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Jurnal Anestesi Perioperatif
Published by Universitas Padjadjaran
ISSN : 23377909     EISSN : 23388463     DOI : 10.15851/jap
Core Subject : Health, Education,
Education Health Professions
Jurnal Anestesi Perioperatif (JAP)/Perioperative Anesthesia Journal is to publish peer-reviewed original articles in clinical research relevant to anesthesia, critical care, case report, and others. This journal is published every 4 months with 9 articles (April, August, and December) by Department of Anesthesiology and Intensive Care Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung.
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Perbandingan antara Sevofluran dan Propofol Menggunakan Total Intravenous Anesthesia Target Controlled Infusion terhadap Waktu Pulih Sadar dan Pemulangan Pasien pada Ekstirpasi Fibroadenoma Payudara Arvianto, Arvianto; Oktaliansah, Ezra; Surahman, Eri
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (621.483 KB) | DOI: 10.15851/jap.v5n1.1002

Abstract

Penggunaan total intravenous anesthesia (TIVA) dengan propofol terus meningkat karena mudah untuk dikendalikan, onset cepat, durasi singkat, efek samping minimal, serta pemulihan psikomotor dan kognitif lebih cepat. Teknologi target controlled infusion (TCI) diciptakan untuk mempermudah dilakukan TIVA bagi dokter anestesi. Penelitian ini bertujuan mengetahui perbandingan waktu pulih sadar dan pemulangan pasien antara teknik anestesi sevofluran dan TIVA TCI propofol. Penelitian ini dilakukan secara acak terkontrol buta tunggal terhadap 36 orang pasien bedah rawat jalan, wanita usia 18–65 tahun dengan status fisik American Society of Anesthesiologists (ASA) kelas I–II yang menjalani operasi biopsi ekstirpasi fibroadenoma payudara satu sisi di Rumah Sakit Dr. Hasan Sadikin Bandung periode Agustus–November 2015. Sampel dikelompokkan secara random menjadi kelompok sevofluran dan TCI. Kelompok sevofluran mendapatkan anestesi inhalasi sevofluran dan kelompok TCI mendapatkan anestesi TCI propofol dengan metode Schnider Effect Concentration (ec). Waktu pulih sadar dan pemulangan pasien dikumpulkan dan dianalisis menggunakan uji-t, uji Mann-Whitney, dan chi-kuadrat dengan tingkat kepercayaan 95%. Hasil penelitian menunjukkan perbandingan waktu pulih sadar pada kelompok sevofluran, 429±0,763 menit, sedangkan kelompok TCI 9,356±2,331 menit. Simpulan penelitian adalah teknik anestesi sevofluran memberikan waktu pulih sadar yang lebih cepat dan TIVA TCI propofol memberikan waktu pemulangan pasien yang lebih cepat.Kata kunci: Fibroadenoma payudara, sevofluran, TIVA TCI propofol, waktu pulih sadar, waktu pemulangan pasien Comparison of Emergence Time and Discharge Time between Sevoflurane and Propofol Using Total Intravenous Anesthesia with Target Controlled Infusion in Patients Underwent Extirpation of Breast FibroadenomaTotal intravenous anesthesia (TIVA) with propofol is increasingly used, because it is easy to control, has rapid onset, short duration, minimal adverse effects, and rapid recovery of the psychomotor and cognitive functions. This study was conducted to compare the emergence and discharge time between patients receiving sevoflurane and propofol with TCI. A single blind randomized controlled clinical trial was conducted on 36 female patients aged 18–65 years with American Society of Anesthesiologists (ASA) physical status I–II, who underwent breast fibroadenoma extirpation biopsy at the outpatient surgical unit in Dr. Hasan Sadikin General Hospital Bandung. The subjects were randomized and divided into two groups: sevoflurane group receiving inhalation anesthesia with sevoflurane and target controlled infusion (TCI) group receiving propofol TCI Schnider’s Effect Concentration (ec). The mergence time and discharge time were recorded for each group and analysis was performed using Mann Whitney test, t-test and chi-square/Fisher’s exact with 95% confidence interval. This study showed that the emergence time in sevoflurane group and TCI group were 7.429±0.763 minutes and 9.356±2.331 minutes, respectively. The result showed that sevoflurane provides shorter emergence time while TIVA with TCI propofol provides shorter discharge time.Key words: Breast fibroadenoma, emergence time, patients discharging time TIVA TCI propofol, sevoflurane 
Lactate Clearance sebagai Prediktor Mortalitas pada Pasien Sepsis Berat dan Syok Septik di Intesive Care Unit Rumah Sakit Dr. Hasan Sadikin Bandung Kurniawan, Muhammad Budi; Pradian, Erwin; Nawawi, Muthalib
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (599.202 KB) | DOI: 10.15851/jap.v5n1.1003

Abstract

Tingkat mortalitas pasien sepsis berat di Intensive Care Unit (ICU) dihitung dengan menggunakan skor acute physiology and chronic health evaluation (APACHE II), namun memerlukan pemeriksaan yang banyak serta kompleks. Penurunan lactate clearance berhubungan dengan kondisi mikrosirkulasi yang buruk. Lactate clearance diharapkan memiliki kemampuan untuk menentukan tingkat mortalitas pasien sepsis berat dan syok septik. Penelitian ini bertujuan mengetahui kegunaan lactate clearance sebagai prediktor mortalitas pasien sepsis berat dan syok sepsis di ICU Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung yang lebih mudah dan efisien. Penelitian ini dilakukan secara prospektif observasional cohort terhadap 51 orang. Penelitian dilakukan di ICU RSHS Bandung dari bulan September–November 2015 dengan uji Mann Whitney pada data numerik dan Exact Fisher pada data kategorik. Setiap subjek penelitian diperiksa nilai laktat secara berkelanjutan pada jam pertama (H0) dan jam ke-24, kemudian dihitung nilai lactate clearance dengan rumus laktat awal-laktat serial/laktat awal x 100%. Subjek dibagi menjadi 2 kelompok berdasar atas nilai lactate clearance rendah (<40%) dan nilai lactate clearance tinggi (>40%). Hasil penelitian menunujukkan bahwa lactate clearance memiliki sensisitivitas 100%; spesifisitas 88,4%; nilai duga positif 89,2%; nilai duga negatif 100%; rasio kemungkinan positif 86,6%; rasio kemungkinan negatif 0 dan akurasi 94,11%. Simpulan penilitian adalah lactate clearance dapat digunakan sebagai prediktor mortalitas pada pasien sepsis berat dan syok septik di ICU RSHS Bandung.Kata kunci: Lactate clearance, mortalitas, sepsisLactate Clearance as Mortality Predictor in Severe Sepsis and Septic Shock Patient in Intensive Care Unit Dr. Hasan Sadikin General Hospital Bandung Mortality incidence predictor used for sepsis and shock septic in Intensive Care Unit (ICU) were measured using Acute Physiology and Chronic Health Evaluation (APACHE) II score, which needs many complex examinations. The purpose of this study was to examine lactate clearance as an alternative mortality predictor. Decreased percentage of lactate clearance is related to poor perfusion in microcirculation which leads to the possibility that lactate clearance can be used to predict mortality incidence in severe sepsis and shock septic patients in the ICU of Dr. Hasan Sadikin General Hospital Bandung. This was a prospective observational cohort study involving 51 patients who met sepsis and shock septic criteria during the period of September to November 2015. Lactate was examined continuously in all patients at first hour (H0) and H24 and then the lactate clearance value was measured using the following formula: lactate initial–lactate delayed/lactate initial x100%. Subjects were divided into two groups according to the low lactate clearance(<40%) and high lactate clearance (>40%). The Mann Whitney test was used for numeric data and exact Fisher test was used for categorical data. Results showed that the lactate clearance had a sensitivity of 100%, specificity of 88.4%, positive predictive value of 89.2%, negative predictive value of 100%, likelihood ratio positive of 86.6%, likelihood ratio negative of 0% and accuracy of 94.11%. Thus, lactate clearance can be used to predict mortality incidence in severe sepsis and shock septic patients.Key words: Lactate clearance, mortality, sepsis 
Perbandingan Efek Induksi Propofol dengan Ketamin terhadap Penurunan Nilai Neutrofil pada Pasien dengan Tindakan Anestesi Umum Putra, Angga Permana; Arifin, Hasanul; Mursin, Chairul M.
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (719.611 KB) | DOI: 10.15851/jap.v5n1.999

Abstract

Leukosit merupakan bagian dari imunitas bawaan. Penurunan nilai neutrofil dapat dipakai sebagai parameter yang sederhana untuk mengukur berat ringannya stres dan inflamasi sistemik pada pasien. Beberapa penelitian mengemukakan pengaruh obat-obat anestesi terhadap leukosit dan penelitian yang lain melihat dari pengaruh obat-obat anestesi terhadap fungsi dari subset leukosit terutama neutrofil. Tujuan penelitian ini mengetahui perbedaan efek induksi propofol dengan ketamin terhadap penurunan nilai neutrofil pada pasien dengan tindakan anestesi umum di Instalasi Bedah Pusat RSUP H. Adam MalikMedan mulai Mei–Juni 2016. Penelitian uji klinis dengan  randomized control trial double blind dilakukan pada 32 pasien ASA I dan II dibagi dalam 2 kelompok yang menjalani operasi dengan anestesi umum. Pasien pada kelompok propofol (A) diberikan induksi dengan propofol 2 mg/kgBB. Kelompok ketamin diinduksi ketamin 2 mg/kgBB. Kemudian diukur nilai neutrofil (%) pada saat sebelum induksi (T1), 10 menit setelah intubasi (T2), dan 60 menit setelah insisi kulit (T3). Dengan SPSS ver.23, Uji T-independen dan Mann-Whitney U didapatkan hasil T1 neutrofil nilai p=0,636, T2 neutrofil nilai p=0,846, T3 neutrofil nilai p=0,403. Simpulan, terdapat perbedaan efek induksi antara propofol dan ketamin terhadap penurunan nilai neutrofil. Terdapat pengaruh ketamin terhadap penurunan nilai neutrofil, tetapi tidak ada pengaruh propofol terhadap penurunan nilai neutrofil.Kata kunci: Ketamin, leukosit, neutrofil, propofolComparison of Induction Effect between Propofol and Ketamine against Impairment of Neutrophils in Patient with General AnesthesiaLeukocyte is a part of innate immunity elements. Neutrophil impairment of can be used as a simple parameter to measure the severity of stress and systemic inflammation in patients. Some research suggests the influence of anesthetic drugs on leukocytes and other studies look at the effect of anesthetic drugs on leukocyte subset functions, especially neutrophils. This study aimed to reveal the difference in the induction effect of propofol and ketamine against impairment of neutrophils in patients with general anesthesia. This was a double blind randomized control trial conducted in 32 patients ASA I and II who were divided into two groups. These patients underwent general anesthesia at the Central Operating Theater of H. Adam Malik General Hospital during May–June 2016. Group propofol (A) received 2 mg/kgBW propofol, while group ketamine (B) received 2 mg/kgBW ketamine. Neutrophils were measured before induction (T1), 10 minutes after intubation (T2), and 60 minutes after intubation (T3). By using T-independent and Mann-Whitney U test in SPSS ver.23, it was found that the the p-values for T1. T2, and T3 neutrophils were 0.636,0.846, and 0.403. respectively. In conclusion, there is a difference in induction effect between propofol and ketamine against impairment of neutrophils with no effect is found for propofol.Key words: Ketamine, leukocyte, neutrophils, propofol  
Perbandingan Pemberian 20 mL dengan 30 mL Bupivakain 0,5% terhadap Mula Kerja dan Lama Kerja Blokade Saraf Iskiadikus Pendekatan Parasakral Menggunakan Alat Stimulasi Saraf pada Operasi Ekstremitas Bawah Amrizal, Canang Irving; Yadi, Dedi Fitri; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (554.584 KB) | DOI: 10.15851/jap.v5n1.1004

Abstract

Blokade saraf iskiadikus pendekatan parasakral merupakan salah satu pilihan anestesi untuk operasi ekstremitas bawah. Blokade ini memiliki angka keberhasilan yang tinggi dan membutuhkan anestetik lokal yang lebih sedikit. Penelitian ini bertujuan membandingkan pemberian 20 mL dengan 30 mL bupivakain 0,5% terhadap mula kerja dan lama kerja blokade saraf iskiadikus pendekatan parasakral menggunakan alat stimulasi saraf di Rumah Sakit Dr. Hasan Sadikin Bandung dan RSD Dr. Slamet Garut selama periode bulan Oktober–November 2015. Penelitian eksperimental secara randomized controlled trial dilakukan pada 36 pasien dewasa yang menjalani operasi ekstremitas bawah. Pasien dibagi dalam dua kelompok secara acak, tiap-tiap kelompok terdiri atas 18 pasien. Kelompok A mendapatkan bupivakain 0,5% sebanyak 20 mL dan kelompok B mendapatkan 30 mL. Hasil menunjukkan bahwa mula kerja blokade sensorik dan motorik pada kedua kelompok tidak berbeda bermakna (p>0,05). Hasil penelitian menggunakan uji-t dan uji Mann Whitney menunjukkan bahwa lama kerja blokade sensorik dan motorik pada kelompok A lebih singkat bermakna dibanding dengan kelompok B (p<0,05). Simpulan penelitian ini adalah pemberian 20 mL bupivakain 0,5% pada blokade saraf iskiadikus pendekatan parasakral menghasilkan mula kerja blokade sensorik dan motorik yang sama cepat dan lama kerja blokade sensorik dan motorik yang lebih singkat dibanding dengan pemberian 30 mL bupivakain 0,5%.Kata kunci: Blokade saraf iskiadikus, bupivakain, lama kerja blokade, mula kerja blokade, pendekatan parasakralComparison of Onset and Duration of Action between 20 mL with 30 mL of 0.5% Bupivacaine on Ischiadicus Nerve Block with Parasacral Approach Assisted by a Nerve Stimulator for Lower Ekstremity SurgeryIschiadicus nerve block with parasacral approach is an anesthetic option for surgery in the lower extremity. This method offers many advantages such as high rate of successful block and less use of local anesthetic agent. The purpose of this study was to compare the onset and duration of action of ischiadicus nerve block with parasacral approach assisted by a nerve stimulator using 20 mL of 0.5% bupivacaine to 30 mL of 0.5% bupivacaine in Dr. Hasan Sadikin General Hospital Bandung and Dr. Slamet Hospital Garut between the period of October to November 2015. This experimental randomized controlled study was performed on 36 adult patients undergoing lower extremity surgeries. Patients were divided randomly into two groups consisting of 18 patients. Group A was given 20 mL of 0.5% bupivacaine while group B was given 30 mL of 0.5% bupivacaine. The onset and duration of action of sensory and motoric blocks were recorded. The t-test and Mann Whitney test used in this study showed that the duration of sensory and motoric blocks in group A was significantly shorter than that of group B (p<0.05). It is concluded that the ischiadicus nerve block with parasacral approach using 20 mL of 0.5% bupivacaine has the same onset but shorter duration of sensory and motoric blocks compared to 30 mL of 0.5% bupivacaine.Key words: Bupivacaine, duration of block, ischiadicus nerve block, onset of block, parasacral approach 
Perbandingan Efek Pemberian Eritromisin 250 mg Oral dengan Metoklopramid 10 mg Oral terhadap Jumlah dan pH Cairan Lambung pada Pasien yang Menjalani Operasi Elektif dengan Anestesi Umum Mursali, Andi; Maskoen, Tinni T.; Tavianto, Doddy
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (557.074 KB) | DOI: 10.15851/jap.v5n1.1000

Abstract

Aspirasi pulmonal akibat isi lambung merupakan penyebab kematian yang berhubungan dengan anestesi. Eritromisin 250 mg oral dan metoklopramid 10 mg oral digunakan untuk menurunkan jumlah dan meningkatkan pH cairan lambung. Penelitian ini bertujuan membandingkan efek eritromisin 250 mg oral dan metoklopramid 10 mg oral terhadap jumlah dan pH cairan lambung pasien yang menjalani operasi elektif dengan anestesi umum. Penelitian ini merupakan uji klinis acak buta ganda pada 42 pasien yang termasuk dalam kriteria inklusi pasien dengan American Society of Anesthesiologist (ASA) kelas I, usia 18–60 tahun, dijadwalkan operasi elektif dengan anestesi umum dan diintubasi di Rumah Sakit Dr Hasan Sadikin Bandung periode Agustus–September 2015. Pasien dibagi menjadi 2 kelompok 21 orang masing-masing. Kelompok A mendapatkan eritromisin 250 mg oral dan kelompok B metoklopramid 10 mg oral yang diberikan 1 jam sebelum induksi anestesi. Setelah dilakukan intubasi, cairan lambung diambil menggunakan spuit 50 mL melalui nasogastric tube (NGT) no 18, dimasukkan ke gelas ukur, diukur jumlah dan pH nya. Analisis statistik menggunakan uji Mann–Whitney. Hasil menunjukkan kelompok A didapatkan 90,5% pasien dengan jumlah cairan <25 mL, sedangkan kelompok B 57,1%, perbedaan bermakna secara statistik (p<0,014). Simpulan, eritomisin 250 mg oral lebih menurunkan jumlah dan meningkatkan pH cairan lambung dibanding dengan metoklopramid 10 mg oral pada pasien yang menjalani anestesi umum.Kata kunci: Eritromisin, jumlah cairan lambung, metoklopramid, pH cairan lambung Comparison of the Effect of 250 mg Oral Erythromycine and 10 mg Oral Metoclopramide on Gastric Fluid Volume and pH in Patients Undergoing Elective Operation in General AnesthesiaPulmonary aspiration caused by gastric contents is one of the leading causes of anesthesia-related deaths. Combination of >25 mL volume and a <2.5 pH is a high risk to lung damage. Oral Erythromycin 250 mg and Oral metoclopramide 10 mg can be used to reduce the gastric fluid volume and increase the gastric fluid pH. The purpose of this study was compare the effects between oral erythromycin 250 mg and oral metoclopramide 10 mg on the volume and pH of gastric fluid in patients undergoing elective general anesthesia. This study was a double blind randomized clinical trial on 42 patients who met the inclusion criteria. Patients were divided into 2 groups with 21 patients in each group. Group A received 250 mg of oral erythromycin and group B received 10 mg of metoclopramide, 1 hour before the induction of anesthesia.After intubation, gastric fluid was collected using a 50 mL syringe via the nasogastric tube (NGT). It was then placed in a beaker glass to have its volume and pH measured. A statistical analysis using the Mann–Whitney test was performed. In group A, 90.5% of patients were found to have gastric fluid volume <25 mL, while group B had 57.1%, in which the difference was statistically significant (p <0.014). Hence, the administration of erythromycin 250 mg orally is more effective in reducing the gastric fluid volume and increasing the gastric fluid pH compared to oral administration of etoclopramide 10 mg in patients undergoing general anesthesia.Key words: Erythromycin, gastric fluid volume, metoclopramid, gastric pH
Mual Muntah Pasien Pascavitrektomi: Perbedaan Rumatan Kombinasi Sevofluran 1,2%-Fentanil 1,2 μg/kgBB/jam dengan Rumatan Sevofluran 2% Marsaban, Arif H. M.; Kapuangan, Christopher; Yulian, Anggadria Iqbal
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (700.098 KB) | DOI: 10.15851/jap.v5n1.996

Abstract

Vitrektomi merupakan operasi yang sering dilakukan dengan insidens mual muntah pascaoperatif yang cukup tinggi. Kombinasi opioid - anestetik inhalasi merupakan pilihan dalam rumatan anestesia umum karena mempunyai efek sinergis. Perbandingan dosis kombinasi fentanil dan sevofluran dengan timbulnya efek samping mual muntah pascaoperatif belum pernah dilaporkan. Penelitian ini bertujuan mengetahui perbedaan insidens mual muntah pascavitrektomi antara rumatan kombinasi sevofluran 1,2%- fentanil 1,2 μg/kgBB/jam dan sevofluran 2%. Penelitian ini merupakan uji klinis acak tersamar tunggal terhadap pasien yang menjalani vitrektomi dengan anestesia umum di Ruang operasi mata Kirana RSUPN Cipto Mangunkusumo Jakarta Mei–Juli 2015. Enam puluh dua pasien yang akan menjalani vitrektomi dengan anestesia umum dirandomisasi ke dalam dua kelompok, yaitu kelompok yang mendapat rumatan kombinasi sevofluran 1,2%-fentanil 1,2 μg/kgBB/jam dan kelompok dengan rumatan sevofluran 2%. Pengukuran mual muntah pascabedah dilakukan dengan metode wawancara langsung. Analisis data dilakukan dengan uji chi-kuadrat dan uji Fisher sebagai uji alternatif. Insidens mual antara kedua kelompok berbeda bermakna pada periode 0–2 jam pascaoperasi (p<0,05), sedangkan pada periode 2–6 jam, insidens mual antara kedua kelompok tidak berbeda bermakna (p>0,05). Simpulan, rumatan anestesia dengan sevofluran 1,2%-fentanil 1,2 μg/kgBB/jam menimbulkan insidens mual dalam 2 jam pertama pascavitrektomi yang lebih rendah dibanding dengan sevofluran 2%.Kata kunci: Fentanil, mual muntah pascavitrektomi, sevoflurane Anesthesia for vitrectomy patient has a high incidence of postoperative nausea and vomiting (PONV).Combination of opioid and inhalation anesthesias has been commonly used for anesthesia maintenance  due to their sinergystic effect. The effect of fentanyl-sevoflurane dosage to PONV incidence in vitrectomy surgery has never been studied. This study aimed to determine the difference in PONV incidence between combination of sevoflurane 1.2%-fentanyl 1.2 μg/kgBW/hour and sevoflurane 2% for anesthesia maintenance. This study was a single blind randomized study in vitrectomy patients with general anesthesia at Kirana Operating Theatre of Dr.Cipto Mangunkusumo National General Hospital during May–July 2015. Sixty two patients who were undergoing vitrectomy surgery with general anesthesia were randomized into sevofluran 1.2%- fentanil 1.2 μg/kgBW/hour group and sevoflurane 2% group. Postoperatively, the incidences of PONV were recorded. Data were collected by anamnesis method and analyzed by chi-square and Fisher test. There was a significant difference of nausea incidence between the two intervention groups within 0–2 hours postvitrectomy period (p<0.05) but no significant difference within 2–6 hours postvitrectomy period (p>0.05). In conclusion, sevoflurane 1.2%-fentanyl 1.2 μg/kgBW/hour has lower incidence of postvitrectomy nausea within the first 2 hour compared to sevoflurane 2%.Key words: Fentanyl, postvitrectomy nausea and vomiting, sevoflurane 
Gambaran Kontaminasi Bakteri pada Sirkuit Pernapasan Anestesi di Ruang Operasi Rumah Sakit Dr. Hasan Sadikin Bandung pada Bulan Agustus 2015 Suryadi, Suryadi; Fuadi, Iwan; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (602.025 KB) | DOI: 10.15851/jap.v5n1.1001

Abstract

Rumah Sakit Dr. Hasan Sadikin Bandung memakai sirkuit pernapasan dalam melakukan tindakan anestesi di ruang operasi. Sirkuit tersebut digunakan berulang dan diganti setiap 24 jam. Penelitian ini dilakukan untuk mengetahui gambaran kontaminasi bakteri pada sirkuit pernapasan anestesi. Penelitian dilakukan dengan metode deskriptif observasional secara cross–sectional. Sebanyak 102 sampel dari 51 sirkuit pernapasan anestesi diperiksa kultur bakteri sebelum dan sesudah digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung selama 3 hari pada bulan Agustus 2015. Pengambilan sampel dilakukan dengan metode apus pada konektor Y sirkuit pernapasan anestesi sebelum dan sesudah digunakan dalam 24 jam. Hasil penelitian ini menunjukkan tidak ada kontaminasi bakteri pada sirkuit pernapasan anestesi sebelum digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung. Kontaminasi bakteri pada sirkuit pernapasan anestesi sesudah digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung adalah 25,49%. Gambaran pola bakteri yang teridentifikasi adalah bakteri Micrococcus spp., Bacillus spp., Streptococcus viridans, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis, dan Staphylococcus saprophyticus. Simpulan penelitian ini adalah tidak ditemukan kontaminasi bakteri pada sirkuit pernapasan anestesi sebelum digunakan dan ditemukan kontaminasi bakteri pada sirkuit pernapasan anestesi sesudah digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung.Kata kunci: Gambaran pola bakteri, kontaminasi bakteri, sirkuit pernapasan anestesi Description of Bacteria Contamination in Anesthesia Breathing Circuit in Operating Room Dr. Hasan Sadikin Bandung General Hospital in August 2015Breathing circuits have been used repeatedly to perform anesthesia in the operating theater of Dr. Hasan Sadikin General Hospital with a replacement interval of every 24 hours. This study was conducted to determine the contamination of bacteria in the anesthesia breathing circuits. This was an observational descriptive cross–sectional study on 102 samples from 51 anesthesia breathing circuits. These samples were cultured before and after the use of breathing circuit in the operating room of Dr. Hasan Sadikin General Hospital for 3 days in August 2015. Sampling was performed using swab method at the Y connector of anesthesia breathing circuit before and after use within a period of 24 hours. The results showed that no bacterial contamination was found in the anesthesia breathing circuit before use in the operating theatre of Dr. Hasan Sadikin Hospital Bandung. Bacterial contamination of anesthesia breathing circuit after use was 25.49%. The bacteria identified were Micrococcus spp., Bacillus spp., Streptococcus viridans, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis and Staphylococcus saprophyticus. It is concluded that no bacterial contamination of anesthesia breathing circuit before use; however, bacterial contamination was found after the use of anesthesia breathing circuits in the operating theatre of Dr. Hasan Sadikin General Hospital Bandung.Key words: Anesthesia breathing circuits, bacterial contamination, description of the bacteria 
Perbandingan Obat Kumur Benzydamine Hydrochloride 22,5 mg dan Ketamin 40 mg dalam Mengurangi Nyeri Tenggorok dan Suara Serak Akibat Intubasi Endotrakeal Firza, Teuku Andrian; Umar, Nazaruddin; Ihsan, Muhammad
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (625.284 KB) | DOI: 10.15851/jap.v5n1.997

Abstract

Nyeri tenggorok dan suara serak merupakan komplikasi yang sering muncul pada anestesi umum dengan intubasi endotrakeal yang memengaruhi kenyamanan dan kepuasan pasien setelah operasi. Penelitian ini bertujuan mengetahui efektivitas obat kumur benzydamine hydrochloride dan ketamin dalam mengurangi nyeri tenggorok dan suara serak setelah anestesi umum dengan intubasi endotrakeal. Terdapat 58 pasien berusia 16–60 tahun yang akan menjalani anestesi umum di Instalasi Bedah Sentral RSUP H. Adam Malik Medan pada bulan Oktober–November 2013 dengan intubasi endotrakeal secara acak tersamar ganda dan dibagi dalam 2 kelompok yang sama besar. Sepuluh menit sebelum masuk kamar operasi, pasien menerima obat kumur ketamin atau benzydamine hydrochloride sebanyak 15 mL untuk dikumur selama 60 detik. Setelah operasi pasien diberikan ketorolak. Penilaian nyeri tenggorok dan suara serak dilakukan pada 1, 6, 12, dan 24 jam setelah selesai operasi. Hasil penelitian 6 pasien dikeluarkan dari penelitian. Insiden nyeri tenggorok pada jam I pada kelompok ketamin 14 dari 26 dan benzydamine hydrochloride 18 dari 26, sedangkan insidens suara serak pada jam I pada kelompok ketamin 16 dari 26 dan benzydamine hydrochloride 18 dari 26. Secara umum benzydamine hydrochloride lebih baik dibanding dengan ketamin, namun dengan uji chi-kuadrat tidak berbeda antara kedua kelompok obat.Kata kunci: Benzydamine hydrochloride, intubasi endotrakeal, ketamin, nyeri tenggorok, suara serakComparison of Benzydamine Hydrochloride 22.5 mg and Ketamine 40 mg Mouthwash Reduce Sore throat and Hoarseness after Endotracheal IntubationSore throat and hoarseness is a frequent complication in general anesthesia with endotracheal intubation, which affects the comfort and satisfaction of patients after surgery. This study aimed to determine the effectiveness of ketamine and benzydamine hydrochloride mouthwash in reducing sore throat and hoarseness following general anesthesia with endotracheal intubation. Fifty eight patients aged 16–60 years undergoing general anesthesia at the Central Operating Theater of H. Adam Malik General Hospital Medan with endotracheal intubation during October–November 2013 were double-blind randomized and divided equally into 2 groups. Ten minutes before entering the operating room, patients received ketamine or benzydamine hydrochloride mouthwash as much as 15 mL for a 60 seconds gargle. After surgery, patients were given ketorolac. Assessment on sore throat and hoarseness was performed at 1, 6, 12, 24 after the completion of surgery. Six patients were excluded from the study. The incidence of sore throat in the first hour in ketamine group was 14 of 26 and 18 of 26 in hydrochloride benzydamine group. Meanwhile, the incidence of hoarseness in the first hour for both groups were 16 of 26 and 18 of 26, respectively. In general, benzydamine hydrochloride is better than ketamine although the difference is not statistically significant.Key words: Benzydamine hydrochloride, endotracheal intubation, ketamine, sore throat, hoarseness 
Perbandingan Validitas Sistem Penilaian APACHE II, SOFA, dan CSOFA Sebagai Prediktor Mortalitas Pasien yang Dirawat di Instalasi Rawat Intensif RSUP H. Adam Malik Medan Andrias, Andrias; Hanafie, Achsanuddin; Wijaya, Dadik Wahyu
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (642.097 KB) | DOI: 10.15851/jap.v5n1.998

Abstract

Sistem penilaian APACHE II dan SOFA masih digunakan sebagai instrumen objektif untuk memprediksi mortalitas pasien di Instalasi Rawat Intensif (IRI), namun masih kurang praktis. Sistem penilaian CSOFA dengan parameter serta biaya pengeluaran yang lebih sedikit dan praktis diharapkan memiliki akurasi yang lebih baik. Tujuan penelitian ini mendapatkan alternatif yang lebih sederhana, mudah dan murah, namun tetap memiliki akurasi yang baik sebagai prediktor mortalitas pasien selain APACHE II dan SOFA. Penelitian uji diagnostik cross sectional dilakukan pada bulan Februari–April 2016 di IRI RSUP H. Adam Malik. Subjek penelitian 71 pasien dewasa yang memenuhi kriteria inklusi dinilai APACHE II, SOFA, dan CSOFA setelah dirawat 24 jam pertama, kemudian dilihat mortalitasnya pada akhir masa rawatan. Analisis statistik menggunakan tabel 2x2 serta receiving operating curve (ROC), dihitung juga sensitivitas, spesifisitas, nilai prediksi negatif dan positif, serta likelihood ratio dengan SPSS ver.23. CSOFA memiliki kemampuan yang sangat baik dalam memprediksi mortalitas dengan luas area under ROC (AuROC) 87,6%. APACHE II memiliki kemampuan yang baik dalam memprediksi mortalitas dengan luas AuROC 84,7%. SOFA memiliki kemampuan yang cukup dalam memprediksi mortalitas dengan luas AuROC 79,1%. Simpulan, sistem penilaian CSOFA dapat dijadikan sebagai prediktor mortalitas pasien selain APACHE II dan SOFA di IRI RSUP HAM.Kata kunci: APACHE II, CSOFA, mortalitas, SOFA Comparison of APACHE II, SOFA, and CSOFA Scoring System Validity as Mortality Predictor in ICU Patients in H. Adam Malik General HospitalThe APACHE II and SOFA scoring systems are still used as the objective instruments for predicting mortality in patients admitted to the Intensive Care Unit (ICU); however, the two are still considered less practical. CSOFA, with more practical parameters as well as a lower cost, is expected to provide better accuracy. The purpose of this study was to get a simpler, easier, and cheaper alternative, but with good accuracy, to APACHE II and SOFA as a predictor of mortality in patients admitted to the ICU of H. Adam Malik (HAM) Hospital. A cross-sectional diagnostic test study was conducted in February–April 2016 at the ICU of H. Adam Malik General Hospital. A sample of 71 adult patients that met the inclusion criteria was assessed by APACHE II, SOFA, and CSOFA at the first 24 hours after treatment. The mortality was then observed at the end of treatment. Statistical analysis using 2x2 tables and receiving operating curve (ROC) were used to calculate the sensitivity, specificity, positive, and negative predictive values, as well as the likelihood ratio using SPSS ver.23. CSOFA in this study presented a very good ability in predicting mortality with an Area under ROC (AuROC) of 87.6% while APACHE II had a good ability in predicting mortality with an AuROC of 84.7%. SOFA had sufficient ability in predicting mortality with an AuROC of 79.1%. In conclusion, CSOFA scoring system can be used as a patient mortality predictor as an alternative to APACHE II and SOFA in the ICU.Key words: APACHE II, CSOFA, mortality, SOFA 
Perbandingan Validitas Sistem Penilaian APACHE II, SOFA, dan CSOFA Sebagai Prediktor Mortalitas Pasien yang Dirawat di Instalasi Rawat Intensif RSUP H. Adam Malik Medan Andrias Andrias; Achsanuddin Hanafie; Dadik Wahyu Wijaya
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (642.097 KB) | DOI: 10.15851/jap.v5n1.998

Abstract

Sistem penilaian APACHE II dan SOFA masih digunakan sebagai instrumen objektif untuk memprediksi mortalitas pasien di Instalasi Rawat Intensif (IRI), namun masih kurang praktis. Sistem penilaian CSOFA dengan parameter serta biaya pengeluaran yang lebih sedikit dan praktis diharapkan memiliki akurasi yang lebih baik. Tujuan penelitian ini mendapatkan alternatif yang lebih sederhana, mudah dan murah, namun tetap memiliki akurasi yang baik sebagai prediktor mortalitas pasien selain APACHE II dan SOFA. Penelitian uji diagnostik cross sectional dilakukan pada bulan Februari–April 2016 di IRI RSUP H. Adam Malik. Subjek penelitian 71 pasien dewasa yang memenuhi kriteria inklusi dinilai APACHE II, SOFA, dan CSOFA setelah dirawat 24 jam pertama, kemudian dilihat mortalitasnya pada akhir masa rawatan. Analisis statistik menggunakan tabel 2x2 serta receiving operating curve (ROC), dihitung juga sensitivitas, spesifisitas, nilai prediksi negatif dan positif, serta likelihood ratio dengan SPSS ver.23. CSOFA memiliki kemampuan yang sangat baik dalam memprediksi mortalitas dengan luas area under ROC (AuROC) 87,6%. APACHE II memiliki kemampuan yang baik dalam memprediksi mortalitas dengan luas AuROC 84,7%. SOFA memiliki kemampuan yang cukup dalam memprediksi mortalitas dengan luas AuROC 79,1%. Simpulan, sistem penilaian CSOFA dapat dijadikan sebagai prediktor mortalitas pasien selain APACHE II dan SOFA di IRI RSUP HAM.Kata kunci: APACHE II, CSOFA, mortalitas, SOFA Comparison of APACHE II, SOFA, and CSOFA Scoring System Validity as Mortality Predictor in ICU Patients in H. Adam Malik General HospitalThe APACHE II and SOFA scoring systems are still used as the objective instruments for predicting mortality in patients admitted to the Intensive Care Unit (ICU); however, the two are still considered less practical. CSOFA, with more practical parameters as well as a lower cost, is expected to provide better accuracy. The purpose of this study was to get a simpler, easier, and cheaper alternative, but with good accuracy, to APACHE II and SOFA as a predictor of mortality in patients admitted to the ICU of H. Adam Malik (HAM) Hospital. A cross-sectional diagnostic test study was conducted in February–April 2016 at the ICU of H. Adam Malik General Hospital. A sample of 71 adult patients that met the inclusion criteria was assessed by APACHE II, SOFA, and CSOFA at the first 24 hours after treatment. The mortality was then observed at the end of treatment. Statistical analysis using 2x2 tables and receiving operating curve (ROC) were used to calculate the sensitivity, specificity, positive, and negative predictive values, as well as the likelihood ratio using SPSS ver.23. CSOFA in this study presented a very good ability in predicting mortality with an Area under ROC (AuROC) of 87.6% while APACHE II had a good ability in predicting mortality with an AuROC of 84.7%. SOFA had sufficient ability in predicting mortality with an AuROC of 79.1%. In conclusion, CSOFA scoring system can be used as a patient mortality predictor as an alternative to APACHE II and SOFA in the ICU.Key words: APACHE II, CSOFA, mortality, SOFA 

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