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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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Perbandingan Efek Pemberian Eritromisin 250 mg Oral dengan Metoklopramid 10 mg Oral terhadap Jumlah dan pH Cairan Lambung pada Pasien yang Menjalani Operasi Elektif dengan Anestesi Umum Mursali, Andi; Maskoen, Tinni T.; Tavianto, Doddy
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (557.074 KB) | DOI: 10.15851/jap.v5n1.1000

Abstract

Aspirasi pulmonal akibat isi lambung merupakan penyebab kematian yang berhubungan dengan anestesi. Eritromisin 250 mg oral dan metoklopramid 10 mg oral digunakan untuk menurunkan jumlah dan meningkatkan pH cairan lambung. Penelitian ini bertujuan membandingkan efek eritromisin 250 mg oral dan metoklopramid 10 mg oral terhadap jumlah dan pH cairan lambung pasien yang menjalani operasi elektif dengan anestesi umum. Penelitian ini merupakan uji klinis acak buta ganda pada 42 pasien yang termasuk dalam kriteria inklusi pasien dengan American Society of Anesthesiologist (ASA) kelas I, usia 18–60 tahun, dijadwalkan operasi elektif dengan anestesi umum dan diintubasi di Rumah Sakit Dr Hasan Sadikin Bandung periode Agustus–September 2015. Pasien dibagi menjadi 2 kelompok 21 orang masing-masing. Kelompok A mendapatkan eritromisin 250 mg oral dan kelompok B metoklopramid 10 mg oral yang diberikan 1 jam sebelum induksi anestesi. Setelah dilakukan intubasi, cairan lambung diambil menggunakan spuit 50 mL melalui nasogastric tube (NGT) no 18, dimasukkan ke gelas ukur, diukur jumlah dan pH nya. Analisis statistik menggunakan uji Mann–Whitney. Hasil menunjukkan kelompok A didapatkan 90,5% pasien dengan jumlah cairan <25 mL, sedangkan kelompok B 57,1%, perbedaan bermakna secara statistik (p<0,014). Simpulan, eritomisin 250 mg oral lebih menurunkan jumlah dan meningkatkan pH cairan lambung dibanding dengan metoklopramid 10 mg oral pada pasien yang menjalani anestesi umum.Kata kunci: Eritromisin, jumlah cairan lambung, metoklopramid, pH cairan lambung Comparison of the Effect of 250 mg Oral Erythromycine and 10 mg Oral Metoclopramide on Gastric Fluid Volume and pH in Patients Undergoing Elective Operation in General AnesthesiaPulmonary aspiration caused by gastric contents is one of the leading causes of anesthesia-related deaths. Combination of >25 mL volume and a <2.5 pH is a high risk to lung damage. Oral Erythromycin 250 mg and Oral metoclopramide 10 mg can be used to reduce the gastric fluid volume and increase the gastric fluid pH. The purpose of this study was compare the effects between oral erythromycin 250 mg and oral metoclopramide 10 mg on the volume and pH of gastric fluid in patients undergoing elective general anesthesia. This study was a double blind randomized clinical trial on 42 patients who met the inclusion criteria. Patients were divided into 2 groups with 21 patients in each group. Group A received 250 mg of oral erythromycin and group B received 10 mg of metoclopramide, 1 hour before the induction of anesthesia.After intubation, gastric fluid was collected using a 50 mL syringe via the nasogastric tube (NGT). It was then placed in a beaker glass to have its volume and pH measured. A statistical analysis using the Mann–Whitney test was performed. In group A, 90.5% of patients were found to have gastric fluid volume <25 mL, while group B had 57.1%, in which the difference was statistically significant (p <0.014). Hence, the administration of erythromycin 250 mg orally is more effective in reducing the gastric fluid volume and increasing the gastric fluid pH compared to oral administration of etoclopramide 10 mg in patients undergoing general anesthesia.Key words: Erythromycin, gastric fluid volume, metoclopramid, gastric pH
Perbandingan Angka Keberhasilan Pemasangan Laryngeal Mask Airway (LMA) Jenis Klasik pada Usaha Pertama antara Teknik Balon Dikempiskan dan Dikembangkan Sebagian pada Pasien Dewasa Harahap, Yustisa Sofirina; Tavianto, Doddy; Surahman, Eri
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 (405.299 KB) | DOI: 10.15851/jap.v4n1.743

Abstract

Laryngeal mask airway (LMA) jenis klasik merupakan alat bantu jalan napas supraglotis yang paling sering digunakan sebagai alternatif pilihan dari intubasi endotrakeal. Tujuan penelitian ini adalah mengetahui perbandingan angka keberhasilan pemasangan LMA jenis klasik pada usaha pertama antara teknik balon dikempiskan dan dikembangkan sebagian pada pasien dewasa. Penelitian dilakukan dengan uji acak lengkap terkontrol tersamar tunggal terhadap 70 pasien yang berusia 18–60 tahun dan status fisik American Society of Anesthesiologists (ASA) I–II yang menjalani operasi terencana dengan anestesi umum, dan tidak terdapat kontraindikasi pemasangan LMA di Instalasi Bedah Sentral Rumah Sakit Dr. Hasan Sadikin Bandung. Dilakukan randomisasi blok permutasi dan dikelompokkan menjadi kelompok teknik balon dikempiskan dan kelompok teknik balon dikembangkan sebagian. Data hasil penelitian dianalisis dengan uji chi-kuadrat dan Uji Mann-Whitney dengan p<0,05 dianggap bermakna. Penelitian ini berlangsung pada Februari–Maret 2015. Hasil penelitian menunjukkan teknik balon dikembangkan sebagian angka keberhasilan lebih tinggi 33 dari 35 dibanding dengan balon dikempiskan 27 dari 35 pada usaha pertama yang berbeda bermakna (p<0,05). Simpulan, teknik pemasangan LMA jenis klasik pada pasien dewasa dengan teknik balon dikembangkan sebagian angka keberhasilannya lebih tinggi daripada balon dikempiskan.Kata kunci: Laryngeal mask airway jenis klasik, teknik balon dikembangkan sebagian, teknik balon dikempiskanComparison of Success Rate between Fully Deflated and Partially Inflated Cuff Technique in Classic Laryngeal Mask Airway (cLMA) Insertion on First Attempt in Adult PatientsAbstractClassic laryngeal mask airway (cLMA) is the most widely used supraglottic airway device and is a satisfactory alternative to endotracheal intubation. The purpose of this study was to compare the success rate of cLMA insertion using fully deflated technique and partially inflated technique in adult patients. This was a complete randomized controlled single blind trial on 70 patients, 18–60 years old, American Society of Anesthesiologists (ASA) I–II, who underwent elective surgery in general anesthesia and in whom the use of LMA was not contraindicated. This study was performed at the Central Operating Theater, Dr. Hasan Sadikin General Hospital,Bandung. After using a permutation block randomization, the subjects were divided into fully deflated technique group and partially inflated technique group. Correct placement in first attempt was confirmed. Data were analyzed using chi-square test and Mann-Whitney test, where a p value of <0.05 was considered significant. The study was held in a period of February toMarch 2015. The results of this study showed that the partially inflated technique was more successful, 33 of 35, than the fully deflated technique, 27 of 35, on the first attempt. In addition, the statistical analysis results also showed that the ratio of success rate between both treatment groups of cLMA insertion was significantly different (p<0.05). The success rate of partially inflated technique of cLMA insertion iss higher than the fully deflated technique in adult patients.Key words: Fully deflated technique, partially inflated technique, the classic laryngeal mask airway (cLMA) DOI: 10.15851/jap.v4n1.743
Kesesuaian Pengkajian Nyeri Pascaoperasi dan Tidak Lanjutnya dengan Standar Prosedur Operasional Asesmen Nyeri pada Pasien Pediatrik di RSUP Dr. Hasan Sadikin Bandung Tahun 2016 Tanjung, Iervan Churniawan; Tavianto, Doddy; Suwarman, Suwarman
Jurnal Anestesi Perioperatif Vol 6, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (805.121 KB) | DOI: 10.15851/jap.v6n3.1347

Abstract

Nyeri bukan hanya persepsi sensorik, tetapi juga emosi, kognitif, dan perubahan perilaku Pengkajian nyeri pada anak dinilai dengan berbagai sistem skoring. Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung telah membuat Standar Prosedur Operasional untuk menilai nyeri di ruang perawatan. Penelitian bertujuan mengetahui kesesuaian pengkajian nyeri pascaoperasi dan tindak lanjutnya dengan SPO asesmen nyeri pada pasien pediatrik di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung pada tahun 2016. Penelitian menggunakan metode deskriptif observasional retrospektif terhadap 158 rekam medis pasien pediatrik yang dirawat pada tahun 2016. Penelitian dilakukan di RSUP Dr. Hasan Sadikin sejak Februari sampai dengan Maret 2018. Hasil penelitian mengungkapkan bahwa pengkajian nyeri sesuai SPO adalah 150 pasien (94,9%), tidak sesuai SPO 8 pasien (5,1%). Tindak lanjut pengkajian nyeri yang sesuai SPO adalah 138 pasien (87,4%), tidak sesuai SPO 13 pasien (8,2%), dan tidak dilakukan tindak lanjut 7 pasien (4,4%). Evaluasi ulang setelah tindak lanjut pengkajian nyeri sesuai SPO adalah 130 pasien (82%) dan tidak sesuai SPO 28 pasien (18%). Simpulan penelitian ini bahwa pengkajian nyeri pascaoperasi dan tindak lanjutnya sebagian besar sudah sesuai dengan Standar Prosedur Operasional. Kata kunci: Nyeri pascaoperasi, pediatrik, pengkajian nyeriCompliance of Postoperative Pain and Follow Up Assessment with Painful Assessment Standard Operating Procedures in Pediatric Patientsin Dr. Hasan Sadikin Bandung Year 2016Pain does not only involve sensoric perception. It also involves emotional, cognitive, and behavioral changes. Pain assessment inf children is performed using various scoring systems. Dr. Hasan Sadikin General Hospital Bandung has developed Standard Operating Procedures to assess pain in treatment rooms. The objective of this study was to determine the compliance of postoperative pain assessment and its follow-up to the SOP on pediatric pain assessment in Dr. Hasan Sadikin General Hospital Bandung in 2016. This was a retrospective observational descriptive study on 158 medical records of pediatric patients who were treated during the period of 2016. The study was conducted from February to March 2018. It was revealed that pain assessment was assessed in compliance to the SOP in 150 patients (94.9%) while the remaining 8 patients (5.1%) were not assessed according to the SOP. The follow-up of pain assessment was performed in compliance with the SOP in 138 patients (87.4%), Thirteen patients (8.2%) were followed up using procedures that are not in compliance with the SOP while 7 patients (4.4%) were not followed up at all. Reevaluation after pain assessment follow up was performed in compliance with the SOP in 130 patients (82%) while the remaining 28 patients (18%) were reevaluated without using the SOP. It is concluded that most postoperative pain assessments and their follow-up are conducted in compliance with the Standard Operating Procedures.Key words: Postoperative pain, pediatric, pain assessment
Gambaran Penggunaan, Obat, Teknik, dan Permasalahan yang Dihadapi pada Blokade Kaudal di Kota Bandung Tahun 2016 Harsono, Handoyo; Tavianto, Doddy; Suwarman, Suwarman
Jurnal Anestesi Perioperatif Vol 6, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (822.207 KB) | DOI: 10.15851/jap.v6n3.1487

Abstract

Penanganan nyeri pada pasien anak merupakan tantangan yang cukup besar bagi dokter spesialis anestesi. Blokade kaudal merupakan salah satu teknik anestesi regional yang mudah dan sangat efektif sebagai analgetik pada anak yang menjalani operasi di bawah umbilikus. Data yang diperoleh dari Inggris dan Irlandia selama bulan April sampai dengan Juni 2008 menunjukkan bahwa penggunaan blokade kaudal masih rendah ( 61% ). Tujuan penelitian ini adalah mengetahui penggunaan, obat, teknik, dan masalah yang dihadapi pada blokade kaudal di Kota Bandung. Penelitian dilakukan selama bulan Maret hingga April 2018. Penelitian ini bersifat deskriptif dengan  menggunakan kuesioner yang diberikan kepada 70 dokter spesialis anestesi di kota Bandung yang direspons oleh 64 orang (78%) dengan mengembalikan kuesioner. Dari penelitian ini didapatkan dokter spesialis anestesi yang melakukan blokade kaudal pada tahun 2016 sebesar 55%. Blokade kaudal digunakan untuk kombinasi anestesi dan analgesik pascaoperasi pada 62% responden. Teknik yang digunakan dalam blokade kaudal ini adalah blind technique tanpa alat bantu. Obat yang paling sering digunakan adalah bupivakain (91%). Permasalahan yang dihadapi di Kota Bandung yang mengakibatkan rendahnya penggunaan blokade kaudal adalah keterbatasan waktu tindakan (20%) dan ketersediaan obat dan alat (23%).Kata kunci: Blokade kaudal, bupivakain, teknik butaOverview on Usage, Drug, Technique and Problems on Caudal Blockade Procedure in Bandung City on 2016Pediatric pain management in pediatric is a big challenge for anesthesiologists. The caudal blockade is one of the easy and highly effective analgesic approaches for surgical procedure below umbilicus in children. Data from Ireland and United Kingdom show that the application of caudal blockade is relatively low (61%). The aim of this study was to explore the drug, technique, and challenges faced in caudal blockade application in Bandung City. This study was conducted from March to April 2018. This was a descriptive study using a questionnaire distributed to 70 anesthesiologist in Bandung city. The response rate was 77.65% (64 persons). This study found that 59.09% anesthesiologist had performed caudal block during 2016 which was used for anesthesia and post-operative analgesics by 61,54% respondents. Blind technique was used in this procedure without using additional equipment. The most frequently used was bupivacaine (97.44%). The low application of caudal block in Bandung during 2016 was caused by the limited time for the procedure (23.44%) and the availability of drug and equipment (23.44%).Key words: Caudal block, Bupivacaine, Blind technique
Tata Laksana Anestesi pada Pasien Anak dengan Hipersplenism, Thalassemia Mayor, dan Trombositopenia yang Menjalani Splenektomi Tavianto, Doddy; Nurchaeni, Ati
Majalah Anestesia dan Critical Care Vol 34 No 2 (2016): Juni
Publisher : Perdatin Pusat

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Abstract

Thalassemia merupakan penyakit genetik pembentukan rantai globin pada hemoglobin. Operasi spelenektomi pada pasien hipersplenism dengan thalassemia mayor dan trombositopenia merupakan hal yang menantang bagi seorang ahli anestesi dikarenakan manifestasi sistemik yang timbul karena thalassemia, penumpukan kadar besi, dan komplikasi agen kelasi besi. Kasus ini mempresentasikan tentang seorang anak perempuan usia 6 tahun dengan thalasemia mayor dan trombositopenia yang menjalani operasi splenektomi dalam anestesi umum. Operasi berlangsung selama 6 jam dengan perdarahan 2.700 mL dengan transfusi 700 mL PRC, 300 mL FFP, dan 200 mL trombosit. Hemodinamik intraoperatif pernah mengalami penurunan dikarenakan perdarahan akibat terpotongnya arteri gastric brevis. Setelah operasi pasien diekstubasi dan dirawat di HCU. Kata kunci : Hipersplenism, splenektomi, thalasemia mayor, trombositopenia Anesthetic Management in Paediatric Patient with Hypersplenism, Major Thalassemia, and Trombocitopenia undergo Splenectomy Splenectomy surgery in hypersplenism patient with thalassemia major and thrombocitopenia may be challenging to anaesthesiologist because of systemic manifestations of thalassemia, iron overload, and complications of chelation therapy. This case presenting a 6-year-old girl with thalassemia and thrombocitopenia undergo splenectomy surgery in general anaesthesia. The surgery took 6 hours with 2,700 mL blood loss and was transfused with 700 mL PRC, 300 mL FFP, and 200 mL thrombocytes. Haemodynamic intra operative decreased because of bleeding cut brevis gastric artery. After surgery patient was extubated then was treated in high care unit. Key words: Hypersplenism, major thalassemia, thrombocytopenia, splenectomy
Kejadian Post Dural Puncture Headache dan Nilai Numeric Rating Scale Pascaseksio Sesarea dengan Anestesi Spinal Dino Irawan; Doddy Tavianto; Eri Surahman
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1080.4 KB)

Abstract

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
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 Fadlyansyah Ramli; Doddy Tavianto; Tinni T. Maskoen
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1249.217 KB)

Abstract

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  
Kesesuaian Pengkajian Nyeri Pascaoperasi dan Tidak Lanjutnya dengan Standar Prosedur Operasional Asesmen Nyeri pada Pasien Pediatrik di RSUP Dr. Hasan Sadikin Bandung Tahun 2016 Iervan Churniawan Tanjung; Doddy Tavianto; Suwarman Suwarman
Jurnal Anestesi Perioperatif Vol 6, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (805.121 KB) | DOI: 10.15851/jap.v6n3.1347

Abstract

Nyeri bukan hanya persepsi sensorik, tetapi juga emosi, kognitif, dan perubahan perilaku Pengkajian nyeri pada anak dinilai dengan berbagai sistem skoring. Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung telah membuat Standar Prosedur Operasional untuk menilai nyeri di ruang perawatan. Penelitian bertujuan mengetahui kesesuaian pengkajian nyeri pascaoperasi dan tindak lanjutnya dengan SPO asesmen nyeri pada pasien pediatrik di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung pada tahun 2016. Penelitian menggunakan metode deskriptif observasional retrospektif terhadap 158 rekam medis pasien pediatrik yang dirawat pada tahun 2016. Penelitian dilakukan di RSUP Dr. Hasan Sadikin sejak Februari sampai dengan Maret 2018. Hasil penelitian mengungkapkan bahwa pengkajian nyeri sesuai SPO adalah 150 pasien (94,9%), tidak sesuai SPO 8 pasien (5,1%). Tindak lanjut pengkajian nyeri yang sesuai SPO adalah 138 pasien (87,4%), tidak sesuai SPO 13 pasien (8,2%), dan tidak dilakukan tindak lanjut 7 pasien (4,4%). Evaluasi ulang setelah tindak lanjut pengkajian nyeri sesuai SPO adalah 130 pasien (82%) dan tidak sesuai SPO 28 pasien (18%). Simpulan penelitian ini bahwa pengkajian nyeri pascaoperasi dan tindak lanjutnya sebagian besar sudah sesuai dengan Standar Prosedur Operasional. Kata kunci: Nyeri pascaoperasi, pediatrik, pengkajian nyeriCompliance of Postoperative Pain and Follow Up Assessment with Painful Assessment Standard Operating Procedures in Pediatric Patientsin Dr. Hasan Sadikin Bandung Year 2016Pain does not only involve sensoric perception. It also involves emotional, cognitive, and behavioral changes. Pain assessment inf children is performed using various scoring systems. Dr. Hasan Sadikin General Hospital Bandung has developed Standard Operating Procedures to assess pain in treatment rooms. The objective of this study was to determine the compliance of postoperative pain assessment and its follow-up to the SOP on pediatric pain assessment in Dr. Hasan Sadikin General Hospital Bandung in 2016. This was a retrospective observational descriptive study on 158 medical records of pediatric patients who were treated during the period of 2016. The study was conducted from February to March 2018. It was revealed that pain assessment was assessed in compliance to the SOP in 150 patients (94.9%) while the remaining 8 patients (5.1%) were not assessed according to the SOP. The follow-up of pain assessment was performed in compliance with the SOP in 138 patients (87.4%), Thirteen patients (8.2%) were followed up using procedures that are not in compliance with the SOP while 7 patients (4.4%) were not followed up at all. Reevaluation after pain assessment follow up was performed in compliance with the SOP in 130 patients (82%) while the remaining 28 patients (18%) were reevaluated without using the SOP. It is concluded that most postoperative pain assessments and their follow-up are conducted in compliance with the Standard Operating Procedures.Key words: Postoperative pain, pediatric, pain assessment
EFEK EUTECTIC MIXTURE OF LOCAL ANAESTHETICS (EMLA) UNTUK MENGURANGI NYERI PENYUNTIKAN JARUM SPINAL DI RUMAH SAKIT UMUM PUSAT Dr. HASAN SADIKIN BANDUNG Yuanda Rizawan Putra; Doddy Tavianto; Dewi Yulianti Bisri
Jurnal Anestesi Perioperatif Vol 7, No 3 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v7n3.1833

Abstract

Eutectic mixtures of local anaesthetics (EMLA) dapat mengurangi nyeri akibat penyuntikan jarum spinal. Penelitian bertujuan mengetahui efek EMLA terhadap nyeri saat penyuntikan jarum spinal. Metode penelitian adalah eksperimental secara acak terkontrol buta ganda pada pasien yang menjalani operasi elektif dalam anestesi spinal di ruang operasi sentral RSUP Dr. Hasan Sadikin Bandung dari bulan September hingga Oktober 2019. Data penilaian skor nyeri dilakukan setelah penyuntikan jarum spinal menggunakan Numeric pain rating score yang dianalisis dengan Uji Mann-Whitney. Hasil perhitungan statistik diperoleh Skor nyeri setelah aplikasi EMLA lebih rendah dibanding dengan skor nyeri (1 vs 4) dengan perbedaan yang sangat bermakna (p<0,001). Simpulan penelitian ini menunjukkan EMLA dapat mengurangi nyeri saat penyuntikan jarum spinal.Eutectic Mixture of Local Anesthetics (EMLA) Effect on Spinal Neddle Injection PainEutectic mixtures of local anesthetics can reduce pain caused by spinal injections. The purpose of this study was to understand the effect of EMLA on spinal injection pain. This was an experimental randomized single blind study involving all patients who underwent spinal anesthesia from September–October 2019 in Dr. Hasan Sadikin General Hospital. Pain score assessment was performed right after spinal injection using the numeric pain rating score. Data were then analyzed with Mann-Whitney test. Results showed that injection pain score in patients using EMLA was lower (1 vs 4) than patients who did not use EMLA (p<0.001). Therefore, EMLA can reduce spinal injection pain.
Perbandingan Efek Pemberian Eritromisin 250 mg Oral dengan Metoklopramid 10 mg Oral terhadap Jumlah dan pH Cairan Lambung pada Pasien yang Menjalani Operasi Elektif dengan Anestesi Umum Andi Mursali; Tinni T. Maskoen; Doddy Tavianto
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (557.074 KB) | DOI: 10.15851/jap.v5n1.1000

Abstract

Aspirasi pulmonal akibat isi lambung merupakan penyebab kematian yang berhubungan dengan anestesi. Eritromisin 250 mg oral dan metoklopramid 10 mg oral digunakan untuk menurunkan jumlah dan meningkatkan pH cairan lambung. Penelitian ini bertujuan membandingkan efek eritromisin 250 mg oral dan metoklopramid 10 mg oral terhadap jumlah dan pH cairan lambung pasien yang menjalani operasi elektif dengan anestesi umum. Penelitian ini merupakan uji klinis acak buta ganda pada 42 pasien yang termasuk dalam kriteria inklusi pasien dengan American Society of Anesthesiologist (ASA) kelas I, usia 18–60 tahun, dijadwalkan operasi elektif dengan anestesi umum dan diintubasi di Rumah Sakit Dr Hasan Sadikin Bandung periode Agustus–September 2015. Pasien dibagi menjadi 2 kelompok 21 orang masing-masing. Kelompok A mendapatkan eritromisin 250 mg oral dan kelompok B metoklopramid 10 mg oral yang diberikan 1 jam sebelum induksi anestesi. Setelah dilakukan intubasi, cairan lambung diambil menggunakan spuit 50 mL melalui nasogastric tube (NGT) no 18, dimasukkan ke gelas ukur, diukur jumlah dan pH nya. Analisis statistik menggunakan uji Mann–Whitney. Hasil menunjukkan kelompok A didapatkan 90,5% pasien dengan jumlah cairan <25 mL, sedangkan kelompok B 57,1%, perbedaan bermakna secara statistik (p<0,014). Simpulan, eritomisin 250 mg oral lebih menurunkan jumlah dan meningkatkan pH cairan lambung dibanding dengan metoklopramid 10 mg oral pada pasien yang menjalani anestesi umum.Kata kunci: Eritromisin, jumlah cairan lambung, metoklopramid, pH cairan lambung Comparison of the Effect of 250 mg Oral Erythromycine and 10 mg Oral Metoclopramide on Gastric Fluid Volume and pH in Patients Undergoing Elective Operation in General AnesthesiaPulmonary aspiration caused by gastric contents is one of the leading causes of anesthesia-related deaths. Combination of >25 mL volume and a <2.5 pH is a high risk to lung damage. Oral Erythromycin 250 mg and Oral metoclopramide 10 mg can be used to reduce the gastric fluid volume and increase the gastric fluid pH. The purpose of this study was compare the effects between oral erythromycin 250 mg and oral metoclopramide 10 mg on the volume and pH of gastric fluid in patients undergoing elective general anesthesia. This study was a double blind randomized clinical trial on 42 patients who met the inclusion criteria. Patients were divided into 2 groups with 21 patients in each group. Group A received 250 mg of oral erythromycin and group B received 10 mg of metoclopramide, 1 hour before the induction of anesthesia.After intubation, gastric fluid was collected using a 50 mL syringe via the nasogastric tube (NGT). It was then placed in a beaker glass to have its volume and pH measured. A statistical analysis using the Mann–Whitney test was performed. In group A, 90.5% of patients were found to have gastric fluid volume <25 mL, while group B had 57.1%, in which the difference was statistically significant (p <0.014). Hence, the administration of erythromycin 250 mg orally is more effective in reducing the gastric fluid volume and increasing the gastric fluid pH compared to oral administration of etoclopramide 10 mg in patients undergoing general anesthesia.Key words: Erythromycin, gastric fluid volume, metoclopramid, gastric pH
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