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Journal of Anesthesiology and Clinical Research

JACR
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Published by HM Publisher

ISSN : - EISSN : 27459497 DOI : https://doi.org/10.37275/jacr

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

Journal of Anesthesiology and Clinical Research/JACR that focuses on anesthesiology; pain management; intensive care; emergency medicine; disaster management; pharmacology; physiology; clinical practice research; and palliative medicine.

Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine

Articles 118 Documents

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Is Duration of Endotracheal Tube Intubation Using a Video Laryngoscope Different with a Direct Laryngoscope in Elective Surgery Patients During Pandemic Covid-19? Zaky Hasan; Zulkifli; Agustina Br Haloho; Irfannuddin
Journal of Anesthesiology and Clinical Research Vol. 2 No. 1 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Introduction: Aerosol box is a usefull tools to prevent aerosol and droplet contaminations during laryngoscopy and intubation in COVID-19 pandemic. Video laryngoscope is recommended during this era to increase the operator and patient’s distance during the procedure. However, many anesthesiologists still use direct laryngoscopes due to their availability and familiarity. This study aims to compare endotracheal tube intubation with video laryngoscope compared to direct laryngoscope in elective surgery patients. Methods: This study was a quasi-experimental study. The sample size in each group (video and direct laryngoscope) was 35 subjects. The primary outcome of this study was to compare the duration of intubation between video laryngoscope and direct laryngoscope, while the secondary outcome was to evaluate complications such as broken teeth and sore throat 24 hours post intubation. Results: Direct laryngoscope had shorter intubation duration than video laryngoscope [12.3 (8.9-21.0) vs 13.3 (11.4 – 21.6; p =0.07) respectively. Two complication reported on video laryngoscope groups. Conclusion: Duration of ETT intubation using a direct laryngoscope was shorter during intubation with aerosol box compared to video laryngoscope in elective surgery patients. The box which was being used may limit the space of movement making it difficult to intubate.

The Effects of Ketamin-Midazolam and Ketamin-Propofol on Bispectral Index Score as Sedatives During Bone Marrow Puncture Procedure Among Pediatrics Aldiar; Fredi Heru Irwanto; Andi Miarta; Irfannuddin
Journal of Anesthesiology and Clinical Research Vol. 2 No. 1 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Background: Bone Marrow Puncture (BMP) is an invasive procedure associated with pain and anxiety. The ketamine-midazolam and the ketamine-propofol is an effectivecombination with minimal side effects. This study of the study aims to compare the effect of the combination of ketamine-midazolam and ketamine- propofol on sedation depth based on BIS in pediatric leukemia patients undergoing BMP. Methods: This study was a randomized controlled trial that was done single-blinded. The population was all pediatric patients diagnosed with leukemia who underwent BMP at RSMH and performed sedation. The research sample is the population that fulfill the inclusion and exclusion criteria. The sample size for each group was 25, with 50 Subjects in total. Sampling was done by block randomization. Results: This study found no differences in sex, age, and body weight between the two groups ([p=1.000], [p=0.845], and [p=0.147], respectively). In this study, there was no difference in mean MAP (p=0.592), oxygen saturation (p=0.164), heart rate (p=0.098), and respiratory rate (p=0.252) before intervention between the two groups. BIS value of the two groups had significant difference before and after the intervention where the two groups could reduce BIS to reach the optimal value of sedation <60 (p <0.05) There was no difference in BIS before intervention in the two groups (p=0.385). In this study, it was found that hypersalivation occurred more frequently in the ketamine-midazolam combination group. Conclusion: The combination of ketamine-midazolam and ketamine-propofol was equally good for sedation as indicated by a decrease in the mean BIS in patients undergoing BMP.

The Effectiveness of Mometasone Spray and Triamcinolone Acetonide Gel in Preventing Sore Throat, Cough, and Hoarse after Intubation Zentika. I. Fajri; Fredi Heru Irwanto; A Miarta; Theodorus
Journal of Anesthesiology and Clinical Research Vol. 2 No. 1 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Background: Endotracheal intubation is a procedure performed by inserting an endotracheal tube into the airway. With endotracheal intubation, there can be several complications ranging from mild to severe. Sore throat, coughing, and hoarseness were several endotracheal intbation complications. From several studies, it was found that the incidence of POST was 21-65%. This study aimed to determine the efficacy between 0.1% triamcinolone acetonide gel and 100 mcg mometasone spray in reducing sore throat, cough, and hoarseness due to endotracheal intubation. Method: A Randomized Controlled Trial, Open-Label was carried out on patients undergoing endotracheal intubation with general anesthesia in RSMH operating room from September 2020 - November 2020. Seventy-two study subjects met the inclusion criteria and were divided into two groups, namely the triamcinolone acetonide gel group, and the mometasone spray group. Analyzing data was SPSS version 23. Result: There were no difference between age, sex, ASA PS classification, and length of operation between the two groups (p> 0.05). Mometasone spray 100 mcg and triamcinolone acetonide gel 0.1% had the same effectiveness to reduce endotracheal intubation such as sore throat, cough, and hoarseness within 24 hours of endotracheal intubation (p> 0.05). There was a significant difference in the incidence of sore throat between two groups in the first hour (p = 0.039). Conclusion: There was no statistically significant difference between the efficiency of mometasone spray 100 mcg and triamcinolone acetonide gel 0.1% on a sore throat, cough, and hoarseness within 24 hours of endotracheal intubation (p > 0.05).

Oxycodone 5 Miligram is More Effective Than Ketorolac 30 Miligram in Suppressing Cortisol Levels During General Anesthesia Kelvin; Rizal Zainal; Irwanto FH; Erial Bahar
Journal of Anesthesiology and Clinical Research Vol. 2 No. 1 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Background: Preemptive analgesia is a developing clinical concept, which involves administering analgesics before pain stimulation occurs, to prevent the sensitization of the nervous system to further stimuli that can cause pain. Ketorolac has strong analgesic properties oxycodone is a semisynthetic opioid that is synthesized from the alkaloid thebaine opiate. Pain could induce stress hormone such as cortisol. Study to compare ketorolac and oxycodone with cortisol has not been investigated. This study aimed to assess intravenous administration of ketorolac 30 mg compared with intravenous 5 mg oxycodone for pain as measured by cortisol levels post-intervention in surgery performed under general anesthesia. Method: A study randomized controlled trial in double-blind form for patients at dr. Mohammad Hoesin Palembang, who will undergo elective surgery with general anesthesia at the Central Surgical Installation building, with the period September-October 2020. There are 24 study samples, to anticipate dropouts, an added sample size is 10%, so the sample size is 26 for each treatment group. The selection of subjects according to the purpose of the study was carried out by simple random. Data analysis using SPSS ver 22.0 software. Data were analyzed using Independent T-Test, Mann Whitney, and Chi-Square Test. Result: The results showed, there was a significant difference in the effectiveness of intravenous administration of ketorolac 30 mg and intravenous oxycodone 5 mg on pain as measured by cortisol levels in patients undergoing general anesthesia at dr. Mohammad Hoesin Palembang (p = 0.013). The value of cortisol levels in pre- operative patients who will be given general anesthesia at dr. There was no statistically significant difference between Mohammad Hoesin in the two groups (p = 0.107). The value of cortisol levels in preoperative patients who were given ketorolac 30 mg intravenously at dr. Mohammad Hoesin was 9.90 ± 4.2. The value of cortisol levels in postoperative patients who were given ketorolac 30 mg intravenously at dr. Mohammad Hoesin was 17.75 ± 6.08. The value of preoperative cortisol levels for patients who were given oxycodone 5 mg intravenously at dr. Mohammad Hoesin was 12.03 ± 5.10. The value of postoperative cortisol levels for patients who were given oxycodone 5 mg intravenously at dr. Mohammad Hoesin is 14.50 ± 4.75. Conclusion: There was a significant difference in the effectiveness of intravenous administration of ketorolac 30 mg and oxycodone 5 mg intravenously on BSS levels (p = 0.005) and VAS scores (p = 0.001) who underwent general anesthesia at dr. Mohammad Hoesin Palembang.

Preemptive Ketorolac is as Effective as Oxycodone Decreasing Plasma Cortisol Levels in Patients Undergoing Spinal Anesthesia Rizal Zainal; Nugraha Heryadi; Agustina Br Haloho; Erial Bahar
Journal of Anesthesiology and Clinical Research Vol. 2 No. 1 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Introduction: Post-surgical pain is a complex problem, if not treated properly it can have multisystem negative effects. Hormone cortisol can be increased in stressful situations. A study on the effectiveness of ketorolac and another opioid on cortisol levels has been shown. However, a study about the effect of oxycodone on cortisol levels and its comparison with Ketorolac has never been done before. This study aimed to compare the effect of preemptive administration of 30 mg ketorolac and 5 mg oxycodone on plasma cortisol levels in patients undergoing spinal anesthesia. Methods: A double-blind randomized clinical trial was carried out between October and December 2020 in the central operating room of dr. Mohammad Hoesin Palembang. Surgical patients according to the inclusion criteria who received spinal anesthesia were randomly given 5 mg oxycodone and 30 mg ketorolac intravenously shortly after spinal anesthesia. Cortisol levels were measured before and after the intervention. Data analysis using SPSS ver. 20 Windows with a 95% confidence interval. Result: In total, 56 subjects were included. 29 samples in the ketorolac group and 27 samples in the oxycodone group. There were no significant differences in age, sex, nutritional status, blood sugar, and VAS score. There was no significant difference in the mean of cortisol levels before the intervention in the ketorolac group 12.9421 + 6.096 m/dL and the oxycodone group 14.033 + 4.315 m/dL (p = 0.446). The mean value of cortisol levels after intervention in the ketorolac group was 12.979 + 6.280 m/dL and oxycodone 15.353 + 11.704 m/dL, there was no significant difference in changes in cortisol before and after intervention in the Ketorolac group (p = 0.692) and Oxycodone (p = 0.552). The comparison level of cortisol changes between the two groups was not significantly different (p = 0.267). Conclusion: There was no difference in the comparison of the effect of preemptive administration of 30 mg IV ketorolac and 5 mg IV oxycodone on plasma cortisol levels in patients undergoing spinal anesthesia.

Correlation Between Albumin Level and 28-Days Sepsis Related Mortality Nugroho H.S.; Mafiana R; Irwanto FH; Husin Syarif
Journal of Anesthesiology and Clinical Research Vol. 2 No. 1 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Introduction: The mortality rate from sepsis is much greater than that from acute coronary syndrome or stroke. Uncontrolled release of cytokines (abnormalities in the inflammatory response) such as TNF-α and IL-1, IL-6 can reduce serum albumin level, so that the presence of hypoalbuminemia conditions can indicate how the inflammatory reaction occurs in septic patients. Albumin can be a predictor of mortality in septic patients. This study aims to determine the correlation between serum albumin level and the 28-day mortality of patients with sepsis. Methods: This study is an analytical observational study with a retrospective cohort design. The research was conducted in September 2020 until the completion of data collection at dr. Mohammad Hoesin Hospital Palembang. The sample in this study were all sepsis patients in the intensive care unit who were registered in the Medical Record Installation of dr. Mohammad Hoesin Hospital Palembang from 1 January 2019 to 31 December 2019 met the inclusion and exclusion criteria. After the data was collected, analysis was carried out using the STATA program. Results: The serum albumin value ≤ of 2.6 mg / dL on the fourth day was significant with the mortality of septic patients. Patients with a serum albumin value ≤ 2.6 mg / dL had a risk of 1.288 times experiencing death compared to an albumin value> 2.6 mg / dL. Albumin in the fourth day had moderate correlation with sepsis patient mortality (r = 0.497; p = 0.001) Conclusion: Albumin serum on the fourth day had a moderate correlation with 28 days sepsis patient mortality

Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH) Patients Treated with Laparoscopic Neovaginal with The Davydov Procedure with Epidural Anesthesia: A Case Report Hadrians Kesuma Putra; Amir Fauzi; Ratih Krisna; Aerul Chakra Alibasya; Aidyl Fitrisyah; Alia Desmalia
Journal of Anesthesiology and Clinical Research Vol. 2 No. 1 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Introduction. MRKH syndrome is characterized by incomplete or absent of vaginal and uterine agenesis. Currently there are no official guidelines on the management of MRKH syndrome. This case report is about the operative management in MRKH patients by neovaginal with laparoscopic Davydov procedure. Case presentation. A 26-year-old woman admitted that she had never had a period, the patient admitted that her breasts began to grow at the age of 13, and the patient was planning to get married, and refused to take further planning. The patient then came back to the RSMH urogynecology clinic after marriage, from the examination it was found that the pubic hole was ± 0.5 cm deep, speculum examination could not be done, the uterus could not be palpable from the rectal toucher. From the ultrasound examination, it was found that both ovaries were within normal limits and suspected uterine hypoplasia. Hormone tests were within normal limits, with the following values: LH 27.01 mIU / mL, FSH 57.08 mIU / mL, Estradiol 10 pg / mL, Prolactin 5.94 ng / mL. Patients with a history of atrial septal defect (ASD) and ventricular septal defect (VSD) Conclusion. Treatment of MRKH syndrome patients is usually complex and requires multidisciplinary counseling, therapy, and management, so it is hoped that it can help patients to make a functional vagina. Further research and collaboration from various multidisciplinary make pregnancy in patients with MRKH syndrome, not impossible, along with current technological and scientific developments, the selection of surrogate mothers, and uterine transplantation is an option.

Positive Cumulative Fluids Balance Related to Mortality Events in Sepsis Patients Treated at Intensive Care Unit, Dr. Mohammad Hoesin General Hospital Palembang Zulkifli; Fredi Heru Irwanto; Legiran; Nadia Maharni
Journal of Anesthesiology and Clinical Research Vol. 2 No. 2 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Introduction. Sepsis is a syndrome that describes physiological dysfunction, pathological, and biochemistry caused by infection. Fluid balance is an indicator that can monitor input and output. This study was aimed to evaluate the relationship between positive cumulative fluid balance and the mortality rate of sepsis patients treated in the intensive care unit. Method: This study design is a retrospective study. The inclusion criteria consist of patients diagnosed with sepsis written in the medical record, 18-65 years old, and patients admitted in intensive care unit dr Moh. Hoesin General Hospital. Data were analyzed using SPSS 22.0 with the normality of data distribution, independent sample t-test, Mann-Whitney analysis, chi-square, Fisher’s Exact to measure the relationship, and using Medcalc version 14 application to measure cut-off value, ROC curve AUC, cross-sectional point, sensitivity, and specificity. Result. The result showed that characteristic between age (p=0,491), gender (p=0,703) did not differ significantly between survived and non-survived patient. Length of stay (p=0,002), balance (p=0,000), and ward unit (p=0,014) has a significant different between survived and non survived patient. In chi square analysis, p value=0,000with odds ratio 7,083. Cut-off value of ROC curve is -97 mL with AUC 0,844, sensitivity 76,1% and specificity 79,3%. Conclusion. Cumulative positive balance patient in the sepsis patient correlates with increased mortality in a sepsis patient in Dr. Mohammad Hoesin General Hospital Palembang.

Pericapsular Nerve Group Block (PENG Block) and Spinal Anesthesia as Multimodal Analgetic in Patient with Bipolar Hip Arthroplasty: A Case Report Aidyl Fitrisyah; Stevanus Eliansyah Handrawan; Afrida Yolanda Putri
Journal of Anesthesiology and Clinical Research Vol. 2 No. 2 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Introduction. Intertrochanteric fractures are defined as extracapsular fractures of the proximal femur that occur between the greater and lesser trochanter. Bipolar hip arthroplasty is one of the most common major orthopaedic procedures to improve patient’s functional status and quality of life. Spinal anesthesia is a regional anesthetic technique that is performed by injecting local anesthetic drugs into the subarachnoid space to obtain dermatome-level analgesia and skeletal muscle relaxation. Pain after hip replacement originates mainly from the anterior pelvic capsule. The main target for pelvic analgesia is the anterior capsule which is the most richly innervated part of the joint. PENG block is used to block the articular branches to the pelvis. The patient was assessed with an NRS (numeric rating scale) instrument pre and post operative. Case presentation. A-74 year old woman admitted with complaints of pain in the right hip and diagnosed with a closed fracture of the right intertrochanter and planned for bipolar hip arthroplasty with PENG block and spinal anesthesia. Preoperatively the patient was assessed with an NRS (numeric rating scale) instrument with a score of 6. After the procedure, we reevaluated the pain score using NRS was 2 post operative. Conclusion. Patients receiving a PENG block and spinal anesthesia for intraoperative and postoperative analgesia during hip fracture surgery. Prior to spinal anesthesia, PENG block can be performed as a multimodal analgesia in the patient, PENG block expected to facilitate a sitting position during spinal anesthesia and for postoperative pain management

The Comparison of Duration Endotracheal Tube Insertion Using Aerosol Box And without Aerosol Box in Elective Surgery Patients in the Covid-19 Pandemic Zulkifli; Agustina Br Haloho; Legiran; Muhammad Ikhsan Kartawinata
Journal of Anesthesiology and Clinical Research Vol. 2 No. 2 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Introduction. The aerosol box can reduce the risk of droplet and aerosol transmission from the patient to the operator when performing intubation, but in practice, an aerosol box makes the glottis visualization less evident, and the operator moves less space with less space the aerosol box. This study aimed to compare ETT duration using an aerosol box and without an aerosol box using a video laryngoscope. Methods: This study was a clinical trial with a post-test-only control design. The study was carried out from February 2021 to May 2021 at the Central Operating Theater of dr. Mohammad Hoesin General Hospital Palembang. The sample in this study was all patients who underwent elective surgery under general anesthesia using intubation at the Central Surgical Installation of dr. Mohammad Hoesin Palembang. After the data is collected, it is analyzed using the SPSS 22.0 program with the appropriate test. Results. There were no differences in subject characteristics (age, sex, BMI, Mallampati score, TMD, Cormack Lehane, limited mouth opening, short neck, limited mouth movement) between the group using the aerosol box and the group without the aerosol box. The duration of intubation without an aerosol box is 30.67 + 2.63 seconds, and using an aerosol box is 44.53 + 2.89 seconds. There was a significant difference between the two groups in the duration of patient intubation (p < 0.001). However, there was no significant difference in complications in the two groups (p >0.05). Conclusion. The duration of the endotracheal tube insertion using an aerosol box is more extended than without an aerosol box in elective surgery patients.

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Home Page

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Editorial Team

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Contact Name RACHMAT HIDAYAT

Contact Email hanifmedisiana@gmail.com

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Journal Mail Official journalanesthesiology@gmail.com

Editorial Address Jl. Sirna Raga no 99, 8 Ilir, Ilir Timur 3, Palembang, Sumatera Selatan, Indonesia

Location Kota palembang, Sumatera selatan INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
RACHMAT HIDAYAT

Contact Email
hanifmedisiana@gmail.com

Phone
+6287837160809

Journal Mail Official
journalanesthesiology@gmail.com

Editorial Address
Jl. Sirna Raga no 99, 8 Ilir, Ilir Timur 3, Palembang, Sumatera Selatan, Indonesia

Location
Kota palembang,

Sumatera selatan

INDONESIA