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All Journal Jurnal Anestesi Perioperatif Majalah Anestesia dan Critical Care Jurnal Neuroanestesi Indonesia
Doddy Tavianto
Departemen Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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Kejadian Post Dural Puncture Headache dan Nilai Numeric Rating Scale Pascaseksio Sesarea dengan Anestesi Spinal Irawan, Dino; Tavianto, Doddy; Surahman, Eri
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Kejadian nyeri kepala pascaanestesi spinal (post dural puncture headache; PDPH) berhubungan dengan ukuran lubang dura akibat proses penusukan. Tujuan penelitian ini untuk mengetahui kejadian PDPH pada pasien pascaseksio sesarea dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan Januari–April 2010. Penelitian dilakukan terhadap 115 wanita hamil, status fisik American Society of Anesthesiologist (ASA) II, berusia 18–45 tahun. Penelitian bersifat observasional dengan rancangan cross sectional. Hasil observasi didapatkan kejadian PDPH pada jarum tipe quincke no. 25 sebesar 68,2%, pada jarum tipe quincke no. 27 sebesar 31,8% dan tidak ditemukan pada jarum tipe pencil point no. 27. Nilai numeric rating scale (NRS) dari PDPH pada tipe jarum quincke no. 25 adalah 3–7, pada tipe jarum quincke no. 27 adalah 2–6, dan 0 pada tipe jarum spinal pencil point no. 27. Simpulan penelitian adalah bahwa kejadian PDPH pada pasien seksio sesarea dengan anestesi spinal berdasarkan tipe jarum spinal paling banyak didapatkan pada jarum tipe quincke no. 25, selanjutnya pada jarum tipe quincke no. 27 dan tidak ditemukan pada jarum tipe pencil point no. 27.Kata kunci: Anestesi spinal, numeric rating scale, post dural puncture headacheThe Incidence of Postdural Puncture Headache and Numeric Rating Scale Score After the Caesarean Section with Spinal AnesthesiaAbstractThe incidence of post dural puncture headache (PDPH) is associated with the size of duramater diameter puncture caused by the puncture itself. There are two factors related to this problem, the size of the needle and the shape of the needle’s-end. The purpose of this study was to obtain an overview of incidence of PDPH in patients undergoing caesarean section with regional spinal anesthesia in Dr. Hasan Sadikin Hospital Bandung in January–April 2010. This research was conducted on 115 pregnant woman with physical status of American Society of Anesthesiologist (ASA) II, range of age was 18 to 45 years old. This research was an observational study with cross-sectional design. The incidence of PDPH after the use of Quincke type needle no. 25 was 68.2%, while with Quincke type needle no. 27 was 31.8%, and no PDPH was found on the use of pencil point type needle no. 27. The numeric rating scale (NRS) from PDPH on the use of Quincke type needle no. 25 was 3–7, while on Quincke type needle no. 27 was 2–6, and 0 in pencil point type needle no. 27. As the conclusion, the greatest incidence of PDPH in patients undergoing caesarean section, based on spinal needle type, occurs most with no. 25 Quincke type needles, and less with no. 27 and none with no. 27.Key words: Numeric rating scale, post dural puncture headache, spinal anesthesia DOI: 10.15851/jap.v1n3.197
Penatalaksanaan Anestesi pada Pasien dengan Sick Sinus Syndrome yang Menjalani Laparotomi Ec Perforasi Gaster Halimi, Radian Ahmad; Tavianto, Doddy
Jurnal Anestesi Perioperatif Vol 1, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Disfungsi dari Sinoarterial node (SA node, yang dikenal sebagai “Sick Sinus Syndrome”,  merupakan salah satu penyebab gangguan ritme jantung, dan dapat disebabkan  oleh gangguan baik faktor intrinsik atau faktor ekstrinsik dari SA node. Diagnosis Sick Sinus Syndrome ditegakkan dengan adanya gangguan ritme jantung dengan episode takikardia-bradikardia, dan disertai  gejala klinis seperti; sinkop, palpitasi, atau dapat saja  tanpa gejala klinis. Semua literatur mengatakan penatalaksanaan Sick Sinus Syndrom perioperatif adalah dengan  pemasangan  pacemaker jantung baik transkutaneus maupun secara transvenous pada preoperatif. Seorang pria berumur 75 tahun dengan diagnose peritonitis diffuse yang disebabkan oleh perforasi gaster. Pada pemeriksaan klinis preoperatif didapatkan pasien kompos mentis, anamnesis ada riwayat hipertensi yang tidak terkontrol. Pada pemeriksaan fisik didapatkan bradikardi dengan nadi 31x/menit, tekanan darah 190/100 mmHg. Ditempat tersebut tidak terdapat fasilitas untuk pemasangan pace maker baik trans kutaneous maupun secara transvenous. Dengan pertimbangan sirkulasi organ (mikrosirkulasi) cukup baik ( kompos mentis, SpO2 99% dan setelah optimalisasi diuresi mencapai 1cc/kgBB/jam). Pemeriksaan foto toraks didapatkan kardiomegali tanpa bendungan paru, pemeriksaan laboratorium menunjukkan angka – angka normal termasuk tes fungsi ginjal (kreatinin 0,97 mg/dl dengan ureum 82,6 mg/dl). Diputuskan untuk melakukan tindakan anestesi / pembedahan ditempat ybs dan rencana anestesi adalah dilakukan dengan anestesi umum. Saat pasien masih sadar, mulai diberikan fentanyl secara bertahap, 2 µgr/kgBB. Nadi berkisar antara 28 – 44x/menit, SpO2 98%.  Limabelas menit kemudian diberikan propofol secara titrasi dan setelah pasien tertidur fasilitas intubasi dengan atrakurium. Setelah intubasi  nadi mencapai 44 - 90x/menit dan saat nadi mencapai 90x/menit, didapatkan nadi yang iregular berupa ventricular extrasystole ( VES ) yang multifokal, diputuskan untuk mempertahankan nadi sekitar 35 – 40x/ menit dengan tekanan darah 160/70 mmHg. Selama pembedahan, nadi dan tekanan darah stabil pada kisaran diatas. Pasca bedah pasien dirawat di ruang perawatan intensif selama 2 hari setelah itu pindah ke ruang perawatan biasa dalam keadaan baik. Pasien pulang setelah hari ke 8.Kata kunci: Sick Sinus Syndrome, Bradikardia Anesthesia for Laparatoy e.c Gaster Perforation with Sick Sinus SyndromeSA node dysfunction, or known as  Sick Sinus Syndrome is the common cause of disrythmia and can be caused by intrinsic and extrinsic factors of the SA node. The diagnose performed by the occurrence of bradi- takhikardia episode and the clinical symptoms, could be syncope, palpitation, or maybe asymptomatic. Some of the literature defined that the perioperative management of  sick sinus syndrome is preoperative insertion of pacemaker (transcutaneal or transvenous pacing). A 75 years old man underwent laparotomy with diffuse peritonitis caused by gastric perforation. In preoperative clinical evaluation the patients revealed full awake ( compos mentis), with  history of uncontrolled hypertension. In physical exammination a severe bradicardia was found with pulse of 31x/minute, and the blood pressure was 190/100 mmHg. In this rural hospital there was no fascility to insert the pace-maker. The organ perfusion was considered to be optimal from clinical evaluation ( proved by the wakefullness, SpO2 99%, and diuresis 1cc/kgBW after optimalization ). The chest X’ray showed a cardiomegali without the sign of pulmonary congestion. The laboratory test were within normal limit including the renal function test ( creatinin; 0,97 mg/dl, and ureum 82,6 mg/dl). We decided to perform general anesthesia in this procedure. Before the  induction while patient still awake, fentanyl 2µg/kgBW was given intravenously. Fifteen menue after fentanyl administration induction of anesthesia performed and initiated with propofol intravenous injection slowly until patients felt asleep, than intubated after muscle relaxant intravenous reached  the onset After intubation the pulse / heart rate of patients rose to 44 – 90x/minute. While the pulse was 90/ minute the heart rythm of the patients became irregular, a multifocal ventricular extra systole occured, and it was reversible when the heart rate back to 44x/ minute. We decided to maintain the heart rate between 35 – 40dmitted to the iCU, and after 2 days in the ICU patients was transfered to the ward, and can be dischared home after 8 days.Keywords: Bradikardia, Sick Sinus Syndrome DOI: 10.15851/jap.v1n1.159
Prosedur Anestesi Timektomi pada Kasus Timoma Tanpa Gejala Miastenia Gravis : Sebuah Laporan Kasus Sepviyanti, Fitri; Tavianto, Doddy; Kaswiyan, U.
Jurnal Anestesi Perioperatif Vol 1, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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LAPORAN KASUSTimoma adalah neoplasma primer yang paling sering ditemukan pada mediastinum, dengan angka kejadian 15% dari seluruh massa mediastinum. Timbul pada pasien berusia 40-60 tahun, dengan insiden yang sama pada laki-laki dan perempuan. Lima puluh persen kasus timoma ditemukan secara tidak sengaja pada pemeriksaan radiograf dada rutin sebagai massa mediastinum anterior superior. Tatalaksana untuk timoma adalah tindakan pembedahan atau timektomi. Pengkajian menyeluruh pra operasi dibutuhkan untuk memastikan tidak adanya sindrom paraneoplastik. Tingkat kematian perioperatif cukup tinggi pada pasien yang menjalani timektomi sebelum tahun 1970 antara 5% dan 15%. Setelah tahun 1970, tingkat kematian dalam studi terakhir ditemukan secara konsisten kurang dari 1%. Demikian pula angka kematian timektomi pada pasien miastenia gravis dilaporkan kurang dari 1%. Seorang wanita 69 tahun didiagnosis dengan timoma dan direncanakan untuk menjalani timektomi. Ahli anestesi memutuskan untuk tidak menggunakan pelemas otot karena sadar dapat timbulnya sindrom paraneoplastik akibat timoma, myastenia gravis. Myasthenia gravis akan mempengaruhi efek relaksan otot yang tahan terhadap succinylcholine dan sangat sensitif terhadap bloker non depolar. Pasien tidak memiliki morbiditas apapun serta memiliki kondisi yang baik selama pemulihan.Kata kunci : timoma, miastenia gravis syndrome, anesthesia DOI: 10.15851/jap.v1n1.160
Patofisiologi Pintasan Jantung Paru Tavianto, Doddy; Wargahadibrata, A. Himendra; Gani C., Chairil
Jurnal Anestesi Perioperatif Vol 1, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Perubahan fisiologi yang disebabkan oleh pintasan jantung paru (PJP) adalah perubahan pulsatilitas, pola aliran darah, pengaruh paparan darah terhadap permukaan nonfisiologis, kerusakan darah akibat tekanan (shear stress), hemodilusi, dan respons stres yang berlebihan. Peningkatan keamanan penggunaan PJP bergatung pada pengetahuan dan pemahaman yang baik terhadap perubahan homeostatis sirkulasi normal. Kontrol sirkulasi selama PJP dilakukan dengan memerhatikan aliran darah sistemik, tekanan arteri, tekanan vena, dan distribusi aliran darah. Perubahan sirkulasi selama PJP dapat terjadi saat PJP dimulai, pada periode hipotemia, pada fase pemulihan temperatur (rewarming), saat PJP dengan temperatur hangat (warm CPB) dan PJP juga akan mengakibatkan perubahan pada mikrosirkulasi, serta keadekuatan perfusi jaringan.Kata kunci: Efek pintasan jantung paru, patofisiologi, pintasan jantung paru Patophysiology of Cardiopulmonary Bypassphysiologic changes introduced by cardiopulmonary bypass include an alteration in pulsatile, blood flow >pattern, exposure of blood to nonphysiologic surface, blood damage due to shear stress, hemodilution, and overload stress response. The increase of cardiopulmonary bypass safety depends on good knowledge and understanding on normal circulatory hemostatis changes. Circulation control during cardiopulmonary bypass was done by observing systemic blood flow, arterial pressure, venous pressure, and blood< flow distribution. Circulatory changes during cardiopulmonary bypass can happen on set of action, hipotermia periode, rewarming phase, during cardiopulmonary bypass with warm temperature, and also cardiopulmonary bypass can cause changes in microsirculation and adequacy of tissue perfusion.Key words: Effect of cardiopulmonary bypass, pathophysiology, cardiopulmonary bypass DOI: 10.15851/jap.v1n2.125
Pengaruh Penambahan Klonidin 75 mcg pada 12,5 mg Levobupivakain 0,5% Secara Intratekal terhadap Lama Kerja Blokade Sensorik dan Motorik untuk Bedah Ortopedi Ekstremitas Bawah Ramli, Fadlyansyah; Tavianto, Doddy; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Keterbatasan anestesi spinal antara lain ialah lama kerja blokade sensorik dan motorik terbatas. Penelitian ini bertujuan melihat pengaruh penambahan 75 mcg klonidin pada 12,5 mg levobupivakain 0,5% terhadap lama kerja blokade sensorik dan motorik pada anestesi spinal untuk bedah ortopedi ekstremitas bawah. Penelitian bersifat eksperimental prospektif dengan metode acak terkontrol tersamar ganda pada 36 sampel dengan kriteria American Society of Anesthesiologist (ASA) I-II yang menjalani operasi ortopedi ekstremitas bawah dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Juni–Agustus 2014. Kelompok levobupivakain dan klonidin (LK) mendapatkan 12,5 mg levobupivakain 0,5% ditambah klonidin 75 mcg. Kelompok levobupivakain dan salin (LS) mendapatkan  12,5 mg levobupivakain 0,5% ditambah NaCl 0,9% 0,5 mL. Data hasil penelitian diuji secara statistik menggunakan uji-t, Mann-Whitney, dan chi-kuadrat. Hasil penelitian menunjukkan lama kerja blokade sensorik kelompok LK lebih lama secara bermakna yaitu 244,44 (37,84) menit dibandingkan dengan kelompok LS, yaitu 107,89 (17,63) menit (p=0,000). Lama kerja blokade motorik kelompok LK lebih lama secara bermakna yaitu 278,72 (41,75) menit dibandingkan dengan kelompok LS, yaitu 128,39 (18,26) menit (p=0,000). Simpulan, penambahan klonidin 75 mcg pada 12,5 mg levobupivakain 0,5%  secara intratekal memerpanjang lama kerja blokade sensorik dan motorik.Kata kunci: Anestesi spinal, klonidin, levobupivakain, lama kerja blokade sensorik, lama kerja blokade motorikEffect of Clonidine 75 mcg Addition to Intrathecal 12.5 mg 0.5% Levobupivacaine on Sensoric and Motoric  Blockade Duration in Lower Extremity Orthopedic SurgeryAbstractSpinal anesthesia has some limitations that  limits its use, such as limited duration of action in motoric and sensoric.  This research aimed to provide an overview on the effect of adding clonidine 75 mcg to 12.5 mg  0.5% levobupivacaine on the motoric and sensoric blockade action duration in lower extremity orthopedic surgery spinal anesthesia. This experimental prospective research used double blind randomized controlled trial approach on 36 patients with ASA I-II physical status who underwent lower extremity orthopedic surgery using spinal anesthesia in Dr. Hasan Sadikin General Hospital during the period of June to August 2014.  LC group, clonidine 75 mcg was added to 12.5 mg 0.5% levobupivacaine.  On LS group, 12.5 mg 0.5% mg levobupivacaine mixed with 0.5 mL 0.9% NaCl. The data were then statistically tested using t-test, Mann-Whitney, and chi-square. The result showed that the duration of action of sensoric blockade in LK group was significantly longer, i.e. 224.44 (37.84) minutes compared to LS group, i.e. 107.89 (17.63) minutes (p=0.000).  Duration of action of motoric blockade in LK group was significantly longer, i.e. 278,72 (41,75) minutes, compared to LS group, i.e. 128.39 (18.26) minutes (p=0.000). It is concluded that the additiona of clonidine 75 mcg to 12,5 mg 0,5% levobupivacaine significantly prolongs the duration of action of the motoric and sensoric blockade if given intrathecally.Key words: Clonidine, duration of action, duration of action of motoric blockade, levobupivacaine, spinal anesthesia DOI: 10.15851/jap.v3n1.374  
Keberhasilan Early Goal-Directed Therapy dan Faktor Pengganggu pada Pasien Sepsis Berat di Instalasi Gawat Darurat Rumah Sakit Dr. Hasan Sadikin Bandung yang Akan Menjalani Pembedahan Silviana, Mira; Tavianto, Doddy; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Early goal directed therapy (EGDT) bertujuan menurunkan morbiditas dan mortalitas pada pasien sepsis berat dan syok sepsis namun pelaksanaannya sering menemukan kendala. Tujuan penelitian ini mengevaluasi keberhasilan EGDT pada pasien sepsis berat di Instalasi Gawat Darurat (IGD) Rumah Sakit Dr. Hasan Sadikin Bandung yang menjalani pembedahan serta mencari faktor-faktor yang memengaruhi keberhasilan EGDT. Penelitian dilakukan dengan metode deskriptif observasional pada bulan Juni–Agustus 2014 dengan subjek penelitian pasien IGD berusia >14 tahun dalam kondisi sepsis berat yang menjalani pembedahan. Keberhasilan EGDT ditentukan berdasar atas pedoman surviving sepsis campaign. Hasil penelitian dari 30 pasien didapatkan 27 pasien berhasil dilakukan EGDT, sedangkan 3 pasien meninggal. Faktor yang memengaruhi EGDT, yaitu faktor medis, kecepatan dalam mendiagnosis sepsis berat, lama pemeriksaan penunjang, faktor koagulasi yang memanjang, dan faktor nonmedis, yaitu lamanya keputusan keluarga, prosedur pengurusan administrasi, dan ketersediaan alat. Simpulan, keberhasilan EGDT di Rumah Sakit Dr. Hasan Sadikin dengan faktor medis dan nonmedis sebagai faktor pengganggu yang berperan dalam keberhasilan pelaksanaannya. Kata kunci:  Early goal directed therapy (EGDT), pembedahan, sepsis beratThe Success of Early Goal-Directed Therapy and its Confounding Factors in Patients with Severe Sepsis Admitted to the Emergency Room of Dr. Hasan Sadikin General Hospital for SurgeryEarly goal-directed therapy (EGDT) is conducted to reduce morbidity and mortality in patients with severe sepsis and septic shock. The purpose of this study was to evaluate the success of EGDT in patients with severe sepsis in the emergency room (ER) of Dr. Hasan Sadikin General Hospital Bandung who were going to undergo surgery and the factors that contributed to the success of EGDT. This study was a descriptive observational study that took place in June–August 2014. Subjects were ER patients, aged over 14 years old, who came with severe sepsis condition and were going to undergo surgery. The successful EGDT in this study was determined according to the surviving sepsis campaign (SSC) guideline such as a central venous pressure of 8–12 mmHg, mean arterial pressure of >65 mmHg, and central venous saturation of >70%. In this study, from 30 patients, 27 patients  successfully underwent EGDT and the remaining 3 patients did not survive. Factors that affect the implementation of EGDT were divided into two factors: medical and non-medical factors.  Medical factors were time needed to diagnose patient with severe sepsis, delay in laboratory findings, and abnormality of coagulation factors. The non-medical factors were family consent, procedures related to health insurance, and the availability of central venous catheter. In conclusions, EGDT is successfully achieved in 90% patients with severe sepsis in Dr. Hasan Sadikin General Hospital Bandung.  Factors that contribute to the successful achievement of EGDT include medical and non-medical factors.Key words: Early goal directed therapy, surgery, severe sepsis DOI: 10.15851/jap.v3n2.580
Perbandingan Efek Pemberian Cairan Kristaloid Sebelum Tindakan Anestesi Spinal (Preload) dan Sesaat Setelah Anestesi Spinal (Coload) terhadap Kejadian Hipotensi Maternal pada Seksio Sesarea Fikran, Zaki; Tavianto, Doddy; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Pemberian cairan secara preload sebagai profilaksis sebelum anestesi spinal telah menjadi prosedur rutin untuk mencegah hipotensi ibu selama tindakan seksio sesarea. Tidak seperti koloid, waktu pemberian cairan kristaloid merupakan hal penting karena singkatnya waktu cairan kristaloid berada di ruang intravaskular. Penelitian ini bertujuan mengetahui pengaruh waktu pemberian cairan kristaloid terutama Ringerfundin yang lebih baik antara preload dibanding dengan coload dalam mencegah hipotensi maternal selama anestesi spinal pada seksio sesarea. Penelitian dilakukan di Central Operating Theatre (COT) Rumah Sakit Dr. Hasan Sadikin Bandung periode Juni−Juli 2015 dengan uji klinis acak tersamar tunggal terhadap 36 pasien yang menjalani seksio sesarea dengan status fisik American Society of Anesthesiologist (ASA) II. Kejadian hipotensi dinilai setelah pemberian anestesi spinal sampai bayi lahir. Data hasil penelitian dianalisis dengan uji-t, Uji Mann-Whitney, dan uji chi-kuadrat dengan nilai p<0,05 dianggap bermakna. Insidens hipotensi lebih rendah pada kelompok kristaloid coload dibanding dengan kelompok kristaloid preload (44,4% vs 77,8%; p=0,040). Simpulan penelitian ini menunjukkan bahwa pemberian cairan kristaloid secara coload lebih efektif daripada preload untuk pencegahan hipotensi maternal setelah anestesi spinal pada seksio sesarea.Kata kunci: Anestesi spinal, hipotensi, kristaloid, seksio sesareaComparison of the Effect of Crystalloids Fluid Provision Before Spinal Anesthesia (Preload) and Shortly after Spinal Anesthesia (Co-load) on Maternal Hypotension Incidence in Caesarean DeliveryProphylactic fluid as a preload before spinal anesthesia has been a routine procedure to prevent maternal hypotension during cesarean delivery. Unlike colloid, timing of infusion of crystalloid may be important because it has short linger time in the intravascular space. This study aimed to compare the effect of the timing of administration of crystalloid, especially Ringerfundin, which is more effective between preload and co-load in preventing maternal hypotension during spinal anesthesia for cesarean section. This study was performed at the Central Operating Theatre (COT) of Dr. Hasan Sadikin General Hospital Bandung in June−July 2015 using the single blind randomized controlled trial method on 36 patients who underwent caesarean section with American Society of Anesthesiologist (ASA) II physical status. The incidence of hypotension was observed starting from the time the spinal anesthesia was performed to the time when the baby was born. Data were analyzed statistically using t-test, Mann Whitney test, and chi-square test where a p value of <0.05 considered significant. The incidence of hypotension was lower in the co-load group when compared to the preload group (44.4% vs. 77.8%, p value=0.040). In conclusion, the use of crystalloids for cesarean delivery in co-loading manner is more effective than preloading for the prevention of maternal hypotension after spinal anesthesia.Key words: Cesarean delivery, crystalloid, hypotension, spinal anesthesia DOI: 10.15851/jap.v4n2.818
Gambaran Pengetahuan Klinisi Ruang Rawat Intensif mengenai Ventilator Associated Pneumonia (VAP) Bundle di Ruang Rawat Intensif RSUP Dr. Hasan Sadikin Bandung Sadli, M. Fajar; Tavianto, Doddy; Redjeki, Ike Sri
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Ventilator associated pneumonia (VAP) merupakan infeksi yang terjadi pada pasien yang terintubasi ≥48 jam di ruang rawat intensif. Penanganan VAP merupakan tantangan utama akibat morbiditas dan mortalitas yang tinggi.Ventilator associated pneumonia bundle (VAPb) telah terbukti dapat menurunkan angka kejadian VAP sehingga pengetahuan dokter dan perawat mengenai VAPb menentukan keberhasilan pencegahan VAP di ruang rawat intensif. Tujuan penelitian ini mengetahui pengetahuan dokter dan perawat mengenai VAPb di ruang rawat intensif RSUP Dr. Hasan Sadikin Bandung. Data diambil dari bulan November–Desember 2016. Penelitian deskriptif dengan desain potong lintang ini menggambarkan pengetahuan mengenai VAPb dari dokter residen Departemen Anestesi dan Terapi Intensif dan perawat di ruang rawat intensif RSUP Dr. Hasan Sadikin Bandung. Responden terdiri atas 79 dokter dan 88 perawat. Tingkat pengetahuan VAPb diuji menggunakan 20 pertanyaan kuesioner. Responden perawat terbanyak berjenis kelamin perempuan (74%), berusia ≥30 tahun (92%), status pendidikan diploma III (65%), lama kerja >5 tahun (76%), dan bekerja di Intensive Care Unit (ICU) (32%). Responden dokter terbanyak berjenis kelamin laki-laki (71%), berusia ≥30 tahun (83%), dan telah menyelesaikan stase ICU (61%). Simpulan, nilai kuesioner perawat dan dokter rata-rata berturut-turut 73,63 dan 73,16. Kata kunci: Klinisi ruang rawat intensif, tingkat pengetahuan, ventilator associated pneumonoia bundle Description of Intensive Care Clinician Knowledge about Ventilator Associated Pneumonia (VAP) Bundle in the Intensive Care Unit of  Dr. Hasan Sadikin Hospital BandungVentilator associated pneumonia (VAP) is an infection that occurs in patients who are intubated ≥48 hours in intensive care. Management VAP is a major challenge due to the high morbidity and mortality. Ventilator associated pneumonia bundle (VAPb) has been shown to reduce the incidence of VAP, so knowledge of doctors and nurses about VAPb determine the success of preventing VAP in intensive care. This study aims to know the description of intensive care clinician knowledge about ventilator associated pneumonia bundle in the intensive care of Dr. Hasan Sadikin General Hospital Bandung. Data were collected from November–December 2016. Descriptive study with cross-sectional design depicts VAPb knowledge of resident physicians Department of Anesthesia and Intensive Therapy and nurses in the Intensive Care Department of Dr. Hasan Sadikin Hospital. Respondents consisted of 79 doctors and 88 nurses. The level of knowledge VAPb tested using a 20 question questionnaire. Most nurse respondents were female (74%), aged ≥30 years (92%), educational status diploma III (65%), length of employment >5 years (76%), and work in Intensive Care Unit (ICU) (32%). Most physician respondents were male sex (71%), aged ≥30 years (83%), and had completed stase ICU (61%). In conclution, the mean value of the questionnaire nurses and doctors respectively 73.63 and 73.16. Key words: Intensive care clinician, level of knowledge, ventilator associated pneumonoia bundle
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 Fauzan, Raditya; Tavianto, Doddy; Sitanggang, Ruli Herman
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 (362.981 KB) | DOI: 10.15851/jap.v4n1.746

Abstract

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 
Hubungan antara Lama Puasa Preanestesi dan Kadar Gula Darah Saat Induksi pada Pasien Pediatrik yang Menjalani Operasi Elektif Dausawati, Arsy Felisita; Tavianto, Doddy; Kadarsah, Rudi K.
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (343.248 KB)

Abstract

Puasa preoperatif adalah untuk mengurangi volume, tingkat keasaman lambung, dan mengurangi risiko aspirasi paru. Puasa preoperatif sering kali lebih lama daripada yang direkomendasikan karena berbagai alasan di Rumah Sakit Dr. Hasan Sadikin Bandung. Tujuan penelitian ini adalah mengetahui korelasi antara lama puasa preanestesi dan kadar gula darah saat induksi pada pasien pediatrik di Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian analitik observasional cros sectional dilakukan pada pasien pediatrik pada bulan Januari–Februari 2015 di Instalasi Bedah Sentral Rumah Sakit Dr. Hasan Sadikin Bandung. Uji distribusi data menurut Kolmogorov-Smirnov kemudian dilakukan Uji kolerasi Spearman. Lama puasa minimum, maksimum, dan rata-rata (SD) puasa dari makanan  4, 15, dan 8,7500 (3,48597) jam. Lama puasa minimum, maksimum, dan rata-rata (SD) dari minuman adalah 2, 15, dan 12,56 (3,26) jam. Tidak ditemukan kejadian hipoglikemia pada penelitian ini dengan gula darah sewaktu induksi terendah 59 mg/dL. Terdapat hubungan yang bermakna antara lama puasa preanestesi dengan GDS induksi (p<0,05). Simpulan, lama puasa preanestesi pada pasien pediatrik yang akan menjalani operasi elektif melebihi dari apa yang dianjurkan oleh ASA. Terdapat hubungan antara lama puasa preanestesi dan kadar gula darah saat induksi. Kata kunci: Kadar gula darah, lama puasa preanestesi, operasi elektif, pediatrik Correlation between Preanesthetic Fasting Duration and Blood Glucose Level During Induction in Pediatric Elective Surgery PatientsPreoperative fasting is to reduce the volume and acidity of gastric and further reduce the risk of pulmonary aspiration. Preoperative fasting period often longer than the recommended time for various reasons in Dr. Hasan Sadikin General Hospital Bandung. The purpose of this study was to determine the correlation between preanesthetic fasting duration and blood sugar level induction in pediatric patients in Dr. Hasan Sadikin General Hospital Bandung. An analytical observational cross-sectional study was conducted on pediatric patients during period of January–Februari 2015 at the Central Surgical Installation of Dr. Hasan Sadikin General Hospital Bandung. The minimum, maximum, and mean (SD) fasting from food duration were 4, 15, and 8.7500 (3.48597) hours. The minimum, maximum, and mean (SD) fasting from drinks durations were 2, 15 and 12.56 (3.26) hours. The incidence of hypoglycemia was not found in this study. Based on the result of Spearman correlation test showed a statistically significant relationship between preanesthetic fasting duration and with blood glucose level during induction (p<0.05). In conclusion, preanesthetic fasting duration in pediatric patients who are undergoing an alective surgerybin this hospital is longer than the duration recommended by ASA. There is a correlation between the preanesthetic fasting period and blood sugar level during induction. Key words: Blood glucose levels, duration of preanesthetic fasting, elective surgery, pediatric DOI: 10.15851/jap.v3n3.614
Co-Authors A. Himendra Wargahadibrata A. Himendra Wargahadibrata Andi Mursali Andi Mursali, Andi Arsy Felisita Dausawati Arsy Felisita Dausawati Ati Nurchaeni Nurchaeni Chairil Gani C. Chairil Gani C. Dewi Yulianti Bisri Dino Irawan Dino Irawan Eri Surahman Eri Surahman Ezra Oktaliansah Fadlyansyah Ramli Fadlyansyah Ramli Fikran, Zaki Fitri Sepviyanti Fitri Sepviyanti Gezy Weita Giwangkencana Handoyo Harsono Harsono, Handoyo Hilmy Manuapo Iervan Churniawan Tanjung Ike Sri Redjeki Ike Sri Redjeki M. Andy Prihartono M. Fajar Sadli Mira Silviana Mira Silviana, Mira Nurchaeni, Ati Nurul Subhan Radian Ahmad Halimi Raditya Fauzan Raditya Fauzan, Raditya Reza Widianto Sudjud Rudi K. Kadarsah Rudi K. Kadarsah Rudi Kurniadi Kadarsah Ruli Herman Sitanggang Sadli, M. Fajar Suwarman Suwarman Suwarman Suwarman, Suwarman Tanjung, Iervan Churniawan Tinni T. Maskoen Tinni T. Maskoen Tinni T. Maskoen U. Kaswiyan U. Kaswiyan Yuanda Rizawan Putra Yustisa Sofirina Harahap Yustisa Sofirina Harahap, Yustisa Sofirina Zaki Fikran