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All Journal Majalah Kedokteran Bandung Jurnal Anestesi Perioperatif Majalah Anestesia dan Critical Care Jurnal Anestesi Obstetri Indonesia Jurnal Neuroanestesi Indonesia International Journal of Health Science and Technology Acta Medical and Health Sciences (AMHS)

Dewi Yulianti Bisri

Departemen Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/RSUP Dr. Hasan Sadikin Bandung

Author-ID : 508250

Humanities Biochemistry, Genetics & Molecular Biology Education Engineering Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Sakit Kepala yang dihubungkan dengan Cedera Otak Traumatik Bisri, Dewi Yulianti; Bisri, Tatang
Majalah Anestesia dan Critical Care Vol 32 No 2 (2014): Juni
Publisher : Perdatin Pusat

Show Abstract | Download Original | Original Source | Check in Google Scholar

Sakit kepala adalah salah satu keluhan yang sering setelah cedera otak traumatik (COT) dan disebut sebagai “post-traumatic headache” sakit kepala pascatrauma. Berkisar 30–90% pasien mengalami sakit kepala setelah cedera. Sakit kepala setelah COT dapat berlangsung lama, datang dan hilang dalam waktu satu tahun, menyulitkan melakukan aktivitas sehari-hari, sulit berfikir dan mengingat sesuatu. Setelah cedera kepala berat, pasien mungkin mengalami sakit kepala akibat dari operasi pada tulang kepalanya atau masih adanya kumpulan kecil darah atau cairan di ruang intrakranial. Sakit kepala bisa setelah cedera kepala ringan, sedang dan berat. Sakit kepala ini dapat disebabkan berbagai kondisi antara lain perubahan dalam otak akibat cedera, cedera leher dan tulang kepala yang belum pulih seluruhnya, tegangan dan stres, atau efek samping pengobatan. Ada beberapa tipe sakit kepala antara lain sakit kepala tipe migraine, tension, cervicogenic, dan rebound. Terapi dapat dilakukan dengan merubah pola hidup misalnya harus cukup tidur, olah raga, hindari kopi, hindari makanan tertentu yang memicu sakit kepala seperti anggur (red wine), monosodium glutamat, keju dan terapi obat-obatan misalnya asetaminophen, gabapentin, antidepresant. Akan tetapi, lebih utama adalah pencegahan dengan cara menghindari cedera otak primer, dan apabila terjadi cedera otak primer sebaiknya menghindari dan mengobati cedera otak sekunder dengan pengelolaan perioperatif yang tepat. Kata kunci: Bedah saraf, cedera otak traumatik, neuroanestesi, sakit kepala Headache is one of the most common symptoms after traumatic brain injury (TBI) and called “post-traumatic headache”. Approximately 30–90% of people having headaches. Headaches after TBI can be long-lasting, coming and going even past one year. Headaches can make it hard for you to carry out daily activities or can cause you to have more difficulty thinking and remembering things. Right after a severe TBI, people may have headaches because of the surgery on their skulls or because they have small collections of blood or fluid inside the skull. Headaches can also occur after mild, moderate and severe TBI. These headaches can be caused by a variety of conditions, including a change in the brain caused by the injury, neck and skull injuries that have not yet fully healed, tension and stress, or side effects from medication.There are many kinds of headaches,migraine headaches, tension-type headaches, cervicogenic headaches, and rebound headaches. Treatment a headache after TBI will depend on each individual case. They are lifestyle changes like get enough sleep, get daily exercise, avoid caffeine, avoid certain foods that may trigger a headache, like red wine, monosodium glutamate or certain cheeses, and medicine therapy as acetaminophen, gabapentin, antidepresant. But, more important is prevention with avoid primary brain injury and avoid and treatment secondary brain injury with adequate periopeative management. Key words: headache, neuroanesthesia, neurosurgery, traumatic brain injury Reference Levin M, Ward TN. Headache. Dalam: Silver JM, McAllister TW, Yudofsky SC, penyunting. Textbook of traumatic brain injury. Edisi ke-2. Washington: American Psychiatric Pub Inc;2011,343–50. Lew HL, Lin PH, Fuh JL, Wang SJ, Clark DJ, Walker WC. Characteristics and treatment of headache after traumatic brain injury: A focused review. Am J Phys Med Rehabil 2006;85(7):619–27. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro C A. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med 2008;358(5):453–63. Mihalik JP, Stump JE. Collins MW, Lovell MR, Field M, Maroon JC. Posttraumatic migraine characteristics in athletes following sports-related cocussion. J Neurosurg 2005;102(5):850–55. Hofman JM, Lucas S, Dikmen S, Braden CA, Brown AW, Brunner R, dkk. Natural history of headache after traumatic brain injury. Journal of Neurotrauma 2011;28:1719–25. Walker WC, Seel RT, Curtiss G, Warde DL. Headache after moderate and severe traumatic brain injury: a longitudinal analysis. Arch Phys Med Rehabil 2005;86:1793–800. Sherman KB, Goldberg M, Bell KR. Traumatic brain injury and pain. Phys Med Rehabil Clin N Am. 2006;17:473–90. De Lima Martin HA, Ribas VR, Martins BBM, Ribas RMG, Valenca MM. Posttraumatic headache. Arq Neuropsiquiatr 2009;67(1):43–45. McAllister TW. Mild brain injury. Dalam: Silver JM, McAllister TW, Yudofsky SC, Penyunting. Textbook of traumatic brain injury. Edisi ke-2. Washington: American Psychiatric Pub Inc;2011. hlm. 239–57. Lew Hl, Lin Pri, Fuh JL, Wong SJ, Clark DJ, Walker WC. Characteristic and treatment of headache after traumatic Broun Injury: a focused review. Am J Phys Med Rehabil. 2006;85(7):619–27

SUPINE HYPOTENSION SYNDROME PADA KEHAMILAN Bisri, Dewi Yulianti; Redjeki, Ike Sri; Bisri, Tatang
Majalah Kedokteran Bandung Vol 47, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (566.711 KB)

Supine hypotension syndrome (SHS) dapat terjadi mulai kehamilan trimester 2 dan didefinisikan sebagai penurunan tekanan sistol ?30% pada posisi supine dibanding dengan lateral. Tujuan penelitian mengetahui insidensi SHS pada wanita hamil aterm di Indonesia. Penelitian observasional pada 200 wanita hamil aterm, kehamilan pertama dan kedua, usia 18?40 tahun, tidak memiliki penyakit sertaan, dan akan dilakukan seksio sesarea elektif di Rumah Sakit Ibu dan Anak Melinda dalam periode Maret?Juli 2012. Pasien diberikan 500 cc cairan kristaloid Ringer laktat sebagai pengganti puasa, kemudian dilakukan pemeriksaan tekanan sistol, diastol, rata-rata, laju nadi, dan saturasi oksigen selama 5 menit dengan jarak 1 menit pada posisi supine dan miring kiri 45O. Hasil pengukuran tekanan sistol supine 113,49 (13,20) mmHg, miring 105,20 (12,08) mmHg dengan nilai p=0,93. Tekanan diastol supine 69,05 (7,31) mmHg dan miring 58,58 (7,73) mmHg (p=0,51). Tekanan darah rata-rata supine 84,59 (8,38) mmHg dan miring 75,87 (8,82) mmHg (p=0,62). Laju nadi supine 88,95 (12,19) x/menit, dan miring 86,26 (11,47) x/menit, (p=0,86). SpO2 supine 99,95 (1,11)% dan miring 99,64 (0,67)% (p=0,07). Simpulan, tidak ada perbedaan tekanan sistol, diastol, rata-rata, laju nadi, dan SpO2 wanita hamil aterm pada posisi berbaring dengan posisi miring kiri 450. [MKB. 2015;47(2):102?8]Kata kunci: Posisi supine, posisi miring kekiri, supine hypotension syndrome, wanita hamil atermSupine Hypotension Syndrome in PregnanciesAbstractSupine hypotension syndrome (SHS) can occur starting from the second trimester of pregnancy and is defined as a reduction of systolic blood pressure of ?30% in the supine position compared to lateral position. The purpose of this study was to determine the incidence of SHS in full term pregnant women in Indonesia. An observational study on 200 full term pregnant women, first and second pregnancy, aged 18?40 years, no coexisting diseases, and was going to have an elective cesarean section in Melinda Woman and Child Hospital in the period of March?July 2012. Patients were given 500 cc of Ringer?s lactate crystalloid fluid instead of fasting. Systolic and diastolic blood pressure, mean blood pressure, pulse rate, and oxygen saturation for 5 minutes were then examined every minute. The examination was conducted in the supine and left lateral position of 45O. The results show a systolic blood pressure in supine position of 113.49 (13.20) mmHg and in lateral position of 105.20 (12.08) mmHg (p=0.93). Meanwhile, the supine diastolic blood pressure was 69.05 (7.31) mmHg and lateral position was 58.58 (7.73) mmHg (p=0.51). The mean blood pressure in supine position was 84.59 (8.38) mmHg and 75.87 (8.82) mmHg (p=0.62) in lateral position . The pulse rates for supine and lateral position were 88.95 (12.19)x/min and 86.26 (11.47) x/min (p=0.86), respectively. Supine SpO2 was 99.95 (1.11) % and lateral SpO2 was 99.64 (0.67) % (p=0.07). In conclusion, there is no differences in systolic, diastolic, mean blood pressure, pulse rate and SpO2 of full term pregnant women in supine or left lateral position of 45O. [MKB. 2015;47(2):102?8]Key words: Full term pregnant women, left lateral decubitus, supine hypotension syndrome, supine DOI: 10.15395/mkb.v47n2.461

Perbandingan Aromaterapi Pepermin dengan Ondansetron Intravena sebagai Terapi Rescue Mual Muntah Pascaoperasi Mastektomi Arna Fransisca; Iwan Fuadi; Dewi Yulianti Bisri
Jurnal Anestesi Perioperatif Vol 7, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Mual muntah pascaoperasi merupakan salah satu komplikasi anestesi dan operasi yang menjadi perhatian khusus karena memengaruhi kualitas pelayanan kesehatan, memperpanjang lama perawatan, dan meningkatkan angka morbiditas perioperatif. Pascaoperasi payudara berkaitan dengan angka kejadian mual muntah pascaoperasi yang tinggi. Beberapa konsensus penatalaksanaan mual muntah pascaoperasi merekomendasikan pemberian terapi nonfarmakologi dengan aromaterapi sebagai terapi rescue untuk mengatasi mual muntah pascaoperasi. Tujuan penelitian ini adalah membandingkan aromaterapi pepermin dengan ondansetron sebagai terapi rescue dalam menurunkan kejadian mual muntah pascaoperasi mastektomi. Penelitian ini merupakan penelitian eksperimental yang dilakukan secara prospektif dengan desain penelitian double blind randomized controlled trial dan consecutive sampling terhadap 32 subjek penelitian yang menjalani operasi mastektomi elektif dan memenuhi kriteria inklusi di RSUP Dr. Hasan Sadikin Bandung pada bulan Juli–September 2018. Pada penelitian ini, data ordinal diuji dengan Uji Mann Whitney dan untuk data kategorik diuji dengan uji chi-square. Hasil penelitian ini didapatkan penurunan kejadian mual muntah pascaoperasi yang signifikan pada kelompok pepermin dibanding dengan kelompok ondansetron dengan perbedaan yang bermakna (p<0,05) pada penilaian menit kedua dan menit kelima setelah perlakuan. Simpulan, aromaterapi pepermin efektif menurunkan kejadian mual muntah pascaoperasi mastektomi dan dapat digunakan sebagai alternatif terapi atau terapi tambahan untuk penatalaksanaan mual muntah pascaoperasi.Comparison of Peppermint Aromatherapy with Ondansetron Intravenous as a Rescue for Postoperative Nausea Vomiting after Mastectomy SurgeryPostoperative nausea and vomiting are among anesthesia and surgery complications that receive special considerations as it affects the quality of healthcare services, prolongs care, and increases perioperative morbidities. The incidence of postoperative nausea and vomiting is high in patients that have undergone breast surgery. The consensus for postoperative nausea and vomiting management recommends non-pharmacological treatments, one of which is through the use of aromatherapy as a rescue to resolve postoperative nausea and vomiting. This study aimed to compare the effects of peppermint aromatherapy and ondansetron as a rescue in reducing the incidence of postoperative nausea and vomiting after elective mastectomies. This was a prospective experimental double blind randomized controlled trial study with consecutive sampling on 32 research subjects underwent elective mastectomies and met the inclusion criteria in Dr. Hasan Sadikin General Hospital in July–September 2018. The ordinal data were tested using the Mann Whitney statistics test and the categorical data using the chi square test. The results show a significant decrease in nausea and vomiting incidence in the peppermint group compared to the ondansetron group with significant difference (p<0.05) in two minutes and five minutes after treatment. In conclusion, peppermint aromatherapy is effective in reducing the incidence of postoperative nausea and vomiting after mastectomies and can be used as an alternative or additional treatment in managing postoperative nausea and vomiting.

Perbandingan Peningkatan Laju Nadi dan MAP antara Laringoskopi Menggunakan Bilah Laringoskop Macintosh dan McCoy Andy Hutariyus; Iwan Fuadi; Dewi Yulianti Bisri
Jurnal Anestesi Perioperatif Vol 7, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Tindakan laringoskopi dan intubasi dapat menyebabkan peningkatan kadar katekolamin di dalam darah sehingga meningkatkan respons hemodinamik seperti takikardia, peningkatan tekanan darah, peningkatan tekanan intrakranial, aritmia, dan perubahan segmen ST. Respons ini bergantung pada seberapa banyak manipulasi di daerah lidah, faring, laring, dan epiglotis pada saat laringoskopi direk. Tujuan penelitian ini membandingkan peningkatan laju nadi dan mean arterial pressure (MAP) antara laringoskopi intubasi menggunakan bilah Macintosh dan McCoy. Metode penelitian ini adalah uji klinis acak terkontrol buta tunggal pada 40 pasien yang menjalani operasi dengan anestesi umum di RSUP Dr. Hasan Sadikin Bandung dari bulan Juli hingga Agustus 2018. Subjek penelitian dibagi menjadi dua kelompok, kelompok MI laringoskopi intubasi dengan Macintosh dan kelompok MC laringoskopi intubasi dengan McCoy. Data hasil penelitian diuji secara statistik menggunakan uji t tidak berpasangan dan Uji Mann-Whitney. Hasil penelitian ini menunjukkan perbedaan laju nadi dan MAP setelah intubasi pada kelompok McCoy lebih rendah dibanding dengan Macintosh pada menit ke-1, menit ke-2,5, dan menit ke-5 dengan perbedaan signifikan (p˂0,05). Simpulan penelitian ini menunjukkan bahwa laringoskopi dengan bilah laringoscop McCoy dapat mengurangi peningkatan laju nadi dan MAP dibanding dengan Macintosh. Comparison between Laryngoscopy Using Macintosh and McCoy Laryngoscope Blades in Increasing Heart Rate and Mean Arterial PressureLaryngoscopy and intubation often increase hemodynamic responses such as tachycardia, increased blood pressure, increased intracranial pressure, arrhythmia, and changes on the ST segment due to increased blood catecholamines. This response depends on how much the tongue, pharynx, larynx, and epiglottis are manipulated during a direct laryngoscopy. This study was a single blinded randomized controlled trial on 40 patients who underwent surgery under general anesthesia in Dr. Hasan Sadikin General Hospital from July to August 2018. Subjects of study were randomly divided into two groups, Macintosh (MI) and McCoy (MC) groups. Data were analyzed using t-test and Mann-Whitney test. Results of this study found that lower heart rate and MAP increases were identified in McCoy group when compared to the Macintosh group in minute 1, minute 2,5, and minute 5 after intubation. Both variables had statistically significant differences (p<0.05). This study concludes that laryngoscopy using McCoy laryngoscope blade was is able to prevent increase in heart rate and MAP compared to Macintosh.

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

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 KEJADIAN POSTOPERATIVE COGNITIVE DYSFUNCTION (POCD) FASE AKUT PADA JOINT ARTHROPLASTY DENGAN ANESTESI UMUM DAN ANESTESI EPIDURAL PADA PASIEN USIA LANJUT Syahpikal Sahana; Iwan Abdul Rachman; Dewi Yulianti Bisri
Jurnal Anestesi Perioperatif Vol 8, No 1 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Usia lanjut merupakan faktor risiko terjadinya postoperative cognitive dysfunction (POCD). Pemilihan teknik anestesi yang tepat pada usia lanjut akan menurunkan risiko kejadian POCD. Penelitian ini bertujuan untuk membandingkan angka kejadian POCD pada pasien usia lanjut yang menjalani operasi joint arthroplasty antara anestesi umum dan anestesi epidural. Penelitian berlangsung pada bulan Juli–Oktober 2019 di RSUP Dr. Hasan Sadikin Bandung. Penelitian dilakukan menggunakan metode randomized control trial dengan melibatkan 48 pasien yang menjalani tindakan joint arthroplasty. Subjek penelitian dibagi menjadi kelompok anestesi umum (GA) dan anestesi epidural (EA) menggunakan bilangan acak. Penilaian status mental pasien dilakukan menggunakan Mini mental state examination (MMSE) pada saat preoperasi dan tujuh hari pascaoperasi. Perbandingan proporsi kajadian POCD pada kedua kelompok dianalisis dengan menggunakan uji chi-square. Kejadian POCD pada kelompok GA (37,5%) lebih tinggi dari kelompok EA (8,3%) dan secara statistik perbedaan proporsi kejadian POCD pada kedua kelompok bermakna signifikan p=0,016 (p<0,05). Simpulan penelitian bahwa kejadian postoperative cognitive dysfunction (POCD) pada pasien usia lanjut yang menjalani joint arthroplasty dengan anestesi epidural lebih kecil dibanding dengan anestesi umum. Comparison of General Anesthesia on Postoperative Cognitive Dysfunction (POCD) in Joint Arthroplasty with Epidural Anesthesia in Elderly PatientsOld age is a risk factor for postoperative cognitive dysfunction (POCD). Elder people often have to undergo many surgeries, one of which is joint arthroplasty surgery. Selecting appropriate anesthetic techniques for elderly patients to reduce POCD is always controversial. The study aimedto compare the POCD incidence in elderly patients who underwent joint arthroplasty surgery using the general anesthesia and epidural anesthesia. The study was conducted in July–October 2019 at the RSUP Dr. Hasan Sadikin Bandung. This study used a randomized control trial method involving 48 elderly patients who underwent joint arthroplasty using randomized control trial method. Research subjects were divided into the General Anesthesia group (GA) and the Epidural Anesthesia group (EA) using random numbers. Both groups mental status was assessed using the mini mental state examination (MMSE) during preoperative and seven days postoperatively. A comparison of the proportion of POCD incidence in the two groups were analyzed using the chi-square test. The result showed that the proportion of POCD incidence in the GA group (37.5%) was higher than the EA group (8.3%), and the difference was statistically significant p=0.016 (p<0.05). The study concludes that epidural anesthesia in the joint arthroplasty procedure of elderly patients is superior vs. general anesthesia.

Perbandingan Penggunaan Masker Anestesi Berpewangi dengan Masker Anestesi Tidak Berpewangi terhadap Tingkat Kecemasan Anak pada Induksi Inhalasi Deni Nugraha; Dewi Yulianti Bisri; Radian Ahmad Halimi
Jurnal Anestesi Perioperatif Vol 9, No 1 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n1.2387

Induksi inhalasi dapat memberikan pengalaman emosi yang traumatis terhadap anak seperti perasaan terkekang atau tercekik selama bernapas melalui masker dan bau yang tajam dari gas anestesi. Salah satu pendekatan nonfarmakologis yang dapat dilakukan adalah menggunakan masker beraroma buah-buahan sebelum induksi. Modifikasi sederhana dengan mengoleskan lip balm dengan wangi buah pada permukaan dalam masker anestesi merupakan salah satu pendekatan yang efektif dan murah. Tujuan penelitian ini adalah mengetahui perbandingan pengaruh penggunaan masker anestesi berpewangi dibanding dengan masker anestesi tidak berpewangi terhadap tingkat kecemasan anak pada induksi inhalasi. Penelitian dilakukan menggunakan metode uji klinis acak terkontrol buta tunggal secara prospektif terhadap 38 anak berusia 4–12 tahun yang menjalani anestesi umum dengan status fisik american society of anesthesiologist (ASA) I–II di RSUP Dr. Hasan Sadikin Bandung. Subjek dibagi menjadi dua kelompok, yaitu kelompok yang mendapat masker berpewangi dan kelompok yang mendapat masker tidak berpewangi. Tingkat kecemasan anak di ruang persiapan dan kamar operasi dinilai menggunakan skala modified yale preoperative anxiety scale (MYPAS). Skala MYPAS adalah baku emas untuk evaluasi kecemasan anak yang terdiri atas 22 penilaian dalam 5 kategori dengan realibilitas dan validitas tinggi. Analisis statistik dengan Uji Mann-Whitney. Tingkat kecemasan anak pada kelompok masker berpewangi secara bermakna lebih rendah dibanding dengan kelompok masker tidak berpewangi (p=0,000), namun penilaian di ruang persiapan tidak menunjukkan hasil yang bermakna (p=0,07). Kesimpulan penelitian adalah penggunaan masker anestesi berpewangi pada induksi inhalasi menghasilkan tingkat kecemasan anak yang lebih rendah dibanding dengan penggunaan masker anestesi tidak berpewangi.Comparison of between the Use of Scented Anesthetic Mask and Unscented Anesthetic Mask on Anxiety Level in Children during Inhalation InductionInhalation induction may be a traumatic emotional experience in children as they may feel restricted or suffocated while breathing through the mask and inhaling the sharp smell of the anesthetic gas. A non-pharmacological approach that may be applied include the use of fruit scented masks before induction. This simple modification is done by smearing fruit scented lip balm on the anesthetic mask surface, which is an effective and inexpensive approach. This study aimed to compare the effects of scented anesthetic masks and non-scented masks on child anxiety level during inhalation induction. This was a single blind prospective randomized controlled trial on 38 children aged 4–12 years old underwent general anesthesia with a physical American Society of Anesthesiologist (ASA) status I–II in Dr. Hasan Sadikin General Hospital Bandung. Subjects were divided into two groups: scented mask group and unscented mask group. The anxiety levels in the preparation room and the operating room were measured using the Modified Yale Preoperative Anxiety Scale (MYPAS). MYPAS is the gold standard for evaluating anxiety in children, made up of 22 ratings in 5 categories with high reliability and validity. Statistical analysis was performed using the Mann-Whitney test. The anxiety level in the scented mask group were found to be significantly lower when compared to the unscented group (p=0.000) but the evaluation in the preparation room did not show statistically significant results (p=0.07). This study concludes that the use of scented anesthetic masks in inhaled induction results in lower anxiety levels in children.

Anestesia Spinal Dosis Rendah untuk Seksio Sesarea pada Pasien Mitral Stenosis Berat Nopian Hidayat; Yusmein Uyun; Dewi Yulianti Bisri
Jurnal Anestesi Obstetri Indonesia Vol 2 No 2 (2019): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i2.14

Penyakit jantung pada kehamilan meningkatkan angka morbiditas dan mortalitas ibu dan janin. Mitral stenosis adalah lesi katup jantung yang paling sering didapatkan pada wanita hamil dan hampir selalu disebabkan oleh penyakit jantung rematik. Perubahan fisiologis yang terjadi selama kehamilan dan periode peripartum dapat memperburuk gejala dan derajat penyakit jantung. Akibatnya, banyak wanita pertama kali didiagnosis penyakit jantung selama kehamilan. Seorang wanita berusia 24 tahun gravida 32–33 minggu dengan kongesti gagal jantung fungsional kelas III, mitral stenosis berat, ejection fraction (EF) 59%, regurgitasi trikuspid sedang, dan dilatasi atrium kiri menjalani seksio sesarea dengan anestesi spinal dosis rendah menggunakan bupivakaine 0,5% hiperbarik 7,5 mg ditambah fentanyl 50 mcg secara intratekal. Blok sensoris dicapai setinggi torakal 6 dalam waktu 4 menit 20 detik. Hemodinamik pasien stabil selama operasi maupun pasca operasi. Tidak diperlukan pemberian vasopresor. Pasca operasi pasien dirawat di intensive care unit (ICU) selama 3 hari dengan hemodinamik yang stabil. Laporan ini menyoroti bahwa anestesi spinal dosis rendah dapat menjadi pilihan yang baik dalam manajemen anestesi untuk seksio sesarea yang disertai dengan mitral stenosis berat. Low Dose Spinal Anesthesia for Cesarean Section with Severe Mitral Stenosis Abstract Heart disease in pregnancy increases maternal and fetal morbidity and mortality. Mitral stenosis is the most common heart valve lesion in parturient and is almost always caused by rheumatic heart disease. Physiological changes that occur during pregnancy and the peripartum period can worsen symptoms and the degree of the heart disease. As a result, many women are first diagnosed with heart disease during pregnancy. Twenty four year old woman gravida 32–33 weeks with congestive heart failure class III, severe mitral stenosis, EF 59%, moderate tricuspid regurgitation, and left atrial dilatation undergoing cesarean section with low-dose spinal anesthesia using bupivacaine 0,5% hyperbaric 7.5 mg plus fentanyl 50 mcg intrathecally. Sensory blocks were reached as high as thoracic 6th in 4 minutes and 20 seconds. The patient's hemodynamics are stable during both surgery and post surgery. Vasopressors were not needed. After surgery the patient was transferred to ICU for 3 days with stable hemodynamics. This report highlights that low-dose spinal anesthesia can be a good choice in the management of anesthesia for cesarean section accompanied by severe mitral stenosis.

Perbandingan Pemberian Cairan Koloid Co-loading dengan Infus Efedrin terhadap Pencegahan Hipotensi akibat Anestesi Spinal pada Seksio Sesarea Alifan Wijaya; Dewi Yulianti Bisri; Tatang Bisri
Jurnal Anestesi Obstetri Indonesia Vol 2 No 1 (2019): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i1.29

Latar Belakang: Hipotensi merupakan komplikasi anestesi spinal pada seksio sesarea karena blokade simpatis akibat vasodilatasi arteri dan vena. Pemberian koloid co-loading dapat meningkatkan volume intravaskular sedangkan infus efedrin diharapkan terjadi vasokonstriksi. Tujuan: Untuk membandingkan pemberian efedrin dan cairan koloid co-loading dalam mencegah hipotensi akibat anestesi spinal pada seksio sesarea. Metode: Uji terkontrol acak buta tunggal pada 42 pasien seksio sesarea dengan anestesi spinal yang dilakukan di Rumah Sakit Hasan Sadikin Bandung pada September sampai Oktober 2018. Subjek penelitian dibagi secara acak menjadi 2 kelompok yaitu kelompok pemberian infus efedrin dan kelompok pemberian koloid secara co-loading. Kelompok koloid diberikan cairan koloid sebanyak 7 mL/KgBB selama 20 menit sedangkan kelompok efedrin diberikan efedrin bolus 5 mg pada menit pertama dan kedua, kemudian 15 mg dalam infus selama 15 menit. Tekanan darah diukur setiap 1 menit selama 10 menit, kemudian setiap 3 menit sampai menit ke-45. Analisis statistik yang digunakan adalah uji T tidak berpasangan dan Mann Whitney. Hasil: penelitian menunjukan angka kejadian hipotensi lebih sedikit pada kelompok infus efedrin (5/21) dibandingkan dengan kelompok koloid (15/21) dengan perbedaan yang bermakna (p<0,05). Simpulan: penelitian ini menunjukan bahwa kejadian hipotensi pada pasien seksio sesarea yang dilakukan anestesi spinal lebih banyak pada kelompok koloid co-loading dibandingkan dengan kelompok infus efedrin. Comparison of Colloid Co-loading with Ephedrine Infusion on Prevention of Hypotension Due to Spinal Anesthesia in Cesarean Section Abstract Background: Hypotension is a complication of spinal anesthesia in cesarean section due to sympathetic blockade that causes arterial and venodilation. Administration co-loading of colloid can increase intravascular volume, whereas administration of ephedrine infusion expected to vasoconstric. Objective: To compare administration of co-loading colloid with ephedrine infusion on preventing hypotension due to spinal anesthesia in cesarean section. Method: A single blind randomized controlled trial in 42 patients who underwent cesarean section under spinal anesthesia, the physical status of ASA II which was randomly divided into 2 group administering ephedrine infusion and colloid co-loading. Colloid was given 7 ml/ Kg for 20 minutes, whereas ephedrine bolus 5 mg was given in the first and second minutes, then 15 mg in infusion for 15 minutes. Blood pressure is measured every 1 minute for 10 minutes, then every 3 minutes until the 45th minute. the statistical analysis used is unpaired T test and Mann Whitney. Results: The study showed a lower incidence of hypotension in the ephedrine infusion group (5/21) compared with the colloid group (15/21), this difference was statistically significant (p <0.05). Conclusions: This study show that the incidence of hypotension in cesarean section patients was more in the colloid group compared to the ephedrine group.

Perioperatif Anestesia pada Pasien Seksio Sesarea dengan Skizofrenia Ayu Rosema Sari; Dewi Yulianti Bisri; Yusmein Uyun
Jurnal Anestesi Obstetri Indonesia Vol 3 No 2 (2020): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v3i2.46

Pasien hamil dengan gangguan kejiwaan menjadi kasus yang menantang bagi ahli anestesi obstetri. Seorang ahli anestesi obstetri harus menyadari aspek hukum, etika, dan medis dari kondisi tersebut dan menyelesaikan setiap masalah secara individual. Penilaian pra operasi dan persiapan harus disesuaikan dengan jenis gangguan pasien. Pilihan teknik anestesi tergantung pada status mental pasien, dan perawatan pasca operasi (pemberian obat anti nyeri dan kelanjutan terapi medis penyakit kejiwaan) harus dikelola dengan baik. Seorang wanita 37 tahun, G2P1A0 hamil 40 minggu dengan skizofrenia dilakukan tindakan seksio sesarea, pasien rutin mengkonsumsi obat antipsikotik. Pasien sempat mengalami penundaan operasi karena tidak kooperatif sehingga dikonsulkan ulang ke psikiater. Teknik pembiusan dengan spinal anestesi menggunakan bupivacaine heavy 10mg. Selama operasi berlangsung hemodinamik stabil, tekanan darah sistolik 100–130 mmHg, diastolik 60–90 mmHg, nadi 80–95x/menit, laju nafas 16–20x/menit dengan saturasi oksigen 100%. Bayi lahir 2 menit setelah insisi dengan Apgar score 8/10. Penanganan pasien skizofrenia yang akan dilakukan tindakan seksio sesarea membutuhkan pemahaman yang baik agar tidak terjadi morbiditas maupun mortalitas, mengingat gangguan kejiwaan adalah hal yang cukup lazim terjadi. Perioperative Anesthesia in Cesarean Section Patients with Schizophrenia Abstract Pregnant patients with psychiatric disorders present as challenging cases for obstetric anesthetists. An obstetric anesthetist should be aware of legal, ethical, and medical aspects of the conditions and solve each problem on a individual basis. Preoperative assessment and the preparation should be adjusted according to the type of patient’s disorder. Choice of anesthetic technique should actively be dependent on the mental status of the patient, and postoperative care should be attentively managed regarding pain relief and continuation of medical therapy for the psychiatric disease. A 37-year-old woman, G2P1A0, 40 weeks pregnant with schizophrenia, was performed a cesarean section, patient taking antipsychotic drugs. Anesthetic technique with spinal anesthesia uses Bupivacaine heavy 10mg. During the operation hemodynamically stable, systolic blood pressure 100-130 mmHg, diastolic 60-90 mmHg, pulse 80-95x/min, breathing rate 16-20x/min with 100% oxygen saturation. The baby is born 2 minutes after incision with an Apgar score 8/10. Management of schizophrenia patients who will undergo cesarean section requires a good understanding to prevent morbidity and mortality, considering psychiatric disorders are quite common.

Co-Authors A Himendra Wargahadibrata A. Himendra Wargahadibrata A. Hmendra Wargahadibrata Achmad Adam Achmad Adam, Achmad Adriman, Silmi Adriman, Silmi Ahmado Oktaria Alifahna, Muhammad Rezanda Alifan Wijaya Andy Hutariyus Anwar, Tabihul Arief Cahyadi Arif, Izhar Muhammad Arif, Izhar Muhammad Arna Fransisca Arshad, Muhammad Ayu Rosema Sari Bambang J. Oetoro Bambang J. Oetoro Bangun, Chrismas Gideon Basuki, Wahyu Sunaryo Basuki, Wahyu Sunaryo Boesoirie, M. Adli Boesoirie, M. Adli Cecep Eli Kosasih Cobis, Albinus Yunus Daneswara, Andika Deni Nugraha Dini Handayani Putri Doddy Tavianto Emas, Bagas Eri Surahman Firdaus, Riyadh Firdaus, Riyadh Fitri Sepviyanti Sumardi Fitri Sepviyanti Sumardi Gaus, Syaruddin Giovanni, Cindy Giovanni, Cindy Hana Nur Ramila Harahap, M Sofyan Hermin Aminah Usman Ida Bagus Krisna Jaya Sutawan Ike Sri Redjeki Indrayani, Ratih Rizki Indria Sari Iqbal Pramukti Irina, Rr. Sinta Iwan Abdul Rachman Iwan Fuadi Jasa, Zafrullah Khany Krisna J. Sutawan, Ida Bagus Lalenoh, Diana C Lira Panduwaty Lisda Amalia Longdong, Djefri Frederik M Sofyan Harahap M, Mutivanya Inez M. Sofyan Harahap M. Sofyan Harahap Maharani, Mutivanya Inez Maharani, Nurmala Dewi Mangastuti, Rebecca Sidhapramudita Mangastuti, Rebecca Sidhapramudita Marsudi Rasman Michaela Arshanty Limawan Mirza Oktavian Muhammad Habibi Mutivanya Inez M Nopian Hidayat Nuryanda, Dian Oetoro, Bambang J. Oetoro, Bambang J. Okky Harsono Oktaria, Ahmado Permatasari, Endah Permatasari, Endah Putri, Dini Handayani Radian Ahmad Halimi Rasman, Marsudi Renaldy Sobarna Riki Punisada Riyadh Firdaus Robert Sihombing Ruli Herman Sitanggang Saleh, Siti Chasnak Saleh, Siti Chasnak Saputra, Tengku Addi SATRIYAS ILYAS Sigit Sutanto Sihombing, Robert Siti Chasnak Saleh Soefviana, Stefi Berlian Sri Rahardjo Sugiyanto, Endy Susanto, Yunita Sutaniyasa, I Gede Sutanto, Sigit Syafruddin Gaus Syahpikal Sahana Syifa, Nadia Syifa, Nadia Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tengku Addi Saputra Uhud, Akhyar Nur Umar, Nazaruddin Utama, M Lucky Wahyu Sunaryo Basuki Wargahadibrata, A. Hmendra Wargahadibrata, A. Hmendra Widiastuti, Monika Winarso, Achmad Wahib Wahju Wullur, Caroline Wullur, Caroline Yuanda Rizawan Putra Yunita Susanto Yusmein Uyun Zaka Anwary, Army

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