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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 Parasetamol dengan Ketorolak Intravena Sebagai Analgesia Pre-emtif terhadap Skala Nyeri Pascabedah Labioplasti pada Pasien Pediatrik Boesoirie, Muhamad Adli; Oktaliansah, Ezra; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Parasetamol dan ketorolak merupakan analgetik yang biasa digunakan pada tatalaksana nyeri ringan hingga sedang. Penelitian ini bertujuan membandingkan efek analgesi pre-emtif parasetamol 20 mg/kgBB dengan ketorolak 0,5 mg/kgBB pada pasien pediatrik pascabedah labioplasti yang diukur menggunakan skala nyeri face, legs, activity, crying, consolability (FLACC). Penelitian eksperimental secara uji acak tersamar buta ganda terhadap 66 pasien pediatrik usia 6 bulan–12 tahun dengan status fisik American Society of Anesthesiology (ASA) I–II. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung periode Oktober 2013–Mei 2014. Pasien dibagi menjadi dua kelompok perlakuan, yaitu kelompok parasetamol (P) dan ketorolak (K) yang diberikan 15 menit prabedah. Analisis statistika diuji menggunakan uji-t independen, Mann-Whitney, dan Eksak Fisher. Hasil penelitian menunjukkan bahwa skala FLACC pada kelompok ketorolak pada jam ke-1, 2, 4, 6, dan 24 lebih rendah secara bermakna (p<0,05) dibanding dengan kelompok parasetamol. Simpulan, skala FLACC pemberian ketorolak 0,5 mg/kgBB prabedah pada pasien labioplasti lebih rendah dibanding dengan parasetamol 20 mg/kgBB.Kata kunci: Analgetik, analgesia pre-emtif, ketorolak, labioplasti, parasetamol, skala FLACCComparison between Intravenous Paracetamol and Ketorolac as Preemptive Analgesia on Postoperative Pain Scale in Pediatric Patients Undergo LabioplastyKetorolac and paracetamol are common analgetics used to treat mild to moderate pain. This study compared the efficacy of preemptive analgesia measured using face, legs, activity, crying, consolability (FLACC) scale between groups receiving 20 mg/kgBW paracetamol (P) and 0.5 mg/kgBW ketorolac (K) for pediatric labioplasty procedure. This experimental study is a are double-blind randomized trial against 66 pediatric patients aged 6 months–12 years with the physical status of the American Society of Anesthesiology (ASA) I–II. The study was conducted in Dr. Hasan Sadikin General Hospital Bandung during the period of October 2013–May 2014. The P and K groups received 20 mg/kgBW paracetamol and 0.5 mg/kgBW ketorolac, respectively, 15 minutes preoperatively. Data were analyzed statistically using independent-t, Mann-Whitney, and Fischer’s Exact Test. Results showed that the difference between FLACC scale in P and K groups  was statistically significant (p<0.05). In conclution, FLACC scale in patients who received ketorolac 0.5 mg/kgBW is lower than patients who received paracetamol 20 mg/kgBW.Key words: Analgetics, FLACC scale, ketorolac, labioplasty, paracetamol, preemptive analgesia DOI: 10.15851/jap.v3n1.573
Anesthesia Technique Selection Pattern in Patients Undergoing Lower Extremities Surgery at Dr. Hasan Sadikin General Hospital from January–June 2013 Mudia, Keshina Amalia Mivina; Oktaliansah, Ezra; Prajitno, Ihrul Prianza
Althea Medical Journal Vol 3, No 1 (2016)
Publisher : Althea Medical Journal

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Abstract

Background: Musculoskeletal problems of the lower extremities are becoming more frequent lately. This problem usually requires surgery to be dealt quickly . The role of the anesthesiologist is needed to determine which anesthesia technique that has to be performed. Selection of proper anesthesia technique can reduce the incidence of complications . Objective of this study was to determine anesthesia technique selection pattern in patients undergoing orthopedic surgery at Dr. Hasan Sadikin General Hospital from January–June 2013.Methods: A quantitative study with retrospective descriptive method was conducted. This study was carried out from September–October 2013 at Dr. Hasan Sadikin General Hospital Bandung. Medical records were used as a research instrument. Data collection was conducted using total sampling method. There were 228 data of all cases, but only 151 patients who met the inclusion and exclusion criteria.Results: One hundred fifty one patients were identified. Sixty five subjects (43%) were performed under general anesthesia, 83 subjects (55%) under regional anesthesia and 3 subjects (2%) under combination of general-regional anesthesia. Regional anesthesia techniques consisted of spinal anesthesia (29%), epidural anesthesia (64%), combination of spinal-epidural anesthesia (5%), and peripheral nerve block (2%). Conclusions: Regional anesthesia is the most frequently technique used in lower extremities orthopedic surgery, with epidural anesthesia as the most common regional technique used because of all the benefits. [AMJ.2016;3(1):141–6] DOI: 10.15850/amj.v3n1.717
Angka Mortalitas dan Faktor yang Memengaruhi pada Pasien Trakeoesofageal Fistula (TEF) yang Menjalani Operasi di RSUP Dr. Hasan Sadikin Bandung Sunarya, Unang; Oktaliansah, Ezra; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (697.967 KB) | DOI: 10.15851/jap.v5n2.1111

Abstract

Trakeoesofageal fistula (TEF) merupakan kelainan esofagus yang bersifat kongenital ditandai dengan fistula antara trakea dan esofagus yang merupakan koneksi abnormal yang dapat disertai putusnya antara distal dan proksimal esofagus. Insidensi TEF kongenital mencapai 1:2.400‒4.500 kelahiran hidup. Tujuan penelitian ini mengetahui angka mortalitas dan faktor yang memengaruhi pada pasien TEF yang menjalani operasi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2010–2015. Metode penelitian ini bersifat deskriptif yang dilakukan secara retrospektif terhadap 35 rekam medik pasien TEF yang menjalani operasi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2010‒2015. Hasil penelitian ini menunjukkan angka mortalitas pascaoperasi pasien TEF sebesar 19 dari 34 dan mortalitas tertinggi terjadi pada perempuan 7 dari 12, bayi lahir lahir prematur 5 dari 5, berat badan lahir kurang dari 1.500 gram 1 dari 1, TEF tipe C 19 dari 32, riwayat persalinan di bidan/puskesmas 9 dari 11, disertai kelainan kongenital penyerta selain kelainan anorektal, usia saat operasi lebih dari 7 hari 15 dari 17, penyulit preoperatif lebih dari satu, lama operasi lebih dari 3 jam, tidak dilakukan ekstubasi 15 dari 20, kenaikan berat badan lebih dari 10% 14 dari 18, leakage pascaoperasi dan faktor penyulit pascaoperasi lebih dari satu. Simpulan Angka mortalitas pasien TEF yang menjalani operasi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2010–2015 sebanyak 54,3%. Kata kunci: Mortalitas pascaoperasi, operasi, trakeoesofageal fistula Mortality and The Influencing Factors of Trakeoesofageal Fistula (TEF)Patients which Operated in Dr. Hasan Sadikin General Hospital BandungTracheoesophageal fistula (TEF) is a disorder of the esophagus that is characterized by congenital fistula between the trachea and esophagus wich is an abnormal connection that can be accompanied by a break between the distal and proximal esophagus. The incidence of congenital TEF reached 1:2,400‒4,500 live births. The purpose of this study to determine mortality and factors affecting mortality in patients TEF in Dr. Hasan Sadikin General Hospital Bandung in 2010‒2015. This research method was descriptive retrospectively of 35 patients taken from the medical records underwent surgery TEF in Dr. Hasan Sadikin Central Hospital Bandung in 2010‒2015. Results of this study showed a mortality rate of postoperative patients TEF rate of 19 from 34 and the highest mortality among women 7 from 12, premature birth, birth weigth less than 1,500 g, TEF type C 19 from 36, childbirth history at the midwife 9 from 11, congenital abnormalities other than anorectal disease, age at surgery of more than 7 days 15 from 17, preoperative complications more than one, the operating time of more than 3 hours, do not extubation 15 from 20, weight gain more than 10% 14 from 18, the leakage postoperative and more than one complications postoperative factors. In conclusion, mortality of trakeoesofageal fistula (TEF) patients which operated in Dr. Hasan Sadikin General Hospital Bandung in 2010–2015 was 54.3%.Key words: Postoperative mortality, operatif, tracheoesophageal fistula
Angka Mortalitas pasien Neonatus yang Menjalani Operasi berdasar atas Kenaikan Berat Badan Pascaoperasi yang Dirawat di Neonatal Intensive Care Unit (NICU) Komara, Asep Deden; Oktaliansah, Ezra; Rismawan, Budiana
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (276.698 KB) | DOI: 10.15851/jap.v5n2.1112

Abstract

Salah satu faktor risiko mortalitas pada neonatus yang menjalani operasi adalah regulasi cairan intraoperatif. Tujuan penelitian ini mengetahui angka mortalitas pada neonatus yang menjalani operasi berdasar atas kenaikan berat badan pascaoperasi yang dirawat di NICU. Metode penelitian adalah deskriptif dengan pendekatan retrospektif. Penelitian ini melibatkan 95 subjek penelitian, yaitu neonatus yang menjalani operasi dan dirawat di NICU RSHS Bandung selama tahun 2010‒2015. Data diambil dari rekam medis, pengambilan data mulai tanggal 1 Februari–29 Maret 2017.  Subjek dibagi tiga kelompok, yaitu neonatus yang telah menjalani prosedur operasi yang mengalami kenaikan berat badan pascaoperasi kurang 10% (I), neonatus yang menjalani prosedur operasi yang mengalami kenaikan berat badan 10‒20% (II), dan kelebihan berat badan ≥20% (III). Neonatus pacaoperasi dengan kenaikan berat badan  ≤10% sebanyak  46 pasien dan yang meninggal  sebanyak 10 pasien pada  kenaikan  berat badan 10‒20%  sebanyak 38 pasien, pasien yang meninggal sebanyak 23 pasien, angka mortalitasnya sebesar 60,5%, sedangkan  pada pasien dengan kenaikan berat badan sama dengan atau lebih dari 20% sebanyak 11 pasien atau 11,5% yang meninggal  sebanyak 10 pasien, angka mortalitasnya sebesar 90,9%. Simpulan angka mortalitas pasien neonatus yang menjalani operasi di RSHS dan pascaoperasi dirawat di NICU RSHS selama periode 2010–2015 adalah 45,3%. Kata kunci: Kenaikan berat badan, mortalitas, neonatus The Mortality Rate in Neonatal Patients which Underwent Surgical Procedures-Defined by the Escalation of Postoperative Weight and Those Who were Admitted in Neonatal Intensive Care Unit (NICU) One of the risk factors contributed to this number was the inappropriate management of intraoperative fluid resuscitation. The aim of this study is to understand the mortality rate in neonatal patients which underwent surgical procedures–defined by the escalation of postoperative weight and those who were admitted in NICU. The research method used in this study was a retrospective approach presented in a descriptive manner. The study involved 95 research subjects, which were neonatal patients which underwent surgical procedures and admitted in NICU RSHS Bandung from 2010‒2015. Data collection from Februari 1st–March 29th  2017. The research subjects were classified into three groups, neonatal patients which had escalation of weight postoperative less than 10% and underwent surgical procedure (I), neonatal patients which had escalation of weight postoperative ranging from 10‒20% and underwent surgical procedure (II), meanwhile consist of neonatal patients which had escalation of weight postoperative ≥20% and underwent surgical procedure (III). Result of the study showed there were 46 neonatal patients with 10% weight escalation and 10 out of 46 patients were ceased, meanwhile there were 38 neonatal patients with 10‒20% weight escalation and 23 out of 38 were ceased, and there were 11 neonatal patients with ≥20% weight escalation and 10 out of 11 were ceased. The conclusions of this study found a mortality rate of neonatal patients who underwent surgery and postoperative treated in  NICU RSHS during the period 2010 to 2015 is 45.3%. Key words: Weight gain, mortality, neonatal
Penggunaan Teknik Obat dan Permasalahan Blokade Epidural di Wilayah Jawa Barat pada Tahun 2015 Ibnu, Muhammad; Yadi, Dedi Fitri; Oktaliansah, Ezra
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (685.823 KB) | DOI: 10.15851/jap.v5n3.1171

Abstract

Blokade epidural merupakan salah satu jenis anestesi regional yang memiliki rentang implikasi lebih luas dibanding dengan blokade spinal. Perbedaan teknik maupun rejimen obat untuk blokade epidural meningkat seiring dengan meningkatnya ketertarikan di bidang anestesi regional dikarenakan teknik anestesi regional memberikan efek analgesi yang efektif tanpa memengaruhi kesadaran pasien dan meningkatkan kenyamanan pasien. Tujuan penelitian ini mencari data mengenai penggunaan, teknik, rejimen obat, dan permasalahan yang dialami oleh dokter anestesi di Jawa Barat dalam melakukan blokade epidural. Penelitian ini dilakukan pada bulan Agustus hingga September 2016 di Departemen Anestesiologi dan Terapi Intensif Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian ini bersifat deskriptif dengan pengambilan data menggunakan kuesioner dan pendekatan cross sectional. Kuesioner dikirimkan kepada 120 dokter spesialis anestesi di Jawa Barat melalui jasa pos dan 30 kuesioner diberikan langsung kepada dokter spesialis anestesi yang bekerja di Rumah Sakit Dr. Hasan Sadikin Bandung. Angka respons yang didapatkan sebesar 47,3%. Hasil penelitian ini didapatkan dokter spesialis anestesi yang masih melakukan blokade epidural pada tahun 2015 sebesar 73,2%, teknik penusukan yang paling banyak dilakukan adalah pendekatan midline sebesar 73%, dan identifikasi rongga epidural paling banyak dengan pendekatan lost of resistance sebesar 80,7%. Obat anestesi lokal yang paling banyak digunakan untuk blokade epidural adalah bupivakain sebesar 95,9%. Adjuvan yang paling banyak digunakan adalah fentanil sebesar 92,3%. Permasalahan yang berkaitan dalam pelaksanaan tindakan blokade epidural pada tahun 2015 paling banyak adalah permasalahan staf di ruangan dalam membantu menangani pasien dengan epidural, yaitu sebesar 38,03%.Epidural Blockade Administration Technique and Issues in West Java in 2015Epidural blockade is one of the regional anesthesia techniques with wider implication than the spinal blockade. The techniques and drug regimens used in epidural blockade vary with the increasing interest on regional anesthesia due to its effective analgesic effect without decreasing consciousness and by increasing patients’ comfort. The purpose of this study was to explore the use, techniques, drug regimens, issues experienced by anesthesiologists in West Java in performing epidural blockade. This study was conducted from August to September 2016 at the Department of Anesthesiology and Intensive Therapy, Dr. Hasan Sadikin Hospital Bandung. This was a cross-sectional descriptive study using a questionnaire. Questionnaires were mailed  to 120 anesthesiologists in West Java area and 30 additional questionnaires were distributed directly to anesthesiologists working at Dr. Hasan Sadikin General Hospital Bandung. The response was  47.3%. This study showed that 73.2% anesthesiologists performed epidural blockade in 2015, with 73% used the midline approach and 80.7% used the loss of resistance method to identify the epidural space. The majority used bupivacaine (95.5%) as the local anesthetics. The most frequently used adjuvant was fentanyl (95.9%). The most frequently mentioned problem associated with epidural blockade in 2015 was the lack of staff’s ability to assist the anesthesiologist in performing epidural blockade (38.03%).
Perbandingan Bupivakain Infiltrasi Subkutis dengan Kombinasi Bupivakain Intramuskular Rectus Abdominis dan Subkutis terhadap Mulai Pemberian dan Kebutuhan Analgetik Rescue Pascaoperasi Laparatomi Ginekologi Falah, Said Badrul; Oktaliansah, Ezra; Redjeki, Ike Sri
Jurnal Anestesi Perioperatif Vol 4, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (419.802 KB) | DOI: 10.15851/jap.v4n1.747

Abstract

Penanganan nyeri pascaoperatif kurang baik akan membuat pasien trauma terhadap pembedahan dan menimbulkan komplikasi lain. Penelitian ini bertujuan membandingkan pemberian bupivakain secara kombinasi intramuskular (IMSK) dan subkutis dengan pemberian subkutis saja (SK) terhadap mulai pemberian dan kebutuhan analgetik rescue pascaoperasi laparatomi ginekologi. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung bulan September–Desember 2014 terhadap 46 wanita (18–60 tahun) status fisik American Society of Anesthesiology (ASA) I–II yang menjalani pembedahan laparatomi ginekologi secara uji acak terkontrol buta ganda dalam anestesi umum. Pasien dibagi menjadi dua, yaitu 23 orang menerima bupivakain kombinasi pada otot rectus abdominis dan subkutis dan 23 orang menerima bupivakain infiltrasi subkutis saja. Penilaian skala nyeri menggunakan nilai numeric rating scale dan dilakukan pencatatan pada jam ke-1, 2, 3, 4, 5, 6, 8, 12, dan 24 pascaoperasi. Pemberian analgetik rescue dilakukan bila nilai NRS ≥4. Data dianalisis dengan uji-t, chi-kuadrat, dan Mann-Whitney. Pada penelitian ini ditemukan waktu mulai pemberian analgetik rescue pada kelompok IMSK lebih lama (p<0,01) dan kebutuhan analgetik tambahan dalam 24 jam lebih sedikit (p<0,01) dibanding dengan kelompok SK. Simpulan, pemberian bupivakain secara kombinasi intramuskular dan subkutis lebih baik dibanding dengan pemberian subkutis saja terhadap waktu mulai pemberian dan kebutuhan analgetik rescue dalam 24 jam pascaoperasi laparatomi ginekologi.Kata kunci: Bupivakain, numeric rating scale, otot rectus abdominisComparison between Subcutis Bupivacaine Infiltration and Combined Intramuscular Rectus Abdominal and Subcutis Bupivacaine to on Total Need of Rescue Analgesics after Gynecologic LaparatomyAbstractInappropriate management of post-operative pain will cause trauma to the patient regarding the surgical experience and may possibly cause other complications. This study aimed to compare the administration of intramuscular and subcutis bupivacaine to subcutis only bupivacaine on the start and need for rescue analgesics. This study was conducted in Dr. Hasan Sadikin General Hospital Bandung during the period of September–December 2014 on 46 females aged 18–60 years old with American Society of Anesthesiology (ASA) I–II who underwent gynecological laparatomy under general anesthesia. This was a randomized controlled study. Patients were dividedinto two groups of 23 patients with the first group received combination infiltration and the other received only subcutis administration. The pain scale used was the numerical rating scale measured -1, 2, 3, 4, 5, 6, 8, 12, and 24 hours after surgery. Rescue analgesics was given if NRS was more than 4. Data were analyzed using t-test, chi-square test, and Mann-Whitney test. Observations were performed on time span until there was a need for analgesics for the first time and additional analgesic needed in 24 hours. In this study, the time span until the first dose analgesics was needed was longer and the amount of required analgesics during 24 hours was lower in the combination group (p<0.01). In conclusion, the combination strategy has a better outcome regarding the time span to the start of rescue analgetic and 24 hours analgesic needs.Key words: Bupivacaine, numeric rating scale, abdominal recti muscle 
Perbandingan Pemberian Cairan Liberal dan Restriktif terhadap Mean Arterial Pressure, Laju Nadi, dan Capaian Nilai Post Anesthetic Discharge Scoring System Usia 1–3 Tahun di Bedah Rawat Jalan Somalinggi, Melliana; Sudjud, Reza Widianto; Oktaliansah, Ezra
Jurnal Anestesi Perioperatif Vol 6, No 1 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (913.073 KB) | DOI: 10.15851/jap.v6n1.1289

Abstract

Teknik pemberian cairan liberal yang masih banyak digunakan sering menjadi berlebihan termasuk pada bedah rawat jalan. Puasa yang tepat, operasi yang singkat, serta perdarahan yang minimal pada bedah rawat jalan hanya memerlukan pemberian cairan restriktif. Penelitian ini bertujuan mengetahui mean arterial pressure (MAP) dan laju nadi intraoperatif serta capaian postanesthetic dischange skoring system (PADSS) antara pemberian cairan liberal dan restriktif anak usia 1−3 tahun di bedah rawat jalan. Penelitian bersifat eksperimental acak terkontrol buta tunggal dengan randomisasi secara acak sederhana pada 42 anak usia 1−3 tahun, status fisik American Society of Anesthesiology (ASA) I-II di bedah rawat jalan RSUP Dr. Hasan Sadikin Bandung periode Desember 2016 sampai Mei 2017. Subjek penelitian dikelompokkan menjadi dua, yaitu kelompok liberal diberikan cairan rumatan intraoperatif formula Holiday-Segar, penggantian puasa serta penggantian cairan ‘ruang ketiga’; dan kelompok restriktif diberikan hanya cairan rumatan intraoperatif 2 mL/kgBB/jam. Data dianalisis dengan uji-t dan Uji Mann-Whitney. Dari hasil penelitian didapatkan gambaran MAP dan laju nadi intraoperatif, serta capaian PADSS pada kedua kelompok tidak berbeda bermakna (p>0,05). Simpulan, tidak terdapat perbedaan gambaran MAP dan laju nadi intraoperatif, serta capaian PADSS antara pemberian cairan liberal dan restriktif pada anak usia 1−3 tahun yang menjalani bedah rawat jalan.Kata kunci: Cairan intraoperatif, laju nadi, mean arterial pressure, pediatrik, postanesthetic discharge scoring system
Perbandingan Kebutuhan Propofol dan Lama Bangun antara Kombinasi Propofol-Ketamin dan Propofol-Fentanil pada Pasien yang Dilakukan Kuretase yang Diukur dengan Bispectral Index (BIS) Anggorotomo, Wirawan; Kadarsah, Rudi K.; Oktaliansah, Ezra
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Pemberian sedasi dan analgesi yang efektif, efisien, aman, mudah didapat, dan juga murah diperlukan untuk mengurangi nyeri serta kecemasan selama kuretase.  Tujuan penelitian ini adalah mengetahui perbedaan kebutuhan propofol dan lama bangun antara propofol-ketamin dan propofol-fentanil pada pasien yang dilakukan kuretase. Dilakukan penelitian uji klinis acak tersamar tunggal pada 60 pasien yang menjalani kuretase di Rumah Sakit Dr. Hasan Sadikin Bandung periode September–November 2014.  Pasien dibagi dalam dua kelompok, yaitu propofol-ketamin (PK) dan propofol-fentanil (PF). Data hasil penelitian  untuk tekanan darah, laju nadi, laju napas, saturasi oksigen, dan skor bispectral index (BIS) dianalisis dengan uji-t dan Uji Mann-Whitney. Hasil penelitian menunjukkan kebutuhan propofol berbeda secara sangat bermakna (p<0,001), pada kelompok PK terdapat 4/30 subjek yang mendapatkan tambahan propofol, sedangkan pada kelompok PF sebanyak 14/30 subjek. Lama bangun pada kelompok PK adalah 25,75±2,47 menit, sedangkan pada kelompok PF adalah 21,08±2,52. Secara statistik hasil tersebut berbeda secara sangat bermakna (p<0,001). Simpulan, kebutuhan propofol pada kelompok PK lebih sedikit dibanding dengan kelompok PF dan lama bangun pada kelompok PK lebih lama dibanding dengan kelompok PF. Kata kunci: Bispectral index, kebutuhan propofol, kuretase, lama bangun Comparison of Propofol Requirements and Emergence Time between Propofol-Ketamine and Propofol-Fentanyl Combinations in Patients Undergoing Curretage using Bispectral Index (BIS) MonitoringAdequate administration of safe, easy-to-obtain, and constantly available sedatives and analgesia, is needed for pain reduction throughout curettage procedures. The goal of this study was to examine differences in propofol requirements and emergence time between propofol-ketamine and propofol-fentanyl combinations in patients undergoing curettage. A single-blind randomized controlled trial study was performed on 60 patients who underwent curettage procedures. The patients were divided into two groups: propofol-ketamine (PK) and propofol-fentanyl (PF). Blood pressure, pulse rate, respiration rate, and oxygen saturation and BIS data were analysed using a t-test and Mann-Whitney test. This study showed that propofol requirements differ significantly (p<0.001) between the two groups where in PK group where 4/30 subjects received additional propofol, compared to PF group 14/30 subjects received additional propofol. The wake up time for PK group was 25.75±2.47 minutes compared to 21.08±2.52 minutes for the PF group. The difference was statistically significant (p<0.001). The conclusions of this study are propofol requirements for PK group is less compared to PF group and the emergence time for PK group is longer compared to PF group. Key words: Bispectral index, curettage, emergence time, propofol requirements DOI: 10.15851/jap.v3n3.611
Perbandingan Teknik Insersi Klasik dengan Teknik Insersi Triple Airway Manoeuvre terhadap Angka Keberhasilan dan Kemudahan Pemasangan Laryngeal Mask Airway (LMA) Klasik Simanjuntak, Nelly Margaret; Oktaliansah, Ezra; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Beberapa penelitian telah dilakukan untuk mencari metode yang dapat meningkatkan angka keberhasilan teknik insersi laryngeal mask airway (LMA) klasik dan mengurangi komplikasi yang mungkin terjadi. Penelitian ini bertujuan mengetahui angka keberhasilan dan kemudahan pemasangan LMA klasik pada teknik triple airway manoeuvre (TAM). Penelitian ini adalah eksperimental prospektif dengan metode acak terkontrol tersamar tunggal terhadap pasien yang menjalani operasi terencana dalam anestesi umum di kamar operasi Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung pada bulan April–Juli 2015. Tiga puluh enam pasien pasien berusia 18–60 tahun, status fisik berdasarkan American Society of Anesthesiologists (ASA) kelas I–II dibagi menjadi dua kelompok, yaitu kelompok teknik insersi klasik dan teknik insersi TAM. Pada teknik TAM, seorang penolong melakukan protrusi mandibula dan membuka mulut sementara seorang melakukan insersi LMA klasik. Data hasil penelitian dianalisis dengan uji statistik Eksak Fisher dan Kolmogorov Smirnov. Hasil penelitian menunjukkan bahwa perbandingan angka keberhasilan pemasangan dan kemudahan pemasangan LMA klasik pada kedua kelompok perlakuan berbeda bermakna (p<0,05) dengan teknik insersi TAM memiliki angka keberhasilan lebih tinggi daripada teknik insersi klasik (72,2%) dan teknik insersi TAM memiliki kejadian tahanan di orofaring lebih sedikit dibanding dengan teknik klasik (83,3%). Simpulan, teknik insersi TAM memiliki angka keberhasilan yang lebih tinggi daripada teknik insersi klasik sehingga.Kata kunci: Laryngeal mask airway klasik, teknik triple airway manoeuvre, teknik insersi klasikComparison of Success Rate and Ease of Insertion of Classic Laryngeal Mask Airway when Inserted using Classic Insertion Technique and Triple Airway Maneuver TechniqueAbstractVarious studies are seeking to find new methods to improve techniques of classic laryngeal mask airway (cLMA) insertion and reduce possible complications. This is a clinical study to investigate the succesrate and ease of insertion using triple airway maneuver(TAM) technique and to compare it with the classic technique. This experimental prospective study was conducted using the single-blind randomized controlled trial approach to patients underwent elective surgery under general anesthesia in the operating teather of Dr. Hasan Sadikin General Hospital Bandung during the period of April 2015 to July 2015. Thirty six patients aged 18–60 years old with American Society of Anesthesiologists (ASA) I–II status were randomly divided into two groups receiving either triple airway maneuver (TAM) technique or classic technique. In TAM technique, jaw thrust and mouth opening are facilitated by a technician and the anesthesiologist inserts the LMA. The collected data were analyzed using Fisher Exact and Kolmogorov Smirnov. The statistical analysis showed that the ratio of success rate and the ease of insertion of cLMA between both treatment groups was significantly different (p<0.05) where the TAM technique showed a higher success rate of insertion (72.2%) and less impacts on the oropharynx compared to the classic method (83.3%). Overall , in this study, the TAM technique is associated with higher of success rate compared to the classic technique and the ease of insertion of TAM method makes it worth to be considered as a safe and effective method to establish a secure airway in anesthetized patients.Key words: Classic laryngeal mask airway, ease of insertion, success rate, triple airway manoeuvre DOI: 10.15851/jap.v4n3.900
Perbandingan Pemberian Efedrin 30 mcg/kgBB dengan Efedrin 70 mcg/kgBB Intravena terhadap Skala Nyeri dan Efek Hipotensi pada Penyuntikan Propofol di Rumah Sakit Dr. Hasan Sadikin Bandung Afifuddin, Afifuddin; Sitanggang, Ruli Herman; Oktaliansah, Ezra
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (650.194 KB) | DOI: 10.15851/jap.v5n3.1164

Abstract

Penyuntikan propofol menyebabkan  nyeri dan perubahan tekanan darah. Efedrin merupakan obat yang digunakan untuk mengurangi efek yang tidak diinginkan saat penyuntikan propofol. Penelitian ini bertujuan membandingkan pemberian efedrin 30 mcg/kgBB intravena dengan efedrin 70 mcg/kgBB intravena terhadap skala nyeri dan efek hipotensi pada penyuntikan propofol. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan September hingga November 2015 terhadap 60 orang  pasien dengan  American Society of Anesthesiologist  (ASA) kelas I dan II, usia 18 hingga 60 tahun yang menjalani operasi elektif dengan anestesi umum secara uji acak kontrol buta ganda. Pasien dibagi menjadi dua kelompok, 30 orang menerima efedrin 30 mcg/kgBB dan 30 orang menerima efedrin 70 mcg/kgBB, diberikan 1 menit sebelum penyuntikan propofol. Analisis statistik menggunakan uji Mann-Whitney. Hasil penelitian menunjukkan skala nyeri pada kelompok efedrin 30 mcg/kgBB dan efedrin 70 mcg/kgBB tidak berbeda bermakna (p>0,05), dan perubahan tekanan darah sistole dan diastole efedrin 30 mcg/kgBB dengan efedrin 70 mcg/kgBB berbeda bermakna (p<0,05). Simpulan, efedrin 30 mcg/kgBB dan efedrin 70 mcg/kgBB menurunkan skala nyeri saat penyuntikan propofol, dan efedrin 70 mcg/kgBB mencegah efek hipotensi lebih baik dibanding dengan efedrin 30 mcg/kgBB.  Comparison of 30 mcg/kgBW and 70 mcg/kgBW Intravenous Ephedrine on Pain Scale and Hypotension After Propofol Injection in  Dr. Hasan Sadikin General Hospital BandungInjection of propofol causes pain and blood pressure changes. Propofol can cause pain at the injection site and decrease the blood pressure while ephedrine is considered to minimize those adverse effect. The purpose of the study was to compare the effects of 30 mcg/kgBW and 70 mcg/kgBW intravenous ephedrine on pain score and blood pressure changes after propofol injection. This double-blind randomized control trial was conducted in Dr. Hasan Sadikin General Hospital Bandung, September to November 2015, on 60 patients with American Society of Anesthesiologist (ASA) physical status I and II, aged 18 to 60 years old. Patients were divided into 2 groups of 30 persons; the first group received 30 mcg/kgBW ephedrine and the second group received 70 mcg/kgBW ephedrine one minute before propofol injection. Statistical analysis was performed using the Mann-Whitney test. This study showed no significant difference in pain score between the group that received 30 mcg/kgBW ephedrine and 70 mcg/kgBW (p>0,05), but there were significant differences in blood pressure changes (p<0,05). It can be concluded that 30 mcg/kgBW and 70 mcg/kgBW ephedrine could reduce pain score following propofol injection with 70 mcg/kgBW ephedrine reduces the hypotension effect better than the 30 mcg/kgBW dose.  
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