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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 pada Pasien yang Menjalani Bedah Pintas Koroner berdasar Usia, Jenis Kelamin, Left Ventricular Ejection Fraction, Cross Clamp Time, Cardio Pulmonary Bypass Time, dan Penyakit Penyerta Ariaty, Geeta Maharani; Sudjud, Reza Widianto; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (661.52 KB) | DOI: 10.15851/Jap.v5n3.1167

Abstract

Penyakit jantung koroner (PJK) adalah salah satu penyakit pada sistem kardiovaskular  yang  sering  terjadi  dan  merupakan  problema  kesehatan  utama  di  negara maju. Bedah pintas koroner merupakan salah satu penanganan intervensi PJK. Beberapa faktor risiko berhubungan dengan peningkatan mortalitas pascabedah pintas koroner. Tujuan penelitian ini adalah mengetahui angka mortalitas pada pasien yang menjalani bedah pintas koroner berdasar atas usia, jenis kelamin, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time, dan penyakit penyerta di RSUP Dr. Hasan Sadikin Bandung tahun 2014−2016. Metode yang digunakan pada penelitian ini adalah deskriptif observasional dengan pendekatan retrospektif berdasar atas data rekam medis yang dilakukan bulan April 2017. Dari penelitian diperoleh hasil angka mortalitas pascabedah pintas koroner sebesar 15,15%. Angka mortalitas pasien yang menjalani bedah pintas koroner dipengaruhi beberapa faktor diantaranya usia, jenis kelamin, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time dan penyakit penyerta. Mortality Rate of Patients Underwent Coronary Artery Bypass Graft Surgery based on Age, Gender, Left Ventricular Ejection Fraction, Cross Clamp Time, Cardiopulmonary Bypass Time, and Coexisting DiseaseCoronary heart disease (CHD) is one of the most common cardiovascular diseases and is a major health problem in developed countries. Coronary artery bypass graft surgery (CABG) is one of the intervention treatments of CHD. Several risk factors are associated with increased postoperative CABG mortality. The purpose of this study was to determine the mortality rate of patients undergoing coronary bypass surgery based on age, gender, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time, and coexisting disease at Dr. Hasan Sadikin Bandung General Hospital during 2014-2016. This study was an analytical descriptive study using retrospective approach based on medical record data during April 2017. It was shown that the mortality rate for post-coronary bypass was 30 patients (15.15%). Hence, themortality rate of patients undergoing coronary bypass surgery is affected by several factors including age, gender, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time, and coexisting disease. 
Perbandingan Ketinggian Bantal 4,5 cm dan 9 cm terhadap Visualisasi Glotis Saat Laringoskopi di Rumah Sakit Dr. Hasan Sadikin Bandung Alam, Mohamad Deny Saeful; Suwarman, Suwarman; Redjeki, Ike Sri
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (675.71 KB) | DOI: 10.15851/jap.v5n3.1170

Abstract

Intubasi ialah prosedur baku mempertahankan patensi jalan napas dengan melihat secara langsung glotis melalui alat laringoskop. Visualisasi glotis akan lebih jelas pada saat tindakan laringoskopi langsung pada sniffing position. Ketinggian bantal yang berbeda akan memberikan visualisasi glotis yang berbeda pula. Penelitian ini merupakan penelitian eksperimen kuasi. Jumlah sampel penelitian 30 orang dengan 2 perlakuan berbeda, yaitu bantal dengan ketinggian 4,5 cm dan 9 cm. Pemilihan subjek penelitian dilakukan secara consecutive sampling dengan mengambil setiap subjek penelitian yang memenuhi kriteria inklusi. Subjek penelitian semua pasien yang menjalani operasi elektif dengan anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung periode Juli 2015 yang memenuhi kriteria inklusi. Tujuan penelitian ini adalah mengetahui pengaruh pemakaian bantal 4,5 cm dibanding dengan bantal 9 cm terhadap nilai visualisasi glotis.  Visualisasi glotis dengan ketinggian bantal yang berbeda pada saat tindakan laringoskopi langsung dinilai menggunakan skala kelas Cormarck–Lehane (CL) dan skor percentage of glotic opening (POGO). Distribusi data dengan uji Shapiro Wilks, nilai p ditentukan menggunakan uji Wilcoxon dan bermakna jika p<0,05. Hasil penelitian ini menunjukkan bahwa nilai skala CL modifikasi kedua bantal berada pada kisaran  skala 1 hingga 2c (p=0,007). Skor  POGO bantal ketinggian 4,5 cm berada pada kisaran  20–100% dengan rata-rata 69,33±21,48%. Bantal ketinggian 9 cm skor POGO berada pada kisaran 30,00–80,00% dengan nilai rata-rata 58,333±15,33% (p=0,001). Simpulan, penggunaan bantal ketinggian 4,5 cm memberikan visualisasi glotis yang lebih baik saat laringoskopi langsung dibanding dengan  bantal ketinggian 9 cm.Comparison of 4.5 cm and 9 cm Pillow Height in Glottis Visualization on Laryngoscopy at Dr. Hasan Sadikin General HospitalIntubation is a standard procedure to maintain patency of the airway by  directly visualizing glottis with a laryngoscope. Visualization of the glottis will be clearer when direct laryngoscopy is performed in sniffing position. Different pillows heights will provide different visualization of the glottis. This study was a quasi-experimental study on 30 subjects who were divided into 2 experimental groups of 4.5 cm and 9 cm pillow heights. Subjects were sampled consecutively according to the inclusion and exclusion criteria. The population was all patients underwent elective surgery with general anesthesia at Dr. Hasan Sadikin Hospital Bandung during the period of July 2015. The purpose of this study was to determine the effect of using a pillow height of 4.5 cm when compared to 9 cm pillow height on glottis visualization based on an assessment using Cormarck–Lehane (CL) scale and percentage of glotic opening (POGO) scores. Data distribution was tested by Shapiro Wilks while the p values were determined using Wilcoxon test and was considered meaningful if p<0.05. The results showed that the value of modified CL–class scale for both pillow heights were in the range scale of 1 to 2c (p=0.007). The POGO scores of the 4.5 cm pillow height was in the range of 20–100% with an average percentage of 69.33±21.48%, while the POGO scores of the 9 cm pillow height were in the range of 30.00–80.00% with an average score of 58.333±15.33% (p=0.001). Therefore, the use of 4.5 cm pillow height gives better glottis visualization in direct laryngoscopy compared to the 9 cm pillow height.
Perbandingan antara Uji Mallampati Modifikasi dan Mallampati Ekstensi Sebagai Prediktor Kesulitan Intubasi Endotrakeal di Rumah Sakit Dr. Hasan Sadikin Bandung Swasono, Girindro Andi; Suwarman, Suwarman; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (732.566 KB) | DOI: 10.15851/jap.v5n3.1168

Abstract

Evaluasi potensi intubasi sulit preoperatif sangat penting. Metode standar untuk menilai potensi intubasi sulit adalah metode Mallampati Modifikasi. Metode Mallampati Ekstensi merupakan metode Mallampati Modifikasi dengan ekstensi titik kranioservikal sehingga derajat bukaan mulut lebih lebar dan saluran napas terlihat lebih baik. Tujuan penelitian ini adalah mengetahui ketepatan penilaian Mallampati Ekstensi dibanding dengan Mallampati Modifikasi sebagai prediktor dalam menilai kesulitan intubasi endotrakeal menggunakan laringoskop Macintosh langsung berdasar atas uji Cormack Lehane. Desain penelitian ini adalah observasional analitik dengan metode potong lintang dan uji diagnostik chi square. Hasil penelitian terhadap 382 subjek pada bulan September 2016 hingga bulan Desember 2016 di Rumah Sakit Dr. Hasan Sadikin Bandung didapatkan jenis kelamin perempuan 69,9% dengan median usia 42 tahun. Frekuensi nilai uji Mallampati Ekstensi lebih banyak pada kelas yang lebih rendah dan berbeda secara signifikan dibanding dengan uji Mallampati Modifikasi. Kesesuaian penilaian kelas uji Mallampati Ekstensi dengan Cormack Lehane terdapat pada 318 subjek. Simpulan, uji Mallampati Ekstensi lebih baik daripada uji Mallampati Modifikasi sebagai prediktor menilai kesulitan intubasi endotrakeal menggunakan laringoskop langsung.Comparison between Modified Mallampati Test and Extended Mallampati Test as Predictor of Difficult Endotracheal Intubationat Dr. Hasan Sadikin Hospital BandungPreoperative evaluation of potentially difficult intubation is very important. The standard method for assessing potentially difficult intubation is the Modified Mallampati method. Extended Mallampati method is a Modified Mallampati method with cranioservical extension point that the degree of mouth opening is wider and airway becomes more visible. The purpose of this study was to determine the accuracy of the Extended Mallampati test compared to the Modified Mallampati test as predictors in assessing the difficulty of endotracheal intubation using direct Macintosh laryngoscope based on Cormack Lehane grading. This was a cross-sectional observational analytical study using chi square diagnostic test involving 382 subjects at Dr. Hasan Sadikin Bandung Hospital during the period of September 2016 to December 2016 with 69.9% women and  median age of 42 years. The frequency of the Mallampati Extension test scores was higher in the lower classes, which was significantly different from the results of the Modified Mallampati test. Better appropriateness of the Mallampati Extension test result with Cormack Lehane grading was found in 318 subjects. In conclusion, the Extended Mallampati test is better than Modified Mallampati test when it is used as a predictor in assessing difficult endotracheal intubation using direct laryngoscopy (Cormack Lehane test).  
Perbedaan Pengaruh Morphin Controlled Release 30 mg dan Oxycodone Controlled Release 20 mg Oral terhadap Nyeri Kanker Ritonga, Abdul Hakim; Solihat, Yutu; Veronica, Ade
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (671.14 KB) | DOI: 10.15851/jap.v5n3.1163

Abstract

Morfin-CR dan oksikodon-CR merupakan opioid oral untuk mengatasi nyeri kanker. Penelitian ini bertujuan mempelajari efek morfin-CR dan oksikodon-CR pada nyeri kanker dengan pengukuran visual analogue scale (VAS). Uji klinis dengan desain uji terkontrol acak tersamar ganda untuk membandingkan pengaruh analgetik morfin-CR oral dengan oksikodon-CR oral pada pasien kanker. Pasien yang telah memenuhi kriteria inklusi dibagi menjadi 2 kelompok (n=22), kelompok morfin-CR 30 mg/12jam oral dan  kelompok oksikodon-CR 20 mg/12 jam oral, ditambahkan parasetamol 1.000 mg/6 jam oral. Penilaian skala nyeri dilakukan pada 4 jam, 12 jam, 24 jam, dan 48 jam setelah  pemberian obat. Uji statistik menggunakan uji T berpasangan  untuk  sebelum  perlakuan dan uji T independen untuk sesudah perlakuan pada kedua kelompok. Data karakteristik subjek VAS pada kedua kelompok homogen dan dapat diuji. Nilai VAS antara kelompok morfin-CR dan kelompok oksikodon-CR berbeda bermakna sebelum pemberian obat dengan 4 jam, 12 jam, 24 jam dan 48 jam setelah pemberian obat pertama. Tidak terdapat perbedaan bermakna antara kelompok morfin-CR dan kelompok oksikodon-CR setelah 4 jam, 12 jam, 24 jam, dan 48 jam setelah  pemberian obat (p>0.05). Simpulan, terdapat perbedaan nilai VAS pada tiap-tiap kelompok sebelum dengan 4 jam, 12 jam, 24 jam, 48 jam setelah pemberian, namun tidak terdapat  perbedaan antara kelompok morfin CR dan oksikodon Cr sebelum dengan 4 jam, 12 jam, 24 jam,  dan 48 jam setelah pemberian.Difference between the Effects of 30 mg Oral Morphine Controlled Release 30 mg and 20 mg Oral Oxycodone Controlled Release on Cancer PainMorphine-CR and oxycodone-CR are oral opioids to treat cancer pain. This study aimed to study the effects of Morphine-CR and Oxycodone-CR on cancer pain using the visual analogue scale (VAS). This was a double-blind randomized control clinical trial  comparing the effect of oral morphine-CR analgesic to that of oral oxycodone-CR in cancer patients. Patients who met the inclusion were divided into 2 groups (n=22), the 30 mg/12 hours oral morphine-CR group and the 20 mg/12 hours oral oxycodone-CR added with 1,000 mg/6 hours oral aracetamol. The pain scale assessment was performed at 4 hours, 12 hours, and 48 hours after the administration of the drug. Statistical analysis using the paired T test was performed for the before treatment data and independent T test was performed for the after treatment data in both groups. The subject characteristics were homogeneous; hence, testing can be done. The VAS values between the morphine-CR group and oxycodone-CR group were significantly different between before drug administration and 4 hours, 12 hours, 24 hours, and 48 hours after the first drug administration. There was no significant difference between the morphine CR-group and oxycodone-CR group after 4 hours, 12 hours, and 48 hours of drug administration (p>0.05). Hence, there is a difference in VAS values of both groups between before drug administration and after 4 hours, 12 hours, 24 hours, and 48 hours after drug administration but no differences are found between the two groups after 4 hours, 12 hours, 24 hours, and 48 hours of drug administration. 
Penggunaan Teknik Obat dan Permasalahan Blokade Epidural di Wilayah Jawa Barat pada Tahun 2015 Ibnu, Muhammad; Yadi, Dedi Fitri; Oktaliansah, Ezra
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (685.823 KB) | DOI: 10.15851/jap.v5n3.1171

Abstract

Blokade epidural merupakan salah satu jenis anestesi regional yang memiliki rentang implikasi lebih luas dibanding dengan blokade spinal. Perbedaan teknik maupun rejimen obat untuk blokade epidural meningkat seiring dengan meningkatnya ketertarikan di bidang anestesi regional dikarenakan teknik anestesi regional memberikan efek analgesi yang efektif tanpa memengaruhi kesadaran pasien dan meningkatkan kenyamanan pasien. Tujuan penelitian ini mencari data mengenai penggunaan, teknik, rejimen obat, dan permasalahan yang dialami oleh dokter anestesi di Jawa Barat dalam melakukan blokade epidural. 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 yang masih melakukan blokade epidural pada tahun 2015 sebesar 73,2%, teknik penusukan yang paling banyak dilakukan adalah pendekatan midline sebesar 73%, dan identifikasi rongga epidural paling banyak dengan pendekatan lost of resistance sebesar 80,7%. Obat anestesi lokal yang paling banyak digunakan untuk blokade epidural adalah bupivakain sebesar 95,9%. Adjuvan yang paling banyak digunakan adalah fentanil sebesar 92,3%. Permasalahan yang berkaitan dalam pelaksanaan tindakan blokade epidural pada tahun 2015 paling banyak adalah permasalahan staf di ruangan dalam membantu menangani pasien dengan epidural, yaitu sebesar 38,03%.Epidural Blockade Administration Technique and Issues in West Java in 2015Epidural blockade is one of the regional anesthesia techniques with wider implication than the spinal blockade. The techniques and drug regimens used in epidural blockade vary with the increasing interest on regional anesthesia due to its effective analgesic effect without decreasing consciousness and by increasing patients’ comfort. The purpose of this study was to explore the use, techniques, drug regimens, issues experienced by anesthesiologists in West Java in performing epidural blockade. This study was conducted from August to September 2016 at the Department of Anesthesiology and Intensive Therapy, Dr. Hasan Sadikin Hospital Bandung. This was a cross-sectional descriptive study using a questionnaire. Questionnaires were mailed  to 120 anesthesiologists in West Java area and 30 additional questionnaires were distributed directly to anesthesiologists working at Dr. Hasan Sadikin General Hospital Bandung. The response was  47.3%. This study showed that 73.2% anesthesiologists performed epidural blockade in 2015, with 73% used the midline approach and 80.7% used the loss of resistance method to identify the epidural space. The majority used bupivacaine (95.5%) as the local anesthetics. The most frequently used adjuvant was fentanyl (95.9%). The most frequently mentioned problem associated with epidural blockade in 2015 was the lack of staff’s ability to assist the anesthesiologist in performing epidural blockade (38.03%).
Perbedaan Nilai Agregasi Trombosit Akibat Pengaruh Penggunaan Analgesia Ketorolak dan Ibuprofen Intravena Pascaoperasi di RSUP Haji Adam Malik Medan Fithri, Dewi Yuliana; Wijaya, Dadik Wahyu; Arifin, Hasanul
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (666.266 KB) | DOI: 10.15851/jap.v5n3.1166

Abstract

Obat anti-inflamasi nonsteroid (OAINS) merupakan analgetik yang sering digunakan pada pascaoperasi bedah ortopedi. Penelitian ini bertujuan melihat apakah terdapat perbedaan nilai agregasi trombosit akibat pengaruh penggunaan analgestik ketorolak dengan ibuprofen intravena setelah operasi. Penelitian ini merupakan penelitian uji klinis dengan uji acak tersamar buta ganda yang membandingkan perbedaan pengaruh ketorolak  30 mg intravena/6 jam dengan ibuprofen 800 mg intravena/6 jam. Populasi penelitian ini adalah pasien yang menjalani tindakan pembedahan elektif dengan anestesi umum di RSUP Haji Adam Malik Medan pada bulan Agustus 2016. Pasien dibagi menjadi 2 kelompok dengan tiap-tiap kelompok berjumlah 20 pasien. Ketorolak atau ibuprofen sebagai analgetik diberikan setelah 30 menit selesai operasi, kemudian dilanjutkan per 6 jam sampai dengan 2 hari selesai operasi. Uji statistik menggunakan tes Wilcoxon untuk sebelum perlakuan dan Uji Mann-Whitney untuk sesudah perlakuan pada kedua kelompok. Data karakteristik subjek homogen. Agregasi trombosit pada kelompok ketorolak dengan kelompok ibuprofen berbeda bermakna setelah 10 menit ekstubasi dengan 8 jam setelah pemberian obat terakhir. Tidak terdapat perbedaan bermakna antara kelompok ketorolak dan kelompok ibuprofen setelah 10 menit ekstubasi (p>0,05), namun terdapat perbedaan bermakna pada 8 jam setelah akhir pemberian obat. Simpulan, ketorolak menurunkan persentase agregasi trombosit lebih besar daripada ibuprofen setelah 8 jam pemberian obat terakhir. Differences in Platelet Aggregation Values in Postoperative Intravenous Ketorolac and Ibuprofen Analgesics at Haji Adam Malik Central General Hospital MedanNon-steroidal anti-inflammatory drugs (NSAIDs) are analgesics used for postoperative orthopedic surgery. This study aimed to underrstand the effect of intravenous ketorolac and ibuprofen on platelet aggregation values. This was a double-blind randomized controlled trial that compared the effects of intravenous ketorolac and ibuprofen. The population of this study were patients undergoing elective surgery under general anesthesia at Haji Adam Malik Central General Hospital Medan in August 2016. Patients were divided into 2 groups (n: 20): ketorolac group andibuprofen group. Both group received analgesic 30 minutes after surgery up to 2 days postoperative. The statistical tests used were Wilcoxon test for pre-treatment and Mann-Whitney test for post-treatment in each group. Subject characteristic data were homogenous. Platelet aggregation of ketorolac and ibuprofen groups differed significantly between 10 minutes after extubation and 8 hours after the last drug administration. There was no significant difference between the ketorolac and ibuprofen groups after 10 minutes of extubation (p>0.05); however there was a significant difference at 8 hours after the end of drug administration. In conclusion, ketorolac decreases platelet aggregation percentage greater than ibuprofen after 8 hours of the last drug administration. 
Perbandingan Efek Sevofluran dengan Halotan terhadap Jumlah Neutrofil Hafniana, Hafniana; Arifin, Hasanul
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (655.793 KB) | DOI: 10.15851/jap.v5n3.1169

Abstract

Neutrofil berperan penting dalam respons imun nonspesifik. Penurunan nilai neutrofil dapat dipakai sebagai parameter sederhana untuk mengukur tingkat stres dan inflamasi sistemik. Penelitian ini bertujuan mengetahui efek agen inhalasi sevofluran dan halotan terhadap penurunan neutrofil. Penelitian ini merupakan uji klinis dengan acak tersamar buta ganda yang membandingkan efek sevofluran dengan halotan terhadap  jumlah neutrofil pada 36 pasien ASA I dan II yang menjalani operasi elektif dengan anestesi umum di RSUP Haji Adam Malik Medan periode September 2016. Pasien dibagi dua kelompok, yaitu kelompok yang mendapat agen inhalasi sevofluran dan kelompok yang mendapat inhalasi halotan. Jumlah neutrofil dihitung pada kedua kelompok pada saat sebelum operasi, setelah induksi, dan 90 menit setelah inhalasi. Jumlah neutrofil pada kedua kelompok tidak mengalami penurunan sebelum operasi dan setelah induksi (p>0,005), namun mengalami penurunan pada 90 menit setelah inhalasi (p<0,005) pada tiap-tiap kelompok, namun uji beda antara kelompok sevofluran dan halotan tidak bermakna pada tiga kali pengukuran.  Simpulan, tidak terdapat perbedaan antara sevofluran dan halotan terhadap penurunan jumlah neutrofil.Comparison of  Sevoflurane and Halothane Effects on Neutrophil CountsNeutrophil has an important role in non-spesific immune responses. The declining value of neutrophil can be used as a parameter to measure the level of stress and systemic inflammation. This study aimed to determine the effects of sevoflurane and halothane inhalation agents on the number of neutrophil. This was a double-blind randomized comparing the effects of sevoflurane and halothane on the number of neutrophil in 36 ASA 1 and II patients underwent elective surgery under general anesthesia at Haji Adam Malik Central General Hospital  Medan during September 2016. Patients were divided into two groups: the group that received sevoflurane inhalation and the group that received halothane inhalation. The number of neutrophils was counted in both groups before surgery, after induction, and 90 minutes after inhalation. Both groups did not experience a decrease in neutrophil counts before surgery and after induction (p>0.005), but suffered a decline in the number of neuthrophils 90 minutes after inhalation (p>0.005). The difference between the sevoflurane and halothane groups was not meaningful in the three times of measurement. In conclusion, there is no difference between sevoflurane and halothane terms of declined number of neutrophils. 
Perbandingan Pemberian Efedrin 30 mcg/kgBB dengan Efedrin 70 mcg/kgBB Intravena terhadap Skala Nyeri dan Efek Hipotensi pada Penyuntikan Propofol di Rumah Sakit Dr. Hasan Sadikin Bandung Afifuddin, Afifuddin; Sitanggang, Ruli Herman; Oktaliansah, Ezra
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (650.194 KB) | DOI: 10.15851/jap.v5n3.1164

Abstract

Penyuntikan propofol menyebabkan  nyeri dan perubahan tekanan darah. Efedrin merupakan obat yang digunakan untuk mengurangi efek yang tidak diinginkan saat penyuntikan propofol. Penelitian ini bertujuan membandingkan pemberian efedrin 30 mcg/kgBB intravena dengan efedrin 70 mcg/kgBB intravena terhadap skala nyeri dan efek hipotensi pada penyuntikan propofol. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan September hingga November 2015 terhadap 60 orang  pasien dengan  American Society of Anesthesiologist  (ASA) kelas I dan II, usia 18 hingga 60 tahun yang menjalani operasi elektif dengan anestesi umum secara uji acak kontrol buta ganda. Pasien dibagi menjadi dua kelompok, 30 orang menerima efedrin 30 mcg/kgBB dan 30 orang menerima efedrin 70 mcg/kgBB, diberikan 1 menit sebelum penyuntikan propofol. Analisis statistik menggunakan uji Mann-Whitney. Hasil penelitian menunjukkan skala nyeri pada kelompok efedrin 30 mcg/kgBB dan efedrin 70 mcg/kgBB tidak berbeda bermakna (p>0,05), dan perubahan tekanan darah sistole dan diastole efedrin 30 mcg/kgBB dengan efedrin 70 mcg/kgBB berbeda bermakna (p<0,05). Simpulan, efedrin 30 mcg/kgBB dan efedrin 70 mcg/kgBB menurunkan skala nyeri saat penyuntikan propofol, dan efedrin 70 mcg/kgBB mencegah efek hipotensi lebih baik dibanding dengan efedrin 30 mcg/kgBB.  Comparison of 30 mcg/kgBW and 70 mcg/kgBW Intravenous Ephedrine on Pain Scale and Hypotension After Propofol Injection in  Dr. Hasan Sadikin General Hospital BandungInjection of propofol causes pain and blood pressure changes. Propofol can cause pain at the injection site and decrease the blood pressure while ephedrine is considered to minimize those adverse effect. The purpose of the study was to compare the effects of 30 mcg/kgBW and 70 mcg/kgBW intravenous ephedrine on pain score and blood pressure changes after propofol injection. This double-blind randomized control trial was conducted in Dr. Hasan Sadikin General Hospital Bandung, September to November 2015, on 60 patients with American Society of Anesthesiologist (ASA) physical status I and II, aged 18 to 60 years old. Patients were divided into 2 groups of 30 persons; the first group received 30 mcg/kgBW ephedrine and the second group received 70 mcg/kgBW ephedrine one minute before propofol injection. Statistical analysis was performed using the Mann-Whitney test. This study showed no significant difference in pain score between the group that received 30 mcg/kgBW ephedrine and 70 mcg/kgBW (p>0,05), but there were significant differences in blood pressure changes (p<0,05). It can be concluded that 30 mcg/kgBW and 70 mcg/kgBW ephedrine could reduce pain score following propofol injection with 70 mcg/kgBW ephedrine reduces the hypotension effect better than the 30 mcg/kgBW dose.  
Akupunktur pada Pasien dengan Efek Samping Obat Pascatindakan Anestesi Spinal Kurniawan, Arief; Ibrahim, Asep Sekar
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (694.915 KB) | DOI: 10.15851/jap.v5n3.1165

Abstract

Akupunktur secara luas telah digunakan untuk menginduksi analgesi. Akupunktur dapat digunakan sebagai terapi nyeri, alergi, inflamasi, gangguan metabolik, dan pascastrok. Laporan kasus  ini bertujuan memaparkan manfaat akupunktur sebagai terapi gangguan akibat efek samping obat. Seorang wanita 59 tahun memiliki keluhan  nyeri perut bagian bawah akibat kista ovarium terpuntir. Pasien  alergi terhadap hampir seluruh obat yang pernah diminumnya termasuk antibiotik, analgetik, non steroidal anti inflamatory drugs (NSAID), steroid, dan vitamin. Pasien menjalani kistektomi dengan anestesi spinal menggunakan obat anestetik lokal bupivakain 10 mg di Rumah Sakit Dr. Dustira Cimahi pada 20 Juni 2016. Tiga puluh menit pascabedah pasien mengeluh nyeri di daerah operasi dan muncul efek samping obat dengan keluhan pusing, mual, muka terasa bengkak dan tebal, serta kulit kemerahan seluruh tubuh. Pasien diduga mengalami adverse drug reaction (ADR) akibat bupivakain. Pasien diberi tindakan elektroakupunktur dengan pemasangan jarum akupunktur pada titik insisi, Hegu (LI-4), Neikuan (P-6), Sanyinjiao (SP-6), dan Zusanli (S-36) bilateral dialiri listrik 10 mA pada frekuensi 40 Hz selama 30 menit. Setelah tindakan elektroakupunktur press needle ditempelkan pada titik Hegu sebelah kiri. Keluhan nyeri berangsur menghilang dan akibat efek samping obat tidak dirasakan lagi. Akupunktur dipilih untuk mengatasi nyeri pascaoperasi dan gangguan efek samping obat karena pasien memiliki riwayat alergi obat analgesik dan antialergi. Pada kasus ini akupunktur efektif mengatasi gangguan akibat efek samping obat anestetik lokal pada suntikan spinal. Acupuncture on A Patient with Adverse Drug Reaction after Spinal Anesthesia Acupuncture is widely used to induce analgesia. Acupuncture can be used in the treatment of pain, allergy, inflammation, metabolic disorders, and post-stroke. This case report aimed to describe the benefits of acupuncture as a therapy of adverse reactions to drug. A-59-year woman was presented weith a complaint of lower abdominal pain due to twisted ovarian cyst. She had a history of allergy to almost all drugs i.e. antibiotics, analgesics, non-steroidal anti-inflamatory drugs (NSAIDs), steroids, and vitamins. Patient underwent cystectomy under spinal anesthetic of 10 mg bupivacaine at Dr. Dustira Hospital Cimahi on June 20, 2016. Thirty minutes post-surgery, she started to complain about the pain in the area of the surgery and the signs-symptoms of allergic reactions occurred (dizziness, nausea, swollen and thick feeling of the face, and reddish skin all over the body). Patient was suspected of having adverse drug reactions (ADR) that was most likely the side effects of bupivacaine. She then received electroacupunture to address the postoperative pain and allergic reaction to bupivacaine. Acupuncture needles were placed at the point of incision consisting of Hegu (LI-4), Neikuan (P-6), Sanyinjiao (SP-6), and Zusanli (S-36) bilateral, electrified with 10 mA electricity with a frequency of 40 Hz for 30 minutes. After the electroacupunture was started, the press needle was placed on the left Hegu point. The pain and allergy complaints gradually disappeared. Acupuncture was chosen to treat postoperative pain and adverse drug reactions in this patient because she had a history of allergy to analgesic and anti-allergy drugs. In this particular case, acupuncture has successfully overcome the adverse reactions of local anesthetic drugs in spinal injections.
Angka Mortalitas pada Pasien yang Menjalani Bedah Pintas Koroner berdasar Usia, Jenis Kelamin, Left Ventricular Ejection Fraction, Cross Clamp Time, Cardio Pulmonary Bypass Time, dan Penyakit Penyerta Geeta Maharani Ariaty; Reza Widianto Sudjud; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (661.52 KB) | DOI: 10.15851/Jap.v5n3.1167

Abstract

Penyakit jantung koroner (PJK) adalah salah satu penyakit pada sistem kardiovaskular  yang  sering  terjadi  dan  merupakan  problema  kesehatan  utama  di  negara maju. Bedah pintas koroner merupakan salah satu penanganan intervensi PJK. Beberapa faktor risiko berhubungan dengan peningkatan mortalitas pascabedah pintas koroner. Tujuan penelitian ini adalah mengetahui angka mortalitas pada pasien yang menjalani bedah pintas koroner berdasar atas usia, jenis kelamin, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time, dan penyakit penyerta di RSUP Dr. Hasan Sadikin Bandung tahun 2014−2016. Metode yang digunakan pada penelitian ini adalah deskriptif observasional dengan pendekatan retrospektif berdasar atas data rekam medis yang dilakukan bulan April 2017. Dari penelitian diperoleh hasil angka mortalitas pascabedah pintas koroner sebesar 15,15%. Angka mortalitas pasien yang menjalani bedah pintas koroner dipengaruhi beberapa faktor diantaranya usia, jenis kelamin, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time dan penyakit penyerta. Mortality Rate of Patients Underwent Coronary Artery Bypass Graft Surgery based on Age, Gender, Left Ventricular Ejection Fraction, Cross Clamp Time, Cardiopulmonary Bypass Time, and Coexisting DiseaseCoronary heart disease (CHD) is one of the most common cardiovascular diseases and is a major health problem in developed countries. Coronary artery bypass graft surgery (CABG) is one of the intervention treatments of CHD. Several risk factors are associated with increased postoperative CABG mortality. The purpose of this study was to determine the mortality rate of patients undergoing coronary bypass surgery based on age, gender, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time, and coexisting disease at Dr. Hasan Sadikin Bandung General Hospital during 2014-2016. This study was an analytical descriptive study using retrospective approach based on medical record data during April 2017. It was shown that the mortality rate for post-coronary bypass was 30 patients (15.15%). Hence, themortality rate of patients undergoing coronary bypass surgery is affected by several factors including age, gender, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time, and coexisting disease. 

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