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PERBANDINGAN NYERI YANG TERJADI 24 JAM PASCA OPERASI PADA PENDERITA YANG DIBERIKAN ANESTESIA UMUM DAN ANESTESIA SPINAL Muhammad, Fiska M.; Kumaat, Lucky; Posangi, Iddo
e-CliniC Vol 3, No 3 (2015): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v3i3.10594

Abstract: Pain can be described as an unpleasant sensory and emotional experience associated with tissue damage which has already occured or potentially will be occurred. General anesthesia is oftenly perfomed on a wide range of surgical procedures. There are two techniques of general anesthesia: inhalation anesthesia and intravenous anesthesia. Spinal anesthesia is one of the simplest and most reliable of regional anesthesia technique. This study aimed to compare the pain between general anesthesia and spinal anesthesia 24 hours post operative. This was an analytical prospective study. Samples were 24 patients consisting of 12 patients with general anesthesia and 12 patients with spinal anesthesia. The inclusion criteria were patients aged 20-60 years old, duration of operation 1-4 hours, and the operations were caesarean section and hysterectomy. The pain assessment used VAS score as well as blood pressure, pulse, and respiration. Data were statistically analyzed by using the Mann-Whitney test and showed a p-value 0.876. Conclusion: There was no significant difference in 24-hour-post-operative pain using VAS score among patients with general anesthesia and with spinal anesthesia.Keywords: VAS scores, general anesthesia, spinal anesthesia.Abstrak: Nyeri dapat digambarkan sebagai suatu pengalaman sensorik dan emosional yang tidak menyenangkan yang berkaitan dengan kerusakan jaringan yang sudah atau berpotensi terjadi. Anestesia umum sering dilalukan pada berbagai macam prosedur pembedahan dan terbagi atas anestesia inhalasi dan anestesia intravena. Anestesia spinal merupakan salah satu anestesia yang paling sederhana dan paling dapat diandalkan dari tehnik anestesia regional. Penelitian ini bertujuan untuk mengetahui perbandingan nyeri pada pemberian anestesia umum dan anestesia spinal 24 jam pasca operasi. Penelitian ini menggunakan metode analitik prospektif. Terdapat 24 sampel yang terbagi atas 12 penggunaan anestesia umum dan 12 penggunaan anestesia spinal, dengan kriteria rentang umur pasien 20-60 tahun, lama operasi 1-4 jam serta jenis pembedahan seksio sesarea dan histerektomi. Penilaian nyeri menggunakan skor VAS serta tekanan darah, nadi dan respirasi. Data diolah dengan menggunakan program SPSS versi 20. Hasil uji statistik Mann-Whitney mendapatkan nilai p= 0,876 yang menunjukkan tidak terdapat perbedaan bermakna dari skor VAS. 24 jam pasca operasi dengan anestesia umum dan anestesia spinal. Simpulan: Tidak terdapat perbedaan bermakna nyeri 24 jam pasca operaasi dinilai dengan skor VAS pada pemberian anestesia umum dan anestesia spinal.Kata kunci: Skor VAS, anestesia general, anestesia spinal

PERBANDINGAN EFEKTIVITAS ANTARA LIDOKAIN 0,50 mg/kgBB DENGAN LIDOKAIN 0,70 mg/kgBB UNTUK MENGURANGI NYERI PENYUNTIKAN PROPOFOL SAAT INDUKSI ANESTESIA Rama, Stefhany; Laihad, Mordekhai; Posangi, Iddo
e-CliniC Vol 2, No 1 (2014): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.2.1.2014.3596

Abstract: Induction of general anesthesia is an action to cause an unconsciousness Â state of a patient before commencing a surgical operation. Propofol is a phenol derivative which is widely used as an intravenous anesthetic drug. A venous injection of propofol causes pain in the injection site. Lidocaine can reduce pain the on the injection site of propofol. This study aimed to compare the incidence of patients who still experienced pain on the injection site of propofol although had been administered lidocaine 0.50 mg / kg BW or lidocaine 0.70 mg / kg BW. This was an experimental study conducted at the Central Surgical Installation (IBS) and the emergency operative room at Prof Dr. R. D. Kandou General Hospital Manado from November 2012 to December 2012. The result showed that in the lidocaine 0.5 mg/kg BWÂ group there were 8.3% samples with pain and 91.7% without pain. In the lidocaine 0.7% group, there were no samples (0%) with pain hence 100% without pain. The chi-square test showed a P = 0.307. Conclusion: Although not statistically significant, administration of lidocain 0.70 mg/kg BW was more effective in reduction of pain at the injection sites of propofol than that of lidocain 0.50 mg/kg BW. Keywords: propofol, lidocaine Â Â Abstrak: Induksi anestesia umum ialah tindakan untuk membuat pasien menjadi tidak sadar sehingga memungkinkan dimulainya tindakan pembedahan. Propofol merupakan derivat fenol yang banyak dipakai sebagai obat anestetik intravena. Penyuntikan propofol lewat vena menyebabkan rasa nyeri pada tempat penyuntikan. Pemberian lidokain merupakan salah satu cara untuk mengurangi rasa nyeri pada penyuntikan propofol. Penelitian ini bertujuan untuk membandingkan insiden pasien yang mengalami nyeri saat penyuntikan propofol kelompok lidokain 0,50 mg/kgBB dan kelompok lidokain 0,70 mg/kgBB. Penelitian ini merupakan penelitian eksperimental. Penelitian dilaksanakan di Instalasi Bedah Sentral (IBS) dan ruang OK CITO RSUP Prof. Dr. R. D. Kandou Manado pada bulan November 2012 sampai Desember 2012. Hasil penelitian menunjukkan bahwa jumlah proporsi sampel yang nyeri pada kelompok lidokain 0,5 mg/kg yaitu 8,3% sedangkan yang tidak nyeri 91,7%. Pada kelompok lidokain 0,7 mg/kg tidak dijumpai sampel dengan keluhan nyeri (0%), yang berarti terdapat 100% sampel yang tidak nyeri. Uji statistik dengan chi-square menunjukkan nilai P = 0,307. Simpulan: Walaupun tidak bermakna secara statistik, pemberian lidokain 0,70 mg/kg lebih efektif menurunkan nyeri pada tempat penyuntikan propofol dibandingkan dengan lidokain 0,50 mg/kg. Kata kunci : propofol, lidokain

PERBANDINGAN MUAL â€“ MUNTAH PADA PREMEDIKASI DENGAN PEMBERIAN ONDANSETRON DAN DENGAN DEKSAMETASON PASCA OPERASI SECTIO CAESAREA DENGAN ANESTESI REGIONAL Tewu, Havriray; Posangi, Iddo; Kumaat, Lucky
e-CliniC Vol 3, No 3 (2015): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v3i3.9832

Abstract: Post Operative Nausea and Vomiting (PONV) is nausea-vomiting in 24 hours after anaesthesia and surgery procedures. Nausea-vomiting are the side effects which commonly found after anaethesia and surgery. To prevent the occurence of these side effects, patients are given premedication of ondansetron or dexamethason deksametason. This study aimed to obtain the difference of nause-vomiting in administration of ondansetron and dexamethason post operation. This was an analytical prospective study. Subjects were 10 people. The results showed that there was no significant difference between premedication administration of ondansetron and dexamethason in prevention of nause-vomiting post operation.Keywords: nause-vomiting, premedication, ondansentron, dexamethasonAbstrak: Post Operative Nausea and Vomiting (PONV) adalah perasaan mual-muntah yang dirasakan dalam 24 jam setelah prosedur anestesi dan pembedahan. Mual-muntah ialah efek samping yang sering ditemukan setelah tindakan operasi dan anestesi. Untuk mencegah terjadinya mual dan muntah diberikan premedikasi pemberian ondansentron atau deksametason. Penelitian ini bertujuan untuk mengetahui perbedaan mual-muntah pada pemberian ondansetron dan deksametason pasca operasi. Penelitian ini dilakukan menggunakan metode analitik prospektif. Subyek penelitian berjumlah 10 orang. Hasil penelitian ini didapatkan tidak terdaapt perbedaan bermakna antara premedikasi pemberian ondansetron dengan deksametason dalam mencegah mual â€“muntah.Kata kunci: mual muntah, premedikasi, ondansentron, deksametason

PENATALAKSANAAN CAIRAN PERIOPERATIF PADA KASUS TRAUMA Posangi, Iddo
JURNAL BIOMEDIK : JBM Vol 4, No 1 (2012): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.4.1.2012.743

Abstract: Trauma can be defined as a physical harm or damage to the structure or function of the body, caused by an acute exchange of mechanical, chemical, thermal, radioactive, or biological energy that exceeds the body?s tolerance. The commonly used resuscitation fluids are Ringer?s Lactate solution, normal saline, colloids, hypertonic saline, and blood products (packed red blood cells, fresh frozen plasma, or platelets). Fluid resuscitation strategy consists of early resuscitation and late resuscitation. The management of perioperative fluid therapy in traumatized cases requires a comprehensive understanding regarding the pathophysiology of shock, the consequences of fluid therapy in ongoing bleeding, and the ability to apply the evidence-based studies on each individual with different clinical status. Key words: trauma, fluid resuscitation, shock Abstrak: Trauma dapat didefinisikansebagai cedera atau kerusakan fisik dari struktur atau fungsi tubuh yang disebabkan oleh perubahan energi akut(mekanis, kimiawi, radioaktif, biologik) yang melampaui toleransi tubuh. Cairan resusitasi yang umunya digunakan pada kasus trauma ialah larutan Ringer laktat, NaCl fisiologis, koloid, NaCl hipertonik dan produk darah (packed red blood cells, plasma beku atau trombosit). Strategi resusitasi cairan terdiri dari resusitasi fase awal dan fase akhir. Penatalaksanaan terapi cairan perioperatif pada kasus trauma memerlukam pemahaman yang menyeluruh mengenai patofisiologi syok, efek terapi cairan pada saat perdarahan aktif, dan kemampuan untuk menerapkan bukti ilmiah pada masing-masing individu dengan keadaan klinis yang berbeda.Kata kunci: trauma, resusitasi cairan, syok

PERBANDINGAN SKALA NYERI PASIEN PASCA OPERASI SEKSIO SESAREA YANG DIBERIKAN MORFIN INTRATEKAL DENGAN MORFIN INTRATEKAL DITAMBAH KETOROLAK INTRA Sandy, Indra F.; Posangi, Iddo; Tambajong, Harold F.
e-CliniC Vol 3, No 1 (2015): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.3.1.2015.12740

Abstract: Caesarean section is one of the most common procedures performed. It is estimated that 15% of births worldwide and 21.1% of those in developed countries occur via cesarean section. Surgery causes tissue damage and pain in the abdomen. Postoperative pain is acute pain that occurs after the surgery with a rapid onset. Postoperative pain indicates damages or injuries have occurred with mild-to-severe intensity. Pharmacologic therapies that can be given is an analgesic that can be administered through several routes: parenteral, oral, rectal, transdermal, and intraspinal. This study aimed to determine the patient's postoperative pain scale for caesarean section and compared the pain scale after administration of intrathecal morphine with intrathecal morphine plus ketorolac intravena at the hour 2, 4, and 8. This was a prospective analytical study using a cross sectional approach. Samples were 32 people. The data collected were measured by using VAS pain scale and analyzed using by independent t test and Man Whitney U test. The results showed that at the 2nd hours the average value (mean) pain scale after intrathecal morphine use after surgery was 2.20, while the value of morphine + ketorolac is 0.00. At the 4th hour, the average value (mean) pain scale after intrathecal morphine use after surgery was 4.75, while the value of morphine + ketorolac was 4.55. At the 8th hour average value (mean) pain scale after postoperative intrathecal morphine use was 7.30, while the value of morphine + ketorolac was 5.85. Conclusion: At the 2nd hour, there was a difference in scale of postoperative pain in patients of caesarean section with intrathecal morphine and morphine + ketorolac (p = 0.002). At the 4th, there was no difference in the pain scale postoperative caesarean section patients with intrathecal morphine and morphine + ketorolac (p = 0.363). At the 8th, there were differences in scale of postoperative pain in patients of caesarean section with intrathecal morphine and morphine + ketorolac (p = 0.001). Keywords: caesarean section, scale pain, intrathecal morphine, ketorolac IntravenousÂ Abstrak: Operasi sesar adalah salah satu prosedur yang paling umum dilakukan. Diperkirakan bahwa 15% dari kelahiran seluruh dunia dan 21,1% dari mereka di negara maju terjadi melalui operasi sesar. Tindakan pembedahan menyebabkan kerusakan jaringan dan menimbulkan nyeri pada bagian abdomen.Nyeri pasca operasi merupakan nyeri akut yang terjadi setelah proses pembedahan yang memiliki awitan yang cepat. Nyeri pasca operasi mengindikasikan kerusakan atau cedera telah terjadi dengan intensitas ringan sampai berat.Terapi farmakologis ialah analgesik yang dapat diberikan melalui rute parenteral, oral, rektal, transdermal, atau intraspinal. Penelitian ini bertujuan untuk mengetahui skala nyeri pasien pasca operasi seksio sesarea dan membandingkan skala nyeri setelah pemberian morfin intratekal dengan morfin intratekal ditambah ketorolak inttavena pada jam ke 2, 4, 8. Rancangan penelitian ini bersifat analitik prospektif dengan menggunakan pendekatan potong lintang. Sampel penelitian ini berjumlah 32 orang. Data yang dikumpulkan diukur dengan skala nyeri VAS, kemudian data dianalisis dengan menggunakan uji independent dan uji Man Whitney U. Hasil penelitian memperlihatkan pada jam ke-2 nilai rata-rata (mean) skala nyeri setelah penggunaan morfin intratekal pasca bedah 2,20, sedangkan nilai morfin + ketorolak 0,00.Pada jam ke-4 nilai rata-rata (mean) skala nyeri setelah penggunaan morfin intratekal pascabedah 4,75, sedangkan nilai morfin + ketorolak 4,55. Pada jam ke-8 nilai rata-rata (mean) skala nyeri setelah penggunaan morfin intratekal pasca bedah 7,30, sedangkan nilai morfin + ketorolak 5,85. Simpulan: Pada jam ke-2, terdapat perbedaan skala nyeri pada pasien pasca operasi seksio sesarea dengan pemberian morfin intratekal dan morfin + ketorolac (p=0,002). Pada jam ke-4, tidak terdapat perbedaan skala nyeri pada pasien pasca operasi seksio sesarea dengan pemberian morfin intratekal dan morfin + ketorolac (p=0,363). Pada jam ke-8, terdapat perbedaan skala nyeri pada pasien pasca operasi seksio sesarea dengan pemberian morfin intratekal dan morfin + ketorolak (p = 0,001).Kata kunci: seksio sesarea, skala nyeri, morfin intratekal, ketorolak intravena

PERBANDINGAN EFEKTIFITAS TRAMADOL 1,5 MG/KGBB IV DENGAN KETOROLAK 30 MG IV TERHADAP TINGKAT NYERI PASCA OPERASI SEKSIO SESAREA Yosieto, Aldy; Kumaat, Lucky; Posangi, Iddo
e-CliniC Vol 3, No 1 (2015): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v3i1.6763

Abstract: Surgery lead to pain manifestation that could occur after surgery (post-operative pain). The purpose of this study is to compare the analgesic efficacy of tramadol with ketorolac for preventing post-operative pain in caesarean section patients. This study was performed on 26 female patients, aged 17-64 years old, American Society of Anesthesiologist (ASA) physical state I-II, had 18,5-29,9 Body Mass Index (BMI), who underwent caesarean section surgery in Prof. R. D. Kandou Manado General Hospital from December 2014 to January 2015. The subjects was divided into two groups, who would receive either 1,5 mg/BW intravenous tramadol (drips) or 30 mg intravenous ketorolac, 1,5 hours after the anesthesia induction. Systolic and diastolic blood pressure, heart rate, respiration rate, and Visual Analogue Scale (VAS) score were taken for 8 hours with 2 hours interval (0, 2nd, 4th, 6th, 8th hours). The statistical analysis was done using T-test and Mann-Whitney test.Conclusion: The result is the systolic and diastolic blood pressure, heart rate, respiration rate, and VAS score between the two groups have no significant differences (p>0,05). Therefore, 1,5 mg/BW intravenous tramadol and 30 mg intravenous ketorolac have same analgesic efficacy in preventing post-operative pain in caesarean section patients.Keywords: tramadol, ketorolac, post-operative pain, caesarean sectionAbstrak: Pembedahan dapat menyebabkan timbulnya rasa nyeri yang bisa muncul setelah pembedahan (nyeri pasca operasi). Tujuan penelitian ini adalah untuk mengetahui perbandingan efektifitas tramadol dengan ketorolak terhadap tingkat nyeri pasca operasi seksio sesarea. Penelitian dilakukan pada 26 pasien wanita (17-64 tahun), status fisik American Society of Anesthesiologist (ASA) I-II, dengan Indeks Massa Tubuh (IMT) 18,5-29,9 yang menjalani bedah seksio sesarea di Rumah Sakit Prof. R. D. Kandou Manado di bulan Desember 2014 â€“ Januari 2015. Pasien dibagi menjadi dua kelompok yaitu yang menerima tramadol 1,5 mg/kgBB secara intravena (IV) lewat tetesan infus (drips) atau ketorolak 30 mg IV, 1,5 jam setelah induksi anestesia dilakukan. Data yang diambil adalah nilai tekanan darah sistolik dan diastolik, nadi per menit, respirasi per menit, dan skor Visual Analogue Scale (VAS) setiap 2 jam setelah tramadol atau ketorolak diberikan (jam ke 0, 2, 4, 6, 8). Analisis statistik dilakukan dengan menggunakan uji-t dan uji Mann-Whitney.Simpulan: Ditemukan bahwa nilai tekanan darah sistolik, diastolik, nadi, respirasi, dan skor VAS dari kedua kelompok penelitian tidak memberikan perbedaan yang bermakna (p>0,05). Simpulan penelitian adalah tramadol 1,5 mg/kgBB IV memberikan efek yang sama dengan ketorolak 30 mg IV terhadap nyeri pasca operasi seksio sesarea.Kata kunci: tramadol, ketorolak, nyeri pasca operasi, seksio sesarea

Systematic Review on Hierarchical Culture and Symbolic Violence in Medical Education Environment Posangi, Iddo
Jurnal Sehat Indonesia (JUSINDO) Vol. 7 No. 2 (2025): Jurnal Sehat Indonesia (JUSINDO)
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/.v7i2.383

The medical education environment is often characterized by a strong hierarchical culture, where power imbalances have the potential to give rise to various forms of symbolic violence that are difficult to detect directly. Symbolic violence within medical education systems can negatively impact the psychological well-being of students and medical staff, as well as disrupt the learning process and professionalism within the institution. The aim of this study is to comprehensively review existing literature regarding the role of hierarchical culture in creating and sustaining symbolic violence in medical education environments, as well as to identify its effects on the well-being and professional development of learners, in order to formulate strategic recommendations for more equitable and supportive structural changes. This study uses the Systematic Literature Review (SLR) method to examine in depth the culture of hierarchy and symbolic violence in medical education. SLR was conducted systematically and transparently to identify, assess and synthesize relevant scientific evidence, while assessing the quality of the findings to gain a comprehensive understanding. Data were collected through documentation techniques on scientific literature and documents, enabling the identification of historical and contextual patterns of symbolic violence. The results of the systematic review indicate that the entrenched hierarchical culture in medical education often triggers subtle yet significant symbolic violence. This symbolic violence emerges through hidden mechanisms of domination, such as language, attitudes, and social norms that position certain parties as morally, ethically, and professionally superior. The most commonly reported negative impacts include psychological pressure, decreased motivation to learn, and the creation of an academic environment that is unconducive to the development of competencies and the well-being of medical students.

Burnout in Medical Student: Literature Review Rawis, Joulanda A. M.; Lengkong, Andriessanto C.; Mahama, Inggrid C.; Lampah, Christopher; Posangi, Iddo
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v9i5.15145

Burnout is a condition of emotional exhaustion, depersonalization, and reduced work performance caused by chronic stress. Burnout can occur in various people, including medical students. The purpose of this study was to review the literature on burnout in medical students. This study used a literature research method. Research data were collected using literature search techniques. Research data were obtained from various sources, namely journal articles, books, and research reports. The research data were analyzed using qualitative analysis techniques. The results showed that burnout in medical students is a serious problem. Burnout can occur in medical students at various levels of education, ranging from early semester students to final semester students. Factors that can cause burnout in medical students include high academic loads, demands to be perfect doctors, and stressful working conditions. The negative impacts of burnout on medical students include impaired physical and mental health, decreased academic performance and lower chances of getting a job.

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