioperatif Vol 2, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Tindakan anestesi dan pembedahan adalah salah satu penyebab kejadian hipotermia. Keadaan ini sangat tidak menguntungkan bagi pasien geriatri dengan gangguan fungsi kardiopulmonal. Penelitian dilakukan dengan metode prospektif observasional dengan rancangan penelitian deskriptif kasus kontrol terhadap 129 orang pasien geriatri pascaanestesi umum dan pascaanestesi regional yang masuk ke ruang pemulihan Rumah Sakit Dr. Hasan Sadikin Bandung pada Oktober 2011 sampai Maret 2012. Angka kejadian hipotermia pada pasien geriatri pascaanestesi di ruang pemulihan sebanyak 113 orang (87,6%). Terdapat hubungan bermakna kejadian hipotermia dengan lama perawatan di ruang pemulihan pada pasien geriatri yang telah menjalani operasi elektif di Rumah Sakit Dr. Hasan Sadikin Bandung (p≤0,05). Lama tinggal di ruang pemulihan rata-rata pada pasien hipotermia adalah 110 menit dan pada pasien yang tidak hipotermia 70 menit. Simpulan penelitian ini menunjukkan bahwa angka kejadian hipotermia pascaoperatif geriatri adalah 87,6% dan pasien dengan hipotermia mendapatkan perawatan lebih lama di ruang pemulihan.Kata kunci: Hipotermia pascaanestesi, lama perawatan, geriatri, ruang pemulihanThe Incidence of Hypothermia and Duration of Care in the Recovery Room on Postoperative Geriatric Patients at Dr. Hasan Sadikin Hospital Bandung During October 2011–March 2012Anesthesia and surgery is one of the causes of the incidence of hypothermia . This situation is not favorable for geriatric patients with impaired cardiopulmonary function. This was a prospective observational study with a descriptive case-control design on 129 geriatric patients post general and regional anaesthesia in the recovery room of Dr. Hasan Sadikin Hospital Bandung during the period of October 2011 to March 2012. The incidence of hypothermia in geriatric patients post anaesthesia in recovery room was 113 people (87.6%). There was a significant relationship between the incidence of hypothermia and the duration of care in the recovery room in geriatric patients who have undergone elective surgery at the Dr. Hasan Sadikin Hospital Bandung (p≤0.05) . Average the length of stay in recovery room was 110 minutes in patients experiencing hypothermia while it was 70 minutes in those whom did not experience hypothermia. In conclusions, the incidence of postoperative hypothermia in geriatric patients was 87.6% and patients whom experienced hypothermia have a longer care in the recovery room.Key words: Geriatric, hypothermia post anesthesia, length of stay DOI: 10.15851/jap.v2n1.236
Perbandingan Pengaruh Premedikasi per Rektal antara Klonidin 5 μg/ kgBB dan Ketamin 10 mg/kgBB pada Anak Usia 2–5 Tahun pada Skala Pemisahan Prabedah dan Skala Kemudahan Induksi Sabirin, Mira Rellytania; Oktaliansah, Ezra; Redjeki, Ike Sri
Jurnal Anestesi Perioperatif Vol 2, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Premedikasi pada anak berguna untuk menurunkan kecemasan prabedah dan memudahkan induksi. Penelitian ini bertujuan untuk mengetahui efektivitas klonidin 5 µg/kgBB dibandingkan dengan ketamin 10 mg/kgBB per rektal sebagai premedikasi pada anak. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada November 2011–Februari 2012 menggunakan uji klinis terkontrol samar buta ganda pada 32 pasien pediatrik usia 2–5 tahun yang akan menjalani operasi elektif dan mendapatkan klonidin 5 µg/kgBB atau ketamin 10 mg/kgBB per rektal 45 menit sebelum induksi anestesi. Kualitas skala pemisahan dari orangtua dan skala kemudahan induksi saat pemasangan sungkup muka selama pemberian inhalasi isofluran dianalisis memakai Uji Mann-Whitney dengan tingkat kepercayaan 95%, dianggap bermakna bila p<0,05. Klonidin 5 µg/kgBB memberikan kualitas yang efektif dan baik dalam hal pemisahan dan penerimaan pemasangan sungkup saat induksi dibandingkan dengan ketamin 10 mg/kgBB dengan perbedaan bermakna (p<0,001). Data ini menunjukkan bahwa klonidin 5 µg/kg rektal merupakan pilihan obat premedikasi alternatif yang efektif dan aman untuk diberikan kepada pasien pediatrik.Kata kunci: Klonidin rektal, ketamin rektal, premedikasi, skala kemudahan induksi, skala pemisahanComparison Between Premedication using Clonidine 5 μg/kgBW and Ketamine 10 mg/kgBW per Rectal in Children Aged 2–5 Years to Preoperative Separation Scale and Acceptance of Mask for Induction ScalePremedication in children is used to reduce pre operative anxiety and to facilitate induction. This study was designed to investigate the efficacy of rectal clonidine 5 µg/kgBW in comparison with rectal ketamine 10 mg/kgBW as a premedication in children. The study was conducted at Dr. Hasan Sadikin Hospital Bandung during the period November 2011–February 2012 with a double-blind randomized clinical controlled trials on 32 paediatric patients aged 2–5 years undergoing elective surgery and received either clonidine 5 µg/kgBW or ketamine 10 mg/kgBW rectally 45 min before induction of anesthesia. The quality of separation scale from the parent and the acceptance of mask for induction scale application during inhalation isoflurane were analyzed using Mann Whitney Test with 95% confidence interval, p value <0.05 is considered as statistically significant. Clonidine 5 µg/kgBW provide effective and good qualities of separation and acceptance of mask for induction compared to ketamine 10 mg/kgBW. These data indicate that rectal clonidine 5 µg/kgBW is effective and safe as an alternative drug for premedication in paediatric patients.Key words: Acceptance of mask for induction scale, clonidine, premedication, rectal, separation scale DOI: 10.15851/jap.v2n1.230
Perbandingan Pemulihan Bising Usus pada Pasien Pascaoperasi Histerektomi per Laparotomi Menggunakan Analgetik Kombinasi Ketamin-Morfin dengan Morfin Intravena Setiawan, Irvan; Oktaliansah, Ezra; Boom, Cindy Elfira
Jurnal Anestesi Perioperatif Vol 2, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Disfungsi gastrointestinal merupakan penyulit pascaanestesi yang sering terjadi. Tujuan penelitian ini untuk membandingkan pemulihan bising usus antara pemberian analgetika kombinasi ketaminmorfin dibandingkan dengan morfin. Penelitian dilakukan dengan uji klinis acak terkontrol buta ganda terhadap 36 pasien dengan status fisik American Society of Anesthesiologist (ASA) I dan II yang menjalani operasi histerektomi per laparotomi di Rumah Sakit Dr. Hasan Sadikin Bandung pada April–Agustus 2012. Kedua kelompok menerima dosis awal morfin 0,03mg/kgBB, lalu kelompok K diberikan infus ketamin 4 μg/kgBB/menit, dan kelompok M diberikan morfin infus 10 μg/kgBB/jam. Analisis data memakai uji-t dan Uji Mann Whitney, tingkat kepercayaan 95% dan bermakna bila p<0,05. Hasil penelitian ini menunjukkan waktu pemulihan bising usus pada kelompok K lebih cepat dibandingkan dengan kelompok M dengan berbeda bermakna (p<0,05). Simpulan, pemulihan bising usus lebih cepat pada pemberian analgetika kombinasi ketamin dan morfin dibandingkan dengan morfin pada pasien pascaoperasi histerektomi per laparotomi.Kata kunci: Ketamin, morfin, pemulihan bising usus Comparison of Bowel Sound Recovery in Postoperative Hysterectomy per Laparotomy Patient Between Combination of Intravenous Ketamine - Morphine and MorphineGastrointestinal dysfunction is the most common post anaesthesia complication. The aim of this study is to compare the recovery of bowel sounds between combination of ketamine-morphine analgesia to morphine alone. This is a randomized controlled study on 36 patients with American Society of Anesthesiologist (ASA) physical status I and II who underwent hysterectomy per laparotomy at Dr. Hasan Sadikin Bandung during April–August 2012. Both groups received an initial dose of morphine 0.03 mg/kgBW, while K group received intravenous ketamine 4 μg/kgBW/min, and the M group received morphine 10 μg/kgBW/hr. The results were analyzed using t-test and Mann Whitney test with a confidence level of 95% and were considered significant if p<0.05. The results of this study showed that the recovery time of bowel sounds in K group was significantly faster than in the M group (p<0.05). In conclusion, recovery of bowel sounds is faster in analgesia using combination of ketamine-morphine than morphine in postoperative hysterectomy per laparotomy patients.Key words: Ketamine, morphine, recovery of bowel DOI: 10.15851/jap.v2n1.238
CO2 Gap Sebagai Prediktor Tingkat Mortalitas Pasien Sepsis Berat di Intensive Care Unit Wiraatmaja, Immanuel; Oktaliansah, Ezra; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tingkat mortalitas pasien sepsis berat di Intensive Care Unit (ICU) dihitung dengan menggunakan skor Acute Physiology and Chronic Health Evaluation (APACHE) II dan memerlukan pemeriksaan yang banyak serta kompleks. Peningkatan p (vena-arteri)CO2 (CO2 gap) berhubungan dengan penurunan indeks jantung, karena itu diharapkan CO2 gap memiliki kemampuan untuk menentukan tingkat mortalitas pasien sepsis berat. Penelitian ini bertujuan untuk mengetahui kegunaan CO2 gap sebagai prediktor tingkat mortalitas pasien sepsis berat di ICU Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung yang lebih mudah serta murah.Penelitian ini dilakukan secara prospektif observasional terhadap 50 orang. Penelitian dilakukan di ICU RSHS Bandung dari bulan Agustus 2013–Januari 2014. Setiap subjek penelitian diperiksa nilai CO2 gap. Subjek dibagi ke dalam 2 kelompok berdasarkan nilai CO2 gap menjadi kelompok nilai CO2gap tinggi (nilai CO2 gap ≥6) dan nilai CO2 gap  rendah (nilai CO2 gap<6). Penilaian ulang dilakukan pada hari ke-28 untuk masing-masing kelompok untuk menilai adakah pasien dalam kelompok tersebut yang meninggal. Hasil penelitian menunjukan bahwa CO2 gap memiliki sensitivitas 94,7%; spesifisitas 90,3%; positive predictive value 85,7%; negative predictive value 96,5%; likelyhood ratio positive CO2 gap 9,76; dan likelyhood ratio negative CO2 gap adalah 0,05. Simpulan penelitian adalah CO2 gap dapat digunakan untuk melakukan prediksi tingkat mortalitas pasien sepsis berat.Kata kunci: CO2 gap, mortalitas, sepsisCO2 Gap as a Mortality Incidence Predictor for Severe Sepsis Patient  in Intensive Care Unit The mortality rate of severe sepsis patients in Intensive Care Unit (ICU) is measured by using the Acute Physiology and Chronic Health Evaluation (APACHE) II score, which need various complex examinations. Increased p(venous-arterial) CO2(CO2 gap) relates to decreased cardiac index; therefore, it is expected that CO2 gap can be used to predict mortality incidence in severe sepsis patients in the ICU of Dr. Hasan Sadikin General Hospital (RSHS).This study was a prospective study on 50 patients who met severe sepsis criteria conducted in the ICU of RSHS Bandung from August 2013 to January 2014. The CO2 gap was be measured in all the patients. Subjects were divided into two groups according to the CO2 gap value, i.e. high CO2 gap (≥6) and low CO2 gap (<6). Subjects were then assessed on the 28th day to observe the mortality incidence the respective group. It was shown that a CO2 gap value had a sensitivity of 94.7%, specificity of 90.3%, positive predictive  value of 85.7%, and the negative predictive value of 96.5%. The likelihood ratio of  positive CO2 gap  and negative CO2 gap were 9.76 and 0.05, respectively. In conclusion, CO2 gap can be used to predict the mortality incidence in severe sepsis patients in the ICU of RSHS Bandung. Key words: CO2 gap, mortality, sepsis DOI:10.15851/jap.v2n3.331
Perbandingan Pengaruh Pemberian Granisetron 1 mg Intravena dengan Plasebo (Salin) untuk Mencegah Kejadian Menggigil Pascaanestesi Spinal pada Seksio Sesarea Manunggal, Heru Wishnu; Oktaliansah, Ezra; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Menggigil pascaanestesi merupakan komplikasi yang sering terjadi pada tindakan anestesi. Tujuan penelitian ini untuk mengkaji pemberian granisetron 1 mg intravena dalam mengurangi kejadian menggigil pada pasien yang menjalani seksio sesarea dengan anestesi spinal. Metode penelitian klinis acak terkontrol tersamar ganda pada 38 pasien yang menjalani seksio sesarea di Rumah Sakit Dr. Hasan Sadikin Bandung pada April–September 2011, usia 20–35 tahun, status fisik American Society of Anesthesia (ASA)  II dan  dikelompokkan secara random menjadi  2 kelompok, yaitu kelompok yang menerima granisetron 1 mg intravena atau salin sebelum dilakukan anestesi spinal dengan bupivakain 12,5 mg. Kejadian menggigil dicatat berdasarkan derajat 0–4. Hasil penelitian menunjukan secara statistik data karakteristik pasien dan suhu tubuh inti tidak berbeda antara kedua  kelompok. Kejadian menggigil lebih sedikit pada kelompok granisetron (21,1%) dibandingkan dengan kelompok plasebo (52,6%) dengan hasil statistik bermakna (p<0,05). Simpulan penelitian ini menunjukkan bahwa pemberian granisetron 1 mg intravena sebelum anestesi spinal pada seksio sesarea mengurangi kejadian menggigil pascaanestesi yang dibandingkan dengan plasebo.                                          Kata kunci: Granisetron, menggigil, pascaanestesi spinalEffect of  Granisetron 1 mg Intravenously  to Prevent of Shivering After Spinal Anesthesia for Cesarean SectionPost anesthesia shivering is one of the complications that often occur in anesthetic action. The purpose of this study was to assess the administration of intravenous granisetron 1 mg in reducing the incidence of shivering in patients undergoing caesarean section with spinal anesthesia. Clinical research methods in double-blind randomized controlled 38 patients who underwent seksios esarea at Dr. Hasan Sadikin Hospital Bandung during April–September 2011, aged 20–35 years overall status American Society of Anesthesia (ASA) II physical and random into two groups: the group that received granisetron 1 mg intravenously or saline prior to spinal anesthesia with bupivacaine 12.5 mg. Incidence of shivering recorded by degrees 0–4. The results showed statistically significant patient characteristic data and core body temperature did not differ between the two groups. Shivering less in granisetron group (21.1%) than the placebo group (52.6%) with statistically significant results (p<0.05).The conclusions of this study indicate that administration of granisetron 1 mg intravenously before spinal anesthesia in Caesarean section reduces the incidence of shivering postanesthesia.Key words: Granisetron, shivering, post anesthesia spinal DOI: 10.15851/jap.v2n2.303
Prevalensi dan Faktor Risiko Nyeri Punggung Bawah di Lingkungan Kerja Anestesiologi Rumah Sakit Dr. Hasan Sadikin Bandung Patrianingrum, Meilani; Oktaliansah, Ezra; Surahman, Eri
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Nyeri punggung bawah (NPB) merupakan masalah kesehatan yang banyak dialami oleh tenaga kesehatan. Tujuan penelitian ini untuk mengetahui prevalensi dan faktor risiko nyeri punggung bawah di lingkungan kerja anestesiologi dan terapi intensif Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung. Penelitian ini merupakan penelitian deskriptif dengan rancangan studi potong silang. Subjek penelitian meliputi seluruh peserta pendidikan dokter spesialis (PPDS) dan konsulen anestesiologi di RS Dr. Hasan Sadikin Bandung periode bulan April─Juni 2014. Analisis data dilakukan dengan uji chi-kuadrat, Eksak Fisher dan Kolmogorov Smirnov. Hasil penelitian menunjukkan bahwa prevalensi nyeri punggung bawah yang timbul setelah masuk dalam lingkungan kerja anestesiologi di RSHS adalah 35,7%. Faktor risiko yang signifikan adalah kebiasaan merokok (RR 1,35)  dan kurang olahraga (RR 80,04). Faktor posisi saat melakukan tindakan anestesi signifikan menimbulkan nyeri punggung bawah. Simpulan, prevalensi nyeri punggung bawah setelah masuk lingkungan kerja anestesiologi RSHS Bandung adalah 35,7% dengan faktor risiko adalah merokok dan kurang olahraga. Faktor posisi selama melakukan tindakan anestesi bersama-sama dengan faktor risiko lain mungkin turut memperberat nyeri punggung bawah. Kata kunci: Anestesi, faktor risiko, nyeri punggung bawah, prevalensiPrevalence and Risk Factors of Lower Back Pain in the Anesthesiology Workplace in Dr. Hasan Sadikin General Hospital BandungAbstractLower back pain (LBP) is a common health problem in many health professionals. The purpose of this study was to determine the prevalence and risk factors causing lower back pain in the anesthesiology workplace at Dr. Hasan Sadikin Hospital General Bandung. This research is a descriptive study with cross-sectional design. Subjects on this research were the anesthesiology residents and consultants in Dr. Hasan Sadikin General Hospital Bandung between April and June 2014. Data analysis was performed by chi-square, Exact Fisher and Kolmogorov Smirnov. The results showed that the prevalence of lower back pain that arises after entering the anesthesiology workplace in Dr. Hasan Sadikin General Hospital Bandung was 37.5%. The significant risk factors were smoking (RR 1.348)  and lack of exercise (RR 80.04) while the position factor during conducting anesthesia did not significantly cause lower back pain. The conclusions of this study indicate that the prevalence of low back pain that arises after entering the anesthesiology and intensive therapy workplace in Dr. Hasan Sadikin General Hospital Bandung is 37.5%.  In addition, the risk factors that significantly cause lower back pain in the anesthesiology and intensive therapy workplace in Dr. Hasan Sadikin General Hospital Bandung were smoking and lack of exercise. The position factor during conducting anesthesia together with other risk factors may contribute to the arising of lower back pain. Key words: Anesthesia, lower back pain, prevalence, risk factors DOI: 10.15851/jap.v3n1.379  
Co-Authors A. Himendra Wargahadibrata A. Himendra Wargahadibrata Achmad Noerkhaerin Putra Afifuddin Afifuddin Afifuddin Afifuddin, Afifuddin Agus Fitri Atmoko Ahmado Okatria Anggita Marissa Harahap Anggita Marissa Harahap Anna Christanti Anthon Vermana Ritonga Anthon Vermana Ritonga Ardi Janardika Ardi Zulfariansyah Arvianto Arvianto Arvianto Arvianto, Arvianto Asep Deden Komara Atmoko, Agus Fitri Bernadeth Bernadeth Budiana Rismawan Cindy Elfira Boom Cindy Elfira Boom Dedi Fitri Yadi Dendi Karmena Dendi Karmena, Dendi Dhany Budipratama Doddy Tavianto Eri Surahman Eri Surahman Eri Surahman Erwin Pradian Ferianto Ferianto Ferianto Gavrila Diva Amelis Heru Wishnu Manunggal Heru Wishnu Manunggal Ibnu, Muhamad Ihrul Prianza Prajitno Ihrul Prianza Prajitno Ike Sri Redjeki Ike Sri Redjeki Immanuel Wiraatmaja Immanuel Wiraatmaja Indra Wijaya Indriasari Indriasari Indriasari Indriasari Indriasari Irvan Setiawan Irvan Setiawan Iwan Fuadi Jauharul Alam Jauharul Alam Keshina Amalia Mivina Mudia Keshina Amalia Mivina Mudia, Keshina Amalia Mivina Komara, Asep Deden Linggih Panji Nugraha M. Andy Prihartono M. Erias Erlangga Maria Agnes Berlian Yulriyanita Meilani Patrianingrum Meilani Patrianingrum Melliana Somalinggi Mira Rellytania Sabirin Mira Rellytania Sabirin Mohamad Andy Prihartono Mohamad Andy Prihartono Muhamad Adli Boesoirie Muhamad Adli Boesoirie, Muhamad Adli Muhamad Ibnu Muhammad Ibnu Muhari, Andie Naftalena Naftalena Nelly Margaret Simanjuntak Nobelia Carnationi Novie Salsabila Nurchaeni, Ati Nurchaeni Okatria, Ahmado Putra, Rifki Dwi Anugrah Radian Ahmad Halimi Radian Ahmad Halimi Rakhman Adiwinata Rakhman Adiwinata, Rakhman Rangga Saputra Reza Widianto Sudjud Ricky Aditya Rudi K. Kadarsah Rudi K. Kadarsah Ruli Herman Sitanggang Said Badrul Falah Said Badrul Falah, Said Badrul SATRIYAS ILYAS Septian, Dendi Simanjuntak, Nelly Margaret Sitanggang, Ruli H Somalinggi, Melliana Stefi Berlian Soefviana Suryaningrat, IGB Suwarman Tatang Bisri Tatang Bisri Thayeb, Srilina Tinni T. Maskoen Tinni T. Maskoen Tirto Hartono Vick Elmore Simanjuntak Vick Elmore Simanjuntak Wirawan Anggorotomo Wirawan Anggorotomo, Wirawan