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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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Angka Mortalitas dan Faktor yang Memengaruhi pada Pasien Trakeoesofageal Fistula (TEF) yang Menjalani Operasi di RSUP Dr. Hasan Sadikin Bandung Sunarya, Unang; Oktaliansah, Ezra; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (697.967 KB) | DOI: 10.15851/jap.v5n2.1111

Abstract

Trakeoesofageal fistula (TEF) merupakan kelainan esofagus yang bersifat kongenital ditandai dengan fistula antara trakea dan esofagus yang merupakan koneksi abnormal yang dapat disertai putusnya antara distal dan proksimal esofagus. Insidensi TEF kongenital mencapai 1:2.400‒4.500 kelahiran hidup. Tujuan penelitian ini mengetahui angka mortalitas dan faktor yang memengaruhi pada pasien TEF yang menjalani operasi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2010–2015. Metode penelitian ini bersifat deskriptif yang dilakukan secara retrospektif terhadap 35 rekam medik pasien TEF yang menjalani operasi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2010‒2015. Hasil penelitian ini menunjukkan angka mortalitas pascaoperasi pasien TEF sebesar 19 dari 34 dan mortalitas tertinggi terjadi pada perempuan 7 dari 12, bayi lahir lahir prematur 5 dari 5, berat badan lahir kurang dari 1.500 gram 1 dari 1, TEF tipe C 19 dari 32, riwayat persalinan di bidan/puskesmas 9 dari 11, disertai kelainan kongenital penyerta selain kelainan anorektal, usia saat operasi lebih dari 7 hari 15 dari 17, penyulit preoperatif lebih dari satu, lama operasi lebih dari 3 jam, tidak dilakukan ekstubasi 15 dari 20, kenaikan berat badan lebih dari 10% 14 dari 18, leakage pascaoperasi dan faktor penyulit pascaoperasi lebih dari satu. Simpulan Angka mortalitas pasien TEF yang menjalani operasi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2010–2015 sebanyak 54,3%. Kata kunci: Mortalitas pascaoperasi, operasi, trakeoesofageal fistula Mortality and The Influencing Factors of Trakeoesofageal Fistula (TEF)Patients which Operated in Dr. Hasan Sadikin General Hospital BandungTracheoesophageal fistula (TEF) is a disorder of the esophagus that is characterized by congenital fistula between the trachea and esophagus wich is an abnormal connection that can be accompanied by a break between the distal and proximal esophagus. The incidence of congenital TEF reached 1:2,400‒4,500 live births. The purpose of this study to determine mortality and factors affecting mortality in patients TEF in Dr. Hasan Sadikin General Hospital Bandung in 2010‒2015. This research method was descriptive retrospectively of 35 patients taken from the medical records underwent surgery TEF in Dr. Hasan Sadikin Central Hospital Bandung in 2010‒2015. Results of this study showed a mortality rate of postoperative patients TEF rate of 19 from 34 and the highest mortality among women 7 from 12, premature birth, birth weigth less than 1,500 g, TEF type C 19 from 36, childbirth history at the midwife 9 from 11, congenital abnormalities other than anorectal disease, age at surgery of more than 7 days 15 from 17, preoperative complications more than one, the operating time of more than 3 hours, do not extubation 15 from 20, weight gain more than 10% 14 from 18, the leakage postoperative and more than one complications postoperative factors. In conclusion, mortality of trakeoesofageal fistula (TEF) patients which operated in Dr. Hasan Sadikin General Hospital Bandung in 2010–2015 was 54.3%.Key words: Postoperative mortality, operatif, tracheoesophageal fistula
Penggunaan Anestesi Lokal dan Adjuvan pada Analgesi Epidural di Wilayah Jawa Barat Tahun 2015 Yadi, Dedi Fitri; Ibnu, Muhamad; Oktaliansah, Ezra
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (583.788 KB) | DOI: 10.15851/jap.v5n2.1107

Abstract

Analgesi epidural yang optimal akan menghasilkan penanganan nyeri yang baik dengan efek samping minimal dan meningkatkan kepuasan pasien. Sampai saat ini belum terdapat data di Indonesia khususnya di wilayah Jawa Barat mengenai penggunaan anestesi lokal dan adjuvan pada analgesi epidural. Tujuan penelitian ini mecari data mengenai penggunaan anestesi lokal dan adjuvan yang digunakan oleh dokter spesialis anestesi di wilayah Jawa Barat pada tahun 2015. Penelitian ini dilakukan pada bulan Agustus hingga September 2016 di Departemen Anestesiologi dan Terapi Intensif Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian ini bersifat deskriptif dengan pengambilan data menggunakan kuesioner dan pendekatan cross sectional. Kuesioner dikirimkan kepada 120 dokter spesialis anestesi di Jawa Barat melalui jasa pos dan 30 kuesioner diberikan langsung kepada dokter spesialis anestesi yang bekerja di Rumah Sakit Dr. Hasan Sadikin Bandung. Angka respons yang didapatkan sebesar 47,3%. Hasil penelitian ini didapatkan dokter spesialis anestesi di Jawa Barat yang masih melakukan analgesi epidural pada tahun 2015 sebesar 73,2%. Obat anestesi lokal yang paling banyak digunakan untuk analgesi epidural adalah bupivakain sebesar 94,23%. Konsentrasi terbanyak 0,125% sebesar 82%. Adjuvan yang paling banyak digunakan adalah fentanil sebesar 96,9%. Simpulan penelitian ini sebagian besar dokter spesialis anestesi masih menggunakan epidural sebagai analgesi sehingga bupivakasin dan fentanil menjadi obat terbanyak yang digunakan.Kata kunci: Analgesi epidural, anestesi lokal, adjuvan  Local Anesthetic and Adjuvan Used for Epidural Analgesia in West Java in 2015Optimal analgesia epidural technique should promote effective pain relief with minor adverse event and major pastient satisfactory. Up till now, there was no data about local anesthetic and adjuvan agent used for epidural analgesia by anesthesiologist in Indonesia, especially in West Java. The purpose of this study to find data regarding local anesthetic and adjuvan agent used for epidural analgesia by anesthesiologist in Indonesia, especially in West Java in 2015. This research was conducted from August to September 2016 in the Department of Anesthesiology and Intensive Therapy Dr. Hasan Sadikin Hospital in Bandung. This is a descriptive study with cross sectional approach using questionairre. Questionairre was sent to 120 anesthesiologist through mail and 30 questionairre was given to anesthesiologists worked at Dr. Hasan Sadikin General Hospital Bandung. Response was obtained 47.3%. This study shows that there were 73.2% anesthesiologist performed epidural analgesia in 2015. The most  local anesthetic used in epidural blockade was bupivacaine, amounted 94.23% and the most concentration is 0.125%, amounted 82%. The most used adjuvant was fentanyl, 96.9%. In Conclusion, most of the anesthesiologist used epidural as an analgesia so bupivacaine and fentanyl used most frequentKey words: Epidural analgesia, local anesthetic, adjuvan
Angka Mortalitas pasien Neonatus yang Menjalani Operasi berdasar atas Kenaikan Berat Badan Pascaoperasi yang Dirawat di Neonatal Intensive Care Unit (NICU) Komara, Asep Deden; Oktaliansah, Ezra; Rismawan, Budiana
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (276.698 KB) | DOI: 10.15851/jap.v5n2.1112

Abstract

Salah satu faktor risiko mortalitas pada neonatus yang menjalani operasi adalah regulasi cairan intraoperatif. Tujuan penelitian ini mengetahui angka mortalitas pada neonatus yang menjalani operasi berdasar atas kenaikan berat badan pascaoperasi yang dirawat di NICU. Metode penelitian adalah deskriptif dengan pendekatan retrospektif. Penelitian ini melibatkan 95 subjek penelitian, yaitu neonatus yang menjalani operasi dan dirawat di NICU RSHS Bandung selama tahun 2010‒2015. Data diambil dari rekam medis, pengambilan data mulai tanggal 1 Februari–29 Maret 2017.  Subjek dibagi tiga kelompok, yaitu neonatus yang telah menjalani prosedur operasi yang mengalami kenaikan berat badan pascaoperasi kurang 10% (I), neonatus yang menjalani prosedur operasi yang mengalami kenaikan berat badan 10‒20% (II), dan kelebihan berat badan ≥20% (III). Neonatus pacaoperasi dengan kenaikan berat badan  ≤10% sebanyak  46 pasien dan yang meninggal  sebanyak 10 pasien pada  kenaikan  berat badan 10‒20%  sebanyak 38 pasien, pasien yang meninggal sebanyak 23 pasien, angka mortalitasnya sebesar 60,5%, sedangkan  pada pasien dengan kenaikan berat badan sama dengan atau lebih dari 20% sebanyak 11 pasien atau 11,5% yang meninggal  sebanyak 10 pasien, angka mortalitasnya sebesar 90,9%. Simpulan angka mortalitas pasien neonatus yang menjalani operasi di RSHS dan pascaoperasi dirawat di NICU RSHS selama periode 2010–2015 adalah 45,3%. Kata kunci: Kenaikan berat badan, mortalitas, neonatus The Mortality Rate in Neonatal Patients which Underwent Surgical Procedures-Defined by the Escalation of Postoperative Weight and Those Who were Admitted in Neonatal Intensive Care Unit (NICU) One of the risk factors contributed to this number was the inappropriate management of intraoperative fluid resuscitation. The aim of this study is to understand the mortality rate in neonatal patients which underwent surgical procedures–defined by the escalation of postoperative weight and those who were admitted in NICU. The research method used in this study was a retrospective approach presented in a descriptive manner. The study involved 95 research subjects, which were neonatal patients which underwent surgical procedures and admitted in NICU RSHS Bandung from 2010‒2015. Data collection from Februari 1st–March 29th  2017. The research subjects were classified into three groups, neonatal patients which had escalation of weight postoperative less than 10% and underwent surgical procedure (I), neonatal patients which had escalation of weight postoperative ranging from 10‒20% and underwent surgical procedure (II), meanwhile consist of neonatal patients which had escalation of weight postoperative ≥20% and underwent surgical procedure (III). Result of the study showed there were 46 neonatal patients with 10% weight escalation and 10 out of 46 patients were ceased, meanwhile there were 38 neonatal patients with 10‒20% weight escalation and 23 out of 38 were ceased, and there were 11 neonatal patients with ≥20% weight escalation and 10 out of 11 were ceased. The conclusions of this study found a mortality rate of neonatal patients who underwent surgery and postoperative treated in  NICU RSHS during the period 2010 to 2015 is 45.3%. Key words: Weight gain, mortality, neonatal
Gambaran Pengetahuan Klinisi Ruang Rawat Intensif mengenai Ventilator Associated Pneumonia (VAP) Bundle di Ruang Rawat Intensif RSUP Dr. Hasan Sadikin Bandung Sadli, M. Fajar; Tavianto, Doddy; Redjeki, Ike Sri
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (636.643 KB) | DOI: 10.15851/jap.v5n2.1108

Abstract

Ventilator associated pneumonia (VAP) merupakan infeksi yang terjadi pada pasien yang terintubasi ≥48 jam di ruang rawat intensif. Penanganan VAP merupakan tantangan utama akibat morbiditas dan mortalitas yang tinggi.Ventilator associated pneumonia bundle (VAPb) telah terbukti dapat menurunkan angka kejadian VAP sehingga pengetahuan dokter dan perawat mengenai VAPb menentukan keberhasilan pencegahan VAP di ruang rawat intensif. Tujuan penelitian ini mengetahui pengetahuan dokter dan perawat mengenai VAPb di ruang rawat intensif RSUP Dr. Hasan Sadikin Bandung. Data diambil dari bulan November–Desember 2016. Penelitian deskriptif dengan desain potong lintang ini menggambarkan pengetahuan mengenai VAPb dari dokter residen Departemen Anestesi dan Terapi Intensif dan perawat di ruang rawat intensif RSUP Dr. Hasan Sadikin Bandung. Responden terdiri atas 79 dokter dan 88 perawat. Tingkat pengetahuan VAPb diuji menggunakan 20 pertanyaan kuesioner. Responden perawat terbanyak berjenis kelamin perempuan (74%), berusia ≥30 tahun (92%), status pendidikan diploma III (65%), lama kerja >5 tahun (76%), dan bekerja di Intensive Care Unit (ICU) (32%). Responden dokter terbanyak berjenis kelamin laki-laki (71%), berusia ≥30 tahun (83%), dan telah menyelesaikan stase ICU (61%). Simpulan, nilai kuesioner perawat dan dokter rata-rata berturut-turut 73,63 dan 73,16. Kata kunci: Klinisi ruang rawat intensif, tingkat pengetahuan, ventilator associated pneumonoia bundle Description of Intensive Care Clinician Knowledge about Ventilator Associated Pneumonia (VAP) Bundle in the Intensive Care Unit of  Dr. Hasan Sadikin Hospital BandungVentilator associated pneumonia (VAP) is an infection that occurs in patients who are intubated ≥48 hours in intensive care. Management VAP is a major challenge due to the high morbidity and mortality. Ventilator associated pneumonia bundle (VAPb) has been shown to reduce the incidence of VAP, so knowledge of doctors and nurses about VAPb determine the success of preventing VAP in intensive care. This study aims to know the description of intensive care clinician knowledge about ventilator associated pneumonia bundle in the intensive care of Dr. Hasan Sadikin General Hospital Bandung. Data were collected from November–December 2016. Descriptive study with cross-sectional design depicts VAPb knowledge of resident physicians Department of Anesthesia and Intensive Therapy and nurses in the Intensive Care Department of Dr. Hasan Sadikin Hospital. Respondents consisted of 79 doctors and 88 nurses. The level of knowledge VAPb tested using a 20 question questionnaire. Most nurse respondents were female (74%), aged ≥30 years (92%), educational status diploma III (65%), length of employment >5 years (76%), and work in Intensive Care Unit (ICU) (32%). Most physician respondents were male sex (71%), aged ≥30 years (83%), and had completed stase ICU (61%). In conclution, the mean value of the questionnaire nurses and doctors respectively 73.63 and 73.16. Key words: Intensive care clinician, level of knowledge, ventilator associated pneumonoia bundle
Penutupan Defek Septum Ventrikel Secara Transtorakalis Minimal Invasif dengan Panduan Transesophageal Echocardiography (TEE) Irwanto, Fredi Heru; Puspita, Yusni; Yuliansyah, Rudy
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (837.819 KB) | DOI: 10.15851/jap.v5n2.1113

Abstract

Defek septum ventrikel (ventricular septal defect/VSD) merupakan penyakit jantung bawaan yang paling sering ditemukan pada bayi dan anak. Penutupan defek ini masih memberikan tantangan tersendiri.  Penanganan VSD dengan metode minimally invasive transthoracic merupakan perkembangan inovatif penutupan defek ventrikel. Laporan kasus ini bertujuan memperkenalkan metode terbaru dalam penanganan kasus VSD yang dilakukan di RSUP Dr. Mohammad Hoesin Palembang. Kami melaporkan serial kasus penutupan VSD menggunakan metode minimally invasive transthoracic dengan panduan transesophageal echocardiography (TEE). Transesophageal echocardiography digunakan selama prosedur sebagai panduan penempatan alat dan mengevaluasi hasil operasi. Empat pasien pada periode November 2015 menjalani prosedur penutupan defek, dua pasien laki-laki dan dua perempuan, usia 2 tahun sampai 4 tahun dengan berat badan 12–22 kg, dengan  diameter VSD berdasar atas pemeriksaan ekokardiografi 4–7 mm. Penutupan VSD menggunakan metode minimally invasive transthoracic dengan panduan TEE melalui mini sternotomi menunjukkan prosedur yang aman dan efektif. Penggunaan TEE memberikan informasi yang sangat berguna selama periode intraoperatif.Kata kunci: Defek septum ventrikel, minimal invasif, transesophageal echocardiography Minimally Invasive Transthoracic Ventricular Septal Defect Closure Using Transesophageal Echocardiography GuidanceVentricular septal defect (VSD) is the most common congenital heart disease found in infants and children. Up until now, management of VSD closure remains as a challenge for clinician. Ventricular septal defect closure with minimally invasive transthoracic method is an innovative development of ventricular defect closure. This case report aims to introduce the method of minimally invasive transthoracic VSD closure, which is the latest method in handling cases of VSD conducted at Dr. Mohammad Hoesin General Hospital Palembang. We report a case series VSD closure by the method of minimally invasive transthoracic with transesophageal echocardiography (TEE) guidance. Transesophageal echocardiography is used during the procedure as guidance for the placement of the device, and to evaluate the results of operations. Four patients of the period November 2015. Two girls patients and two boys, ages 2 years to 4 years old weighing 12–22 kg, with a diameter of VSD echocardiography examination between 4–7 mm. The closure of VSD using minimally invasive transthoracic under TEE guiding through mini-sternotomy indicate a safe and effective procedure. The use of TEE provides very useful information during the intraoperative period.Key words: Minimally invasive, transesophageal echocardiography, venticular septal defect
Angka Mortalitas dan Faktor Risiko pada Pasien Geriatri yang Menjalani Operasi Emergensi Akut Abdomen di RSUP Dr. Hasan Sadikin Bandung Tahun 2014−2015 Priyatmoko, Donny Prasetyo; Sudjud, Reza Widianto; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (777.67 KB) | DOI: 10.15851/jap.v5n2.1109

Abstract

Geriatri memiliki kekhususan yang perlu diperhatikan dalam bidang anestesi dan tindakan operasi karena terdapat kemunduran sistem fisiologis dan farmakologis sejalan dengan penambahan usia. Penelitian di Yunani tahun 2007 menjelaskan bahwa angka mortalitas akibat tindakan operasi setelah usia 65 tahun menjadi 3 kali lipat dibanding dengan usia 18−40 tahun. Angka mortalitas geriatri tahun 2007 pada operasi elektif sebesar 5%, sedangkan operasi emergensi sebesar 10%. Tujuan penelitian ini adalah memperoleh angka mortalitas dan faktor risiko pada pasien geriatri yang menjalani operasi emergensi akut abdomen tahun 2014−2015. Tipe penelitian ini merupakan deskriptif dengan pendekatan retrospektif terhadap 180 subjek penelitian yang diambil di bagian rekam medis sejak Juli−Oktober 2016 pada pasien geriatri yang menjalani operasi emergensi akut abdomen di RSUP Dr. Hasan Sadikin Bandung tahun 2014−2015. Hasil penelitian ini memperlihatkan angka mortalitas sebesar 9% dengan faktor penyebab mortalitas paling dominan adalah syok sepsis sebesar 50%. Faktor predisposisi disebabkan oleh indeks massa tubuh <18,5 kg/m2 sebesar 56,3%, diagnosis primer tumor intestinal sebesar 31,3%, penyakit penyerta diabetes melitus sebesar 31,3%, sepsis sebesar 93,8%, hipoalbumin sebesar 56,3% dan status fisik ASA 4E sebesar 62,5%. Simpulan, faktor presipitasi disebabkan oleh waktu respons penanganan >6 jam sebesar 93,8% dan komplikasi pascaoperasi severe sepsis disertai pneumonia sebesar 50%. Kata kunci: Akut abdomen, angka mortalitas, geriatri, operasi emergensi Mortality Rate and Risk Factor in Geriatric Patients Undergo Emergency Surgery for Acute Abdoment in Dr. Hasan Sadikin Hospital Bandung in 2014−2015Geriatric has special anesthetic and surgical consideration because of reducing physiologic function and pharmacodynamic as the age increase. A study in Greece in 2007 shows that surgery in patient more than 65 year old has three times mortality rate than 18–40 years old patients. Geriatric mortality rate in 2007 undergo elective surgery is 5%, while the emergency surgery 10%. Purpose of this study was to obtain mortality rate and risk factor in geriatric patients underwent emergency surgery for acute abdomen in 2014−2015. This was a descriptive retrospective study of 180 subjects taken from the medical records in July to October, 2016 in geriatric patients underwent emergency surgery for acute abdomen at the Dr. Hasan Sadikin hospital in 2014−2015. Results of this study showed a mortality rate of 9%, with most dominant factors that cause mortality was septic shock (50%). Predisposing factors was the body mass index <18.5 kg/m2 (56.3%), the diagnosis of primary tumor intestinal amounted to 31.3%, comorbidities of diabetes mellitus at 31.3%, sepsis (93.8%), hipoalbumin (56.3%) and ASA physical status 4E (62.5%). In conclution, precipitation factors caused by response time >6 hours (93.8%) and postoperative complications of severe sepsis with pneumonia (50%).Key words: Acute abdomen, emergency surgery, geriatrics, mortality rate
Perbandingan Proporsi Penilaian dan Reliabilitas Skala COMFORT dan CPOT dalam Menilai Intensitas Nyeri pada Pasien yang Menggunakan Ventilasi Mekanik di Instalasi Perawatan Intensif RSUP H. Adam Malik Medan Marpaung, Taor; Hanafie, Achsanuddin; Ihsan, Muhammad
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (788.616 KB) | DOI: 10.15851/jap.v5n2.1105

Abstract

Pain, agitation, delirium guidelines tahun 2013 menyatakan bahwa Critical-Care Pain Observation Tool merupakan instrumen penilaian nyeri pada pasien tidak dapat berkomunikasi yang paling valid dan reliabel. Skala COMFORT merupakan standar instrumen penilaian intensitas nyeri di indstalasi rawat intensif RSUP Haji Adam Malik Medan. Tujuan penelitian ini membandingkan proporsi penilaian dan reliabilitas skala COMFORT dengan CPOT dalam menilai intensitas nyeri pada pasien yang menggunakan ventilasi mekanik di Instalasi Perawatan Intensif RSUP Haji Adam Malik, Medan. Penelitian ini menggunakan desain cross-sectional pada 57 pasien di Instalasi Perawatan Intensif RSUP Haji Adam Malik Medan pada Maret–April 2016 yang memenuhi kriteria inklusi. Intensitas nyeri dinilai menggunakan skala COMFORT dan CPOT oleh 2 penilai yang berbeda pada saat istirahat dan saat stimulus noxious. Fisher’s exact test, diperoleh nilai p=0,003 (p<0,05). Tidak terdapat perbedaan reliabilitas yang signifikan secara statistik pada saat stimulus noxious, nilai p = 0,13 (95% IK: - 4–16%; p>0,05). Simpulan penelitian ini adalah CPOT merupakan instrumen penilaian nyeri yang lebih tepat dan cermat dibanding dengan skala COMFORT, namun tidak terdapat perbedaan reliabilitas CPOT dibanding dengan skala COMFORT dalam menilai intensitas nyeri pada pasien yang menggunakan ventilasi mekanik saat stimulus noxious.Kata kunci: Critical-care pain observation tool, PAD guidelines 2013, Skala COMFORTComparison of Proportion Assessment and Reliability COMFORT Scale and CPOT in the Assessment of Pain Intensity in Patients Using Mechanical Ventilation at ICU H. Adam Malik General HospitalPain, agitation, delirium guidelines in 2013 stated that CPOT constitue an assessment instrument of pain in patients unable to communicate valid and reliable. COMFORT scale is a standard assessment instruments of pain intensity in Haji Adam Malik Hospital Intensive Care Unit in Medan. The purpose of this study to compare the proportion of assesment and reliability CPOT with COMFORT scale to assess pain intensity in patients on mechanical ventilation in Haji Adam Malik Hospital Intensive Care Installation. This study used a cross-sectional design of the 57 patients in Haji Adam Malik Hospital Intensive Care Installation in March to April 2016 within the inclusion criteria. Pain intensity was assessed using COMFORT scale and CPOT by two different appraisers at rest and at noxious stimulus. Fisher ‘s exact test, the value was  p=0.003 (p<0.05). No reliability difference significant during noxious stimulus, the value was p=0.13 (95% CI : - 4–16%; p>0.05). Conclusions of this study is CPOT as pain assessment instrument is more precise and accurate than COMFORT scale, but there is no distinction of reliability CPOT compared COMFORT scale to assess pain intensity in patients on mechanical ventilation when noxious stimulus.Key words: COMFORT scale, Critical-care pain observation tool, PAD Guidelines 2013
Perbandingan Pemberian Lidokain 2% 1,5 mg/kgBB Intravena dengan Propofol 0,3 mg/kgBB Intravena Setelah Anestesi Umum Dihentikan terhadap Kejadian Batuk Saat Ekstubasi Bangun Gunawan, Aris; Pradian, Erwin; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (690.983 KB) | DOI: 10.15851/jap.v5n2.1110

Abstract

Pipa endotrakeal (endotracheal tube; ETT) sering digunakan pada prosedur anestesi umum. Batuk saat ekstubasi merupakan komplikasi yang sering terjadi karena iritasi jalan napas akibat pelepasan ETT. Penggunaan lidokain intravena dan propofol intravena telah terbukti mampu menurunkan angka kejadian batuk saat ekstubasi. Tujuan penelitian ini membandingkan angka kejadian batuk saat ekstubasi bangun pemberian lidokain 2% 1,5 mg/kgBB intravena dengan propofol 0,3 mg/kgBB intravena dalam anestesi umum yang diberikan 3 menit setelah sevofluran dan N2O dihentikan pada akhir operasi. Penelitian ini dilaksanakan dari bulan Desember 2016 sampai dengan Februari  2017 di Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian ini dilakukan dengan metode eksperimental dengan teknik acak terkontrol buta tunggal terhadap 72 subjek yang terdiri atas kelompok lidokain (n=36) dan kelompok propofol (n=36). Analisis statisika menggunakan uji chi-square dengan bantuan aplikasi statistical product and service solution (SPSS) versi 20.0 for windows taraf signifikasi 5% dan dianggap bermakna bila p<0,05. Pada hasil penelitian ini didapatkan angka kejadian batuk pada pemberian lidokain 2% 1,5 mg/kgBB lebih rendah dibanding dengan  pemberian propofol 0,3 mg/kgBB (p<0,05) dengan persentase 19,4% dan 44,4%. Simpulan penelitian ini adalah pemberian lidokain 2% 1,5 mg/kgBB intravena lebih baik dibanding dengan propofol 0,3 mg/kgBB intravena untuk menurunkan kejadian batuk pada saat ekstabasi.Kata kunci: Batuk, ekstubasi, lidokain, propofol Comparison between Intravenous Administration of 2% Lidocaine 1,5 mg/kgBW and Propofol 0,3 mg/kgBW after Discontinuation of General Anesthesia against Cough Incidence During Awake ExtubationEndotracheal tube (ETT) is often used in general anesthesia procedures. Coughing at the time of  extubation is a complication that often occurs due to respiratory irritation due to the release of ETT. The use of intravenous lidocaine and intravenous propofol has been shown to decrease the incidence of coughing at the time of extubation. This study aimed to compare the incidence of coughing during awake extubation between 2% of lidocaine 1.5 mg/kgBW intravenously with propofol administered 0.3 mg/kgBW intravenously in general anesthesia 3 minutes after sevoflurane and N2O was stopped at the end of the surgery. This study was conducted from December 2016 until February 2017 in Dr. Hasan Sadikin General Hospital Bandung. The research was done with experimental method with a single blind  randomized controlled trial and was carried out on 72 subjects consisting of lidocaine group (n=36) and propofol group (n=36). Statistic analysis using chi-square test with statistical product and service solution (SPSS) version 20.0 for windows with significance level 5% and considered significant if p<0,05. In the results of this study, the incidence of coughing in group of 2% of lidocaine 1.5 mg/kgBW was lower than group of propofol 0.3 mg/kgBW (p<0.05) with the respective percentages of 19.4% and 44.4%. The conclusion of this study was 2% of lidocaine 1.5 mg/kgBW intravenously is better compared to propofol 0.3 mg/kgBW intravenously to decrease the incidence of coughing at the time of extubation.Key words: Coughing, extubation, lidocaine, propofol
Korelasi antara Lama Pintas Jantung Paru dan Lama Bantuan Ventilasi Mekanis pada Pasien Pascabedah Pintas Arteri Koroner di Unit Perawatan Intensif Jantung Rumah Sakit Dr. Hasan Sadikin Bandung Redjeki, Ike Sri; Setiari, Tias Diah; Sudjud, Reza Widianto
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (632.127 KB) | DOI: 10.15851/jap.v5n2.1106

Abstract

Pintas jantung paru (PJP) diperlukan untuk sebagian besar prosedur bedah pintas arteri koroner (BPAK). Fungsi paru dan oksigenasi menurun sekitar 2–90% pada pasien pascabedah jantung dengan PJP. Ketergantungan terhadap ventilator setelah BPAK secara signifikan berhubungan dengan morbiditas dan mortalitas. Tujuan penelitian ini adalah mengorelasikan waktu PJP dengan lama bantuan ventilasi mekanis pada pasien BPAK. Penelitian ini merupakan analisis kohort retorospektif pada 43 pasien yang menjalani BPAK dengan PJP yang dirawat di Unit Perawatan Intensif Jantung Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Januari 2014 sampai Juni 2015. Lama PJP dibagi menjadi ≤90 menit dan >90. Lama bantuan ventilasi mekanis terbagi menjadi ≤12 jam dan >12 jam. Parameter yang dicatat pada penelitian ini adalah usia, berat badan, tinggi badan, indeks massa tubuh, lama PJP, waktu klem aorta, dan lama bantuan ventilasi mekanis. Analisis stastistik menggunakan uji korelasi Lambda, signifikan jika nilai p<0,05. Penelitian ini menunjukkan korelasi yang cukup kuat antara waktu PJP dan lama bantuan ventilasi mekanis setelah BPAK dengan korelasi positif (0,545) dan signifikan (p<0,05). Simpulan penelitian ini adalah semakin lama waktu PJP berkorelasi dengan memanjangnya lama bantuan ventilasi mekanis. Kata kunci: Bedah pintas arteri koroner, pintas jantung paru, ventilasi mekanis Correlation between Cardiopulmonary Bypass Time and Duration of Mechanical Ventilation after Coronary Artery Bypass Graft at Cardiac Intensive Care Unit of Dr. Hasan Sadikin General Hospital BandungCardiopulmonary bypass (CPB) is necessary for majority of procedures in coronary artery bypass grafting (CABG) surgery. Lung function and oxygenation are impaired in 20% to 90% of CPB cardiac surgery patients. Ventilator dependency following CABG is often associated with significant morbidity and mortality. This study aims to correlate the CPB time and duration of mechanical ventilation after coronary artery bypass graft. This was a retrospective analysis cohort study on 43 consecutive patients undergoing CABG on CPB who admitted to cardiac intensive care unit between January 2014 and June 2015 in Dr. Hasan Sadikin General Hospital Bandung. The CPB time divided into <90 minutes and ≥90 minutes. Duration of mechanical ventilation was defined as ≤12 hours and ≥12 hours ventilation. Parameters recorded in this study were age, weight, height, body mass index, CPB time, aortic cross-clamp time and duration of mechanical ventilation. Statistical analysis was performed using Lambda correlation, significanti if p value <0.05. This study showed moderate correlation between CPB time and duration of mechanical ventilation after CABG surgery with a positive (0.545) and significant correlation (p<0.05). Conclusion of this research is longer CPB timed correlated with prolonged mechanical ventilationKey words: Cardiopulmonary bypass time, coronary artery bypass grafting, mechanical ventilation
Angka Mortalitas pasien Neonatus yang Menjalani Operasi berdasar atas Kenaikan Berat Badan Pascaoperasi yang Dirawat di Neonatal Intensive Care Unit (NICU) Asep Deden Komara; Ezra Oktaliansah; Budiana Rismawan
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (276.698 KB) | DOI: 10.15851/jap.v5n2.1112

Abstract

Salah satu faktor risiko mortalitas pada neonatus yang menjalani operasi adalah regulasi cairan intraoperatif. Tujuan penelitian ini mengetahui angka mortalitas pada neonatus yang menjalani operasi berdasar atas kenaikan berat badan pascaoperasi yang dirawat di NICU. Metode penelitian adalah deskriptif dengan pendekatan retrospektif. Penelitian ini melibatkan 95 subjek penelitian, yaitu neonatus yang menjalani operasi dan dirawat di NICU RSHS Bandung selama tahun 2010‒2015. Data diambil dari rekam medis, pengambilan data mulai tanggal 1 Februari–29 Maret 2017.  Subjek dibagi tiga kelompok, yaitu neonatus yang telah menjalani prosedur operasi yang mengalami kenaikan berat badan pascaoperasi kurang 10% (I), neonatus yang menjalani prosedur operasi yang mengalami kenaikan berat badan 10‒20% (II), dan kelebihan berat badan ≥20% (III). Neonatus pacaoperasi dengan kenaikan berat badan  ≤10% sebanyak  46 pasien dan yang meninggal  sebanyak 10 pasien pada  kenaikan  berat badan 10‒20%  sebanyak 38 pasien, pasien yang meninggal sebanyak 23 pasien, angka mortalitasnya sebesar 60,5%, sedangkan  pada pasien dengan kenaikan berat badan sama dengan atau lebih dari 20% sebanyak 11 pasien atau 11,5% yang meninggal  sebanyak 10 pasien, angka mortalitasnya sebesar 90,9%. Simpulan angka mortalitas pasien neonatus yang menjalani operasi di RSHS dan pascaoperasi dirawat di NICU RSHS selama periode 2010–2015 adalah 45,3%. Kata kunci: Kenaikan berat badan, mortalitas, neonatus The Mortality Rate in Neonatal Patients which Underwent Surgical Procedures-Defined by the Escalation of Postoperative Weight and Those Who were Admitted in Neonatal Intensive Care Unit (NICU) One of the risk factors contributed to this number was the inappropriate management of intraoperative fluid resuscitation. The aim of this study is to understand the mortality rate in neonatal patients which underwent surgical procedures–defined by the escalation of postoperative weight and those who were admitted in NICU. The research method used in this study was a retrospective approach presented in a descriptive manner. The study involved 95 research subjects, which were neonatal patients which underwent surgical procedures and admitted in NICU RSHS Bandung from 2010‒2015. Data collection from Februari 1st–March 29th  2017. The research subjects were classified into three groups, neonatal patients which had escalation of weight postoperative less than 10% and underwent surgical procedure (I), neonatal patients which had escalation of weight postoperative ranging from 10‒20% and underwent surgical procedure (II), meanwhile consist of neonatal patients which had escalation of weight postoperative ≥20% and underwent surgical procedure (III). Result of the study showed there were 46 neonatal patients with 10% weight escalation and 10 out of 46 patients were ceased, meanwhile there were 38 neonatal patients with 10‒20% weight escalation and 23 out of 38 were ceased, and there were 11 neonatal patients with ≥20% weight escalation and 10 out of 11 were ceased. The conclusions of this study found a mortality rate of neonatal patients who underwent surgery and postoperative treated in  NICU RSHS during the period 2010 to 2015 is 45.3%. Key words: Weight gain, mortality, neonatal

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