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Perbandingan Efektivitas Efedrin dengan Ondansetron dalam Mencegah Kejadian Hipotensi dan Bradikardi pada Anestesi Spinal Simanjuntak, Ikrar Rananta; Hanafie, Achsanuddin; Tanjung, Qadri Fauzi
Majalah Anestesia & Critical Care Vol 42 No 2 (2024): Juni
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v42i2.330

Latar Belakang: Anestesi spinal menyebabkan hipotensi. Berbagai metode telah dilakukan untuk mencegah konsekuensi kardiovaskular dari blok subarachnoid. Efedrin adalah suatu zat stereoisomer dari pseudoefedrin yang bekerja pada stimulasi pada reseptor alfa dan beta-adrenoreseptor, yang umumnya digunakan sebagai vasopressor pada kondisi hipotensi selama anestesi. Ondansetron bekerja pada sentral dan perifer, efek sentralnya dimediasi oleh efek antagonis reseptor serotonin 5-HT3. Penelitian ini bertujuan untuk mengetahui perbandingan efektivitas efedrin dengan ondansetron dalam mencegah hipotensi dan bradikardi pada anestesi spinal.Metode: Penelitian ini dilakukan pada 57 pasien yang menjalani prosedur pembedahan abdomen bawah, ginekologi, ekstremitas bawah yang terjadwal elektif dengan anestesi spinal. Sampel dipilih menggunakan metode consecutive sampling. Analisis data dilakukan untuk melihat distribusi frekuensi variabel yang diteliti dan korelasi antar variabel.Hasil: Sebanyak 29 pasien dikelompokan dalam grup efedrin dan sebanyak 28 pasien dikelompokkan dalam grup ondansetron. Dari hasil analisis data, tidak didapatkan hasil yang bermakna dalam perbedaan antara kedua grup efedrin dan ondansetron pada variabel sistol, diastol, maupun mean arterial pressure (MAP) (p > 0,05).Simpulan: Tidak terdapat perbedaan yang signifikan antara ondansetron dan efedrin dalam mencegah bradikardia dan hipotensi pada pasien dengan anestesi spinal. Tidak terdapat hipotensi dan bradikardi dengan pemberian efedrin dan ondansetron sebelum pemberian obat spinal pada pasien anestesi spinal.

History of Cuppping in Medical Perspective Tanjung, Qadri Fauzi; Prima, Agus
Journal of Society Medicine Vol. 1 No. 1 (2022): October
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v1i1.13

Cupping or Al-hijamah is the process of removing harmful blood/toxid-toxins (static) from the body, through the surface of the skin or the process of removing harmful blood/toxid-toxins (static) from the body, through the surface of the skin. The cupping method of treatment has actually been mentioned in the historical records of various great civilisations of the world, including Egypt, China, India, Europe and America. So that various cupping terms are known in the world in various languages including kop, cucurbit, cupping, fire-bottle, blood-letting, pa hou kuan (Mandarin). Through the study of some evidence of historical records, it was found that the beginning of cupping was known to world civilisations since the Sumerian kingdom was established around 4000 years BC, then developed and expanded towards Babylon, Egypt, Saba and the land drained by the Euphrates and Tigris Rivers

Correlation Analysis of Lemon, IDS, and Wilson Scores in Assessing Intubation Difficulty in Patients Undergoing General Anesthesia Sinaga, Ade; Hamdi, Tasrif; Tanjung, Qadri Fauzi
Journal of Society Medicine Vol. 3 No. 8 (2024): August
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i8.159

Introduction: The act of intubating with an endotracheal tube is a definitive airway management technique that provides maximal protection against the occurrence of aspiration of stomach contents or fluids. Some studies recommend the use of a head pillow to improve the laryngoscopic view by enhancing the occipito-atlanto-axial angle and enlarging the submandibular space. The aim of this study was to find out comparison of the level of difficulty of intubation in intubation techniques with and without the use of pillows. Methods: The design of this study was a randomized cross-sectional study with two research groups conducted to compare the difficulty levels of intubation using the technique with and without a pillow. Results: Patients without a pillow often required a little assistance during intubation, while the majority of patients using a pillow were easily intubated. However, no significant difference was found between the two groups (p>0.05). Patients intubated without a pillow had an average score of 15.9±1.6, while those intubated with a pillow had an average score of 10.8±1.8, showing a significant difference between the two groups (p<0.05). Using the Cormack-Lehane score, most patients without a pillow were at grade 2, while the majority of patients with a pillow were at grade 1. A significant difference was found between the two groups (p<0.05). Conclusion: Patients intubated without a pillow often required a little assistance, while the majority of patients intubated with a pillow were easily intubated; however, no significant difference was found between the two groups (p>0.05).

PERBANDINGAN NEBULISASI LIDOKAIN 2% DAN SPRAY LIDOKAIN 10% DALAM MENCEGAH REFLEKS BATUK PADA PASIEN BRONKOSKOPI DENGAN SEDASI DI RSUP HAJI ADAM MALIK MEDAN Pohan, Alfindy Maulana; Tanjung, Qadri Fauzi; Silaen, Ester Lantika Ronauli; Yunanda, Yuki
Jurnal Anestesi Perioperatif Vol 12, No 3 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v12n3.4010

Keluhan batuk sering muncul pada pasien yang menjalani bronkoskopi akibat adanya trauma mekanik pada dinding saluran napas. Lidokain digunakan pada bronkoskopi untuk menekan refleks batuk. Penelitian ini bertujuan menilai efek lidokain yang diberikan secara nebulisasi dan spray terhadap refleks batuk pada pasien bronkoskopi. Desain penelitian randomized control trial dilaksanakan di RSUP Haji Adam Malik bulan Agustus sampai dengan September 2023 pada pasien bronkoskopi dengan sedasi. Sampel yang diperoleh 36 pasien yang dibagi menjadi 2 kelompok yaitu kelompok yang mendapat spray Lidokain 10% dan kelompok yang mendapatkan nebulisasi lidokain 2%. Variabel yang diteliti adalah derajat batuk. Analisis statistik yang digunakan adalah mann whitney. Berdasarkan penelitian yang dilakukan terdapat perbedaan derajat batuk yang bermakna pada pada menit ke-15, menit ke-30 dan postperlakuan (p<0,05). Pada kelompok nebulisasi Lidokain 2% derajat batuk lebih rendah dibanding dengan pada kelompok spray Lidokain 10%. Simpulan: Pemberian nebulisasi lidokain 2% lebih efektif menekan derajat batuk dibanding dengan spray lidokain 10% pada tindakan bronkoskopi dengan sedasi.

The Medical Perspective of Dry Cupping and Wet Cupping: Effects and mechanisms of action: The Medical Perspective of Dry Cupping and Wet Cupping Fauzi Tanjung, Qadri; Ishadi, Hendi
Journal of Society Medicine Vol. 1 No. 1 (2022): October
Publisher : CoinReads Media Prima

This therapy is a method of cleaning the blood and wind by sucking. remove residual toxins in the body through the skin surface by sucking. Cupping is divided into two types, that’s wet cupping and dry cupping. Dry cupping includes slide cupping, fire cupping, and pull cupping. The difference between wet cupping and dry cupping is the presence or absence of blood. Cupping is an alternative method that involves placing a cup on the skin using heat or suction for a few minutes. This will pull the tissue under the skin and form a blood pool so that a localized healing process occurs. Cupping is very beneficial for these patients although the benefits may not be felt in the short term. The side effects caused by cupping are not severe, only cause discomfort due to cupped and incision on the skin. Cupping plays a role in reducing inflammatory mediators formed due to cell inflammation. This substance serves to send pain signals to the brain. Cupping can be used for diseases that are local or systemic. Cupping can be used to reduce pain such as headaches, carpal tunnel syndrome and some other local disease.

The Relationship of Lactate Albumin Ratio With Sofa Score As A Predictor of Sepsis Patients in The Intensive Care Room Karim, Tengku Abdul; Hanafie, Achsanuddin; Tanjung, Qadri Fauzi; Amelia, Rina
Jurnal Health Sains Vol. 6 No. 6 (2025): Journal Health Sains
Publisher : Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jhs.v6i6.2619

Sepsis is a life-threatening organ dysfunction due to dysregulation of the host response to infection which causes systemic changes, namely an increase in the serum lactate/albumin ratio which is associated with mortality. Method:This study is a clinical observational analytical study with a prospective cohort design at fittingAdult patients diagnosed with sepsis in the integrated inpatient ward and intensive care ward at Haji Adam Malik General Hospital, Medan. The subject sampling technique used was non-probability sampling with a consecutive sampling method where 50 subjects were required. Bivariate analysis used the Pearson correlation test and the linear relationship between the lactate-albumin ratio value and the SOFA score used linear regression. A 95% confidence interval with a p value <0.05 was considered significantly significant Results :The results of the research on the first day found that the average LAR H1 was 0.59 + 0.51 (0.12-2.26) and the average SOFA H1 score was 7.32 + 1.88 (7) where an r value of 0.726 was obtained. indicates a high and significant correlation between Lactate Albumin Ratio and SOFA Score as a predictor of sepsis patients (p value = 0.000, p<0.05). On the third day, the average LAR H3 score was 0.12 + 0.29 (0.21-0.47) and the average SOFA H3 score was 9.58 + 2.01 (10) where an r value of 0.33 was found which indicates Very low and insignificant correlation between Lactate Albumin Ratio and SOFA Score as a predictor of sepsis patients (p value = 0.818, p > 0.05). Conclusion:The lactate-albumin ratio was strongly correlated with the SOFA score on the first day of adult patients diagnosed with sepsis in the integrated inpatient ward and intensive care ward.

Gabapentin dan Gabapentin-Amitriptilin sebagai Adjuvan Analgetik Nyeri Kanker di Klinik Nyeri RSUP H. Adam Malik Medan Ramadhan, Muhammad; Tanjung, Qadri Fauzi; Silaen, Ester Lantika; Hamdi, Tasrif; Ihsan, Muhammad; Amelia, Rina
Majalah Anestesia & Critical Care Vol 43 No 3 (2025): Oktober
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v43i3.350

Pendahuluan: Pasien kanker merasakan nyeri yang mempengaruhi kualitas hidup terutama pasien kanker stadium lanjut. Beberapa agen yang digunakan pada nyeri kanker adalah morfin, parasetamol, dan amitriptilin. Antidepresan, anti-epileptik, dan kortikosteroid mulai dieksplorasi untuk terapi nyeri pada penyakit non-kanker, namun penggunaannya dalam nyeri kanker masih belum dipelajari dengan baik. Beberapa studi menyimpulkan manfaat penggunaan gabapentin pada nyeri neuropatik dan nosiseptif, hingga kini belum ada studi efikasi agen tersebut pada nyeri kanker, maka penelitian terfokus kepada efikasi kombinasi antara amitriptilin dan gabapentin. Metode: Penelitian ini menggunakan Randomized Clinical Trial dengan sistem blinding. Dua kelompok sampel diobservasi sebelum pemberian (T0), hari ke-1 (T1), ke-3 (T2), dan ke-7 (T3). Kelompok A menerima gabapentin dan kelompok B menerima gabapentin dengan amitriptilin. Analisis data menggunakan uji t independen atau Mann-Whitney. Hasil: Sebanyak 62 orang dibagi menjadi 2 kelompok. Kelompok A mengalami keluhan mual, muntah, penurunan nafsu makan, dan pusing terbanyak sedangkan kelompok B mengalami keluhan sulit tidur terbanyak. Secara statistik, kelompok A maupun B mampu mereduksi skala nyeri berdasarkan skala pengukuran NRS dan pain detect (p<0,001) serta data keluhan awal dijumpai perbedaan signifikan (p<0,001). Perbedaan yang bermakna secara signifikan antara kedua regimen yang dianalisis juga tidak dijumpai dengan nilai p>0,05 pada seluruh waktu, kecuali pada variabel NRS di T3 (gabapentin (4,03±0,59)) dan kombinasi (3,53±0,82); p=0,009). Simpulan: Temuan mengindikasikan perbedaan yang signifikan mungkin baru terlihat pada hari ke-7 pasca observasi, meskipun pada dasarnya regimen kombinasi lebih efektif untuk mereduksi nyeri dibandingkan gabapentin tunggal. Kelompok kombinasi mengalami penurunan derajat nyeri yang lebih tinggi namun hanya signifikan pada waktu T3-T2 menggunakan skala NRS.

Perbandingan Tingkat Kesulitan Intubasi dengan Menggunakan Bantal dan Tanpa Bantal di Ruang Operasi RSUP H. Adam Malik Sinaga, Ade Putra Fratama; Hamdi, Tasrif; Tanjung, Qadri Fauzi
Majalah Anestesia & Critical Care Vol 43 No 3 (2025): Oktober
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v43i3.406

Latar Belakang: Intubasi endotrakeal merupakan teknik yang cepat, sederhana, dan aman untuk mencapai tujuan manajemen jalan napas. Posisi kepala dan leher yang tepat, sering kali ditingkatkan dengan bantal kepala, sangat penting untuk laringoskopi dan intubasi trakea yang efektif, karena dapat meningkatkan sudut oksipito-atlanto-aksial dan memperbesar ruang submandibular. Metode: Penelitian cross-sectional acak di RSUP H. Adam Malik Medan ini membandingkan kesulitan intubasi dengan dan tanpa menggunakan bantal. Sebanyak 24 subjek dibagi dua kelompok, masing - masing 12 orang. Data meliputi usia, jenis kelamin, indeks massa tubuh (IMT), status ASA, skor Wilson, dan skor Cormack-Lehane. Hasil: Rata-rata usia kelompok tanpa bantal 49,4 ± 12,1 tahun dan dengan bantal 44,3 ± 14,4 tahun. Sebagian besar subjek tanpa bantal adalah laki-laki, sedangkan dengan bantal perempuan. IMT ratarata masing-masing 21,0 ± 1,65 kg/m² dan 21,8 ± 1,85 kg/m². ASA I lebih banyak pada kelompok tanpa bantal, sedangkan ASA I dan II sama pada kelompok dengan bantal. Tidak ada perbedaan signifikan karakteristik dasar kedua kelompok. Skor Wilson memprediksi intubasi mudah pada sebagian besar pasien. Skor rata-rata Wilson lebih tinggi pada kelompok tanpa bantal (15,9 ± 1,6) dibanding dengan bantal (10,8 ± 1,8; p<0,05). Skor Cormack-Lehane menunjukkan kelompok dengan bantal lebih sering pada tingkat 1 dibanding tanpa bantal yang dominan tingkat 2 (p<0,05). Simpulan: Intubasi tanpa bantal membutuhkan sedikit bantuan, sementara sebagian besar pasien yang menggunakan bantal dapat dengan mudah diintubasi. Tidak ada perbedaan yang signifikan di antara kedua kelompok.

COMPARISON OF THE EFFICACY OF INTRAVENOUS NOREPINEPHRINE AND PHENYLEPHRINE AS VASOPRESSOR AGENTS IN THE MANAGEMENT OF SEPTIC SHOCK IN ICU PATIENTS AT HAJI ADAM MALIK GENERAL HOSPITAL USING LACTATE AND STROKE VOLUME VARIATION INDICATORS Attamimi, Fandy Faidhul; Wijaya, Dadik Wahyu; Tanjung, Qadri Fauzi; Amelia, Rina
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.67835

Background: Septic shock is a critical condition requiring intensive management, including vasopressor support to maintain organ perfusion. Norepinephrine and phenylephrine are two commonly used vasopressors, but their relative effectiveness in the context of septic shock remains a subject of debate. This study aims to compare the effectiveness of intravenous norepinephrine and phenylephrine as vasopressor agents in the management of septic shock in ICU patients at Haji Adam Malik General Hospital, using lactate levels and stroke volume variation (SVV) as indicators.Methods: This study was conducted as a randomized controlled trial (RCT). The subjects were ICU patients at Haji Adam Malik General Hospital diagnosed with septic shock and receiving either norepinephrine or phenylephrine as a vasopressor. Evaluations were conducted to monitor changes in lactate levels and SVV at therapy initiation and at specific intervals throughout the treatment period. Data were analyzed using appropriate statistical methods to compare the effects of the two vasopressors.Results: This study included 32 samples divided into two groups: a norepinephrine group and a phenylephrine group, each consisting of 16 patients. After 6 hours of norepinephrine administration, lactate levels significantly decreased from 8.41±1.88 mmol/L to 5.76±1.99 mmol/L. There was also a significant reduction in SVV, from 14.25±2.17 mmHg to 8.18±1.90 mmHg, with statistically significant results (p<0.001). After 6 hours of phenylephrine administration, lactate levels decreased from 7.40±1.77 mmol/L to 6.70±1.77 mmol/L, and SVV decreased from 15.93±2.56 mmHg to 12.50±2.63 mmHg, also showing statistically significant results (p<0.001).Conclusions: travenous norepinephrine is more effective than phenylephrine in reducing lactate levels and improving stroke volume variation in ICU patients with septic shock. These findings support the use of norepinephrine as the primary vasopressor in the management of septic shock, although phenylephrine may still be considered as an alternative with close monitoring of hemodynamic parameters. Further studies are needed to confirm these findings and to explore the mechanisms underlying the differences in efficacy.

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