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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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Hubungan Nilai Mean Platelet Volume (MPV) dengan Skor APACHE II sebagai Prediktor Mortalitas pada Pasien Sepsis Berat di Rumah Sakit Umum Pusat Haji Adam Malik Medan Harto, Soejat; Prihardi, M. Teguh; Hanafie, Achsanuddin
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Sepsis berat merupakan kondisi umum di unit perawatan intensif (UPI) dan rawat inap yang berhubungan dengan mortalitas, morbiditas, dan biaya perawatan yang tinggi. Tujuan penelitian ini ingin mendapatkan skor alternatif yang lebih sederhana, yaitu nilai mean platelet volume (MPV) sebagai prediktor mortalitas pada pasien sepsis berat selain skor APACHE II. Penelitian ini menggunakan desain cross sectional pada 76 pasien sepsis berat dewasa di Rumah Sakit H. Adam Malik Medan pada Oktober 2015–Januari 2016 yang memenuhi kriteria inklusi. Data yang diambil adalah nilai MPV dan skor APACHE II pada saat pertama sekali terdiagnosis sepsis berat, kemudian dilihat mortalitas pasien tersebut. Uji korelasi Spearman menunjukkan bahwa terdapat korelasi lemah yang signifikan (p=0,006) antara MPV dan APACHE II dengan nilai r (korelasi) = 0,314. Nilai MPV pada penelitian ini tidak memiliki kemampuan dalam memprediksi mortalitas (AUC) ROC 58,2% (IK 95%: 45,1–71,2%; p=0,223); sedangkan skor APACHE II memiliki kemampuan yang sedang dalam memprediksi mortalitas (AUC) ROC 70,4% (IK 95%: 58,6–82,2%; p= 0,002). Didapatkan cut-off point untuk APACHE II adalah 19 dengan sensitivitas 65,9%, spesitivitas 65,7%, NPP 69,2%, dan NPN 62,2%. Simpulan penelitian ini adalah nilai MPV tidak dapat dijadikan prediktor mortalitas pada pasien sepsis beratKata kunci: Mean platelet volume, mortalitas UPI, skor APACHE II Correlation between Mean Platelet Volume (MPV) and Apache II Score as Mortality Predictors in Severe Sepsis Patients at Haji Adam Malik General Hospital MedanAbstractSevere sepsis is a general condition in the Intensive Care Unit (ICU) and inpatient wards which correlates with mortality, morbidity, and high cost hospitalization. The main point of this study was to explore the possibility to use the mean platelet volume (MPV) as an easier alternative score for mortality predictor in addition to APACHE II score in severe sepsis patients. This study used cross-sectional design on 76 adult severe sepsis patients in Haji Adam Malik General Hospital Medan who met inclusion criteria during the periood of October 2015 to January 2016. Data collected were MPV value and APACHE II score, which were collected the first time patient was diagnosed as having severe sepsis which was then observed for their mortality The Spearman correlation tests showed that there was a weak yet significant correlation (p=0.006) between MPV and APACHE II with r (correlation) = 0.314. The MPV values in this study were unable to predict mortality (AUC) ROC 58.2% (95% CI: 45.1–71.2%, p=0.223). whereas the APACHE II score has a moderate ability to predict mortality (AUC) ROC 70,4% (95% CI: 58,6–82,2%, p= 0.002). The cut-off point of APACHE II was 19 with a sensitivity of 65.9% and a specificity of 65.7%, and a PPV of 69.2% and NPV of 62.2%. Therefore, based on this study the MPV score cannot be used as a mortality predictor in severe sepsis patients.Key words: APACHE II score, mean platelet volume, ICU mortality DOI: 10.15851/jap.v4n3.901
Perbandingan Efektivitas antara Gabapentin 600 mg dan Gabapentin 900 mg Kombinasi dengan Ketorolak 30 mg/8 Jam sebagai Analgesia Pascabedah pada Total Abdominal Histerektomi dengan Anestesi Umum Camary, Mumya; Ihsan, Mhd.; Wijaya, Dadik Wahyu
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gabapentin berkembang untuk penanganan nyeri akut pascabedah. Tujuan penelitian adalah menilai efektivitas gabapentin 600 mg dan 900 mg per oral kombinasi ketorolak 30 mg/8 jam intravena sebagai analgesia pascabedah pada total abdominal histerektomi dengan anestesi umum. Penelitian uji klinis acak tersamar ganda dilakukan di Rumah Sakit Umum Pusat H. Adam Malik Medan, RSUD Dr. Pirngadi Kota Medan, RS. Haji Medan, dan RS. Putri Hijau selama bulan Oktober 2015–Januari 2016. Terdapat 30 subjek penelitian, usia 18–60 tahun, status fisik American Society of Anesthesiologists (ASA) I–II yang menjalani operasi total abdominal histerektomi dengan anestesi umum. Subjek dibagi menjadi 3, yaitu kelompok A mendapat plasebo, kelompok B mendapat gabapentin 600 mg, dan kelompok C mendapat gabapentin 900 mg kombinasi ketorolak 30 mg/8 jam. Uji Kruskal Wallis digunakan untuk menilai efektivitas skor visual analogue scale (VAS) pascabedah serta uji chi-kuadrat untuk menilai kebutuhan rescue analgetia petidin selama 24 jam pascabedah. Pada perbandingan nilai VAS antara gabapentin 600 mg dan gabapentin 900 mg kombinasi dengan ketorolak 30 mg/8 jam tidak ditemukan perbedaan nilai yang signifikan antara kedua kelompok studi (p>0,05). Simpulan, efek gabapentin 600 mg dengan gabapentin 900 mg kombinasi ketorolak 30 mg/8 jam sebagai analgesia pascabedah tidak berbeda efektivitasnya dalam mengurangi nilai VAS dan kebutuhan rescue analgetia petidin selama 24 jam pascabedah.Kata kunci: Gabapentin, kebutuhan rescue analgetia, visual analogue scaleEffectiveness of Gabapentin 600 mg and 900 mg Combined Ketorolak as Postoperative Analgesics for Hysterectomy under General AnesthesiaAbstractGabapentin is developed recently to manage postoperative acute pain. The purpose of this study was to assess the efficacy of 600 mg and 900 mg oral gabapentin combined with 30 mg/8 hours intravenous ketorolak as the postoperative analgesics for total abdominal hysterectomy under general anesthesiaon visual analogue scale (VAS) and the need of pethidin in 24 hours postoperatively. A double blind controlled trial was performed to 30 subjects in H. Adam Malik Hospital Medan, Dr. Pirngadi Hospital Medan,Haji Hospital Medan,and Putri Hijau Hospital Medan. The study was performed during the period of October 2015 to January 2016. Patients were 18 to 60 years old with PS-ASA I–II who underwent total abdominal hysterectomy under general anesthesia. Subjects were divided into 3 groups.: Group A who received placebo, group B who received 600 mg of gabapentin, and group C who received 900 mg of gabapentin combined with 30 mg/8 hours ketorolak. The efficacy was assessed with post operative visual analogue scale (VAS) using Kruskal Wallis test, and the need for rescue analgesics pethidin in 24 hours postoperatively using chi-square test. The VAS scores of the group that received600 mg gabapentin and the group that received 900 mg gabapentin combined with 30 mg/hour ketorolak were not significantly different (p>0.05). In conclusion, the effects of 600 mg gabapentin and 900 mg gabapentin combined with 30 mg/8 hours ketorolak as the postoperative analgesics for total abdominal hysterectomy under general anesthesia are not different in terms of decreasing VAS score and the need for rescue analgesia pethidine in 24 hours postoperativelyKey words: Gabapentin, the need of analgesia rescue, visual analogue score DOI: 10.15851/jap.v4n3.898
Perbandingan Waktu Awitan dan Lama Kerja Kombinasi Bupivakain 0,5% dan Lidokain 2% dengan Bupivakain 0,5% pada Blokade Infraklavikular untuk Operasi Lengan Bawah Destiara, Andy Pawana; Yadi, Dedi Fitri; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penggunaan kombinasi obat anestesi lokal bupivakain dan lidokain dapat menghasilkan waktu awitan yang cepat dan lama kerja yang panjang. Penelitian ini bertujuan membandingkan waktu awitan dan lama kerja kombinasi bupivakain 0,5% dan lidokain 2% dengan bupivakain 0,5% pada blokade infraklavikular untuk pembedahan lengan bawah. Penelitian menggunakan uji klinis acak terkontrol buta ganda terhadap 36 pasien dewasa usia 18–60 tahun yang menjalani pembedahan lengan bawah dan dilakukan blokade infraklavikular dengan panduan nerve stimulator di Rumah Sakit Dr. Hasan Sadikin Bandung selama periode April–Juni 2015. Pasien dibagi dalam dua kelompok, kelompok bupivakain dan lidokain (BL) dan bupivakain (B). Analisis stastistik menggunakan student’s t-test, chi-square, Eksak Fisher, Kolmogorov Smirnov dan Mann-Whitney U-test. Hasil penelitian didapatkan waktu awitan blokade sensorik dan motorik pada kelompok BL, yaitu 7,1±2 menit dan 10,9±5,3 menit, pada kelompok B, yaitu 19,8±4,5 menit dan 29±7,7 menit. Lama kerja blokade sensorik dan motorik pada kelompok BL, yaitu 540,9±195,1 menit dan 445,6±158,9 menit, pada kelompok B, yaitu 837,6±376,6 menit dan 653,9±304,3 menit. Simpulan, kombinasi bupivakain 0,5% dan lidokain 2% menghasilkan awitan blokade sensorik serta motorik lebih cepat dan lama kerja yang lebih singkat dibanding dengan bupivakain 0,5%.Kata kunci: Blokade infraklavikular, kombinasi bupivakain-lidokain, bupivakain, lama kerja blokade, waktu awitan blokade Comparison of Onset and Duration of Action between 0.5% Bupivacaine and 2% Lidocaine Combination and 0.5% Bupivacaine on Infraclavicular Block for Forearm SurgeryAbstractThe combination of local anesthetic drugs bupivacaine and lidocaine can produce rapid onset and long duration of action. The purpose of this study was to compare the onset and duration of action between 0.5% bupivacaine and 2% lidocaine combination and 0.5% bupivacaine on infraclavicular block for forearm surgery. This study was conducted using a randomized double blind controlled clinical trial on 36 adult patients aged 18–60 years who underwent forearm surgery under infraclavicular block using nerve stimulator guidance in Dr. Hasan Sadikin General Hospital between the period of April to June 2015. Patients were divided into two groups: patients in bupivacaine and lidocaine (BL) group and bupivacaine (B)group. The statistical analysis were performed using the student’s t-test, chi-square, Fisher’s Exact, Kolmogorov Smirnov, and Mann-Whitney U-test. The onsets of sensory and motor blocks in BL group were 7.1±2 min and 10.9±5.3 min, repectively and B group were 19.8±4.5 min and 29±7.7 min, respectively. The durations of sensory and motor blocks in BL group were 540.9±195.1 min and 445.6±158.9 min and B group were 837.6±376.6 min and 653.9±304.3 min. This study reveals that the combination of 0.5% bupivacaine and 2% lidocaine in infraclavikular block had a faster onset of sensory and motor blocks compared to 0.5% bupivacaine and a shorter duration of action compared to 0.5% bupivacaine.Key words: Bupivacaine, combination of bupivacaine–lidocain, duration of block, infraclavicular block, onset of block DOI: 10.15851/jap.v4n3.902
Perbandingan Osmolaritas Plasma Setelah Pemberian Manitol 20% 3 mL/kgBB dengan Natrium Laktat Hipertonik 3 mL/kgBB pada Pasien Cedera Otak Traumatik Ringan-Sedang Batubara, Budi Harto; Umar, Nazaruddin; Mursin, Chairul
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Terapi osmotik adalah salah satu cara penanganan pada cedera kepala traumatik untuk menurunkan tekanan intrakranial (TIK) dengan cara mengatasi edema yang terjadi. Penelitian ini dilakukan pada 30 pasien cedera otak traumatik ringan-sedang yang masuk ke UGD Rumah Sakit H. Adam Malik Medan pada Oktober–Desember 2015 yang memenuhi kriteria inklusi dan tidak termasuk eksklusi. Subjek dibagi menjadi 2 kelompok secara acak, yaitu kelompok A diberikan manitol 20% 3 mL/kgBB dan kelompok B diberikan natrium laktat hipertonik 3 mL/kgBB. Dilakukan penilaian osmolaritas sebelum perlakuan dan 60 menit setelah perlakuan dengan cara pengambilan darah, kemudian dilakukan pemeriksaan laboratorium. Data hasil penelitian diuji dengan uji T-independent dan Uji Mann-Whitney. Dari hasil penelitian didapatkan efek perubahan osmolaritas plasma setelah perlakuan tidak bermakna secara statistik (p>0,05) walaupun osmolaritas plasma akhir setelah perlakuan pada kedua kelompok berbeda bermakna (p<0,05). Volume urin lebih banyak pada kelompok manitol dan bermakna secara statistik (p<0,05), akan tetapi tidak ada perubahan hemodinamik yang bermakna. Dari hasil penelitian disimpulkan bahwa manitol lebih baik dalam hal target osmolaritas plasma pada pasien cedera otak traumatik ringan sedang.Kata kunci: Cedera otak traumatik, manitol 20%, natrium laktat hipertonik, osmolaritasPlasma Osmolarity Changes After Mannitol 20% 3 mL/kgBW and Hypertonic Sodium Lactate Solution 3 mL/kgBW Administration in Patients with Mild-Moderate Traumatic Brain InjuryAbstractOsmotic therapy is one of many modalities to manage traumatic brain injuries aimed to decrease intracranial pressure by alleviating the brain edema. A study was performed on 30 subjects with mild and moderate brain injuries admitted to the emergency department of Adam Malik General Hospital Medan during October–December 2015 who meet the inclusion and exclusion criteria. Subjects were divided randomly into 2 treatment groups, i.e. group A that received mannitol 20% 3 mL/kgBW and group B that received hypertonic natrium lactate 3 mL/kgBW. The measurement of osmolarity was performed before administration of either of mannitol and hypertonic natrium lactate and at 60 minutes after the administration by drawing the blood for blood check. . Data were statistically analyzed using T- independent test and Mann-Whitney test. Plasma osmolarity changes before and after the treatment were not statistically sifgnificant (p>0.05) for each group treatment even though post-treatment plasma osmolarity was statistically significant. Urin output in the mannitol group was higher than in the hypertonic sodium lactate group and was statistically significant (p>0.05); nevertheless, there was no significant difference in the hemodynamic change. Therefore, manitol is better than hypertonic natrium lactate for osmolarity target therapy in patients mild-moderate head injury.Key words: Hypertonic natrium lactate, mannitol 20%, osmolarity, traumatic brain injury DOI: 10.15851/jap.v4n3.677
Efek Penggunaan Leg Wrapping terhadap Kejadian Hipotensi Selama Anestesi Spinal pada Pasien Seksio Sesarea Putri, Yunita Susanto; Fuadi, Iwan; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Hipotensi merupakan komplikasi tersering selama anestesi spinal dengan insidensi >80% meskipun telah diberikan cairan preloading, posisi ibu left lateral tilt, dan penggunaan vasopresor. Terdapat teknik lain untuk mencegah terjadi hipotensi, yaitu penggunaan leg wrapping yang dapat memperbaiki aliran balik vena dengan meningkatkan volume darah sentral. Penelitian ini bertujuan menilai efek penggunaan leg wrapping terhadap kejadian hipotensi selama anestesi spinal pada pasien seksio sesarea. Penelitian bersifat eksperimental acak terkontrol buta tunggal dengan randomisasi secara acak sederhana yang melibatkan 40 ibu hamil American Society of Anesthesiologists (ASA) II yang menjalani seksio sesarea dengan anestesi spinal di Central Operating Theatre (COT) lantai 3, Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Juni–Juli 2015. Subjek penelitian dikelompokkan menjadi dua, yaitu 20 subjek dengan leg wrapping dan 20 subjek tanpa leg wrapping. Tekanan darah dan laju nadi diperiksa setiap dua menit sampai bayi lahir. Data dianalisis dengan uji-t tidak berpasangan dan chi-kuadrat, nilai p<0,05 dianggap bermakna. Analisis statistik menunjukkan kejadian hipotensi pada kelompok tanpa leg wrapping 95% (19 orang) dan 0% pada kelompok dengan leg wrapping dengan perbedaan bermakna (p<0,05). Secara keseluruhan, hemodinamik kelompok dengan leg wrapping lebih stabil dibanding dengan kelompok tanpa leg wrapping. Simpulan, penggunaan leg wrapping sebelum dilakukan anestesi spinal pada pasien yang menjalani seksio sesarea menurunkan angka kejadian hipotensi.Kata kunci: Anestesi spinal, hipotensi, leg wrapping, seksio sesareaEffect of Leg Wrapping on Hypotension Incidence in Cesarean Section with Spinal AnesthesiaAbstractHypotension is the most common complication of spinal anesthesia. The incidence remains high despite adequate fluid preloading, left lateral tilt positioning, and vasopressors use. There is a technique that can be used to prevent hypotension, which is referred as leg wrapping. Leg wrapping can improve venous return by increasing central blood volume. This study aimed to compare the hypotension incidence between with and without leg wrapping during spinal anesthesia for caesarean section. The method used was single blind randomized controlled trial with simple randomization, involving 40 pregnant women ASA II, who underwent cesarean section with spinal anesthesia in COT 3rd floor Dr. Hasan Sadikin General Hospital Bandung during the period of June–July 2015. Subjects were grouped into with leg wrapping and without leg wrapping groups with 20 subjects in each group. Blood pressure and heart rate were recorded every two minutes until the baby was born. Data were then analyzed using t-test and chi-square test with p values <0.05 considered significant. The statistical analysis showed that there were significant differences in the incidence of hypotension (p<0.05) in the group without leg wrapping , i.e. 95% (19 people), and the group with leg wrapping, i.e. 0%. Overall, hemodynamics of the leg wrapping group was more stable than the group without leg wrapping. In conclusion, leg wrapping prior to spinal anesthesia in patients undergoing cesarean section will reduce incidence of hypotension.Key words: Cesarean section, hypotension, leg wrapping, spinal anesthesia DOI: 10.15851/jap.v4n3.903
Gambaran Pola Kuman pada Bilah Laringoskop di Ruang Operasi Rumah Sakit Dr. Hasan Sadikin Bandung Martua, Edwin Haposan; Suwarman, -; Redjeki, Ike Sri
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kebiasaan cara membersihkan bilah laringoskop dapat menyebabkan komplikasi karena potensial kontak dengan mikro-organisme patogen dan dapat menyebabkan infeksi nosokomial. Tujuan penelitian adalah mengetahui gambaran kuman pada bilah laringoskop dengan metode pembersihan yang dilakukan di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung. Penelitian dilakukan menggunakan metode deskriptif observasional dengan cara melakukan pemeriksaan kultur kuman pada 19 bilah laringoskop sebelum digunakan dan yang sudah dibersihkan sesudah tindakan laringoskopi, serta 14 sumber air untuk membersihkan bilah laringoskop di ruang operasi RSHS Bandung pada tanggal Desember 2014–Januari 2015. Hasil penelitian ini ditemukan gambaran pola kuman komensal pada bilah laringoskop yang digunakan sebelum tindakan laringoskopi, yaitu Bacillus spp. 10 dari 19. Ditemukan gambaran pola kuman patogen pada bilah laringoskop yang sudah dibersihkan setelah tindakan laringoskopi di ruang operasi, yaitu Candida non albicans 1 dari 19, Acinobacter baumanii dan Staphylococcus haemolyticus 1 dari 19, serta Klebsiella pneumoniae dan Pseudomonas aeruginosa 1 dari 19. Simpulan, ditemukan kuman patogen pada bilah laringoskop yang sudah dibersihkan sesudah tindakan laringoskopi dan air yang digunakan untuk membersihkan bilah laringoskop di Rumah Sakit Dr. Hasan Sadikin Bandung.Kata kunci: Bilah laringoskop, infeksi nosokomial, laringoskopi, pola kumanBacterial Mapping of Laryngoscope Blade at the Operating Theater of Dr. Hasan Sadikin General Hospital BandungAbstractThe habit of cleaning laryngoscope blades can cause complications due to potential contact with patogenic microorganisms that may cause nosocomial infections. The aim this study was to determine the microbial patterns on the laryngoscope blades cleaned using the cleaning methods applied in Dr. Hasan Sadikin General Hospital (RSHS) Bandung. This study was conducted using the descriptive observational method by taking samples of bacterial culture from 19 laryngoscope blades before laryngoscopy procedures and 19 cleaned laryngoscope after laryngoscopy, as well as from the 14 water sources that were used for cleaning laryngoscope blades in the operating theaters of RSHS Bandung in December 2014–January 2015. The results of this study revealed a commensal microbial pattern of Bacillus spp. on 10 of 19 laryngoscope blades before they were used in laryngoscopy precedures. It was revealed that among the laryngoscopes blade that had been cleaned after laryngoscopy in the operating room. 1 of 19 was found to have a non-Candida albicans pattern, 1 of 19 had Acinobacter baumannii and Staphylococcus haemolyticus pattern, and 1 of 19 had Klebsiella pneumoniae and Pseudomonas aeruginosa pattern. Hence, it can be concluded that pathogenic germs are found in laryngoscope bplades that have been cleaded after laryngoscopy and water that is used to clean them in Dr. Hasan Sadikin General Hospital Bandung.Key words: Bacterial mapping, direct laryngoscopy, laryngoscope blades, nosocomial infections DOI: 10.15851/jap.v4n3.899
Perbandingan Nilai SpO2 dan EtCO2 pada Anestesi Umum dengan Teknik Low Flow dan High Flow Arifin, Hasanul; Andri, Mufti
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

 Metode anestesi umum dengan obat anestesi inhalasi yang saat ini banyak dilakukan adalah teknik high-flow anesthesia (HFA). Penelitian ini bertujuan mengetahui perbandingan penilaian SpO2 dan EtCO2 antara teknik anestesi low flow dan high flow. Penelitian ini merupakan uji klinis acak tersamar tunggal pada 54 pasien dewasa, usia 21–50 tahun, status fisik menurut American Society of Anesthesiologist (ASA) 1 yang akan menjalani operasi elektif dengan anestesi umum dan intubasi di Rumah Sakit H. Adam Malik Medan. Sampel dibagi menjadi dua kelompok, yaitu kelompok A mendapat teknik low flow anesthesia (FGF 1 L/menit) dan kelompok B mendapat teknik high flow anesthesia (FGF 4 L/menit). Dilakukan penilaian SpO2, EtCO2 setiap 10 menit selama anestesi. Uji statistik menggunakan Uji Mann-Whitney U dan t-test pada perangkat lunak SPSS 23. Penelitian ini menunjukkan SpO2 selama anestesi pada kelompok low flow anesthesia 98,63%±0,39%, high flow anesthesia 98,70%±0,37%. EtCO2 selama anestesi pada kelompok low flow anesthesia 33,73 mmHg±0,54 mmHg, high flow anesthesia 32,77 mmHg±0,39 mmHg. Nilai SpO2 dan EtCO2 selama anestesi pada kedua kelompok tidak terdapat perbedaan yang bermakna (p>0,05). Simpulan, menunjukkan tidak ada perbedaan nilai SpO2 dengan EtCO2 kedua jenis teknik anestesi.Kata kunci: EtCO2 , high flow anesthesia, isofluran, low flow anesthesia, SpO2Difference in Spo2 and EtC02 Values between Low Flow and High Flow AnesthesiaCurrent general anesthesia method through the use of inhalational anesthetics uses the high-flow anesthesia (HFA) approach. This study aimed to compare the SpO2 and EtCO2 in low flow anesthesia and high flow anesthesia. This is a single blind, randomized clinical trial on 54 adult patients, 21–50 years, with physical status ASA 1 who underwent elective surgery under general anesthesia through intubation at H. Adam Malik Medan General Hospital during the period of October 2014 to April 2015. Samples were divided into two groups of 27 subjects. Group A received low flow anesthesia (FGF 1 liter/minute) and group B received high flow anesthesia (FGF 4 liters/minute). The SpO2 and EtCO2 were observed every 10 minutes during anesthesia. Analysis was performed using Mann-Whitney U test and t-test in SPSS 23 software. This study showed that the mean SpO2 during anesthesia for the low flow anesthesia group was 98.63% ± 0.39, and 98.70%±0.37 for the high flow anesthesia. The mean EtCO2 values during anesthesia were 33.73 mmHg± 0.54 and 32.77 mmHg±0.39 for the low flow anesthesia group and high flow anesthesia, respectively. There was no significant difference in SpO2 and EtCO2 values during anesthesia in both groups (p>0.05). Hence, it is concluded that there is no significant difference in SpO2 and EtCO2 values between low flow and high flow anesthesia techniques.Key words: EtCO2, high flow anesthesia, isoflurane, low flow anesthesia, SpO2  
Perbandingan Teknik Insersi Klasik dengan Teknik Insersi Triple Airway Manoeuvre terhadap Angka Keberhasilan dan Kemudahan Pemasangan Laryngeal Mask Airway (LMA) Klasik Simanjuntak, Nelly Margaret; Oktaliansah, Ezra; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Beberapa penelitian telah dilakukan untuk mencari metode yang dapat meningkatkan angka keberhasilan teknik insersi laryngeal mask airway (LMA) klasik dan mengurangi komplikasi yang mungkin terjadi. Penelitian ini bertujuan mengetahui angka keberhasilan dan kemudahan pemasangan LMA klasik pada teknik triple airway manoeuvre (TAM). Penelitian ini adalah eksperimental prospektif dengan metode acak terkontrol tersamar tunggal terhadap pasien yang menjalani operasi terencana dalam anestesi umum di kamar operasi Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung pada bulan April–Juli 2015. Tiga puluh enam pasien pasien berusia 18–60 tahun, status fisik berdasarkan American Society of Anesthesiologists (ASA) kelas I–II dibagi menjadi dua kelompok, yaitu kelompok teknik insersi klasik dan teknik insersi TAM. Pada teknik TAM, seorang penolong melakukan protrusi mandibula dan membuka mulut sementara seorang melakukan insersi LMA klasik. Data hasil penelitian dianalisis dengan uji statistik Eksak Fisher dan Kolmogorov Smirnov. Hasil penelitian menunjukkan bahwa perbandingan angka keberhasilan pemasangan dan kemudahan pemasangan LMA klasik pada kedua kelompok perlakuan berbeda bermakna (p<0,05) dengan teknik insersi TAM memiliki angka keberhasilan lebih tinggi daripada teknik insersi klasik (72,2%) dan teknik insersi TAM memiliki kejadian tahanan di orofaring lebih sedikit dibanding dengan teknik klasik (83,3%). Simpulan, teknik insersi TAM memiliki angka keberhasilan yang lebih tinggi daripada teknik insersi klasik sehingga.Kata kunci: Laryngeal mask airway klasik, teknik triple airway manoeuvre, teknik insersi klasikComparison of Success Rate and Ease of Insertion of Classic Laryngeal Mask Airway when Inserted using Classic Insertion Technique and Triple Airway Maneuver TechniqueAbstractVarious studies are seeking to find new methods to improve techniques of classic laryngeal mask airway (cLMA) insertion and reduce possible complications. This is a clinical study to investigate the succesrate and ease of insertion using triple airway maneuver(TAM) technique and to compare it with the classic technique. This experimental prospective study was conducted using the single-blind randomized controlled trial approach to patients underwent elective surgery under general anesthesia in the operating teather of Dr. Hasan Sadikin General Hospital Bandung during the period of April 2015 to July 2015. Thirty six patients aged 18–60 years old with American Society of Anesthesiologists (ASA) I–II status were randomly divided into two groups receiving either triple airway maneuver (TAM) technique or classic technique. In TAM technique, jaw thrust and mouth opening are facilitated by a technician and the anesthesiologist inserts the LMA. The collected data were analyzed using Fisher Exact and Kolmogorov Smirnov. The statistical analysis showed that the ratio of success rate and the ease of insertion of cLMA between both treatment groups was significantly different (p<0.05) where the TAM technique showed a higher success rate of insertion (72.2%) and less impacts on the oropharynx compared to the classic method (83.3%). Overall , in this study, the TAM technique is associated with higher of success rate compared to the classic technique and the ease of insertion of TAM method makes it worth to be considered as a safe and effective method to establish a secure airway in anesthetized patients.Key words: Classic laryngeal mask airway, ease of insertion, success rate, triple airway manoeuvre DOI: 10.15851/jap.v4n3.900
Gambaran Tata Cara dan Angka Keberhasilan Penyapihan Ventilasi Mekanik di Ruang Perawatan Intensif Rumah Sakit Dr. Hasan Sadikin Bandung Sitorus, Richard Pahala; Fuadi, Iwan; Zulfariansyah, Ardi
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (552.472 KB) | DOI: 10.15851/jap.v4n3.897

Abstract

Penyapihan ventilasi mekanik adalah suatu proses pelepasan bantuan ventilator yang dilakukan secara bertahap atau langsung oleh seorang dokter Intensive Care Unit (ICU). Penelitian ini bertujuan mengetahui gambaran tata cara dan angka keberhasilan penyapihan ventilasi mekanik yang dilakukan di ICU Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung. Metode penelitian ini adalah deskriptif observasional prospektif dan merupakan studi cross sectional. Penelitian ini melibatkan 50 pasien yang dirawat di ICU RSHS Bandung pada bulan Juli–September 2015. Data dicatat dan dikelompokkan sesuai dengan variabel karakteristik tata cara dan angka keberhasilan penyapihan ventilasi mekanik. Hasil penelitian ini menunjukkan tata cara penyapihan ventilasi mekanik yang paling banyak dilakukan adalah once daily trial of T piece sebanyak 22 pasien (44%) kemudian continous positive airway pressure (CPAP) sebanyak 40%, intermittent trial of T-piece sebanyak 10%, dan pressure support ventilation (PSV) 6%. Angka keberhasilan penyapihan ventilasi mekanik sebanyak 44 orang (88%) dan angka kegagalan penyapihan ventilasi mekanik adalah sebanyak 6 orang (12%) sehingga harus dilakukan re-intubasi. Tata cara penyapihan ventilasi mekanik yang paling banyak digunakan di ICU RSHS Bandung adalah once daily trial of T piece dan angka keberhasilan penyapihan ventilasi mekanik sebesar 88%.Kata kunci: Angka keberhasilan, tata cara penyapihan, ventilasi mekanikProcedures and Success Rate of Mechanical Ventilation Weaning in Intensive Care Unit of Dr. Hasan Sadikin General Hospital BandungAbstractMechanical ventilation weaning is a process of withdrawing ventilator assistance gradually or immediately by Intensive Care Unit (ICU) physicians. This study aimed to describe the procedure and the success rate of mechanical ventilation weaning performed at the ICU of Dr. Hasan Sadikin General Hospital (RSHS) Bandung. This was a cross-sectional descriptive prospective observational and study involving 50 patients treated at the ICU of RSHS Bandung during the period of July to September 2015. Data were recorded and classified in accordance with the variable characteristics of the procedure and the success rate of mechanical ventilation weaning. The results indicated that the most widely used mechanical ventilation weaning procedures were T-piece once daily trial in 22 patients (44%), continous positive airway pressure (CPAP) in 40%, T-piece intermittent trial in 10%, and pressure support ventilation (PSV)in 6%. Mechanical ventilation weaning success rate was 88% and the failure rate was 12% (6 patients) which required re-intubation. The most widely used procedure for mechanical ventilation weaning at the ICU of Dr. Hasan Sadikin General Hospital Bandung is T-piece once daily trial and the mechanical ventilation weaning success rate is 88%.Key words: Mechanical ventilation, success rate, weaning procedure  
Perbandingan Efektivitas antara Gabapentin 600 mg dan Gabapentin 900 mg Kombinasi dengan Ketorolak 30 mg/8 Jam sebagai Analgesia Pascabedah pada Total Abdominal Histerektomi dengan Anestesi Umum Mumya Camary; Mhd. Ihsan; Dadik Wahyu Wijaya
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gabapentin berkembang untuk penanganan nyeri akut pascabedah. Tujuan penelitian adalah menilai efektivitas gabapentin 600 mg dan 900 mg per oral kombinasi ketorolak 30 mg/8 jam intravena sebagai analgesia pascabedah pada total abdominal histerektomi dengan anestesi umum. Penelitian uji klinis acak tersamar ganda dilakukan di Rumah Sakit Umum Pusat H. Adam Malik Medan, RSUD Dr. Pirngadi Kota Medan, RS. Haji Medan, dan RS. Putri Hijau selama bulan Oktober 2015–Januari 2016. Terdapat 30 subjek penelitian, usia 18–60 tahun, status fisik American Society of Anesthesiologists (ASA) I–II yang menjalani operasi total abdominal histerektomi dengan anestesi umum. Subjek dibagi menjadi 3, yaitu kelompok A mendapat plasebo, kelompok B mendapat gabapentin 600 mg, dan kelompok C mendapat gabapentin 900 mg kombinasi ketorolak 30 mg/8 jam. Uji Kruskal Wallis digunakan untuk menilai efektivitas skor visual analogue scale (VAS) pascabedah serta uji chi-kuadrat untuk menilai kebutuhan rescue analgetia petidin selama 24 jam pascabedah. Pada perbandingan nilai VAS antara gabapentin 600 mg dan gabapentin 900 mg kombinasi dengan ketorolak 30 mg/8 jam tidak ditemukan perbedaan nilai yang signifikan antara kedua kelompok studi (p>0,05). Simpulan, efek gabapentin 600 mg dengan gabapentin 900 mg kombinasi ketorolak 30 mg/8 jam sebagai analgesia pascabedah tidak berbeda efektivitasnya dalam mengurangi nilai VAS dan kebutuhan rescue analgetia petidin selama 24 jam pascabedah.Kata kunci: Gabapentin, kebutuhan rescue analgetia, visual analogue scaleEffectiveness of Gabapentin 600 mg and 900 mg Combined Ketorolak as Postoperative Analgesics for Hysterectomy under General AnesthesiaAbstractGabapentin is developed recently to manage postoperative acute pain. The purpose of this study was to assess the efficacy of 600 mg and 900 mg oral gabapentin combined with 30 mg/8 hours intravenous ketorolak as the postoperative analgesics for total abdominal hysterectomy under general anesthesiaon visual analogue scale (VAS) and the need of pethidin in 24 hours postoperatively. A double blind controlled trial was performed to 30 subjects in H. Adam Malik Hospital Medan, Dr. Pirngadi Hospital Medan,Haji Hospital Medan,and Putri Hijau Hospital Medan. The study was performed during the period of October 2015 to January 2016. Patients were 18 to 60 years old with PS-ASA I–II who underwent total abdominal hysterectomy under general anesthesia. Subjects were divided into 3 groups.: Group A who received placebo, group B who received 600 mg of gabapentin, and group C who received 900 mg of gabapentin combined with 30 mg/8 hours ketorolak. The efficacy was assessed with post operative visual analogue scale (VAS) using Kruskal Wallis test, and the need for rescue analgesics pethidin in 24 hours postoperatively using chi-square test. The VAS scores of the group that received600 mg gabapentin and the group that received 900 mg gabapentin combined with 30 mg/hour ketorolak were not significantly different (p>0.05). In conclusion, the effects of 600 mg gabapentin and 900 mg gabapentin combined with 30 mg/8 hours ketorolak as the postoperative analgesics for total abdominal hysterectomy under general anesthesia are not different in terms of decreasing VAS score and the need for rescue analgesia pethidine in 24 hours postoperativelyKey words: Gabapentin, the need of analgesia rescue, visual analogue score DOI: 10.15851/jap.v4n3.898

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