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Jurnal Anestesi Perioperatif
Published by Universitas Padjadjaran
ISSN : 23377909     EISSN : 23388463     DOI : 10.15851/jap
Core Subject : Health, Education,
Education Health Professions
Jurnal Anestesi Perioperatif (JAP)/Perioperative Anesthesia Journal is to publish peer-reviewed original articles in clinical research relevant to anesthesia, critical care, case report, and others. This journal is published every 4 months with 9 articles (April, August, and December) by Department of Anesthesiology and Intensive Care Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung.
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Perbandingan Gabapentin 600 mg dengan Pregabalin 150 mg Preoperatif terhadap Nilai Numeric Rating Scale dan Pengurangan Kebutuhan Opioid Pascaoperasi Modifikasi Radikal Mastektomi Agustine, Rully; Oktaliansyah, Ezra; Surahman, Eri
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gabapentin dan pregabalin mempunyai efek antihiperalgesia, antialodinia, dan antinosiseptif untuk mengurangi nyeri pascaoperatif. Penelitian ini bertujuan untuk membandingkan gabapentin 600 mg (n=22) dengan pregabalin 150 mg (22) terhadap nyeri pascaoperatif modifikasi mastektomi radikal, yang dilakukan terhadap 44 wanita (18–65 tahun) status fisik American Society of Anesthesiologist (ASA) I-II secara uji acak terkontrol buta ganda dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung pada November 2011 sampai Maret 2012. Analisis statistik menggunakan Uji Mann-Whitney, uji-t dan uji chi-kuadrat dengan tingkat kepercayaan 95% dan bermakna bila p<0,05. Penilaian skala nyeri menggunakan nilai numeric rating scale (NRS). Nilai NRS saat berbaring pada kelompok gabapentin 600 mg dan pregabalin 150 mg adalah sama (p>0,05). Nilai NRS saat mobilisasi pregabalin 150 mg lebih baik daripada gabapentin 600 mg pada tujuh dari sepuluh waktu pengukuran (p<0,05). Pemberian analgetik tambahan pascaoperatif antara kedua kelompok adalah sama (p>0,05). Simpulan, pregabalin 150 mg preoperatif lebih baik dari gabapentin 600 mg dalam menurunkan nilai NRS pascaoperasi. Gabapentin 600 mg dan pregabalin 150 mg mampu menurunkan kebutuhan opioid pascaoperatif. Kata kunci: Gabapentin, kebutuhan analgetik opioid, numeric rating scale, nyeri pascaoperatif, pregabalin Comparison of Pre Operative Gabapentin 600 mg and Pregabalin 150 mg to the Value of Numeric Rating Scale and the  Reduction of Post Operative Opioid Requirement after Modified Radical MastectomyGabapentin and pregabalin has anti hiperalgesia, anti allodynia, and anti nocicentive effect that can be used as an additional medication to reduce postoperative pain. This study compared gabapentin 600 mg and pregabalin 150 mg in managing  postoperative pain following modified radical mastectomy.  The study was done by conducting a double blind randomized controlled trial of 44 patients who underwent modified radical mastectomy operation under general anesthesia, aged 18–65 years, with American Society of Anesthesiologist (ASA) physical status I-II at Dr. Hasan sadikin General Hospital Bandung during November 2011 to March 2012. Patients were divided into two groups 600 mg gabapentin (n=22), and 150 mg pregabalin (n=22). Statistical analysis using Mann-Whitney Test, t-test and chi-square test with 95% confidence interval and considered significant if p<0.05. The quality of pain was assessed by using a numeric rating scale. The NRS value at rest was similar in both groups (p>0.05). NRS during mobilization were significantly different in nine measurements (p<0.05). Total postoperative additional analgesia shown no significant differences in both groups (p>0.05). Oral preoperatif pregabalin 150 mg is better than gabapentin 600 mg for reducing post operative NRS. Gabapentin 600 mg and pregabalin 150 mg reduced postoperative opioid consumption.Key words: Gabapentin, numeric rating scale score, opioid analgesic requirement, post operative, pregabalin DOI: 10.15851/jap.v2n2.305
Perbandingan Pengaruh Nifedipin 20 mg per Oral 2 Jam Preoperasi dengan Plasebo terhadap Suhu Inti pada Pasien yang Menjalani Operasi Modified Radical Mastectomy dengan Anestesi Umum Trisnadi, Saleh; Suwarman, -; Nawawi, Abdul Muthalib
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Upaya pencegahan hipotermia dapat dilakukan dengan mengurangi perbedaan antara suhu inti dan perifer sebelum dilakukan pembedahan dengan pemberian vasodilator. Tujuan penelitian ini untuk mengetahui efek penggunaan antara nifedipin 20 mg dan plasebo per oral 2 jam preoperasi selama operasi modifikasi mastektomi radikal terhadap penurunan suhu tubuh. Penelitian  menggunakan metode prospektif, terkontrol, tersamar, buta ganda pada 30 pasien berusia 18–60 tahun, status fisik American Society Of Anesthesiologist (ASA) I dan II, yang menjalani operasi modifikasi mastektomi radikal di Rumah Sakit Dr. Hasan Sadikin Bandung pada Juni sampai Agustus 2012. Secara acak dibagi menjadi 2 kelompok, yaitu kelompok yang mendapat nifedipin 20 mg per oral 2 jam preoperasi dengan plasebo. Dilakukan pencatatan suhu timpani setiap 10 menit dari awal induksi hingga akhir anestesi. Data hasil penelitian diuji secara statistik dengan Uji Mann-Whitney. Suhu inti rata-rata pada kelompok nifedipin adalah 36,37 oC lebih besar dibandingkan dengan kelompok kontrol yaitu 35,61 oC dengan perbedaan bermakna (p<0,05). Simpulan penelitian ini menunjukkan bahwa penggunaan obat nifedipin dapat mencegah hipotermia selama operasi dibandingkan dengan plasebo (kontrol).Kata kunci: Nifedipin, suhu inti tubuh, vasodilatorEffect of 20 mg Nifedipine Orally 2 Hours Before the Operation on Core Temperature in Patients Undergoing Modified Radical Mastectomy Surgery with General AnesthesiaStrategy of prevention the initial redistribution hypothermia is based on the reduction of the heat gradient between the core and perifer before surgery by administering vasodilators. The purpose of this study was to asses the effect of oral nifedipine 20 mg 2 hours before anesthesia in preventing hypothermia in patients undergoing modified radical mastectomy under general anesthesia and to compare the decreased rate of body temperature oral nifedipine with placebo. The research was done with the prospective method, randomized double-blind controlled study in 30 patients aged 18–60 yrs, American Society of Anesthesiologist (ASA) physical status I-II, underwent modified radical mastectomy surgery, were randomly divided into two groups at Dr. Hasan Sadikin General Hospital Bandung during June until August 2012. One group was given oral nifedipine 20 mg 2 hours before general anesthesia and the other group was given placebo. Tymphani temperature was recorded during anesthesia every 10 minutes. Research data was tested statistically by the Mann-Whitney test. The average core temperature in the nifedipine was 36.37 ° C which was higher than the control group 35.61 ° C (p<0.05). It can be concluded that the use of nifedipine can prevent intraoperative hypothermia.Key words: Core temperature, nifedipine, vasodilator DOI: 10.15851/jap.v2n2.306
Perbandingan Penambahan PePerbandingan Penambahan Petidin 0,25 mg/kgBB dengan Klonidin 1 µg/kgBB pada Bupivakain 0,25% untuk Blok Infraorbital pada Labioplasti Anak terhadap Lama Analgesia Pascaoperasi Ramadani, Dewi; Fuadi, Iwan; Nawawi, Abdul Muthalib
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Nyeri pascalabioplasti dapat dicegah dengan blok infraorbital bilateral. Penelitian bertujuan membandingkan lama analgesi blok infraorbital pascalabioplasti anak antara penambahan petidin 0,25 mg/kgBB dan klonidin 1 µg/kgBB pada bupivakain 0,25% menggunakan skala nyeri skor face, leg, activity, cry, consolability (FLACC). Penelitian prospektif, uji klinis acak terkontrol tersamar tunggal dilakukan bulan Maret–September 2013 pada 30 pasien status fisik American Society of Anesthesiologist (ASA) II, usia 3 bulan–1 tahun yang menjalani labioplasti dengan blok infraorbital bilateral di Rumah Sakit Dr. Hasan Sadikin Bandung. Subjek dibagi dua kelompok, masing-masing 15 orang. Kelompok BP menerima blok infraorbital dengan adjuvan petidin dan kelompok BK dengan klonidin. Setelah induksi anestesi, dilakukan blok infraorbital sebanyak 1 mL pada tiap sisi wajah. Analisis data dengan uji t menunjukkan perbedaan lama analgesi pascaoperasi yang sangat bermakna (p<0,01) antara kelompok BP (1.828 menit) dan kelompok BK (1.072 menit). Simpulan penelitian ini adalah penambahan petidin 0,25 mg/kgBB pada bupivakain 0,25% untuk blok infraorbital labioplasti anak memberikan analgesi pascaoperasi lebih lama dibandingkan dengan klonidin 1 µg/kgBB. Kata kunci: Blok infraorbital, bupivakain, klonidin, labioplasti, petidinComparison Addition of  Pethidine 0.25 mg/kgBW  with Clonidine 1 µg/kgBW in Bupivacaine 0.25%  to Infraorbital Block in Paediatric Labioplasty for Duration Post Operative Analgesia Post operative pain for labioplasty can be prevented by bilateral infraorbital block. This study aimed to compare the effectiveness addition of pethidine 0.25 mg/kgBW and clonidine 1 µg/kgBW to bupivacaine 0.25%  for postoperative analgesia using infraorbital block in paediatric labioplasty with a pain scale score face, leg, activity, cry, consolability (FLACC). The study was a single-blind randomized controlled trial from March to September 2013 involving  30 pediatric patients, physical status American Society of Anesthesiologist (ASA) II, ages 3 months–1 year for labioplasty surgery with bilateral infraorbital block  at  Dr. Hasan Sadikin Hospital  Bandung. Subjects were grouped into two groups: 15 subjects using adjuvant pethidine 0.25 mg/kgBW (BP) and 15 subjects using adjuvant clonidine 1 ug/kgBW (BK). After induction of anesthesia, infraorbital block done 1 mL on each side of the face. Data were analyzed by t test, showed a highly significant difference (p<0.01) in BP group compared with BK, the average length of postoperative analgesia 1.828 minutes (30 hours) vs 1072 minutes (18 hours). The conclusions is the addition of pethidine 0.25 mg/kgBW in bupivacaine 0.25%  to infraorbital block in paediatric labioplasty provide postoperative analgesia longer than of clonidine 1 µg/kgBW.Key words: Bupivacaine, clonidine, infraorbital block, labioplasty, pethidine DOI: 10.15851/jap.v2n2.302
Perbandingan Lama Analgesia antara Kombinasi Bupivakain 0,125% dan Tramadol 1 mg/kgBB dengan Bupivakain 0,125% Melalui Blokade Kaudal pada Pasien Anak Pascaoperasi Hipospadia Wijayanti, Viana; Sitanggang, Ruli Herman; Wargahadibrata, A. Himendra
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Blokade kaudal merupakan teknik anestesi regional yang paling banyak dilakukan pada operasi anak. Penelitian ini bertujuan mengetahui perbandingan lama analgesia kombinasi bupivakain dan tramadol dengan bupivakain melalui blokade kaudal pada pasien anak balita pascaoperasi hipospadia. Penelitian dilakukan terhadap 30 pasien, usia 1–5 tahun, status fisik American Society of Anesthesia (ASA) I di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Maret hingga Mei 2010. Tipe penelitian ini adalah eksperimental, rancangan acak lengkap terkontrol, tersamar tunggal. Kelompok BT menggunakan kombinasi bupivakain 0,125% dan tramadol 1 mg/kgBB  dan kelompok B menggunakan bupivakain 0,125%.  Data hasil penelitian diuji dengan uji-t. Lama analgesia pascaoperasi pada kelompok BT lebih panjang dibandingkan dengan kelompok B dengan hasil yang sangat bermakna (p<0,01). Kelompok BT dengan lama analgesia 531,33 (SD 42,86) menit dan kelompok B, 370,00 (SD 37,37) menit.  Simpulan penelitian ini adalah penggunaan kombinasi bupivakain 0,125% dan tramadol 1 mg/kgBB (0,5 mL/kgBB) untuk blokade kaudal  sebagai analgetik pascaoperasi hipospadia, menghasilkan lama analgesia yang lebih panjang bila dibandingkan dengan bupivakain 0,125%.  Kata kunci: Blokade kaudal, bupivakain, operasi hipospadia, tramadolComparison of the Duration of Analgesia between Combination of 0.125% Bupivacaine Mixed with Tramadol 1 mg/kgBW and 0.125% Bupivacaine Through Caudal Blockade in Toddlers after Hypospadia Surgery Caudal block is the most common regional anesthetic technique performed in pediatric surgery. This study was designed to compare the duration of analgesia of caudal block between combination of bupivacaine with tramadol and bupivacaine in toddler with hypospadia repair. Thirty American Society of Anesthesia (ASA) I toddlers, aged 1–5 years old at Dr. Hasan Sadikin General Hospital Bandung, runs from March to May, 2010. Patients in group BT, received 0.125% bupivacaine mixed with tramadol 1 mg/kgBW  0.5 mL/kgBW and group B, received plain 0.125% bupivacaine in the same total volume. This type of research is experimental. It was  a single blind randomized controlled trial. Duration of postoperative analgesia were noted. The t-test was used for analysing the data of this study. The duration of analgesia in group BT 531.33 (SD 42.86) was significantly longer than in group B 370.00 (SD 37.37) minutes with p value<0.001. Caudal administration of 0.125% bupivacaine mixed with tramadol 1 mg/kgBW resulted in longer duration of analgesia compared with 0.125% of bupivacaine.  Key words: Bupivacaine, caudal block, hypospadia repair, tramadol DOI: 10.15851/jap.v2n2.307
Perbandingan Pengaruh Pemberian Granisetron 1 mg Intravena dengan Plasebo (Salin) untuk Mencegah Kejadian Menggigil Pascaanestesi Spinal pada Seksio Sesarea Manunggal, Heru Wishnu; Oktaliansah, Ezra; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Menggigil pascaanestesi merupakan komplikasi yang sering terjadi pada tindakan anestesi. Tujuan penelitian ini untuk mengkaji pemberian granisetron 1 mg intravena dalam mengurangi kejadian menggigil pada pasien yang menjalani seksio sesarea dengan anestesi spinal. Metode penelitian klinis acak terkontrol tersamar ganda pada 38 pasien yang menjalani seksio sesarea di Rumah Sakit Dr. Hasan Sadikin Bandung pada April–September 2011, usia 20–35 tahun, status fisik American Society of Anesthesia (ASA)  II dan  dikelompokkan secara random menjadi  2 kelompok, yaitu kelompok yang menerima granisetron 1 mg intravena atau salin sebelum dilakukan anestesi spinal dengan bupivakain 12,5 mg. Kejadian menggigil dicatat berdasarkan derajat 0–4. Hasil penelitian menunjukan secara statistik data karakteristik pasien dan suhu tubuh inti tidak berbeda antara kedua  kelompok. Kejadian menggigil lebih sedikit pada kelompok granisetron (21,1%) dibandingkan dengan kelompok plasebo (52,6%) dengan hasil statistik bermakna (p<0,05). Simpulan penelitian ini menunjukkan bahwa pemberian granisetron 1 mg intravena sebelum anestesi spinal pada seksio sesarea mengurangi kejadian menggigil pascaanestesi yang dibandingkan dengan plasebo.                                          Kata kunci: Granisetron, menggigil, pascaanestesi spinalEffect of  Granisetron 1 mg Intravenously  to Prevent of Shivering After Spinal Anesthesia for Cesarean SectionPost anesthesia shivering is one of the complications that often occur in anesthetic action. The purpose of this study was to assess the administration of intravenous granisetron 1 mg in reducing the incidence of shivering in patients undergoing caesarean section with spinal anesthesia. Clinical research methods in double-blind randomized controlled 38 patients who underwent seksios esarea at Dr. Hasan Sadikin Hospital Bandung during April–September 2011, aged 20–35 years overall status American Society of Anesthesia (ASA) II physical and random into two groups: the group that received granisetron 1 mg intravenously or saline prior to spinal anesthesia with bupivacaine 12.5 mg. Incidence of shivering recorded by degrees 0–4. The results showed statistically significant patient characteristic data and core body temperature did not differ between the two groups. Shivering less in granisetron group (21.1%) than the placebo group (52.6%) with statistically significant results (p<0.05).The conclusions of this study indicate that administration of granisetron 1 mg intravenously before spinal anesthesia in Caesarean section reduces the incidence of shivering postanesthesia.Key words: Granisetron, shivering, post anesthesia spinal DOI: 10.15851/jap.v2n2.303
Perbandingan Efek Pregabalin 150 mg dengan 300 mg Dosis Tunggal terhadap Nilai Numeric Rating Scale dan Kebutuhan Analgetik Pascabedah pada Pasien Histerektomi Abdominal Elvidiansyah, -; Fuadi, Iwan; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Pregabalin memiliki efek antihiperalgesia, antialodinia, dan antinosiseptif. Penelitian bertujuan untuk membandingkan pregabalin 150 mg dengan 300 mg dosis tunggal 1 jam prabedah terhadap nyeri pascabedah dan kebutuhan opioid pada operasi histerektomi abdominal dalam anestesi umum. Uji klinik acak terkontrol buta ganda dilakukan terhadap 60 wanita (18–60 tahun) status fisik American Society of Anesthesiologist (ASA) I–II di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Mei–Agustus 2013. Pasien dibagi menjadi dua kelompok yang menerima pregabalin 150 mg atau 300 mg. Analisis statistik data hasil penelitian menggunakan uji-t, chi-kuadrat, dan Uji Mann-Whitney. Pada penelitian ini ditemukan nilai numeric rating scale (NRS) saat mobilisasi pada kelompok pregabalin 150 mg dan pregabalin 300 mg  berbeda bermakna (p<0,05). Pemberian analgetik tambahan pascabedah antara kedua kelompok tidak berbeda bermakna (p>0,05). Simpulan penelitian adalah pregabalin dosis 150 mg memiliki efek analgesia dan penambahan opioid yang tidak jauh berbeda dibandingkan dengan dosis 300 mg.Kata kunci: Histerektomi abdominal, numeric rating scale, nyeri pascabedah, pregabalinComparison Between the Effect of Single Dose 150 mg and 300 mg Pregabalin of Numeric Rating Scale Value and Post operative Analgesia Requirement  in Abdominal Hysterectomy PatientsPregabalin has the effect of anti hyperalgesia, anti allodynia, and anti nociception. This study aimed to compare single dose of 150 mg pregabalin with 300 mg pregabalin given 1 hour preoperatively in regards to postoperative pain and opioid requirements in abdominal hysterectomy patients. Double blind randomized controlled trial has been conducted on 60 women (18–60 years),  American Society of Anesthesiologist (ASA) physical status I-II, who underwent abdominal hysterectomy in a double-blind randomized controlled trial under general anesthesia in Dr. Hasan Sadikin Hospital-Bandung within May to August 2013. Patients were divided into two groups whose received 150 mg pregabalin or 300 mg pregabalin pre operatively. Statistical analysis of research data is performed using the student’s t-test, chi square, and Mann-Whitney U-test. This study found that numeric rating scale (NRS) scores during mobilization in the 150 mg pregabalin group and 300 mg pregabalin were significantly different (p<0.05). There was no significant differences in postoperative supplemental analgesic administration between the two groups (p>0.05). The conclusion of the study is preoperative pregabalin dosage 150 mg and 300 mg has insignificant differences in its therapeutic effect and supplemental opioid.Key words: Abdominal hysterectomy, numeric rating scale, postoperative pain, pregabalin DOI: 10.15851/jap.v2n2.308
Perbandingan Efek Anestesi Spinal dengan Anestesi Umum terhadap Kejadian Hipotensi dan Nilai APGAR Bayi pada Seksio Sesarea Flora, Lasmaria; Redjeki, Ike Sri; Wargahadibrata, A. Himendra
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Teknik anestesi spinal atau anestesi umum pada seksio sesarea menyebabkan penurunan tekanan darah berbeda, demikian pula nilai APGAR bayi.  Tujuan penelitian ini untuk mengetahui kejadian hipotensi, nilai APGAR 1 menit dan 5 menit antara tindakan anestesi spinal dan anestesi umum. Penelitian dilakukan dengan cara randomized cross sectional pada 70 pasien di Rumah Sakit Dr. Hasan Sadikin Bandung pada Februari–Maret 2011. Setelah dilakukan randomisasi, pasien dibagi dalam dua kelompok, yaitu kelompok I (anestesi spinal) dan kelompok II (anestesi umum).  Data kejadian hipotensi dianalisis dengan uji chi-kuadrat, untuk nilai APGAR menggunakan Uji Mann-Whitney. Hasil penelitian menunjukkan kejadian hipotensi 57,1% pada kelompok anestesi spinal, sedangkan kelompok anestesi umum hanya 5,7% (p<0,001). Nilai APGAR rata-rata 1 menit pada kelompok anestesi spinal 8, sedangkan pada kelompok anestesi umum 7,06.  Berdasarkan Uji Mann Whitney didapatkan p<0,001. Nilai APGAR rata-rata 5 menit pada kelompok anestesi spinal 9,71,  sedangkan pada  kelompok   anestesi   umum  9,31 (p=0,015). Simpulan penelitian ini adalah angka kejadian hipotensi lebih tinggi pada anestesi spinal daripada anestesi umum.  Nilai APGAR bayi 1 menit dan 5 menit lebih tinggi pada anestesi spinal dibandingkan dengan anestesi umum.Kata kunci: Anestesi spinal, anestesi umum, hipotensi, nilai APGAR, seksio sesarea                      Comparison of  Effects  between  Spinal Anesthesia and General Anesthesia  on Hypotension and APGAR Scoring Values  of Caesarean Section BabiesTechnique of spinal anesthesia or general anesthesia on cesarean section causes decreasing in different blood pressure and APGAR score.  The purpose of this study was to identify the difference of hypotension, APGAR score 1 minute and 5 minutes on the action of spinal anesthesia and general anesthesia. A randomized cross sectional was conducted on 70 patients at Dr. Hasan Sadikin Hospital Bandung during February–March 2011. Patients were divided into two groups: group I (spinal anesthesia) and group II (general anesthesia).   The data of hypotension was analyzed with chi square test, for the APGAR score with Mann Whitney test. Result of the study showed that the case of hypotension was got 57.1% for the group of spinal anesthesia whereas the group of general anesthesia only 5.7% (p<0.001).  The mean of APGAR score 1 minute for the group spinal anesthesia was 8 whereas the group of general anesthesia was 7.06.  According to Mann Whitney test  got p<0.001.  The mean of APGAR score 5 minutes for the group spinal anesthesia was 9.71, whereas the mean for the group of general anesthesia was 9.31.  According to Mann Whitney test got p=0.015. The conclusion of the this study is the case of hypotension value is higher for the spinal anesthesia compared to general anesthesia.  APGAR score 1 minute and 5 minutes are higher for spinal anesthesia compared to general anesthesia.Key words: APGAR score, caesarean section, general anesthesia, hypotension,  spinal anesthesia   DOI: 10.15851/jap.v2n2.304
Perbandingan Pemberian Metoprolol Tartrat dengan Lidokain secara Intravena terhadap Perubahan Tekanan Darah dan Laju Nadi Akibat Tindakan Laringoskopi dan Intubasi Koswara, Yovita; Pradian, Erwin; Redjeki, Ike Sri
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tindakan laringoskopi dan intubasi endotrakeal dapat menyebabkan tekanan darah dan laju nadi naik secara mendadak akibat rangsangan terhadap sistem simpatis. Tujuan penelitian ini untuk mengetahui pengaruh pemberian metoprolol 5 mg intravena dibandingkan dengan lidokain 1,5 mg/kgBB untuk mengurangi lonjakan hemodinamik akibat laringoskopi intubasi. Penelitian ini dilakukan secara uji klinis acak terkontrol buta ganda terhadap 40 pasien dengan status fisik American Society of Anesthesiologist (ASA) I−II yang menjalani operasi dengan teknik anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung dari bulan Juli−Agustus 2013. Subjek dibagi menjadi 2 kelompok, yaitu kelompok yang diberikan metoprolol 5 mg intravena atau lidokain 1,5 mg/kgBB 3 menit sebelum tindakan laringoskopi dan intubasi. Data penelitian dianalisis dengan uji-t, dengan nilai p<0,05 dianggap bermakna. Analisis statistik menunjukkan bahwa pada 2 menit dan 3 menit setelah intubasi antara kedua kelompok didapatkan perbedaan bermakna pada seluruh  parameter hemodinamik dengan nilai  p<0,05. Simpulan dari penelitian ini adalah metoprolol 5 mg secara intravena memberikan hasil lebih baik dibandingkan dengan lidokain 1,5 mg/kgBB dalam hal mengurangi lonjakan hemodinamik akibat tindakan laringoskopi intubasi.Kata kunci: Intubasi, laringoskopi, lidokain, metoprololComparison of Intravenous Metoprolol Tartrate and Lidocaine on Changes of Blood Pressure and Heart Rate During Laryngoscopy and IntubationLaryngoscopy and endotracheal intubation associated with a sudden rise in blood pressure and pulse rate due to stimulation of sympathetic activity. The aim of this study was to compare effectiveness of metoprolol 5 mg intavenously and lidocaine 1.5 mg/kgBW to attenuate hemodynamic response evoked by laryngoscopy and intubation. This was an experimental randomized double blind controlled trial study was conducted in 40 patients with American Society of Anesthesiologist (ASA) physical status I or II who will have surgery with general anesthesia techniques in Hasan Sadikin Hospital Bandung from July−August 2013. Subjects were divided into two groups wich received metoprolol 5 mg intravenously or lidocaine 1.5 mg/kgBW 3 minutes before laryngoscopy and intubation. All data were analysed using t-test, with  p value < 0.05 considered significant. Statistical analysis showed that on second and third minutes after intubation and laryngoscopy showed a significant differences on hemodynamic parameter between two groups with  p value <0.05. The conclusions of this study are intravenous 5 mg of metoprolol found to be better than lidocaine 1.5 mg/kgBW to attenuate hemodynamic response evoked by laryngoscopy and  intubation.Key words: Intubation, laryngoscopy, lidocaine, metoprolol DOI: 10.15851/jap.v2n2.309
Penatalaksanaan Anestesi Pasien Transposition of the Great Arteries pada Operasi Mouth Preparation Nugraha, Ade Arya; Suwarman, -; Zulfariansyah, Ardi
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Transposition of the great arteries (TGA) disebabkan kegagalan pemisahan trunkus arteriosus, sehingga aorta keluar dari bagian anterior ventrikel kanan dan arteri pulmonal keluar dari ventrikel kiri. TGA termasuk kelainan jantung bawaan tipe sianotik. Seorang anak perempuan berusia 4 tahun datang untuk perawatan dan pencabutan gigi sebagai persiapan untuk operasi koreksi TGA di Rumah Sakit Dr. Hasan Sadikin Bandung pada Januari 2014. Anamnesis didapatkan riwayat kebiruan sejak bayi dan pada pemeriksaan fisis didapatkan anak yang tampak sianosis, SpO2 70–80%, murmur sistol, dan jari tabuh. Pada pemeriksaan ekokardiografi didapatkan kelainan TGA. Manajemen anestesi pada pasien ini dilakukan dengan menggunakan ketamin dan vekuronium untuk induksi serta pemeliharaan dengan O2 dan air, serta sevofluran. Manajemen anestesi dilakukan dengan target mencegah penurunan miring systemic vascular resistance (SVR) dibandingkan dengan pulmonary vascular resistance (PVR). Simpulan, prinsip pengelolaan perioperatif pembedahan nonkardiak pada pasien TGA adalah menjaga agar tidak terjadi penurunan SVR dan peningkatan PVR.Kata kunci: Kelainan jantung kongenital sianotik, pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), transposition of the great arteries (TGA)Management of Anesthesia in Patients Transposition of the Great Arteries which Undergo Mouth PreparationTransposition of the great arteries (TGA) results from failure of the truncus arteriosus to spiral, so that the aorta arises from the anterior portion of the right ventricle and the pulmonary artery arises from the left ventricle. TGA which is the type of cyanotic congenital heart disease. A girl of 4 years came for treatment and tooth extraction as preparation for the surgical correction of  TGA at the Dr. Hasan Sadikin Hospital –Bandung within January 2014. Patient with a history of blue when she was a baby and on physical examination found the child looking cyanosis, SpO2 70–80%, sistolic murmur and clubbing finger. Abnormalities on echocardiography obtained TGA.  Anesthetic management of this patients was performed using ketamine and vecuronium for induction and maintenance with O2, N2O, and sevoflurane. Cyanotic attacks can occur preoperative, intraoperative, and post operative, which was treated by increasing systemic vascular resistance (SVR) compared to pulmonary vascular resistance. In conclusions, perioperative management principal for non cardiac surgery on transposition of the great arteries (TGA) is to keep SVR from decline and  increase on PVR.Key words: Cyanotic congenital heart defects, pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), transposition of the great arteries (TGA)   DOI: 10.15851/jap.v2n2.320

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