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All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Majalah Anestesia & Critical Care (MACC)
Andi Adil
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Health Professions Medicine & Pharmacology Public Health

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Perbedaan Konsentrasi Levobupivakain Isobarik pada Blok Transverse Abdominis Plane terhadap Intensitas Nyeri dan Kadar Beta Endorfin pada Pasien Pasca Seksio Sesarea Prawira, Lienardy; Andi Muhammad Takdir Musba; Alamsyah Ambo Ala Husain; Syafruddin Gaus; Nur Surya Wirawan; Andi Adil
Majalah Anestesia & Critical Care Vol 41 No 3 (2023): Oktober
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v41i3.299

Abstract

Latar Belakang: Blok Tranversus Abdominis Plane (TAP) menjadi salah satu pilihan ketika ada kontraindikasi penggunaan morfin intratekal sebagai tatalaksana nyeri pasca seksio sesarea (SC). Konsentrasi anestesi lokal yang optimal untuk blok TAP hingga saat ini belum memiliki pedoman baku. Penelitian ini membandingkan pengaruh perbedaan konsentrasi levobupivakain isobarik 0,125% dan 0,25% pada blok TAP terhadap intensitas nyeri dan kadar beta endorfin dalam serum darah pasca SC. Metode: Penelitian ini merupakan penelitian analitik dengan desain eksperimental menggunakan rancangan acak tersamar ganda. Populasi penelitian adalah pasien gravida yang menjalani SC elektif dengan anestesi spinal, kemudian dibagi secara acak melalui komputer menjadi kelompok kontrol (levobupivakain isobarik 0,25%) dan kelompok perlakuan (levobupivakain isobarik 0,125%). Analgetik pasca bedah kedua kelompok diberikan dexketoprofen intravena dan paracetamol oral. Intensitas nyeri pasca bedah dinilai dengan numerical rating scale (NRS) pada jam ke-2, 4, 6, 8, 12 dan 24. Kadar beta endorfin dalam serum darah diperiksa sebelum dilakukan blok, jam ke 8 dan 24 pascablok TAP. Waktu pertama rescue analgetik dan total konsumsi opioid 24 jam pasca bedah dicatat. Hasil: Tidak didapatkan perbedaan signifikan pada perbandingan nilai NRS pada jam ke-2, 4, 6, 8, 12 dan 24 antar kelompok (p>0,05). Perubahan kadar beta endorfin dalam serum darah tidak didapatkan perbedaan signifikan pada tiap waktu pengukuran per kelompok dan antar kelompok (p>0,05). Tidak didapatkan adanya rescue analgetik 24 jam pasca bedah. Simpulan: Blok TAP menggunakan anestetik lokal levobupivakain isobarik 0,125% dan 0,25% pada pasien pascapembedahan SC memiliki intensitas nyeri dan perubahan kadar beta endorfin yang sama.
An internal iliac artery ligation technique for bleeding control in the placenta accreta spectrum disorder Riu, Deviana Soraya; Sunarno, Isharyah; Pelupessy, Nugraha; Bakri, Syarif; Muchtar, Faisal; Andi Adil; Muhiddin, Rachmawati
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 4 October 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i4.2134

Abstract

Objective: To assess the contribution of internal iliac artery ligation to bleeding control during surgery. Methods: This retrospective study used secondary data from medical records. All patients diagnosed with PASD from January 2019 – to December 2022 were included in this study. Participants were grouped based on operation technique, and the blood loss and operative duration were evaluated. The tests used were the Kruskal-Wallis and the Mann-Whitney U tests. Results: 108 PAS patients were discovered. The most age group was between 20-35 years with parity of more than or equal to 4, history of Cesarean section once, gestational age at termination 34-36 weeks, and maternal death in 7 out of 101 cases. There were 49 resections, 13 resections with internal iliac artery ligation, 34 hysterectomies, and 12 hysterectomies with internal iliac artery ligation. There was no difference in bleeding and operative duration between resection vs. resection with internal iliac artery ligation (p: 0.113; p: 0.639), hysterectomy vs. a hysterectomy with internal iliac artery ligation ((p:0.052; P:0.723), and resection with ligation vs hystetectomy with the internal iliac artery ligation (p:0.052; p:0.723). Bleeding and operative duration differed significantly between resection vs. hysterectomy (p:0.002; p:0.013). All patients underwent tourniquet placement. Conclusion An Internal iliac artery ligation was not shown to reduce bleeding in treating PASD. Keywords: accreta, internal iliac artery, placenta .
Co-Authors Alamsyah Ambo Ala Husain Andi Muhammad Takdir Musba Muchtar, Faisal Muhiddin, Rachmawati Nur Surya Wirawan Pelupessy, Nugraha Prawira, Lienardy Riu, Deviana Soraya Sunarno, Isharyah Syafruddin Gaus Syarif Bakri, Syarif