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All Journal Jurnal Anestesi Perioperatif Majalah Anestesia dan Critical Care Jurnal Neuroanestesi Indonesia

Ruli Herman Sitanggang

Departemen Anestesiologi Dan Terapi Intensi Fakultas Kedokteran Universitas Padjadjaran /RSHS Bandung

Author-ID : 382464

Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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Perbandingan Klonidin 0,5 mg/kgBB Intravena dengan Tramadol 0,5 mg/kgBB Intravena Sebagai Profilaksis Kejadian Menggigil Pascaanestesia Spinal pada Seksio Sesarea Lira Panduwaty; - Suwarman; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Menggigil merupakan komplikasi yang sering terjadi pascaanestesi spinal, akibat gangguan kontrol termoregulasi. Klonidin merupakan agonis adrenergik α2 yang memiliki efek antihipertensi, analgetik, sedasi, dan antimenggigil. Tujuan penelitian ini untuk menilai perbandingan klonidin 0,5 μg/kgBB dengan tramadol 0,5 mg/kgBB dalam menurunkan kejadian menggigil pada pasien yang menjalani seksio sesarea dengan anestesi spinal. Metode penelitian adalah uji klinis acak terkontrol tersamar ganda pada 58 pasien yang menjalani operasi seksio sesarea di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Januari−April 2014, usia 18−45 tahun, status fisik menurut American Society of Anesthesiologist (ASA) II dan dibagi secara acak menjadi 2 kelompok, yaitu kelompok yang menerima klonidin 0,5 μg/kgBB intravena dan kelompok tramadol 0,5 mg/kgBB intravena sebelum dilakukan anestesi spinal dengan bupivakain 12,5 mg. Analisis statistik menggunakan uji-t, uji chi-kuadrat, dan Uji Eksak Fisher. Hasil penelitian menunjukkan kejadian menggigil pada kelompok klonidin lebih sedikit bila dibandingkan dengan kelompok tramadol, baik di kamar operasi (3,44% vs 10,34%) maupun di ruang pemulihan (3,44% vs 17,24%). Simpulan dari penelitian ini menunjukkan bahwa pemberian klonidin 0,5 μg/kgBB intravena sebelum anestesi spinal pada seksio sesarea mengurangi kejadian menggigil dan efek samping.Kata kunci: Klonidin, menggigil, pascaanestesi spinal, tramadol Comparison of Intravenous 0.5 mg/kgBW Clonidine Intravenous and 0.5 mg/kgBW Tramadol as Post Spinal Anesthesia Shivering Prophylactic Agent in Caesarean SectionAbstract Shivering, as a result of impaired thermoregulatory control, is known as a frequent complication of post-spinal anesthesia. Clonidine is an α2-adrenergic agonist that has anti-hypertensive, analgesic, sedation and anti-shivering effects. The purpose of this study is to compare the use of 0.5 μg/kgBW clonidine with 0.5 mg/kgBW tramadol in reducing the incidence of shivering in patients undergoing cesarean section with spinal anesthesia. The method applied was the double-blind randomized controlled clinical trial in 58 patients undergoing caesarean surgery at the Dr. Hasan Sadikin General Hospital Bandung in the period of January−April 2014, age 18−45 years, American Society of Anesthesiologist (ASA) physical status II, and divided into two groups; a group receiving 5 μg/kgBW intravenous clonidine and a group receiving 0.5 mg/kgBW intravenously tramadol prior to spinal anesthesia with bupivacaine 12.5 mg. The statistical analyses used were the t test, chi-square test and Fisher’s Exact test. The incidence of shivering were less in the clonidine group compared to the tramadol group in operating theatre (3.44% vs 10.34) and recovery room (3.44% vs 17.24%). The conclusion of this study showed that the administration of 0.5 μg/kgBW clonidine intravenously before spinal anesthesia for cesarean section reduces the incidence of shivering and side effects.Keywords: Clonidine, post spinal anesthesia, shivering, tramadol DOI: 10.15851/jap.v3n1.378

Perbandingan Efek Pregabalin 150 mg dengan 300 mg Dosis Tunggal terhadap Nilai Numeric Rating Scale dan Kebutuhan Analgetik Pascabedah pada Pasien Histerektomi Abdominal - Elvidiansyah; Iwan Fuadi; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Pregabalin memiliki efek antihiperalgesia, antialodinia, dan antinosiseptif. Penelitian bertujuan untuk membandingkan pregabalin 150 mg dengan 300 mg dosis tunggal 1 jam prabedah terhadap nyeri pascabedah dan kebutuhan opioid pada operasi histerektomi abdominal dalam anestesi umum. Uji klinik acak terkontrol buta ganda dilakukan terhadap 60 wanita (18–60 tahun) status fisik American Society of Anesthesiologist (ASA) I–II di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Mei–Agustus 2013. Pasien dibagi menjadi dua kelompok yang menerima pregabalin 150 mg atau 300 mg. Analisis statistik data hasil penelitian menggunakan uji-t, chi-kuadrat, dan Uji Mann-Whitney. Pada penelitian ini ditemukan nilai numeric rating scale (NRS) saat mobilisasi pada kelompok pregabalin 150 mg dan pregabalin 300 mg berbeda bermakna (p<0,05). Pemberian analgetik tambahan pascabedah antara kedua kelompok tidak berbeda bermakna (p>0,05). Simpulan penelitian adalah pregabalin dosis 150 mg memiliki efek analgesia dan penambahan opioid yang tidak jauh berbeda dibandingkan dengan dosis 300 mg.Kata kunci: Histerektomi abdominal, numeric rating scale, nyeri pascabedah, pregabalinComparison Between the Effect of Single Dose 150 mg and 300 mg Pregabalin of Numeric Rating Scale Value and Post operative Analgesia Requirement in Abdominal Hysterectomy PatientsPregabalin has the effect of anti hyperalgesia, anti allodynia, and anti nociception. This study aimed to compare single dose of 150 mg pregabalin with 300 mg pregabalin given 1 hour preoperatively in regards to postoperative pain and opioid requirements in abdominal hysterectomy patients. Double blind randomized controlled trial has been conducted on 60 women (18–60 years), American Society of Anesthesiologist (ASA) physical status I-II, who underwent abdominal hysterectomy in a double-blind randomized controlled trial under general anesthesia in Dr. Hasan Sadikin Hospital-Bandung within May to August 2013. Patients were divided into two groups whose received 150 mg pregabalin or 300 mg pregabalin pre operatively. Statistical analysis of research data is performed using the student’s t-test, chi square, and Mann-Whitney U-test. This study found that numeric rating scale (NRS) scores during mobilization in the 150 mg pregabalin group and 300 mg pregabalin were significantly different (p<0.05). There was no significant differences in postoperative supplemental analgesic administration between the two groups (p>0.05). The conclusion of the study is preoperative pregabalin dosage 150 mg and 300 mg has insignificant differences in its therapeutic effect and supplemental opioid.Key words: Abdominal hysterectomy, numeric rating scale, postoperative pain, pregabalin DOI: 10.15851/jap.v2n2.308

Perbandingan Ketepatan Pengukuran Tekanan Balon Pipa Endotrakeal setelah Intubasi antara Metode Palpasi pada Pilot Balon dan Teknik Melepas Spuit secara Pasif Gunawan Mutiara; - Suwarman; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Metode palpasi pada pilot balon merupakan teknik yang tidak akurat untuk menentukan tekanan balon pipa endotrakeal (endotracheal tube/ETT). Tujuan penelitian ini membandingkan ketepatan pengukuran tekanan balon ETT antara metode palpasi pada pilot balon (MP) dan teknik melepas spuit secara pasif (MSP). Penelitian dilakukan pada bulan Juni 2014 di Rumah Sakit Dr. Hasan Sadikin Bandung, menggunakan metode kuantitatif eksperimen dengan rancangan uji acak silang tersamar tunggal. Subjek penelitian adalah 94 orang pasien berusia 18−65 tahun dengan status fisik American Society of Anesthesiologists (ASA) I–III, yang menjalani pembedahan dengan anestesi umum secara intubasi endotrakeal. Saat akan dilakukan intubasi, balon ETT dikembangkan dengan dua teknik yang berbeda kelompok metode palpasi (n=48) dan kelompok teknik melepas spuit secara pasif (n=46). Data hasil penelitian dianalisis menggunakan uji-t tidak berpasangan dan uji chi-kuadrat. Hasil penelitian didapatkan tekanan rata-rata pada kelompok MP 57,7±26,0 cmH2O dan MSP 28,7±4,5 cmH2O, sedangkan untuk ketepatan pengukuran pada kelompok MSP 56,5% dan kelompok MP 6,2% (p<0,001). Simpulan penelitian ini menunjukkan bahwa metode palpasi merupakan teknik pengukuran tekanan balon ETT yang tidak adekuat.Kata kunci: Metode palpasi pada pilot balon, teknik melepas spuit secara pasif, endotracheal tubeComparison between Pilot Balloon Palpation Method and Passive Release Technique on the Accuracy of Measurements of Endotracheal Tube Cuff Pressure Estimation of cuff pressure by palpating the pilot balloon is not accurate to determine the cuff pressure of endotracheal tube (ETT). Hence, this study we conducted to compare the accuracy of indirect measurements between pilot balloon palpation method (MP) and passive release technique (MSP). This was a single blind randomized crossover study performed in june 2014 at Dr. Hasan Sadikin General Hospital Bandung, in which patients received each technique and as a control group. Subjects were 94 patients aged 18−65 years old with American Society of Anesthesiologists (ASA) physical status I−III who underwent surgery requiring tracheal intubation. These subjects were randomized into two groups. After induction of anesthesia, the cuff was inflated with two different techniques: pilot balloon palpation technique (n=48) and passive release technique (n=46). Data were statistically analyzed using independent t-test and chi-square test. The mean cuff pressures of group MP was 57.7±26.0 cmH2O and for group MSP was 28.7±4.5 cmH2O, whereas the precision of measurements in the MSP group was 56.5% and 6.2% in the MP group (p<0.001). It is conclude that the palpation method for cuff inflation are inadequate. Therefore, it is suggested that the endotracheal tube cuff pressure must be kept within the optimal range using a standard manometer. Key words: Endotracheal cuff pressure, passive release technique, pilot balloon palpation method DOI: 10.15851/jap.v3n3.608

Perbandingan Analgesia Epidural Menggunakan Bupivakain 0,125% dengan Kombinasi Bupivakain 0,0625% dan Fentanil 2 μg/mL terhadap Nyeri dan Blok Motorik pada Persalinan Normal Oktofina K. Mose; Udin Sabarudin; Ruli Herman Sitanggang; Cindy E. Boom
Jurnal Anestesi Perioperatif Vol 1, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Analgesia epidural merupakan standar emas untuk memfasilitasi persalinan normal tanpa nyeri. Tujuan penelitian ini adalah untuk membandingkan analgesia epidural bupivakain 0,125% dengan bupivakain 0,0625% ditambah fentanil 2 μg/mL yang diukur dengan numeric rating scale (NRS) dan blok motorik yang dinilai dengan skala bromage selama persalinan normal. Penelitian dilakukan sebagai uji klinis acak terkontrol buta ganda terhadap 34 parturien primigravida dengan status fisik ASA II yang direncanakan melahirkan normal di ruang bersalin Rumah Sakit Dr. Hasan Sadikin Bandung pada Desember 2011–Juni 2012. Subjek dikelompokkan menjadi 2, kelompok bupivakain (B) dan kelompok bupivakain fentanil (BF). Hasil penelitian dianalisis memakai uji chi-kuadrat dan uji t-independent dengan tingkat kepercayaan 95% dan dianggap bermakna bila p<0,05 dan sangat bermakna jika p<0,001. Hasil penelitian didapatkan nilai NRS kelompok B vs BF tidak berbeda bermakna dengan nilai p>0,05. Nilai bromage kelompok B vs BF berbeda bermakna dengan nilai p<0,05 pada menit ke-90. Simpulan penelitian ini adalah analgesia yang dihasilkan pada kombinasi bupivakain 0,0625% + fentanil 2 μg/mL sama dengan bupivakain 0,125% dan mengurangi kejadian blok motorik selama persalinan normal yang diberikan analgesia epidural.Kata kunci: Bromage score, bupivakain, epidural, fentanil, numeric rating scale (NRS), parturien, primigravida Comparison of Epidural Analgesia Bupivacaine 0.125% with Combination of 0.0625% Bupivacaine and Fentanyl 2 μg /mL to the Pain and Motoric Block in Normal Labor Epidural analgesia became the gold standard to facilitate normal labor without pain. The purpose of this study was to compare bupivacaine 0.125% versus bupivacaine 0.0625% + fentanyl 2 μg/mL epidural analgesia in the reduction of pain during labor as measured by the numeric rating scale (NRS) and motor block was assessed using the bromage score. A randomized double blind controlled clinical trial was conducted on 34 primigravida parturien with ASA physical status II planned for vaginal birth at delivery in delivery room Dr. Hasan Sadikin Hospital-Bandung within December 2011–June 2012. Subjects were randomly assigned into two groups. The research data were analyzed using of the chi-square and independent ttest with 95% confidence level and considered significant when p<0.05 and highly significant if p<0.001. The results of this study showed that the NRS B vs BF group was not significantly different with p value >0.05. Bromage score B vs BF group significantly different with p value <0.05 at 90 minutes. This study concluded that the combination of 0.0625% bupivacaine + fentanyl 2 μg/mL produce analgesia similar to that provided by infusion of 0.125% bupivacaine and reduce the incidence of motor block during labor.Key words: Bupivacaine, bromage score, epidural, fentanyl, numeric rating scale (NRS), parturien, primigravida DOI: http://dx.doi.org/10.15851/jap.v1n2.120

Pengaruh Duduk 5 Menit Dibanding dengan Langsung Dibaringkan pada Pasien yang Dilakukan Anestesi Spinal dengan Bupivakain Hiperbarik 0,5% 10 mg terhadap Perubahan Tekanan Arteri Rata-rata dan Blokade Sensorik Raditya Fauzan; Doddy Tavianto; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 4, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Anestesi spinal sering kali mengakibatkan hipotensi karena blokade simpatis yang tinggi. Penelitian ini bertujuan melihat pengaruh duduk 5 menit dibanding dengan langsung dibaringkan setelah pemberian anestesi spinal dengan bupivakain 0,5% hiperbarik 10 mg terhadap tekanan arteri rata-rata dan ketinggian blokade sensorik. Penelitian dilakukan dengan metode acak terkontrol tersamar tunggal pada 36 orang pasien dengan status fisik American Society of Anesthesiologist (ASA) I–II yang menjalani operasi perut bagian bawah dan ekstermitas bawah di Rumah Sakit Umum Dr. Hasan Sadikin Bandung pada bulan Maret–Mei 2015. Analisis statistik tekanan arteri rata-rata menggunakan Uji Mann-Whitney dan ketinggian blokade sensorik dengan Uji Kolmogorov Smirnov. Penurunan tekanan arteri rata-rata kelompok 1 (duduk selama 5 menit) lebih sedikit dibanding dengan kelompok 2 (langsung dibaringkan) dengan perbedaan yang bermakna (p<0,05). Ketinggian blokade sensorik rata-rata kelompok 1 terbanyak pada T10 (14 dari 18) dan kelompok 2 pada T6 (8 dari 18). Simpulan, posisi duduk selama 5 menit setelah anestesi spinal dengan bupivakain 0,5% hiperbarik 10 mg menyebabkan penurunan tekanan arteri rata-rata lebih kecil dan ketinggian blokade sensorik lebih rendah dibanding dengan posisi langsung dibaringkan.Kata kunci: Anestesi spinal, bupivakain 0,5% hiperbarik, blokade sensorik, posisi badan, tekanan arteri rata-rataEffects of 5-Minute Sitting Compared to Immediately Lying Down After 10 mg of 0.5% Hiperbaric Bupivacaine Administration on Mean Arterial Pressure and Level of Sensory Blockade in Patients Receiving Spinal AnesthesiaAbstractSpinal anesthesia frequently results in hypotension due to high sympathetic blockade. The aim of this study was to examine effect of sitting for 5 minutes compared to immediately lying down after 10 mg of 0.5% hiperbaric bupivacaine administration with regards to the mean arterial pressure and level sensory blockade in patients who underwentd spinal anesthesia. This was a single blind randomized controlled trial in 36 patients with American Society of Anesthesiologists (ASA) I–II undergoing lower abdominal and lower extremities surgery under spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung during the period of March to May 2015. Data were statistically analyzed using Mann Whitney test for mean arterial pressure and Kolmogorov Smirnov test for level sensory blockade. The results showed a decrease of mean arterial pressure in group 1 (sitting 5 minutes) which was lower than group 2 (immediately lying down) with significant difference (p<0.05). Level of sensory blockade in group 1 at T 10 (14 from 18) was higher than in group 2 at T6 (8 from 18, p=0.001). It is concluded in this study that sitting for 5 minutes after spinal anesthesia using 10 mg 0.5%. bupivacaine hiperbaric decreases the intraoperative sensory of blockade height and mean arterial pressure.Key words: Bupivacaine, body potition, mean arterial preassure, sensory blockade, spinal anesthesia

Lama Pengerjaan, Volume Anestetik Lokal, dan Angka Keberhasilan Blokade Aksilar dengan Panduan Pencitraan Ultrasonografi pada Prosedur Arterio-Venous Shunt Ara Guntara; Dedi Fitri Yadi; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Kunci keberhasilan melakukan blokade aksilar adalah mendistribusikan secara optimal anestetik lokal ke sekeliling saraf, hal ini tercapai dengan panduan pencitraan ultrasonografi. Penelitian ini bertujuan menilai lama pengerjaan, volume anestetik lokal, dan angka keberhasilan blokade aksilar dengan panduan pencitraan ultrasonografi. Metode penelitian adalah deskriptif prospektif. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Maret–April tahun 2014 terhadap 40 pasien (21‒60 tahun), status fisik American Society of Anesthesilogist (ASA) II, menjalani pembedahan dalam blokade aksilar dengan panduan pencitraan ultrasonografi. Fungsi sensorik dan motorik dinilai setiap 5 menit selama 15 menit. Keberhasilan blokade dinilai dari hilangnya fungsi sensorik dan motorik pada saraf medialis, radialis, ulnaris, dan muskulokutaneus. Hasil penelitian didapatkan lama pengerjaan blokade aksilar rata-rata dengan panduan pencitraan ultrasonografi 548 detik (9,1 menit), volume anestetik lokal dibutuhkan 10 mL dan angka keberhasilan blokade aksilar sebesar 97,5%. Penelitian lain lama pengerjaan dengan bantuan alat stimulasi saraf tepi selama 11,2 menit, volume total anestetik lokal dibutuhkan 30‒40 mL, dan angka keberhasilan 60‒85%. Simpulan, panduan pencitraan ultrasonografi dapat mempersingkat pengerjaan, mengurangi volume obat anestesi lokal, dan meningkatkan keberhasilan blokade aksilar.Kata kunci: Arterio-venous shunt, blokade aksilar, panduan ultrasonografiProcedure Time, Local Anaesthetic Volume, and Success Rate of Axillary Block with Ultrasound Guidance in Arterio-Venous Shunt ProcedureThe key requirement for successful axillary block is to ensure optimal distribution of local anesthetic around the nerve structure. This goal is most effectively achieved under sonographic visualization. This study aimed to assess block procedure time, minimum volume of local anesthetic required, and success rate of axillary brachial plexus block under ultrasound guidance. This study was conducted between March and April 2014 in Dr. Hasan Sadikin General Hospital, Bandung. This was an observational prospective study involving 40 patients (21‒60 years old) with American Society of Anesthesiologist (ASA) physical status II who underwent arterio-venous shunt under axillary brachial plexus block. Sensory and motor functions were assessed every five minutes for 15 minutes. A successful block was defined as complete sensoric and motoric loss in median, radial, ulnar, and musculocutaneus nerve distributions by 15 minutes. Results showed average block procedure time of 548 seconds (9.1 min), total volume of local anesthetic of 10 mL, and block success rate of 97.5%. This study concludes that ultrasound guidance can reduce block procedure time and required local anesthetic volume as well as improving the success rate of axillary brachial plexus block. Key words: Arterio-venous shunt, axillary block, ultrasound guidance DOI: 10.15851/jap.v2n3.329

Perbandingan Tramadol dengan Lidokain untuk Mengurangi Derajat Nyeri Penyuntikan Propofol Oka Endarto; Ruli Herman Sitanggang; Budiana Rismawan
Jurnal Anestesi Perioperatif Vol 7, No 2 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Propofol adalah obat anestesi intravena yang sering digunakan untuk tidakan medis karena memiliki onset dan durasi cepat. Nyeri saat penyuntikan propofol merupakan permasalahan yang sering dikeluhkan pasien dan berbagai metode telah dilakukan untuk mengurangi derajat nyeri penyuntikan propofol, namun masih didapatkan nyeri. Lidokain menjadi standar emas untuk mengurangi derajat nyeri penyuntikan propofol, tetapi masih memiliki efek samping seperti penekanan fungsi jantung sehingga dipilih tramadol yang tidak menekan fungsi jantung dan dapat menurunkan kebutuhan obat antinyeri selama maupun setelah operasi. Penelitian ini bertujuan membandingkan pemberian tramadol dengan lidokain untuk mengurangi derajat nyeri penyuntikan propofol. Metode penelitian menggunakan uji klinis acak buta tunggal terhadap 60 pasien yang menjalani operasi elektif. Pasien dibagi menjadi 2 kelompok, yaitu perlakuan tramadol (kelompok T) dan perlakuan lidokain (kelompok L) disertai pembendungan vena permukaan menggunakan tourniquet, kemudian diberikan tramadol atau lidokain. Setelah 1 menit tourniquet dilepaskan dan diikuti dengan penyuntikan ¼ dosis total propofol untuk induksi selama 5 detik, lalu dilakukan penilaian derajat nyeri menggunakan verbal rating score. Hasil penelitian menunjukkan penurunan derajat nyeri penyuntikan propofol pada kedua kelompok dan tidak terdapat perbedaan bermakna (p>0,05), namun melalui uji statistik dengan tingkat kepercayaan sebesar 95% menyatakan tramadol memiliki risiko relatif kemungkinan terjadi nyeri ringan lebih kecil dibanding dengan lidokain menurunkan derajat nyeri penyuntikan propofol. Simpulan, Tramadol memiliki kekuatan yang sama dengan lidokain dalam menurunkan derajat nyeri penyuntikan propofol.Comparison between Tramadol and Lidocaine in Reducing Pain Triggered by Propofol InjectionPropofol is a commonly used intravenous anesthetics in medical procedure. Pain during propofol injection is a commonly reported adverse effect of this injection. Various methods have been proposed to reduce pain but often fail. Lidocaine is the gold standard for reducing pain during injection of propofol but has a suppressive effect on the heart. Tramadol does not have a suppressive effect and reduce the need for anti-pain medication during and after surgery thereforeTramadol is chosen for this purpose. This study aimed to compare the administration of tramadol and lidocaine to reduce the level of pain during propofol injection. This was a single blind randomized clinical trial on 60 patients underwent elective surgery. Patients were divided into 2 groups: the first group received tramadol (group T) and the second group received lidocaine (group L). Tourniquet was used on each patient before injection of tramadol or lidocaine was given and it was removed after 1 minute. Pain severity was assessed 5 seconds after propofol injection using the verbal rating score. This study discovered that pain during propofol injection was reduced with the use of tramadol and lidocaine without significant difference between the two (p>0.05). However, tramadol has a lower probability of mild pain than lidocaine with interval confidence 95%. In conclusion, tramadol has the same potential as lidocaine in reducing the level of pain related to propofol injection.

Hubungan antara Durasi Puasa Preoperatif dan Kadar Gula Darah Sebelum Induksi pada Pasien Operasi Elektif di Rumah Sakit Dr. Hasan Sadikin Bandung Budi Hartanto; - Suwarman; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Puasa preoperatif merupakan keharusan sebelum dilakukan tindakan anestesi. Alasan utamanya adalah untuk mengurangi volume lambung, tingkat keasaman lambung, dan mengurangi risiko aspirasi paru. Namun, puasa preoperatif sering kali lebih lama daripada yang direkomendasikan karena berbagai sebab. Tujuan penelitian ini mengetahui durasi puasa preoperatif pada pasien operasi elektif dan hubungan antara durasi puasa preoperatif dan kadar gula darah sebelum induksi pasien operasi elektif di Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian observasional dilakukan selama 1–31 Juni 2014 dengan melakukan wawancara pasien sebelum induksi anestesi dan pengukuran kadar gula darah menggunakan glukometer. Analisis korelasi menggunakan Uji Mann-Whitney. Hasil penelitian pada 371 pasien didapatkan lama puasa dari makanan padat, durasi minimum adalah 4 jam, maksimum 20,5 jam, dan rata-rata 10,42 jam. Pada puasa dari minuman, durasi puasa minimum adalah 2 jam, maksimum 18 jam dengan rata-rata 8,06 jam. Terdapat 8 pasien dengan kadar gula darah kurang dari 70 mg/dL dengan rentang kadar gula darah 59–70 mg/dL dan rentang durasi puasa 6–18 jam. Tiga di antaranya orang lanjut usia di atas 60 tahun. Sebanyak 253 pasien berpuasa makanan padat >8 jam dan 357 pasien berpuasa minuman >2 jam. Simpulan, tidak terdapat hubungan antara durasi puasa dan kadar gula darah sebelum induksi.Kata kunci: Durasi puasa preoperatif, kadar gula darah, operasi elektifCorrelation between Preoperative Fasting Duration and Blood Glucose Level before Induction in Elective Surgery Patients in Dr. Hasan Sadikin General Hospital BandungPreoperative fasting is a requisite before anesthesia. The main reason for preoperative fasting is to reduce gastric volume and acidity and, thus, decrease the risk of pulmonary aspiration. However, preoperative fasting is usually prolonged beyond the recommended time for various reasons. Despite the many adverse effects of prolonged fasting, patients sometimes fast for a prolonged time when the surgery is delayed for different reasons. The aim of this study was to assess the duration of preoperative fasting for elective surgery and its correlation with blood glucose after preoperative fasting in Dr. Hasan Sadikin General Hospital Bandung. An observational study was conducted from 1- 31 June 2014. Patients were interviewed before induction, and blood glucose level was measured using a glucometer. A correlation analysis was performed using Mann-whitney test. All 371 elective surgery patients admitted during the study period were included. The minimum, maximum, and mean fasting hours for food were 4, 20.5, and 10.42, respectively. The minimum, maximum, and mean fasting hours for fluid were 2, 18, and 8.06, respectively. Only 8 patients had blood a glucose level below 70 mg/dL with blood glucose levels range from 59 to 70 mg/dL and duration of fasting range from 6 to 18 hours. Three of elderly patients, who was above 60 years old, participated in this study. There were 253 patients (68.2%) fasted from solid food more than 8 hours and there were 357 (96.2%) fasted from clear fluid more than 2 hours. It is concluded that there is no correlation between duration of fasting and blood sugar level before induction.Key words: Duration of preoperative fasting, elective surgery, blood glucose level DOI: 10.15851/jap.v4n2.822

Perbandingan Numeric Rating Scale antara Infiltrasi Analgesia Tramadol 1 mg/kgBB dan Bupivakain 0,25% Pascaoperasi Hernia Inguinalis Reponibel Dadang Mulyawan; - Suwarman; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 2, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Pencegahan dan penatalaksanaan nyeri akut pascaoperasi merupakan faktor yang menentukan untuk mengurangi kemungkinan terjadinya nyeri kronik. Penelitian ini bertujuan untuk membandingkan tramadol 1 mg/kgBB dengan bupivakain 0,25% yang diberikan secara infiltrasi subkutan sebelum penutupan kulit terhadap nyeri pascaoperasi hernia inguinalis reponibel. Penelitian dilakukan terhadap 32 orang yang terbagi secara acak ke dalam 2 kelompok dengan usia 18–65 tahun, status fisik American Society of Anesthesiologist (ASA) I–II yang menjalani operasi hernia inguinalis reponibel secara uji acak terkontrol buta ganda dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Juni 2012. Penilaian skala nyeri dilakukan pada jam ke-0, 1, 2, 3, 4, 5, 6, 8, 10, dan selanjutnya sampai tercapainya nilai NRS>4. Analisis statistik menggunakan independent t-test dan chi-kuadrat. Hasil penelitian ini mendapatkan nilai NRS kelompok tramadol yang lebih rendah pada jam ke-3 dan jam ke-4 dibandingkan dengan kelompok bupivakain. Pada kelompok tramadol ditemukan durasi analgesi yang lebih panjang daripada kelompok bupivakain dengan perbedaan bermakna (p<0,05). Simpulan penelitian ini adalah pemberian infiltrasi subkutan tramadol 1 mg/kgBB menurunkan nilai NRS lebih baik daripada bupivakain 0,25% pascaoperasi hernia inguinalis reponibel dan durasi analgesi yang lebih panjang tanpa ada perbedaan efek samping yang bermakna.Kata kunci: Bupivakain, infiltrasi subkutan, numeric rating scale, nyeri pascaoperasi, tramadolNumeric Rating Scale Comparison between 1 mg/kgBW Tramadol and 0.25% Bupivacaine Infiltration Analgesia after Reducible Inguinal Hernia SurgeryPrevention and management of acute postoperative pain is an essential factor contributing to the likelihood of chronic pain development. The objective of this study is to compare 1 mg/kgBW tramadol and 0.25% bupivacaine administered as a subcutaneous infiltration prior to wound closure for post operative pain after reducible inguinal hernia surgery. Study was conducted on 32 patients (18–65 years) ASA I–II who underwent reducible inguinal hernia surgery at Dr. Hasan Sadikin Hospital Bandung during June 2012. Pain scale assessment was done using a numeric rating scale (NRS) and were recorded at 0, 1, 2, 3, 4, 5, 6, 8, 10, hours and thereafter until it reaches the value of NRS >4. NRS on the tramadol group was significantly lower during the 3rd and 4th hour compared to the bupivacaine group. Duration of analgesia was longer in the tramadol compared to bupivacaine group. In conclusions, the subcutaneous infiltration of tramadol 1 mg/ kgBW is better compared to bupivacaine 0.25% in reducing postoperative NRS value in reducible inguinalhernia surgery and provides a longer duration of analgesia, with no significant differences in side effects.Key words: Bupivacain, post operative pain, subcutaneous infiltration, tramadol, visual analogue scale DOI: 10.15851/jap.v2n1.235

Perbandingan Antara Fentanil 2 μg/kgBB/jam dan Scalp Block Terhadap Peningkatan Hemodinamik dan Kadar Glukosa Darah Sewaktu Saat Pemasangan Pin Kepala Pada Kraniotomi Robert Sihombing; Dewi Yulianti Bisri; Ruli Herman Sitanggang
Jurnal Neuroanestesi Indonesia Vol 7, No 2 (2018)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Latar Belakang dan Tujuan: Opioid dosis tinggi efektif memblokade nyeri pada operasi kraniotomi namun memiliki efek yang tidak diinginkan. Alternatif lain menggunakan teknik scalp block dikombinasikan dengan anestesi umum. Tujuan penelitian ini untuk membandingkan hemodinamik dan kadar glukosa darah sewaktu (GDS) antara fentanil 2 μg/kgBB/jam dan scalp block saat pemasangan pin kepala pada kraniotomi pengangkatan tumor elektif dengan anestesi umum. Subjek dan Metode: Penelitian ini dilakukan pada 28 pasien yang direncanakan pembedahan tumor otak elektif. Subjek penelitian dibagi menjadi dua kelompok: scalp block dan kelompok fentanil 2 μg/kgBB/jam. Tekanan arteri rerata, laju nadi dan kadar GDS intraoperatif dinilai dan dianalisis menggunakan uji-t berpasangan dan Chi-square.Hasil: MAP dan laju nadi antara kedua grup memiliki perbedaan signifikan (p0,05). Kelompok fentanil memiliki MAP dan laju nadi lebih tinggi dibanding dengan kelompok scalp block. Namun perbandingan kadar GDS antara kedua kelompok tidak menunjukkan hasil yang signifikan (p0,05).Simpulan: Scalp block lebih efektif dalam mengurangi peningkatan hemodinamik namun sama efektif dengan fentanil 2 μg/kgBB/jam dalam mengurangi peningkatan kadar GDS pada pasien yang menjalani operasi kraniotomi pengangkatan tumor elektif.Comparison Between Fentanyl 2 μg/kg/hr and Scalp Block of Hemodynamic Improvement and Blood Glucose Levels During Head Pin Installment in CraniotomyBackground and Objective: High dose opioids is one of the most effective techniques for blocking pain in craniotomy surgery but it has undesirable effect. Other alternative to overcome pain in craniotomy is using a scalp block technique in combination with general anesthesia. The aim of this study was to compare the increase of hemodynamic and blood glucose levels (BGL) between fentanyl 2 μg/kgBW/hr and scalp block during head pin installment in craniotomy surgery.Subject and Method: Twenty eight patients undergoing elective craniotomy tumor removal surgery were enrolled in the study. The patients were divided into two groups: scalp block and fentanyl 2 μg/kgBW/hr. Intraoperative mean arterial pressure (MAP), heart rate (HR) and BGL were recorded, and analyzed by paired t-test and Chisquare.Result: MAP and HR showed significant differences between groups (p0,05), wherein fentanyl group had higher MAP and HR than scalp block group. However, BGL during head pin installment did not show significant results between the two groups (p 0,05).Conclusion: Scalp block is more effective than fentanyl 2 μg/kgBW/hr in reducing increased of hemodynamic but equally effective with fentanyl in reducing increased of BGL during head pin installment in craniotomy tumor removal.

Co-Authors - Elvidiansyah - Elvidiansyah - Suwarman A. Himendra Wargahadibrata A. Himendra Wargahadibrata Afifuddin Afifuddin Afifuddin Afifuddin, Afifuddin Akhmad Rhesa Sandy Annisa Isfandiary Ismandiya Annisa Isfandiary Ismandiya, Annisa Isfandiary Anthon Vermana Ritonga Anthon Vermana Ritonga Ara Guntara Ara Guntara Ardi Zulfariansyah Ardi Zulfariansyah Ariaty, Geeta Maharani Aris Gunawan Arnanto, Yodi Suryo Budi Hartanto Budi Hartanto Budiana Rismawan Cindy E. Boom Cindy E. Boom Dadang Mulyawan Dadang Mulyawan Dedi Fitri Yadi Dewi Yulianti Bisri Doddy Tavianto Erias, Muhammad Erik Efendi Erik Efendi Erwin Pradian Ezra Oktaliansah Geeta Maharani Ariaty Gunawan Mutiara Gunawan Mutiara, Gunawan Gunawan, Aris Harly, Patra Rijalul Harniati, Siti Ike Sri Redjeki Indriasari Indriasari Iwan Fuadi Lira Panduwaty M. Andy Prihartono M. Erias Erlangga M. Erias Erlangga, M. Erias Mahathir Harry Permana Muhammad Erias Nurita Dian Kestriani Oka Endarto Oktofina K. Mose Oktofina K. Mose Raditya Fauzan Raditya Fauzan, Raditya Ratu Lewi Ratu Lewi, Ratu Reza Widianto Sudjud Robert Sihombing Ronald Tikuali Salukanan Salukanan, Ronald Tikuali SATRIYAS ILYAS Selly Oktarina Rosita Selly Oktarina Rosita Sihombing, Robert Suryadi Suryadi Suryadi Suryadi Suwarman Suwarman Suwarman Suwarman Suwarman Suwarman, Suwarman Tatang Bisri Tatang Bisri Tatang Bisri Tinni T. Maskoen Tinni T. Maskoen Udin Sabarudin Udin Sabarudin Viana Wijayanti Viana Wijayanti Wirawijaya, Dear Mohtar Wirawijaya, Dear Mohtar Wirawijaya Wullur, Caroline Yodi Suryo Arnanto

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