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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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Prevalensi dan Faktor Risiko Nyeri Punggung Bawah di Lingkungan Kerja Anestesiologi Rumah Sakit Dr. Hasan Sadikin Bandung Patrianingrum, Meilani; Oktaliansah, Ezra; Surahman, Eri
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Nyeri punggung bawah (NPB) merupakan masalah kesehatan yang banyak dialami oleh tenaga kesehatan. Tujuan penelitian ini untuk mengetahui prevalensi dan faktor risiko nyeri punggung bawah di lingkungan kerja anestesiologi dan terapi intensif Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung. Penelitian ini merupakan penelitian deskriptif dengan rancangan studi potong silang. Subjek penelitian meliputi seluruh peserta pendidikan dokter spesialis (PPDS) dan konsulen anestesiologi di RS Dr. Hasan Sadikin Bandung periode bulan April─Juni 2014. Analisis data dilakukan dengan uji chi-kuadrat, Eksak Fisher dan Kolmogorov Smirnov. Hasil penelitian menunjukkan bahwa prevalensi nyeri punggung bawah yang timbul setelah masuk dalam lingkungan kerja anestesiologi di RSHS adalah 35,7%. Faktor risiko yang signifikan adalah kebiasaan merokok (RR 1,35)  dan kurang olahraga (RR 80,04). Faktor posisi saat melakukan tindakan anestesi signifikan menimbulkan nyeri punggung bawah. Simpulan, prevalensi nyeri punggung bawah setelah masuk lingkungan kerja anestesiologi RSHS Bandung adalah 35,7% dengan faktor risiko adalah merokok dan kurang olahraga. Faktor posisi selama melakukan tindakan anestesi bersama-sama dengan faktor risiko lain mungkin turut memperberat nyeri punggung bawah. Kata kunci: Anestesi, faktor risiko, nyeri punggung bawah, prevalensiPrevalence and Risk Factors of Lower Back Pain in the Anesthesiology Workplace in Dr. Hasan Sadikin General Hospital BandungAbstractLower back pain (LBP) is a common health problem in many health professionals. The purpose of this study was to determine the prevalence and risk factors causing lower back pain in the anesthesiology workplace at Dr. Hasan Sadikin Hospital General Bandung. This research is a descriptive study with cross-sectional design. Subjects on this research were the anesthesiology residents and consultants in Dr. Hasan Sadikin General Hospital Bandung between April and June 2014. Data analysis was performed by chi-square, Exact Fisher and Kolmogorov Smirnov. The results showed that the prevalence of lower back pain that arises after entering the anesthesiology workplace in Dr. Hasan Sadikin General Hospital Bandung was 37.5%. The significant risk factors were smoking (RR 1.348)  and lack of exercise (RR 80.04) while the position factor during conducting anesthesia did not significantly cause lower back pain. The conclusions of this study indicate that the prevalence of low back pain that arises after entering the anesthesiology and intensive therapy workplace in Dr. Hasan Sadikin General Hospital Bandung is 37.5%.  In addition, the risk factors that significantly cause lower back pain in the anesthesiology and intensive therapy workplace in Dr. Hasan Sadikin General Hospital Bandung were smoking and lack of exercise. The position factor during conducting anesthesia together with other risk factors may contribute to the arising of lower back pain. Key words: Anesthesia, lower back pain, prevalence, risk factors DOI: 10.15851/jap.v3n1.379  
Perbandingan Efek Pemberian Norepinefrin Bolus Intravena dengan Norepinefrin Infus Kontinu dalam Tatalaksana Hipotensi, Laju Nadi, dan Nilai APGAR pada Seksio Sesarea dengan Anestesi Spinal Sumardi, Fitri Sepviyanti; Nawawi, Abdul Muthalib; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Vasopresor sering digunakan dalam tatalaksana hipotensi anestesi spinal pada seksio sesarea. Penelitian bertujuan membandingkan efek pemberian norepinefrin bolus intravena dengan norepinefrin infus kontinu dalam tatalaksana hipotensi pada anestesi spinal pasien seksio sesarea dan pengaruh pada laju nadi serta nilai APGAR. Penelitian bersifat eksperimental acak tersamar ganda pada 44 ibu hamil status fisik American Society of Anesthesiologist (ASA) II yang menjalani seksio sesarea dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin Bandung pada September–November 2013. Subjek penelitian dibagi menjadi 2 kelompok yaitu kelompok  norepinefrin bolus intravena 4 µg (NB) dan kelompok norepinefrin infus kontinu 8 µg/menit (NK). Data dianalisis dengan uji-t, Uji Mann-Whitney, chi-kuadrat dan uji-t analysis of variance (ANOVA), nilai p<0,05 dianggap bermakna. Hasil penelitian menunjukkan bahwa peningkatan tekanan darah sistol, diastol, dan rata-rata lebih tinggi pada kelompok NB (p=0,000). Perubahan laju nadi secara umum pada kedua kelompok relatif stabil dan nilai APGAR menunjukkan perbedaan yang tidak bermakna (p>0,05). Simpulan penelitian ini adalah kedua cara pemberian norepinefrin ini dapat digunakan dalam tatalaksana hipotensi anestesi spinal tanpa memengaruhi laju nadi dan nilai APGAR.   Kata kunci: Anestesi spinal, hipotensi, nilai APGAR, norepinefrin, seksio sesareaEffect of Intravenous Norepinephrine Bolus and Norepinephrine Continuous Infusion on Hypotension Management, Heart Rate, and APGAR Score in Caesarean Section Patient under Spinal AnesthesiaAbstractVasopresors are commonly used for the treatment of hypotension in spinal anesthesia for cesarean section. This research aimed to compare intravenous bolus of norepinephrine to continuous infusion of norepinephrine effectiveness in hypotension management in caesarean section patient under spinal anesthesia and their effect on heart rate and APGAR Score, The experimental study was conducted in a double-blind randomized manner to 44 American Society of Anesthesiologist (ASA) physical status II pregnant women undergoing cesarean section with spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung within the period of September to -November 2013. The Study  subjects were grouped into two groups, the first group received 4 µg intravenous bolus of norepinephrine group (NB) and and the second received 8 µg/minute continuous infusion of norepinephrine group (NK).  Data were analyzed by t-test, Mann-Whitney test, chi-square and analysis of variance (ANOVA) t-test with p<0.05 was considered significant. The results showed that the increase in systolic, diastolic and mean arterial blood pressures were higher in the NB group (p=0.000). Changes in heart rate were generally relatively stable in both groups and APGAR score showed a non-significant difference (p>0.05). Conclusion from this study is the administration of norepinephrine in both ways can be used for the treatment of hypotension of spinal anesthesia without affecting the heart rate and APGAR scoreKey words: APGAR score, caesarean section, hypotension, norepinephrine, spinal anaesthesia DOI: 10.15851/jap.v3n1.375  
Perbandingan antara Sevofluran dan Enfluran terhadap Kontraksi Uterus, Jumlah Perdarahan, dan Skor APGAR pada Seksio Sesarea Elektif Resvita, RR. Pramada; Redjeki, Ike Sri; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Anestetika volatil memiliki sifat fisikokimia yang berbeda-beda yang akan memberikan pengaruh berbeda juga terhadap kontraksi uterus,  jumlah perdarahan dan skor APGAR. Tujuan penelitian ini adalah menilai perbedaan pengaruh antara sevofluran dan enfluran terhadap kontraksi uterus, jumlah perdarahan, dan skor APGAR. Penelitian ini adalah randomized controlled trial (RCT) pada 36 pasien seksio sesarea elektif di Rumah Sakit Melinda pada Juni–Agustus 2011. Pasien dibagi dalam dua kelompok: kelompok I (sevofluran) dan kelompok II (enfluran). Analisis data hasil penelitian dilakukan dengan melakukan uji-t,  Fisher’s Exact Test, dan Uji Mann-Whitney. Hasil penelitian menunjukkan bahwa kontraksi uterus lebih baik pada kelompok sevofluran (p<0,05) dan jumlah perdarahan lebih sedikit pada kelompok sevofluran (p<0,05). Tidak didapatkan perbedaan yang signifikan untuk skor APGAR (p>0,05). Simpulan penelitian ini adalah kontraksi uterus pada seksio sesarea dengan sevofluran lebih baik dibandingkan dengan enfluran dan jumlah perdarahan lebih sedikit pada sevofluran. Skor APGAR pada kedua kelompok tidak menunjukkan perbedaan.Kata kunci: Enfluran, jumlah perdarahan, kontraksi uterus (LAS), seksio sesarea, sevofluran, skor APGARComparison between Sevoflurane and Enflurane Effects on Uterine Contraction, Amount of Bleeding, and APGAR Score in Elective Caesarean SectionAbstractDifferent volatile agents with different physicochemical properties affect uterine contraction, amount of bleeding, and APGAR score in different ways. The objective of this study was to evaluate the effects of different volatile agents, i.e., sevoflurane and enflurane, on  uterine contraction, amount of bleeding, and APGAR score. A randomized controlled trial (RCT) was conducted on 36 patients undergoing elective caesarean section. These patients were randomly divided into two groups, group I (sevoflurane) and group II (enflurane). The data were analyzed using t-test, Mann-Whitney, and fisher exact tests. The result of this study showed that there was a significant difference in the strength of uterine contraction among the sevoflurane group and the enflurane group (p<0.05) and also a significant difference in the amount of bleeding among the two groups (p<0.05), with better results seen ion the sevoflurane group. However, there was no significant difference found oin the APGAR score among the two groups. It is concluded in this study that sevoflurane gives better results in terms of uterine contraction with less bleeding compared to the enflurane group. No difference is found in the APGAR score in sevoflurane and enflurane groups.Key words: Amount of bleeding,  APGAR score, caesarean section, enflurane, sevoflurane, uterine contraction (LAS) DOI: 10.15851/jap.v3n1.381  
Perbandingan Penambahan Klonidin Intratekal 15 µg dan 30 µg pada 12,5 mg Bupivakain 0,5% terhadap Kejadian Menggigil Pascaanestesi Spinal pada Seksio Sesarea Yusup Mansur, Iman Muhammad; Pradian, Erwin; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
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Menggigil pascaanestesi spinal merupakan efek samping yang sering terjadi. Penelitian ini bertujuan untuk membandingkan penambahan klonidin intratekal antara 15 µg dan 30 µg pada 12,5 mg bupivakain. Penelitian adalah eksperimental dengan uji klinis rancangan acak lengkap terkontrol buta tunggal pada 80 wanita yang menjalani seksio sesarea dengan anestesi spinal,  status fisik American Society of Anesthesiologist (ASA) II, berusia 18–42 tahun, dibagi secara random menjadi dua kelompok, kelompok I menggunakan 12,5 mg bupivakain 0,5 % dan klonidin 15 µg, sedangkan kelompok II mendapat penambahan klonidin 30 µg. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada periode Oktober–Desember 2011. Perbandingan proporsi kejadian kedua kelompok dianalisis secara statistik menggunakan uji chi-kuadrat, sedangkan derajat menggigil dengan Uji Mann-Whitney. Hasil penelitian menunjukkan bahwa kejadian menggigil pascaanestesi pada kelompok II sebanyak 2 pasien, sedangkan pada kelompok I adalah 10 pasien. Simpulan, penambahan klonidin intaratekal 30 µg pada bupivacain 0,5% untuk mencegah menggigil pascaanestesi spinal lebih baik dibandingkan dengan klonidin intratekal 15 µg. Kata kunci: Klonidin intratekal, menggigil pascaanestesi, mencegah menggigil, suhu intiComparison of  15 µg  and 30 µg Intrathecal Clonidine in 12.5 mg 0.5% Bupivacain for Post Spinal Anesthesia Shivering in Caesarean SectionAbstractShivering is a frequently experienced side effect of post-subarachnoid block. This study aimed to determine the which of 15 µg  dose and 30 µg dose of intrathecal Clonidine is better prevents Post anaesthesia shivering. The research was conducting by clinical trials of a single blind randomized controlled design. Eighty pregnant female patients with ASA physical status II, aged 18–42 years, who underwent a caesarean section were randomly divided into two groups, spinal anesthesia performed by using 12.5 0.5% mg bupivacain and 15 µg clonidine in Group I and the same dose of bupicavain but with 30 µg clonidine in group II. The incidence proportion of both groups were statistically compared using chi square test, while the degree of shivering was analyzed using Mann-Whitney test. The results showed that the characteristics of patient data and the core temperature did not statistically different between the two groups. The incidence and degree of shivering were different between the two groups,  with were 2 patients experienced shivering incidence in group II and 10 patients experienced the incidence in group I. It is concluded that the addition of intrathecal 30 µg clonidine to 0.5% bupivacain prevents post-subarachnoid spinal block shivering better than in trathecal clonidine 15 µg.   Key words: Core temperature, intrathecal clonidine post anaesthesia shivering, prevent shivering
Penentuan Garis Interkrista Iliaka terhadap Vertebra dengan Teknik Palpasi untuk Kepentingan Blokade Neuroaksial yang Diproyeksikan oleh Pencitraan Ultrasonografi Safirta, Rian; Yadi, Dedi Fitri; Nawawi, Abdul Muthalib
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Blokade neuroaksial membutuhkan penanda anatomis sebagai panduan letak penyuntikan. Salah satu penanda anatomis yang dipakai adalah garis interkrista iliaka atau garis Tuffier. Berbagai penelitian menunjukkan variabilitas letak garis interkrista iliaka terhadap vertebra. Penelitian ini bertujuan untuk mengetahui letak garis interkrista iliaka yang dibentuk dengan teknik palpasi terhadap vertebra menggunakan pencitraan ultrasonografi. Penelitian ini merupakan penelitian deskriptif kategorik yang dilakukan secara prospektif observasional terhadap 56 subjek di Rumah Sakit Dr. Hasan Sadikin Bandung dari bulan Januari hingga Februari 2014. Setiap subjek penelitian dilakukan pencatatan usia dan jenis kelamin kemudian dilakukan pengukuran tinggi badan, berat badan, dan indeks massa tubuh. Setelah itu ditentukan garis interkrista iliaka masing-masing subjek penelitian dan dilakukan pencitraan menggunakan ultrasonografi untuk menentukan proyeksi terhadap vertebra. Data dikelompokkan secara kategorik sesuai parameter yang diukur sebelumnya. Hasil penelitian menunjukkan bahwa sebagian besar proyeksi garis interkrista iliaka terhadap vertebra adalah setinggi lumbar 3 yang didapatkan pada subjek penelitian laki-laki dengan karakteristik tinggi badan di atas rata-rata tinggi badan orang Indonesia. Simpulan penelitian adalah jenis kelamin dan tinggi badan memengaruhi letak proyeksi dari garis interkrista iliaka terhadap vertebra pada subjek.Kata kunci: Blokade neuroaksial, garis Tuffier, ultrasonografiThe Intercristal Line Location Identified by Palpation Towards Vertebrae for Neuraxial Blockade as Measured by Ultrasound Imaging AbstractIn order to perform neuraxial block, a marker is needed as a puncture guide. One of the markers used worldwide is the intercristal line or Tuffier’s line. Many studies have shown that the line location in vertebrae is variable; hence this study was conducted to identify the intercristal line location through palpation towards the vertebrae in Indonesian people, which was measured by ultrasound imaging. This study was a categorical descriptive research conducted prospectively towards 56 people who met the inclusion criteria in Dr. Hasan Sadikin General Hospital Bandung from January to February 2014. The subject’s age, sex, height, and weight were directly measured and recorded and body mass index was also calculated. The intercristal line was then drawn and ultrasonography was performed to identify the vertebral level of the line. The results were categorized according to the previous parameters. It was shown that most of the intercrestal lines  were located in lumbar 3 and they were mostly in men with above average height. In conclusion, sex and height are some of the factors that affect the intercristal line location towards the vertebraKey words: Neuraxial block, Tuffier’s line, ultrasound imaging DOI: 10.15851/jap.v3n1.380  
Gambaran Jenis Bakteri pada Ujung Kateter Epidural di Rumah Sakit Dr. Hasan Sadikin Bandung Hidayat, Indra Nur; Suwarman, -; Surahman, Eri
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Analgesia epidural merupakan metode yang efektif untuk tatalaksana pengelolaan  nyeri pascaoperatif. Meskipun jarang, infeksi dapat terjadi setelah proses pemasangan kateter epidural. Penelitian ini bertujuan untuk mengetahui apakah ada bakteri pada ujung kateter epidural dan bakteri apa yang tersering pada ujung kateter epidural. Penelitian ini adalah penelitian deskriptif  prospektif yang dilakukan terhadap 52 orang pasien yang menjalani anestesi epidural  dan digunakan sebagai analgetik epidural selama bulan Februari 2014 di Rumah Sakit Dr. Hasan Sadikin Bandung.  Anastesi epidural dipasang dengan tindakan aseptik dan antiseptik sebelum operasi dan kemudian digunakan sebagai analgetik epidural setelah hari ketiga kateter epidural dicabut dengan tindakan antiseptik dan  aseptik  sebelumnya kemudian dibuat apus mengunakan swab steril dan diperiksakan  kultur bakteri  di  laboratorium mikrobiologi, Patologi Klinik di Rumah Sakit Dr. Hasan Sadikin Bandung. Hasil penelitian ini didapatkan 14 dari 52 kateter epidural yang dipasang pada bulan Februari 2014 terkontaminasi oleh bakteri. S. epidermidis, S. hominis, dan Acinetobacter baumannii merupakan bakteri yang ditemukan pada ujung kateter epidural. Simpulan, didapatkan  hasil 26% dari 52 ujung kateter yang digunakan sebagai analgetik epidural  terkontaminasi oleh bakteri. Bakteri yang tersering yang ditemukan di dalam  rongga epidural adalah Staphylococcus epidermidis diikuti oleh Staphylococcus hominis dan  Acinetobacter baumannii.Kata kunci: Analgesia epidural, kultur bakteri, ujung kateter epiduralBacterial Profile of Epidural Catheters Tips in Dr. Hasan Sadikin General Hospital BandungAbstractEpidural analgesia is an effective method for post-operative pain management. Although rare, the infection may occur after an epidural catheter insertion process.  There are very few reported cases; however some cases of infection, such as epidural abscess, is are  serious and  life threatening cases if not diagnosed early and treated well. The aim of this study was to prove the presence of bacterial contamination on epidural catheters tips and to describe the kind of bacteria found. This descriptive prospective study  was  conducted on 52 patients who  used  epidural anesthesia and epidural analgesics during the month of February 2014 in Dr Hasan Sadikin Hospital General Bandung. Epidural anesthesia was performed using antiseptic and aseptic procedures before the surgery, then used as epidural analgesia. After the third day, the catheter was removed using aseptic and antiseptic procedures and the tip catheter was smeared by a sterile swab. Cultures were then grown and examined at the microbiology laboratory of the Clinical Phatogology Department of Dr. Hasan Sadikin General Hospital Bandung. It was revealed that 14 of 52 epidural catheters placed during the month of February 2014 were contaminated by bacteria. S. epidermidis, S. hominis, and Acinetobacter baumannii were found on epidural catheter tips. It is concluded in this study that 26.3% of 52 catheter tips used as an epidural analgesic were contaminated by  bacteria. The most common bacteria found in the epidural space is Staphylococcus epidermidis,  followed by Staphylococcus hominis and Acinetobacter baumannii.Key words: Analgetic epidural, bacterial cultur, epidural catheter tip DOI: 10.15851/jap.v3n1.377  
Mula dan Lama Kerja Levobupivakain untuk Blokade Peribulbar pada Operasi Vitrektomi di Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung Saptadi, Ari; Fuadi, Iwan; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Blokade peribulbar dapat memfasilitasi operasi vitrektomi dengan terciptanya akinesia yang baik. Tujuan penelitian ini meneliti mula kerja dan lama kerja levobupivakain untuk blokade peribulbar pada operasi vitrektomi. Penelitian observasional dilakukan pada 64 pasien di kamar operasi lantai 3 di Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung selama bulan Maret−April 2014. Pengambilan sampel dilakukan dengan metode simple random sampling. Penilaian keberhasilan blokade peribulbar menggunakan sistem Ocular Anasthetic Scoring System (OASS). Pada penelitian ini didapatkan mula kerja rata-rata 23,6±3,7 menit, tercepat 16 menit dan paling lambat 30 menit serta lama kerja rata-rata 5,34±0,5 jam, paling pendek 4,5 jam dan paling panjang 7 jam. Simpulan penelitian ini adalah levobupivakain sebagai anestetik lokal dengan mula kerja dan lama kerja yang cukup baik digunakan pada operasi vitrektomi dengan teknik blokade peribulbar di Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung.Kata kunci: Blokade peribulbar, levobupivakain, mula kerja, lama kerja obat, Ocular  Anasthetic Scoring System (OASS)Onset and Duration of Levobuvacaine in Peribulbar Block for Vitrectomy in National Eye Centre of Eye Hospital Cicendo BandungAbstractPeribulbar block can facilitate good akinesia for vitrectomy. The aim of this study was to observes the onset and duration of levobupivacaine in peribulbar block for vitrectomy. This observational research of 64 patients was conducted at the operating theater in the National Eye Center of Eye Hospital Cicendo Bandung from March−April 2014. Samples were colected using simple random sampling method. The success of the peribulbar block was assessed with Ocular Anasthetic Scoring System (OASS). The results on this study shows that the onset of levobupivacaine action was around 23.6±3.7 minutes with an action duration of 5.34±0.5 hours. It is concluded that the use of levobupivacaine for peribulbar block in eye surgery (vitrectomy) in National Eye Center of Eye Hospital Cicendo Bandung is acceptable.Key words: Peribulbar block, levobupivacaine, onset, duration of drug, ocular achinetic scoring system DOI: 10.15851/jap.v3n1.373  
Perbandingan Klonidin 0,5 mg/kgBB Intravena dengan Tramadol 0,5 mg/kgBB Intravena Sebagai Profilaksis Kejadian Menggigil Pascaanestesia Spinal pada Seksio Sesarea Panduwaty, Lira; Suwarman, -; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
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Abstract

Menggigil merupakan  komplikasi  yang sering terjadi pascaanestesi spinal, akibat gangguan kontrol termoregulasi. Klonidin merupakan agonis adrenergik α2 yang memiliki efek antihipertensi, analgetik, sedasi, dan antimenggigil. Tujuan penelitian ini untuk menilai perbandingan klonidin 0,5 μg/kgBB dengan tramadol 0,5 mg/kgBB dalam menurunkan kejadian menggigil pada pasien yang menjalani seksio sesarea dengan anestesi spinal. Metode  penelitian adalah uji klinis acak  terkontrol tersamar ganda pada 58 pasien yang menjalani operasi seksio sesarea di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Januari−April 2014, usia 18−45 tahun, status fisik menurut American Society of Anesthesiologist (ASA) II dan dibagi secara acak menjadi 2 kelompok, yaitu kelompok yang menerima klonidin 0,5 μg/kgBB intravena dan  kelompok  tramadol 0,5 mg/kgBB intravena sebelum dilakukan anestesi spinal dengan bupivakain 12,5 mg. Analisis statistik menggunakan uji-t, uji chi-kuadrat, dan Uji Eksak Fisher. Hasil penelitian menunjukkan kejadian menggigil pada kelompok klonidin lebih sedikit bila dibandingkan dengan kelompok tramadol, baik di kamar operasi (3,44% vs 10,34%) maupun di ruang pemulihan (3,44% vs 17,24%). Simpulan dari penelitian ini  menunjukkan  bahwa  pemberian klonidin 0,5 μg/kgBB intravena sebelum anestesi spinal pada seksio sesarea mengurangi kejadian menggigil dan efek samping.Kata kunci: Klonidin, menggigil, pascaanestesi spinal, tramadol Comparison of Intravenous 0.5 mg/kgBW Clonidine Intravenous and 0.5 mg/kgBW Tramadol as Post Spinal Anesthesia Shivering Prophylactic Agent in Caesarean SectionAbstract Shivering, as a result of impaired thermoregulatory control, is known as a frequent complication of post-spinal anesthesia. Clonidine is an α2-adrenergic agonist that has anti-hypertensive, analgesic, sedation and anti-shivering effects. The purpose of this study is to compare the use of  0.5 μg/kgBW clonidine with 0.5 mg/kgBW tramadol in reducing the incidence of shivering in patients undergoing cesarean section with spinal anesthesia. The method applied was the double-blind randomized controlled clinical trial in 58 patients undergoing caesarean surgery at the Dr. Hasan Sadikin General Hospital Bandung in the period of January−April 2014, age 18−45 years, American Society of Anesthesiologist (ASA) physical status II, and divided into two groups; a group receiving 5 μg/kgBW intravenous clonidine and a group receiving 0.5 mg/kgBW intravenously tramadol prior to spinal anesthesia with bupivacaine 12.5 mg. The statistical analyses used were the t test, chi-square test and Fisher’s Exact test. The incidence of shivering were less in the clonidine group compared to the tramadol group in operating theatre (3.44% vs 10.34) and recovery room (3.44% vs 17.24%). The conclusion of this study showed that the administration of 0.5 μg/kgBW clonidine intravenously before spinal anesthesia for cesarean section reduces the incidence of shivering and side effects.Keywords: Clonidine, post spinal anesthesia, shivering, tramadol DOI: 10.15851/jap.v3n1.378  
Pengaruh Penambahan Klonidin 75 mcg pada 12,5 mg Levobupivakain 0,5% Secara Intratekal terhadap Lama Kerja Blokade Sensorik dan Motorik untuk Bedah Ortopedi Ekstremitas Bawah Ramli, Fadlyansyah; Tavianto, Doddy; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1249.217 KB)

Abstract

Keterbatasan anestesi spinal antara lain ialah lama kerja blokade sensorik dan motorik terbatas. Penelitian ini bertujuan melihat pengaruh penambahan 75 mcg klonidin pada 12,5 mg levobupivakain 0,5% terhadap lama kerja blokade sensorik dan motorik pada anestesi spinal untuk bedah ortopedi ekstremitas bawah. Penelitian bersifat eksperimental prospektif dengan metode acak terkontrol tersamar ganda pada 36 sampel dengan kriteria American Society of Anesthesiologist (ASA) I-II yang menjalani operasi ortopedi ekstremitas bawah dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Juni–Agustus 2014. Kelompok levobupivakain dan klonidin (LK) mendapatkan 12,5 mg levobupivakain 0,5% ditambah klonidin 75 mcg. Kelompok levobupivakain dan salin (LS) mendapatkan  12,5 mg levobupivakain 0,5% ditambah NaCl 0,9% 0,5 mL. Data hasil penelitian diuji secara statistik menggunakan uji-t, Mann-Whitney, dan chi-kuadrat. Hasil penelitian menunjukkan lama kerja blokade sensorik kelompok LK lebih lama secara bermakna yaitu 244,44 (37,84) menit dibandingkan dengan kelompok LS, yaitu 107,89 (17,63) menit (p=0,000). Lama kerja blokade motorik kelompok LK lebih lama secara bermakna yaitu 278,72 (41,75) menit dibandingkan dengan kelompok LS, yaitu 128,39 (18,26) menit (p=0,000). Simpulan, penambahan klonidin 75 mcg pada 12,5 mg levobupivakain 0,5%  secara intratekal memerpanjang lama kerja blokade sensorik dan motorik.Kata kunci: Anestesi spinal, klonidin, levobupivakain, lama kerja blokade sensorik, lama kerja blokade motorikEffect of Clonidine 75 mcg Addition to Intrathecal 12.5 mg 0.5% Levobupivacaine on Sensoric and Motoric  Blockade Duration in Lower Extremity Orthopedic SurgeryAbstractSpinal anesthesia has some limitations that  limits its use, such as limited duration of action in motoric and sensoric.  This research aimed to provide an overview on the effect of adding clonidine 75 mcg to 12.5 mg  0.5% levobupivacaine on the motoric and sensoric blockade action duration in lower extremity orthopedic surgery spinal anesthesia. This experimental prospective research used double blind randomized controlled trial approach on 36 patients with ASA I-II physical status who underwent lower extremity orthopedic surgery using spinal anesthesia in Dr. Hasan Sadikin General Hospital during the period of June to August 2014.  LC group, clonidine 75 mcg was added to 12.5 mg 0.5% levobupivacaine.  On LS group, 12.5 mg 0.5% mg levobupivacaine mixed with 0.5 mL 0.9% NaCl. The data were then statistically tested using t-test, Mann-Whitney, and chi-square. The result showed that the duration of action of sensoric blockade in LK group was significantly longer, i.e. 224.44 (37.84) minutes compared to LS group, i.e. 107.89 (17.63) minutes (p=0.000).  Duration of action of motoric blockade in LK group was significantly longer, i.e. 278,72 (41,75) minutes, compared to LS group, i.e. 128.39 (18.26) minutes (p=0.000). It is concluded that the additiona of clonidine 75 mcg to 12,5 mg 0,5% levobupivacaine significantly prolongs the duration of action of the motoric and sensoric blockade if given intrathecally.Key words: Clonidine, duration of action, duration of action of motoric blockade, levobupivacaine, spinal anesthesia DOI: 10.15851/jap.v3n1.374  
Pengaruh Penambahan Klonidin 75 mcg pada 12,5 mg Levobupivakain 0,5% Secara Intratekal terhadap Lama Kerja Blokade Sensorik dan Motorik untuk Bedah Ortopedi Ekstremitas Bawah Fadlyansyah Ramli; Doddy Tavianto; Tinni T. Maskoen
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1249.217 KB)

Abstract

Keterbatasan anestesi spinal antara lain ialah lama kerja blokade sensorik dan motorik terbatas. Penelitian ini bertujuan melihat pengaruh penambahan 75 mcg klonidin pada 12,5 mg levobupivakain 0,5% terhadap lama kerja blokade sensorik dan motorik pada anestesi spinal untuk bedah ortopedi ekstremitas bawah. Penelitian bersifat eksperimental prospektif dengan metode acak terkontrol tersamar ganda pada 36 sampel dengan kriteria American Society of Anesthesiologist (ASA) I-II yang menjalani operasi ortopedi ekstremitas bawah dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Juni–Agustus 2014. Kelompok levobupivakain dan klonidin (LK) mendapatkan 12,5 mg levobupivakain 0,5% ditambah klonidin 75 mcg. Kelompok levobupivakain dan salin (LS) mendapatkan  12,5 mg levobupivakain 0,5% ditambah NaCl 0,9% 0,5 mL. Data hasil penelitian diuji secara statistik menggunakan uji-t, Mann-Whitney, dan chi-kuadrat. Hasil penelitian menunjukkan lama kerja blokade sensorik kelompok LK lebih lama secara bermakna yaitu 244,44 (37,84) menit dibandingkan dengan kelompok LS, yaitu 107,89 (17,63) menit (p=0,000). Lama kerja blokade motorik kelompok LK lebih lama secara bermakna yaitu 278,72 (41,75) menit dibandingkan dengan kelompok LS, yaitu 128,39 (18,26) menit (p=0,000). Simpulan, penambahan klonidin 75 mcg pada 12,5 mg levobupivakain 0,5%  secara intratekal memerpanjang lama kerja blokade sensorik dan motorik.Kata kunci: Anestesi spinal, klonidin, levobupivakain, lama kerja blokade sensorik, lama kerja blokade motorikEffect of Clonidine 75 mcg Addition to Intrathecal 12.5 mg 0.5% Levobupivacaine on Sensoric and Motoric  Blockade Duration in Lower Extremity Orthopedic SurgeryAbstractSpinal anesthesia has some limitations that  limits its use, such as limited duration of action in motoric and sensoric.  This research aimed to provide an overview on the effect of adding clonidine 75 mcg to 12.5 mg  0.5% levobupivacaine on the motoric and sensoric blockade action duration in lower extremity orthopedic surgery spinal anesthesia. This experimental prospective research used double blind randomized controlled trial approach on 36 patients with ASA I-II physical status who underwent lower extremity orthopedic surgery using spinal anesthesia in Dr. Hasan Sadikin General Hospital during the period of June to August 2014.  LC group, clonidine 75 mcg was added to 12.5 mg 0.5% levobupivacaine.  On LS group, 12.5 mg 0.5% mg levobupivacaine mixed with 0.5 mL 0.9% NaCl. The data were then statistically tested using t-test, Mann-Whitney, and chi-square. The result showed that the duration of action of sensoric blockade in LK group was significantly longer, i.e. 224.44 (37.84) minutes compared to LS group, i.e. 107.89 (17.63) minutes (p=0.000).  Duration of action of motoric blockade in LK group was significantly longer, i.e. 278,72 (41,75) minutes, compared to LS group, i.e. 128.39 (18.26) minutes (p=0.000). It is concluded that the additiona of clonidine 75 mcg to 12,5 mg 0,5% levobupivacaine significantly prolongs the duration of action of the motoric and sensoric blockade if given intrathecally.Key words: Clonidine, duration of action, duration of action of motoric blockade, levobupivacaine, spinal anesthesia DOI: 10.15851/jap.v3n1.374  

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