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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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Lama Pengerjaan, Volume Anestetik Lokal, dan Angka Keberhasilan Blokade Aksilar dengan Panduan Pencitraan Ultrasonografi pada Prosedur Arterio-Venous Shunt Guntara, Ara; Yadi, Dedi Fitri; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Kunci keberhasilan melakukan blokade aksilar adalah mendistribusikan secara optimal anestetik lokal ke sekeliling saraf, hal ini tercapai dengan panduan pencitraan ultrasonografi. Penelitian ini bertujuan menilai lama pengerjaan, volume  anestetik lokal, dan angka keberhasilan blokade aksilar dengan panduan pencitraan ultrasonografi. Metode penelitian adalah deskriptif prospektif. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Maret–April tahun 2014 terhadap 40 pasien (21‒60 tahun), status fisik American Society of Anesthesilogist (ASA) II, menjalani pembedahan dalam blokade aksilar dengan panduan pencitraan ultrasonografi. Fungsi sensorik dan motorik dinilai setiap 5 menit selama 15 menit. Keberhasilan blokade dinilai dari hilangnya fungsi sensorik dan motorik pada saraf medialis, radialis, ulnaris, dan muskulokutaneus. Hasil penelitian didapatkan lama pengerjaan blokade aksilar rata-rata dengan panduan pencitraan ultrasonografi 548 detik (9,1 menit), volume anestetik lokal dibutuhkan 10 mL dan angka keberhasilan blokade aksilar sebesar 97,5%. Penelitian lain lama pengerjaan dengan bantuan alat stimulasi saraf tepi selama 11,2 menit, volume total anestetik lokal dibutuhkan 30‒40 mL, dan angka keberhasilan 60‒85%.  Simpulan, panduan pencitraan ultrasonografi dapat mempersingkat pengerjaan, mengurangi volume obat anestesi lokal, dan meningkatkan keberhasilan blokade aksilar.Kata kunci: Arterio-venous shunt, blokade aksilar, panduan ultrasonografiProcedure Time, Local Anaesthetic Volume, and Success Rate of Axillary Block with Ultrasound Guidance in Arterio-Venous Shunt ProcedureThe key requirement for successful axillary block is to ensure optimal distribution of local anesthetic around the nerve structure. This goal is most effectively achieved under sonographic visualization. This study aimed to assess block procedure time, minimum volume of local anesthetic required, and success rate of axillary brachial plexus block under ultrasound guidance. This study was conducted between March and April 2014 in Dr. Hasan Sadikin General Hospital, Bandung. This was an observational prospective study involving 40 patients (21‒60 years old) with American Society of Anesthesiologist (ASA) physical status II who underwent arterio-venous shunt under axillary brachial plexus block. Sensory and motor functions were assessed every five minutes for 15 minutes. A successful block was defined as complete sensoric and motoric loss in median, radial, ulnar, and musculocutaneus nerve distributions by 15 minutes. Results showed average block procedure time of 548 seconds (9.1 min), total volume of local anesthetic of 10 mL, and  block success rate of 97.5%. This study concludes that ultrasound guidance can reduce block procedure time and required local anesthetic volume as well as improving the success rate of axillary brachial plexus block. Key words: Arterio-venous shunt, axillary block, ultrasound guidance DOI: 10.15851/jap.v2n3.329
Pemberian Strepsils® Sebagai Lozenge Praoperasi untuk Mengurangi Nyeri Tenggorok Pascaintubasi Pipa Endotrakeal Priyonggo, Reko; Suwarman, -; Nawawi, Abdul Muthalib
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Nyeri tenggorok pascaoperasi atau post operative sore throat (POST) terjadi karena iritasi dan inflamasi lokal di daerah faring, laring, dan trakea akibat trauma pemasangan pipa endotrakeal. Penelitian ini bertujuan mengetahui efek tablet hisap Strepsils® untuk mengurangi POST pada pasien yang dilakukan anestesi umum dengan intubasi pipa endotrakeal. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan Oktober–November 2013, terhadap 66 pasien status fisik American Society of Anesthesiologist (ASA) I–II secara prospektif single blind randomized controlled trial. Pasien dibagi menjadi dua kelompok, yaitu kelompok I, sebanyak 33 orang mendapatkan Strepsils® dan kelompok II, sebanyak 33 orang mendapatkan plasebo. Pasien diminta untuk mengulum permen sebelum induksi. Data dianalisis dengan uji-t, uji chi-kuadrat, dan Uji Mann-Whitney. Keluhan POST lebih banyak terjadi pada kelompok II dibandingkan dengan kelompok I. Secara statistik pada T0 didapatkan hasil perbedaan yang bermakna (p<0,05). Pada kelompok II, POST dengan skor 1 sebesar 14 (42%) kasus, dibandingkan dengan kelompok I sebesar 3 (9%) kasus dan tidak ada skor 2. Pada T2 didapatkan hasil perbedaan bermakna (p<0,05), POST sebesar 11 (33%) pada kelompok II, sedangkan kelompok I didapatkan 2(6%) kasus. Pada T4 didapatkan perbedaan tidak bermakna (p>0,05), POST pada kelompok II sebesar 3 (9%) kasus, sedangkan kelompok I skor 1 sebesar 1 (3%) kasus. Simpulan, pemberian Strepsils® praoperasi dengan anestesi umum mengurangi kejadian dan derajat POST.Kata kunci: Analgetik, antiinflamasi, Strepsils®, post operative sore throat Strepsils® as Pre-operative Lozenge to Attenuate Post-endotracheal Tube Intubation Related Sore Throat AbstractPost- operative sore throat (POST) is caused by local inflammation and irritation at pharynx and larynx due to traumatic endotracheal tube installation. Sixty six patients, ASA I–II, who underwent elective surgery under general anesthesia and installation of endotracheal tube were enrolled in this single blind randomized controlled trial. Patients were randomly allocated into two groups of 33 subjects: receiving Lozenge and receiving placebo. Designated as Group I (Strepsils®  group) and Group II (Placebo group). Patients were asked to suck the candy slowly in the mouth before the induction of anesthesia.  Data were analyzed with t-test, Chi-square test and Mann-Whitney test using SPSS ver. 13 program for Windows. The results were POST 9.1% and 42.4% at T0, 6.1% and 33.3% at T2 for Strepsils®  and Placebo groups, respectively, which were statistically significant (p<0.05). In T4 and T24, non-significant differences were found (p>0.05). In conclusion, dissolving Strepsils® slowly in the mouth before induction of anesthesia pre-operatively reduces POST following general anesthesia.Key words: Analgetic, antiinflammatory, Strepsils®, post operative sore throat DOI: 10.15851/jap.v2n3.334
Reliabilitas dan Validitas Penilaian Skala Sedasi Richmond Agitation Sedation Scale (RASS) dan Ramsay pada Pasien Kritis dengan Ventilasi Mekanik di Ruang Perawatan Intensif Suhandoko, -; Pradian, Erwin; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penggunaan secara rutin skala subjektif untuk nyeri, agitasi, dan sedasi akan mendorong penatalaksanaan yang lebih efektif pada pasien untuk mencapai titik akhir yang spesifik. Setiap metode subjektif skala sedasi harus dievaluasi dalam hal reliabilitas dan validitas. Tujuan penelitian untuk mengetahui reliabilitas dan validitas skala Richmond Agitation Sedation Scale (RASS) dan Ramsay pada pasien kritis yang dirawat dengan ventilasi mekanik di ruang perawatan intensif. Jumlah subjek penelitian 82 pasien yang dinilai dengan skala sedasi RASS dan Ramsay setelah diberikannya obat analgesia dan sedasi. Penelitian observasional deskriptif yang dilakukan berdasarkan urutan datang pasien selama 4 bulan penelitian dari Mei–Agustus 2014. Metode Alpha Cronbach untuk menentukan reliabilitas dan Rank Spearman untuk menentukan validitas. Hasil penelitian ini didapatkan Skala RASS dengan nilai reliabilitas tertinggi Alpha Cronbach (α):0,951, serta nilai validitas tertinggi dengan Rank Spearman (rs):0,743. Skala Ramsay dengan nilai reliabilitas tertinggi Alpha Cronbach (α):0,921, serta nilai validitas tertinggi dengan Rank Spearman (rs):0,922. Simpulan dari penelitian ini adalah skala RASS menunjukkan keandalan dan koefisien validitas lebih tinggi daripada skala Ramsay. Kata kunci: Penilaian skala sedasi, reliabilitas, validitasRichmond Agitation Sedation Scale (RASS) and Ramsay Assessment Reliability and Validity in Critically Ill Patients with Mechanical Ventilation Support in Intensive Care Unit Routine use of subjective scales for pain, agitation, and sedation promotes more effective patient management in order to reach specific end-points. Each subjective sedation scale method should be evaluated in terms of its reliability and validity. The purpose of this study was to fassess the reliability and validity of Richmond Agitation Sedation Scale (RASS) and Ramsay scale. Subjects were 82 (eighty two) patients assessed using RASS and Ramsay sedation scale after receiving analgesia and sedation drug. This study was an observational study with cross sectional descriptive sampling conducted in consecutive patients sampling within a period of 4 months during May–August 2014. The results of the assessment were analyzed using Alpha Cronbach to determine the reliability and Rank Spearman to test the validity. It was revealed that  RASS scale had the highest reliability value with Alpha Cronbach (α):0.951 and the highest validity with Rank Spearman (rs):0.743 while the highest reliablity value achieved using the Ramsay scale was Alpha Cronbach (α):0.921 with Rank Spearman (rs): 0.922 as the highest validity score. It is concluded, therefore, that the RASS scale shows higher reliability and validity coefficients than the Ramsay scale. Key words: Assessment sedation scale, reliability, validity DOI: 10.15851/jap.v2n3.330
Pemberian Magnesium Sulfat Intravena Meningkatkan Efek Analgesia Pascaoperasi pada Bedah Mayor Menggunakan Anestesi Umum Irawan, Hengki; Subagiartha, I Made; Widnyana, I Made Gede
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Penatalaksanaan nyeri akut pascaoperasi merupakan tugas penting dokter anestesi. Morfin banyak digunakan untuk mengontrol nyeri pascaoperasi. Tujuan penelitian ini untuk mengetahui pengaruh pemberian MgSO4 intravena selama operasi terhadap efek analgesia dan kebutuhan morfin pascaoperasi. Penelitian ini adalah uji klinik blok tersamar ganda. Tiga puluh enam subjek usia 21–55 tahun dialokasikan ke dalam kelompok A yang diberikan MgSO4 30 mg/kgBB intravena 15 menit dilanjutkan 15 mg/kgBB/jam sampai akhir operasi dan kelompok B diberikan NaCl 0,9% dengan volume sama yang menjalani operasi bedah mayor di RSUP Sanglah Denpasar pada Juni–Agustus 2014. Data hasil penelitian dianalisis dengan Uji Mann-Whitney. Nilai visual analog scale (VAS) diam dan bergerak pada jam ke-4 dan ke-8 pada kelompok Mg berbeda bermakna (p<0,05). Perbedaan konsumsi morfin pascaoperasi pada jam ke-4, ke-8, dan ke-24 berbeda bermakna (p<0,05). Simpulan penelitian ini adalah pemberian MgSO4 intravena selama operasi meningkatkan efek analgesia dan menurunkan kebutuhan morfin pascaoperasi.Kata kunci: Analgesia pascaoperasi, anestesi umum, bedah mayor, magnesium sulfatIntravenous Magnesium Sulphate Administration to Improve Post-operative Analgesia Effect in Major Surgery with General AnesthesiaAbstractRelieving acute post-operative pain is an important role of anesthesiologist. Morphine is frequently used to control moderate to severe post operative pain. The objective of this study is to understand the effect of intravenous MgSO4 administration in improving post-operative analgesia effect. This study was a double-blind randomized block clinical trial. The subjects of this study were patients who underwent major surgeries in Sanglah Hospital during the period of June to August 2014. Thirty six subjects age 21–55 years allocated to group A received intravenous MgSO4 30 mg/kgBW intravenous bolus in 15 minutes followed by 15 mg/kgBW/hour until the surgery is finished and group B received NaCl 0.9% with the same volume. Data were then analyzed using  the Mann-Whitney Test. The stationary and mobile VAS scores in the  4th and 8th hour in Mg group were significantly different (p<0.05). Post-operative morphine consumptions in the 4th, 8th, and 24th hour were significantly different between the Mg and NaCl 0.9% groups (p<0.05). It is concluded that the administration of  intravenous MgSO4 during operation increases analgesia effect and reduces post-operative morphine needKey words: General anesthesia, magnesium sulfate, major surgery, post-operative analgesia DOI: 10.15851/jap.v2n3.335
CO2 Gap Sebagai Prediktor Tingkat Mortalitas Pasien Sepsis Berat di Intensive Care Unit Wiraatmaja, Immanuel; Oktaliansah, Ezra; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Tingkat mortalitas pasien sepsis berat di Intensive Care Unit (ICU) dihitung dengan menggunakan skor Acute Physiology and Chronic Health Evaluation (APACHE) II dan memerlukan pemeriksaan yang banyak serta kompleks. Peningkatan p (vena-arteri)CO2 (CO2 gap) berhubungan dengan penurunan indeks jantung, karena itu diharapkan CO2 gap memiliki kemampuan untuk menentukan tingkat mortalitas pasien sepsis berat. Penelitian ini bertujuan untuk mengetahui kegunaan CO2 gap sebagai prediktor tingkat mortalitas pasien sepsis berat di ICU Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung yang lebih mudah serta murah.Penelitian ini dilakukan secara prospektif observasional terhadap 50 orang. Penelitian dilakukan di ICU RSHS Bandung dari bulan Agustus 2013–Januari 2014. Setiap subjek penelitian diperiksa nilai CO2 gap. Subjek dibagi ke dalam 2 kelompok berdasarkan nilai CO2 gap menjadi kelompok nilai CO2gap tinggi (nilai CO2 gap ≥6) dan nilai CO2 gap  rendah (nilai CO2 gap<6). Penilaian ulang dilakukan pada hari ke-28 untuk masing-masing kelompok untuk menilai adakah pasien dalam kelompok tersebut yang meninggal. Hasil penelitian menunjukan bahwa CO2 gap memiliki sensitivitas 94,7%; spesifisitas 90,3%; positive predictive value 85,7%; negative predictive value 96,5%; likelyhood ratio positive CO2 gap 9,76; dan likelyhood ratio negative CO2 gap adalah 0,05. Simpulan penelitian adalah CO2 gap dapat digunakan untuk melakukan prediksi tingkat mortalitas pasien sepsis berat.Kata kunci: CO2 gap, mortalitas, sepsisCO2 Gap as a Mortality Incidence Predictor for Severe Sepsis Patient  in Intensive Care Unit The mortality rate of severe sepsis patients in Intensive Care Unit (ICU) is measured by using the Acute Physiology and Chronic Health Evaluation (APACHE) II score, which need various complex examinations. Increased p(venous-arterial) CO2(CO2 gap) relates to decreased cardiac index; therefore, it is expected that CO2 gap can be used to predict mortality incidence in severe sepsis patients in the ICU of Dr. Hasan Sadikin General Hospital (RSHS).This study was a prospective study on 50 patients who met severe sepsis criteria conducted in the ICU of RSHS Bandung from August 2013 to January 2014. The CO2 gap was be measured in all the patients. Subjects were divided into two groups according to the CO2 gap value, i.e. high CO2 gap (≥6) and low CO2 gap (<6). Subjects were then assessed on the 28th day to observe the mortality incidence the respective group. It was shown that a CO2 gap value had a sensitivity of 94.7%, specificity of 90.3%, positive predictive  value of 85.7%, and the negative predictive value of 96.5%. The likelihood ratio of  positive CO2 gap  and negative CO2 gap were 9.76 and 0.05, respectively. In conclusion, CO2 gap can be used to predict the mortality incidence in severe sepsis patients in the ICU of RSHS Bandung. Key words: CO2 gap, mortality, sepsis DOI:10.15851/jap.v2n3.331
Perbandingan Pemberian Parecoxib Na 40 mg Intravena Preoperatif dengan Pascaoperatif dalam Penatalaksanaan Nyeri Pascaoperatif pada Operasi Laparotomi Ginekologis Anom Yuswono, Ardhana Risworo; Maskoen, Tinni T.; Fuadi, Iwan
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Multimodal analgesia dan preemptive analgesia menjadi terapi yang efektif dalam penatalaksanaan nyeri pascaoperatif. Tujuan penelitian ini adalah untuk menganalisis perbandingan pemberian parecoxib Na 40 mg intravena preoperatif dengan pascaoperatif terhadap nilai NRS. Penelitian ekperimental dengan rancangan analisis komparatif dilaksanakan dari Maret–Juni 2013. Subjek adalah wanita usia 18-60 tahun yang menjalani operasi laparatomi ginekologis dengan anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung. Subjek terdiri atas 18 orang pada masing masing kelompok. Parecoxib Na 40 mg diberikan pada dua kelompok perlakuan, yaitu pre atau pascaoperatif. Tramadol 200 mg diberikan pascaoperatif pada semua kelompok dan dilakukan penilaian NRS di ruang pemulihan. Nilai NRS 1 lebih banyak ditemukan pada kelompok I, nilai NRS 3 lebih banyak didapatkan pada kelompok II. Nilai NRS pada kelompok I didapatkan nyeri ringan 15 orang dan nyeri sedang 3 orang. Pada kelompok II didapatkan nyeri ringan 15 orang dan nyeri sedang 3 orang, berdasarkan analisis uji chi-kuadrat tidak terdapat perbedaan nilai NRS kedua kelompok. Tidak didapatkan subjek yang memerlukan analgetik tambahan. Simpulan penelitian ini adalah bahwa tidak terdapat perbedaan antara pemberian parecoxib Na 40 mg preoperatif dan pascaoperatif dalam penatalaksanaan nyeri pascaoperatif. Efek analgetik yang lebih baik didapatkan pada pemberian parecoxib Na preoperatif dengan nilai NRS yang lebih rendah. Kata kunci: Laparatomi ginekologis, numerical rating scale, parecoxib Na, preoperatif, pascaoperatifComparison of Pre-operative and Post-operative Intravenous 40 mg Parecoxib Na in Gynecologic Laparatomy Surgery Post-Operative Pain Management AbstractMultimodal analgesia regimens  and preemptive analgesia will improve post- operative  pain relief. The purpose of this study was to compare pre- and post- operative parecoxib 40 mg intravenous to NRS value. This experimental study with comparative analytical method was conducted in women 18 to 60 years old who underwent gynecologic laparatomy at Dr. Hasan Sadikin General Hospital Bandung during the period of March to June 2013. Subjects consisted of 18 women for each pre-operative and post-operative group. Parecoxib 40 mg were given to the two groups, pre-operative (group I) and post-operative (group II), while intravenous tramadol 200 mg was also also given to all groups post-operatively. The NRS was calculated at recovery room. NRS value 1 was more frequent in group I while the NRS value 3 more frequent in group II. NRS values  in group I: 15 with mild pain (83.3%), 3 with moderate pain (16.7%). In group II the values were 15 with mild pain (83.3%), 3 with moderate pain (16.7%), which was not significant. In conclusion, there is no difference between pre-operative and post-operative parecoxib sodium 40 mg for post operative pain management. There is a better analgetic effect in the group with pre-operative parecoxib which is apparent from lower NRS.Key words: Gynecological laparatomy, numerical rating scale, parecoxib Na, post operative, pre operative DOI: 10.15851/jap.v2n3.327
Efektivitas Pemberian Cairan Praoperatif Ringer Laktat 2 mL/kgBB/jam Puasa untuk Mencegah Mual Muntah Pascaoperasi Wijaya, Andi Ade; Fithrah, Bona A.; Marsaban, Arif H. M.; Hidayat, Jefferson
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Teknik nonfarmakologi yang dapat dilakukan untuk menurunkan angka kejadian mual muntah pascaoperasi adalah pemberian cairan praoperatif. Tujuan penelitian ini untuk mengetahui efektivitas pemberian cairan praoperatif Ringer laktat 2 mL/kgBB/jam puasa untuk menurunkan angka kejadian mual muntah pascamastektomi. Penelitian ini merupakan uji klinis acak yang dilakukan pada bulan Maret–April 2013 di Rumah Sakit Kanker Dharmais, Rumah Sakit Persahabatan, Rumah Sakit Fatmawati, dan Rumah Sakit Cipto Mangunkusumo Jakarta, pada pasien status fisik American Society of Anesthesiologist (ASA) 1–2. Sebanyak 102 pasien diacak ke dalam kelompok hidrasi dan kelompok kontrol. Analisis data dilakukan menggunakan uji chi-kuadrat. Terdapat perbedaan yang signifikan dalam kejadian mual pada 0–1 jam pascaoperasi (kelompok hidrasi 20% vs kelompok kontrol 39%) dan pada 0–24 jam pascaoperasi (kelompok hidrasi 22% vs kelompok kontrol 41%). Walaupun tidak berbeda secara statistik, angka kekerapan mual pada 1–24 jam pascaoperasi lebih rendah pada kelompok hidrasi 12% (6) dibandingkan dengan kelompok kontrol 23% (12). Tidak ada perbedaan secara statistik pada angka kekerapan muntah di kedua kelompok penelitian. Pemberian cairan praoperatif Ringer laktat 2 mL/kgBB/jam puasa efektif untuk menurunkan angka kejadian mual pascaoperasi mastektomi pada 1 jam pertama pascaoperasi.  Kata kunci: Cairan praoperatif, mastektomi, mual muntah pascaoperasi Effectiveness of Pre-operative Lactated Ringer’s Solution 2 mL/kgBW/h in Fasting Patients to Prevent Post-operative Nausea and Vomiting Non pharmacologic approaches to overcome post operative nausea and vomiting include giving pre-operative hydration. The objective of this study was to learn the efficacy of pre-operative lactated Ringer’s solution (2 mL/kgBW/hour) in fasting patients to overcome the post-operative nausea and vomiting in mastectomy surgery. This study was a randomized clinical trial that conducted in March to April 2013 in Dharmais Hospital-National Cancer Center,  Persahabatan Hospital, Fatmawati Hospital, and Rumah Sakit Cipto Mangunkusumo Jakarta to patients with  American Society of Anesthesiologist (ASA) physical status 1–2. A total of 102 patients were randomized into the hydration group and control group. Data analysis was performed using chi-square test or appropriate test using SPSS ver. 15. There were statistically significant differences in the incidence of nausea at 0–1 hour post-operative (19.6% in hydration group vs. 39.2% in control group) and at 0–24 hours post-operative (21.6% in hydration group vs. 41.2% control group). The incidence of 1–24 hours PONV, although not statistically significant, was higher in the control group (11.8% in hydration group vs. 23.5% in control group). There was no difference in vomiting incidence between the two groups. Pre-operative lactated Ringer’s solution 2 mL/kgBW/hour in fasting patients effectively reduces the incidence of post-operative nausea one hour after operation. Key words: Mastectomy, post-operative nausea and vomiting pre-operative hydration DOI: 10.15851/jap.v2n3.332
Hubungan Lima Parameter Kraniofasial dengan Skor Cormack-Lehane pada Anak Indonesia Usia 4–12 Tahun Kapuangan, Christoper; Tanod, Jemmy Wilson; Wijaya R., Andi Ade; Soenarto, Ratna Farida
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penilaian jalan napas sangat penting dilakukan, terutama pada pasien anak. Pedoman yang ada pada dewasa tidak dapat dipakai pada populasi pediatri. Tujuan penelitian ini untuk mengetahui hubungan antara lima ukuran parameter kraniofasial dan skor Cormack-Lehane pada populasi anak usia 4–12 tahun di Indonesia. Penelitian ini bersifat observasional analitik yang dilakukan di Rumah Sakit Dr. Cipto Mangunkusumo Jakarta dari Maret sampai September 2013. Pengumpulan data dilakukan secara berurutan pada 134 pasien yang menjalani anestesia umum. Pengukuran dilakukan dari jarak tepi bawah bibir ke ujung mentum, jarak angulus mandibula ke ujung mentum, jarak tragus telinga ke sudut bibir, jarak mentohioid dan jarak antara angulus mandibula kanan dan kiri. Tingkat kesulitan laringoskopi dinilai menggunakan skor Cormack-Lehane, kemudian dibagi menjadi mudah dan sulit. Analisis data dilakukan menggunakan Uji Mann-Whitney dan uji-t tidak berpasangan untuk mencari hubungan antara lima parameter tersebut dan skor Cormack-Lehane. Penelitian ini tidak mendapatkan hubungan yang bermakna antara semua parameter kraniofasial di atas dan skor Cormack Lehane (nilai p berturut adalah 0,349; 0,638; 0,499; 0,765; dan 0,301). Simpulan, pada populasi anak Indonesia usia 4–12 tahun, lima parameter kraniofasial tidak dapat digunakan untuk prediksi kesulitan visualisasi laring.Kata kunci: Jalan napas, parameter kraniofasial, pediatri, skor Cormack-LehaneAssociation between Five Craniofacial Parameters and Cormack-Lehane Score in 4 to 12 Years-old Indonesian Paediatric Patients AbstractAirway assessment is very important, especially in pediatric patients. Adult airway guidelines can not be applied to pediatric population. The aim of this study was to determine the association between five craniofacial parameters and the Cormack-Lehane scores in 4 to 12 year-old Indonesian pediatric patients. This was an observational analytic study conducted in RSUPN Cipto Mangunkusumo from March to September 2013. Data were collected consecutively on 134 patients who underwent general anesthesia. The distance of the lower lip to mentum, mandibular angle to mentum, ear tragus to mouth, mentohyoid distance and distance of left and right mandibles were measured. Laryngoscopic difficulty levels were assessed using Cormack-Lehane score and divided into two groups: easy and difficult. Data analysis was performed using the Mann-Whitney Test and unpaired t-test to find the association between those five parameters and the Cormack-Lehane score. This study did not find any significant relationshis between all craniofacial parameters above and Cormack Lehane scores (p values: 0.349, 0.638, 0.499, 0.765, and 0.301 respectively). We concluded that in Indonesian pediatric population aged 4 to 12 years, the five craniofacial parameters cannot be used to predict laryngeal visualization.Key words: Airway, pediatric, Cormack-Lehane score DOI: 10.15851/jap.v2n3.328
Letak Conus Medularis terhadap Vertebra Menggunakan Hasil Pencitraan Magnetic Resonance Imaging di Rumah Sakit Dr. Hasan Sadikin Bandung untuk Anestesi Spinal Nurfitriani, -; Nawawi, Abdul Muthalib; Yadi, Dedi Fitri; Anwary, Farhan
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kepentingan dari conus medularis bagi dokter spesialis anestesi adalah saat dilakukan tindakan anestesi spinal yang memiliki risiko terjadi trauma medula spinalis yang serius. Conus medularis dapat diidentifikasi melalui hasil pencitraan magnetic resonance imaging (MRI). Penelitian yang dilakukan sekarang bertujuan untuk mengetahui distribusi letak ujung conus medularis pada orang Indonesia secara observasional deskriptif dengan menggunakan hasil pencitraan magnetic resonance imaging (MRI) lumbosakral. Penelitian dilakukan melalui pemeriksaan terhadap letak ujung conus medularis secara retrospektif pada 135 hasil pencitraan MRI pasien usia 18–65 tahun dari bulan Januari 2013 hingga Maret 2014 di Departemen Radiologi Rumah Sakit Dr. Hasan Sadikin Bandung. Dari penelitian ini didapatkan letak ujung conus medularis paling banyak berada setinggi sepertiga tengah L1, dengan rentang mulai dari setinggi sepertiga tengah T12 hingga sepertiga bawah L2. Berdasarkan parameter jenis kelamin didapatkan distribusi letak conus medularis pada perempuan cenderung lebih kaudal dibandingkan dengan laki-laki.Kata kunci: Conus medularis, magnetic resonance imaging, orang IndonesiaDetermination of Conus Medullaris Position within the Vertebra using Magnetic Resonance Imaging in Dr. Hasan Sadikin General Hospital Bandung for Spinal Anesthesia PurposeAbstractThe position of conus medullaris is important to be identified by anesthesiologists during spinal anesthesia to avoid serious spinal cord trauma risk. Conus medullaris can be accurately identified through magnetic resonance imaging (MRI) images. The aim of this study was to determine the distribution of conus medullaris in Indonesians through a descriptive observation using magnetic resonance imaging (MRI) images of lumbosacral. The locations of conus medullaris were observed retrospectively on 135 MRI images scanned, aged 18–65 years, during the period of January 2013 to March 2014 at the Departement of Radiology, Dr. Hasan Sadikin General Hospital Bandung. From this study, it was revealed that the conus medullaris are mostly located at the middle third of L1, ranging from the middle third of T12 to the lower third of L2. With gender as a parameter, it was shown that the distribution of conus medullaris in women tends  to be more caudal than in men.Key words: Conus medullaris, Indonesian, magnetic resonance imaging DOI: 10.15851/jap.v2n3.333
Letak Conus Medularis terhadap Vertebra Menggunakan Hasil Pencitraan Magnetic Resonance Imaging di Rumah Sakit Dr. Hasan Sadikin Bandung untuk Anestesi Spinal - Nurfitriani; Abdul Muthalib Nawawi; Dedi Fitri Yadi; Farhan Anwary
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1164.456 KB)

Abstract

Kepentingan dari conus medularis bagi dokter spesialis anestesi adalah saat dilakukan tindakan anestesi spinal yang memiliki risiko terjadi trauma medula spinalis yang serius. Conus medularis dapat diidentifikasi melalui hasil pencitraan magnetic resonance imaging (MRI). Penelitian yang dilakukan sekarang bertujuan untuk mengetahui distribusi letak ujung conus medularis pada orang Indonesia secara observasional deskriptif dengan menggunakan hasil pencitraan magnetic resonance imaging (MRI) lumbosakral. Penelitian dilakukan melalui pemeriksaan terhadap letak ujung conus medularis secara retrospektif pada 135 hasil pencitraan MRI pasien usia 18–65 tahun dari bulan Januari 2013 hingga Maret 2014 di Departemen Radiologi Rumah Sakit Dr. Hasan Sadikin Bandung. Dari penelitian ini didapatkan letak ujung conus medularis paling banyak berada setinggi sepertiga tengah L1, dengan rentang mulai dari setinggi sepertiga tengah T12 hingga sepertiga bawah L2. Berdasarkan parameter jenis kelamin didapatkan distribusi letak conus medularis pada perempuan cenderung lebih kaudal dibandingkan dengan laki-laki.Kata kunci: Conus medularis, magnetic resonance imaging, orang IndonesiaDetermination of Conus Medullaris Position within the Vertebra using Magnetic Resonance Imaging in Dr. Hasan Sadikin General Hospital Bandung for Spinal Anesthesia PurposeAbstractThe position of conus medullaris is important to be identified by anesthesiologists during spinal anesthesia to avoid serious spinal cord trauma risk. Conus medullaris can be accurately identified through magnetic resonance imaging (MRI) images. The aim of this study was to determine the distribution of conus medullaris in Indonesians through a descriptive observation using magnetic resonance imaging (MRI) images of lumbosacral. The locations of conus medullaris were observed retrospectively on 135 MRI images scanned, aged 18–65 years, during the period of January 2013 to March 2014 at the Departement of Radiology, Dr. Hasan Sadikin General Hospital Bandung. From this study, it was revealed that the conus medullaris are mostly located at the middle third of L1, ranging from the middle third of T12 to the lower third of L2. With gender as a parameter, it was shown that the distribution of conus medullaris in women tends  to be more caudal than in men.Key words: Conus medullaris, Indonesian, magnetic resonance imaging DOI: 10.15851/jap.v2n3.333

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