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All Journal Jurnal Neuroanestesi Indonesia The Journal of Society Medicine (JSOCMED)
Syaputra, Adhika
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Comparison of Changes in Cortisol Levels in the Blood of Patients Undergoing Craniotomy Using Continuous Infusion Lidocaine and Fentanyl Syaputra, Adhika; Irina, Rr Sinta; Lubis, Andriamuri Primaputra; Harahap, Juliandi
Jurnal Neuroanestesi Indonesia Vol 13, No 1 (2024)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v13i1.565

Abstract

Background and Objectives: Craniotomy is a surgical procedure that involves part of the skull, temporarily removing it to expose the brain and carrying out intracranial procedures. The surgery can be considered as the standard model for assessing cortisol as a stress response. Cortisol in the blood can cause hemodynamic and physiological changes in the body such as increased heart rate, increased blood pressure, and also increased blood sugar levels. Some literature showed that continuous infusion of fentanyl and lidocaine - has an effect in maintaining the responses to stress, namely the level of cortisol in the blood. The aim aimed to determine the comparison of changes in cortisol levels in the bloodpatients undergoing craniotomy using continuous infusion lidocaine and continuous infusion fentanyl.Subject and Method: This research used a double-blind randomized controlled trial (RCT) with a pre-test and post-test with a control group design. This study divided the samples into 2 groups. Continuous infusion of lidocaine and continuous infusion of fentanyl were then checked for cortisol levels in the patient's blood before and after undergoing craniotomy.Results: The result of 28 samples that underwent craniotomy, 6 samples were excluded, so the total number of samples analyzed was 22 samples. Differences in mean cortisol levels before and after surgery in the lidocaine and fentanyl groups were 193.90 nmol/L and 153.90 nmol/L respectively with a P value of 0.021.Conclusion: In the study, it was found that cortisol levels increased in both fentanyl and lidocaine groups after a craniotomy. There is a significant difference between the two groups of fentanyl and lidocaine, where statistically the fentanyl group was better at maintaining blood cortisol levels after craniotomy than the lidocaine group.
Patterns of Antibiotic Use in The One Hour Bundle Treatment of Sepsis Syaputra, Adhika; Wijaya, Dadik Wahyu; Hanafie, Achsanuddin
Journal of Society Medicine Vol. 1 No. 3 (2022): December
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (414.644 KB) | DOI: 10.47353/jsocmed.v1i3.17

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Introduction: Sepsis and septic shock are major health problems, affecting millions of people worldwide and a leading cause of death. Administration of broad-spectrum empiric antibiotics as a one hour sepsis bundle treatment is associated with antimicrobial resistance which has various adverse effects and reduces the quality of health services. The aim of this research was to determine the pattern of empiric antibiotic use in the management of one hour bundle of sepsis at Haji Adam Malik General Hospital Medan. Method: This study used a descriptive method from November 2022 to December 2022 in the Emergency Room (ER), Medical Inpatient Room, Surgical Inpatient Room, and Adult Intensive Care Unit (ICU) of Haji Adam Malik General Hospital Medan. This study used a consecutive sampling technique to recruit 42 sepsis patients who were given a one hour bundle of sepsis according to the inclusion and exclusion criteria. This descriptive analysis was used to determine the characteristics of the sample, namely age, sex, culture results, and antibiotic sensitivity test results. Results: The most common use of antibiotics in the one hour bundle sepsis strategy was ceftriaxone 1 gram in 20 patients (47.6%), Ampicillin-Sulbactam 1.5 grams in 10 patients (23.8%), Levofloxacin 750 mg in 6 patients (14.3%), Meropenem 1 gram in 4 patients (9.5%), and Ciprofloxacin 200 mg in 2 patients (4.8%). Conclusion: Antibiotic administration time is less than 1 hour in the one hour bundle strategy carried out in the ER. Most of the antibiotics given are in accordance with the antibiotic sensitivity test results, but there are still some patients who still experience resistance to the antibiotics.given so it is important to always or immediately carry out culture and sensitivity tests on patients so that the antibiotics given can be more optimal
Co-Authors Hanafie, Achsanuddin Harahap, Juliandi Irina, Rr Sinta Lubis, Andriamuri Primaputra Wijaya, Dadik Wahyu