Purwoko Purwoko
Departemen Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Sebelas Maret Surakarta/RSUD Dr. Moewardi, Surakarta

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Perbedaan Efek Tramadol Infus Kontinyu dan Bolus Intermiten terhadap Numeric Rating Scale (NRS) Pasien Pasca Multipel Odontektomi Ardana Arianto; Purwoko Purwoko; Nugraha Afandi
Jurnal Anestesi Perioperatif Vol 10, No 3 (2022)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v10n3.2489

Abstract

Penggunaan tramadol bolus berulang secara teratur atau sesuai dengan permintaan adalah bentuk administrasi analgesia dalam terapi nyeri pascaoperasi. Penelitian ini bertujuan membandingkan efek tramadol infus kontinu dengan bolus intermiten terhadap numeric rating scale pascamultipel odontektomi. Penelitian ini dilaksanakan RSUD Dr. Moewardi, Surakarta dan RSUD KET Setjonegoro, Wonosobo mulai bulan September–November 2018 menggunakan uji klinik acak tersamar tunggal pada 36 pasien yang dilakukan multipel odontektomi dan memenuhi kriteria inklusi. Sampel dibagi menjadi 2 kelompok, yaitu kelompok I tramadol bolus awal 100 mg selanjutnya infus kontinu 0,25 mg/kg/jam ditambah parasetamol 500 mg/8 jam bolus dan kelompok II tramadol bolus awal 100 mg, selanjutnya 50 mg/8 jam bolus ditambah parasetamol 500 mg/8 jam. Semua pasien mendapatkan perlakuan anestesi umum sesuai dengan standar dan kemudian dilakukan penilaian skala nyeri jam ke-2, 6, 12, 24 pascaoperasi. Selain itu juga dinilai efek mual muntah pascaoperasi. Hasil uji statistik didapatkan nilai p=0,240 (p>0,05) jam ke-2, p=0,007 (p<0,05) jam ke-6, p=0,658 (p>0,05) jam ke-12, p=0,219 (p>0,05) jam ke-24 yang berarti terdapat perbedaan signifikan NRS pada jam ke-6 pascaoperasi antara kelompok I dan II. Hasil uji statistik didapatkan nilai p=0,743 (p>0,05) yang berarti tidak terdapat perbedaan efek samping mual-muntah pascamultipel odontektomi pada kedua kelompok. Simpulan, terdapat perbedaan efektivitas analgetik yang diukur dengan NRS pascamultipel odontektomi dengan diberikan tramadol infus kontinu dibanding dengan tramadol bolus intermiten pada 6 jam pascaoperasi. Differences of Continuous Infusion and Intermittent Tramadol Effect on Numeric Rating Scale in Post Multiple Odontectomy PatientsThe use of regular or on-demand repeated bolus tramadol is a form of analgesia administration in the treatment of postoperative pain. This study aimed to find better ways of analgesic administration after multiple odontectomy. This research was conducted in Dr. Moewardi General Hospital, Surakarta, and KET Setjonegoro General Hospital, Wonosobo, from September to November 2018, using a single-blind randomized clinical trial in 36 patients who had multiple odontectomy and met the inclusion criteria. Samples were divided into two groups. Group I received: an initial bolus of tramadol 100 mg, then a continuous infusion of 0.25 mg/kg/hour plus paracetamol 500 mg/8 hours bolus, and group II received initial bolus tramadol 100 mg, then 50 mg/8 hours bolus plus paracetamol 500 mg/8 hours. All patients received standard general anesthetic treatment and then postoperative pain assessment at 2, 6, 12, and 24 hours. Besides, the effects of postoperative nausea were also assessed. Statistical test results p = 0.240 (p>0.05) at the second hour, p = 0.007 (p<0.05) at the 6th hour, p=0.658 (p>0.05) at the 12th hour, p = 0.219 (p>0.05) at the 24th hour, meaning there was a difference in NRS at the 6th hour postoperatively between groups I and II. Statistical test results were p = 0.743 (p> 0.05), meaning there were no differences in the side effects of nausea post multiple odontectomy in the two groups. In conclusion, there is a significant difference in analgesic efficacy as measured by NRS post multiple odontectomy with continuous tramadol infusion compared with intermittent tramadol boluses at the 6th hour postoperatively.
Pengaruh Pemberian Ekstrak Ikan Gabus Terhadap Kreatinin Serum Dan Albumin Serum Pada Pasien Radioterapi Purwoko Purwoko; Muhammad Husni Thamrin; Rio Rusman
Jurnal Anestesi Perioperatif Vol 10, No 3 (2022)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v10n3.2486

Abstract

Sebagian besar pasien keganasan yang dilakukan radioterapi dengan atau tanpa kemoterapi disertai dengan hipoalbuminemia dan kerusakan ginjal, terutama keganasan regio pelvis. Human albumin telah dikenal memiliki efek nefroprotektif. Ekstrak ikan gabus, salah satu sumber albumin preparat oral dapat menjadi alternatif yang efektif dan lebih murah untuk mengurangi risiko kerusakan ginjal pada keganasan. Tujuan penelitian ini adalah menganalisis pengaruh pemberian ekstrak ikan gabus terhadap kreatinin dan albumin serum pada pasien radioterapi. Penelitian ini dilakukan pada pasien yang menjalani radioterapi yang dibagi menjadi dua kelompok, kelompok kontrol diberikan plasebo dan kelompok perlakuan diberikan ekstrak ikan gabus. Penelitian dilakukan bulan Juli 2019 di Instalasi Radiologi RSUD Dr. Moewardi. Kadar albumin, ureum, dan kreatinin serum diperiksa sebelum dan sesudah perlakuan. Hasil penelitian pada kedua kelompok terjadi penurunan kadar albumin serum, walaupun penurunan pada kelompok perlakuan lebih banyak, tetapi perbedaan ini tidak bermakna. Kadar ureum dan kreatinin serum pada kelompok perlakuan terjadi penurunan, sedangkan pada kelompok kontrol terjadi peningkatan, tetapi perbedaan ini tidak bermakna. Kesimpulan, tidak terdapat pengaruh penggunaan ekstrak ikan gabus terhadap kadar albumin, ureum, dan kreatinin serum pada pasien yang menjalani radioterapi.Effect of Snakehead Fish Extract on Creatinine and Albumin Serum levels in Radiotherapy PatientsMost malignancy patients who undergo radiotherapy with or without chemotherapy are accompanied by hypoalbuminemia and kidney injury, especially malignancy of the pelvic region. Human albumin has been known to have nephroprotective effects. Snakehead fish extract, one of the oral albumin sources, can be an effective and cheaper alternative to reduce the risk of kidney injury in malignancies. This study aimed to analyze snakehead fish extract's effect on creatinine and albumin serum level in radiotherapy patients. This study was conducted on patients who underwent radiotherapy and were divided into two groups, the control group was given a placebo, and the experimental group was given snakehead fish extract. Albumin, urea, and creatinine serum levels were checked before and after treatment. Study results showed a decrease in serum albumin levels in both groups. However, the decrease in the treatment group was more than in the control group; this difference was insignificant. Urea and creatinine serum levels decreased in the experimental group, whereas in the control group, there was an increase, but this difference was not statistically significant. In conclusion, the administration of snakehead fish extract has no significant effect on albumin, urea, and creatinine serum level in patients undergoing radiotherapy.