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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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Search results for , issue "Vol 8, No 2 (2020)" : 8 Documents clear
Efek Granisetron Intravena terhadap Perubahan Tekanan Darah pada Seksio Sesarea dengan Anestesi Spinal Jaya Supriyanto; Suwarman Suwarman; Iwan Abdul Rachman
Jurnal Anestesi Perioperatif Vol 8, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n2.2041

Abstract

Hipotensi merupakan komplikasi paling sering pada seksio sesarea dengan anestesi spinal. Pencegahan hipotensi dapat dilakukan dengan pemberian cairan, obat-obatan, pengurangan dosis obat anestesi lokal, dan intervensi mekanik. Granisetron sebagai antagonis reseptor 5hydroxytryptamine3 (5HT3) dapat digunakan untuk mencegah hipotensi pada seksio sesarea dengan anestesi spinal. Penelitian ini bertujuan mengetahui pengaruh pemberian granisetron 1 mg intravena terhadap perubahan tekanan darah pada seksio sesarea dengan anestesi spinal. Penelitian ini dilakukan periode Desember 2019–Februari 2020 di RSUP Dr. Hasan Sadikin Bandung. Metode penelitian ini adalah uji klinis tersamar ganda pada 34 pasien ASA II yang menjalani seksio sesarea dengan anestesi spinal. Subjek penelitian dibagi secara acak menjadi 2 kelompok, yaitu kelompok kontrol diberikan NaCl 0,9% dan kelompok granisetron diberikan granisetron 1 mg intravena pada 5 menit sebelum anestesi spinal. Tekanan darah diperiksa setiap 1 menit selama 20 menit setelah anestesi spinal, kemudian setiap 2,5 menit sampai operasi selesai. Data dianalisis dengan uji t, Uji Mann Whitney, dan Uji kolmogorov-smirnov, nilai p<0,05 dianggap bermakna. Kejadian hipotensi pada kelompok kontrol (79%) lebih tinggi dari kelompok granisetron (29%). Penurunan tekanan darah pada kelompok kontrol lebih besar dibanding dengan kelompok granisetron dengan perbedaan signifikan (p<0,05). Simpulan, pemberian granisetron 1 mg intravena dapat mengurangi kejadian hipotensi pada seksio sesarea dengan anestesi spinal.Effect of Intravenous Granisetron on Blood Pressure in Cesarean Section under Spinal AnesthesiaHypotension is the most frequent complication in cesarean section with spinal anesthesia. The prevention of hypotension includes fluid and drugs administration, lower local anesthetic doses, and mechanic interventions. Granisetron is a 5HT3 receptor antagonist that can be used to prevent hypotension in cesarean section with  spinal anesthesia. This study aimed to determine the effects of intravenous administration of 1 mg granisetron on blood pressure in patients undergoing cesarean section with spinal anesthesia. This study was a double blinded clinical study on 34 patients ASA II undergoing cesarean sections with spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, during the period of December 2019 to February 2020. Subjects were  divided randomly into 2 groups; a control group that received 0.9% NaCl  and a granisetron group that received 1 mg intravenous granisetron 5 minutes before spinal anesthesia.  Blood pressure was evaluated every minute for 20 minutes after the spinal anesthesia, and then every 2.5 minutes until the surgery was  completed.  Data were analyzed using t-test, Mann Whitney test, and Kolmogorov-Smirnov test with p value<0.05 considered significant. Incidence of hypotension in the control group was higher than the granisetron group (79%vs29%) with blood pressure decrease significantly higher in the control group (p<0.05). Thus, administration of intravenous 1 mg granisetron may reduce the incidence of hypotension in cesarean sections with spinal anesthesia.
Perubahan Waktu Reaksi terhadap Stimulus Visual pada PPDS Anestesiologi dan Terapi Intensif RSUP Dr. Hasan Sadikin Bandung Setelah Bertugas Selama 24 Jam Lukman Hidayat; Iwan Fuadi; Iwan Abdul Rachman
Jurnal Anestesi Perioperatif Vol 8, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n2.2034

Abstract

Waktu reaksi dibutuhkan oleh dokter anestesi karena harus berpikir dan bertindak cepat serta tepat dalam situasi kritis mengancam jiwa pasien. Jaga malam selama 24 jam dapat meyebabkan kelelahan dan gangguan tidur sehingga waktu reaksi menjadi lebih lambat. Tujuan penelitian ini mengetahui perubahan waktu reaksi terhadap stimulus visual pada PPDS Anestesiologi dan Terapi Intensif FK Unpad setelah bertugas selama 24 jam di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini berlangsung pada bulan Oktober–November 2019 merupakan pretest and posttest control group design dilakukan pada 58 peserta dengan menilai waktu reaksi sebelum bertugas dan setelah bertugas selama 24 jam diperiksa menggunakan metode Ruler Drop. Analisis data menggunakan Uji Wilcoxon karena data distribusi tidak normal berdasar atas hasil Uji Kolgomorov Smirnov. Pada penelitian ini diperoleh median waktu reaksi setelah bertugas selama 24 jam menjadi lebih lama dibanding dengan sebelum bertugas. Nilai median waktu reaksi sebelum bertugas adalah 0,20 detik (range 0,10–0,25 detik), sedangkan waktu reaksi setelah bertugas selama 24 jam adalah 0,23 detik (range 0,17–0,32 detik), dengan rerata lama jam tidur selama bertugas 24 jam adalah 2,32±1,552 jam. Simpulan, waktu reaksi lebih lama pada peserta PPDS Anestesiologi dan Terapi Intensif FK UNPAD setelah bertugas selama 24 jam. Change in Visual Stimulus Reaction Time of Anesthesiology and Intensive Care Residents after a 24-Hour ShiftA good reaction time is crucial for anesthesiologists when doing their work because their quick thinking and action are critical in life-threatening situations. A 24-hour shift may cause fatigue and sleep disturbances, lowering cognitive function and reaction time necessary for patient care. This study aimed to assess changes in the visual reaction time of the Anesthesiology and Intensive Care resident doctors FK Unpad after 24-hour shift in Dr. Hasan Sadikin General Hospital Bandung, Indonesia. This pretest and posttest control study was performed July–October 2019 on 58 subjects by evaluating the reaction time before and after a 24-hour shift using the ‘ruler drop’ method. Data were analyzed with Wilcoxon test after data were proven to be non-normally distributed based on the results of the Kolgomorov Smirnov test. The median visual  reaction time after a 24-hour shift was observed to be slower that before the shift , with 0.20 seconds reaction time before the shift (range 0.10–0.25 seconds) and 0.23 seconds after the shift (range 0.17–0.32 seconds). The average sleep time among the residents who work in the 24-hour shift was 2.32±1,552 hours. Hence, the visual reaction time is slower after 24-hour shift among residents of Anesthesiology and Intensive Care
Hidrotoraks Masif Dekstra dengan Penyulit ARDS Akibat Komplikasi Pemasangan Kateter Vena Sentral Jugular Interna Kinanti Narulita Dewi; Wiwi Jaya; Arie Zainul Fatoni
Jurnal Anestesi Perioperatif Vol 8, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n2.2072

Abstract

Hidrotoraks merupakan komplikasi yang jarang terjadi akibat pemasangan kateter vena sentral dengan angka insidensi 0,4–1,0%. Insidensi komplikasi mekanik lebih rendah pada insersi vena jugularis dibanding dengan vena subklavia. Pada kasus ini, kami melaporkan pasien laki-laki berusia 63 tahun dengan berat badan 70 kg. Pasien dengan ASA 4E sepsis dan curiga keganasan. Pasien ini didiagnosis akut abdomen karena  total bowel obstruction dan rencana dilakukan tindakan laparotomi dengan anestesi umum. Pasien ini telah dipasang kateter vena sentral saat di IGD. Pasien dilakukan tindakan anestesi umum selama 3 jam dan mendapatkan cairan intraoperatif 1.500 cc melalui kateter vena sentral. Pascaoperasi, pasien tidak dapat dilakukan ekstubasi karena napas tidak adekuat dan hemodinamik tidak stabil sehingga pasien dirawat di ruang ICU. Saat pasien tiba di ruang ICU, pada pemeriksaan fisis ditemukan suara napas paru kanan menurun dan perkusi redup pada paru kanan. Hasil analisis gas darah menunjukkan hipoksemia berat dan asidosis. Pemeriksaan foto rontgen dada ditemukan gambaran efusi pleura masif. Kami melakukan evakuasi kurang lebih 2,2 liter cairan berwarna kemerahan dari kavum pleura dan memasang selang chest tube pada paru kanan. Pasien mengalami acute respiratory distress syndrome (ARDS). Tata laksana pasien dengan sepsis dan ARDS berfokus pada prinsip lung protective strategy dan sepsis bundle sesuai dengan surviving sepsis campaign (SSC) 2018.Right Massive Hydrothorax with ARDS due to Complication of Internal Jugular Central Venous Catheter InsertionHydrothorax is a rare complication seen in approximately 0.4–1.0 % of all catheter placements. The major mechanical complication incidence of internal jugular vein insertion is lower than the one in the subclavia vein. This study presented a case of a 63-year-old, 70 kg man with ASA 4E sepsis and suspected malignancy. Patient was diagnosed with acute abdomen pain due to total bowel obstruction and underwent exploratory laparotomy with general anesthesia. A right jugular central venous catheter (CVC) was inserted in the ER. Patient was under general anesthesia for 3 hours and 1,500 cc intra operative fluid was administered through the CVC. After surgery, the patient experienced extubation failure and was admitted to ICU because of inadequate spontaneous breathing and hemodynamic instability. Patient experienced reduced breath sound and the resonance to percussion was dull in the right hemithorax. The BGA presented severe hypoxemia and acidosis while the chest x-ray showed right sided massive pleural effusion. Almost 2.2 liter of clear reddish fluid was drained from pleural cavity and a chest tube was inserted. Patient was then diagnosed as having acute respiratory distress syndrome (ARDS). Treatment for sepsis and ARDS was then given by focusing on the principle of lung protective strategy and sepsis bundle according to surviving sepsis campaign (SSC) 2018.
Pengaruh Premedikasi Midazolam 0,04 mg/kgBB sebelum Anestesi Spinal terhadap Respons Tubuh saat Insersi Jarum Spinal dan Kepuasan Anna Christanti; Ezra Oktaliansah; Indriasari Indriasari
Jurnal Anestesi Perioperatif Vol 8, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n2.2035

Abstract

Conscious sedation pada pasien yang dilakukan tindakan anestesi spinal membuat pasien menjadi lebih nyaman, kooperatif selama penyuntikan, dan mengurangi respons tubuh saat insersi jarum spinal. Midazolam memiliki efek ansiolitik, sedatif-hipnotik, amnesia, melemaskan otot, dan mengurangi mual-muntah akibat pembedahan. Tujuan penelitian ini mengetahui pengaruh premedikasi midazolam 0,04 mg/kgBB yang diberikan 30 menit sebelum dilakukan anestesi spinal terhadap respons tubuh pasien saat insersi jarum spinal dan kepuasan pasien terhadap anestesi spinal. Penelitian dilakukan periode September–Desember 2019 di RSUP Dr. Hasan Sadikin Bandung. Penelitian bersifat prospektif eksperimental menggunakan uji klinis acak buta ganda terhadap 46 subjek yang dibagi acak ke dalam 2 kelompok, yaitu kelompok kontrol (kelompok K, n=23) dan kelompok premedikasi midazolam (kelompok M, n=23). Pasca- pemberian premedikasi midazolam dinilai respons tubuh pasien saat insersi jarum spinal menggunakan prick response score dan kepuasan pasien dengan numeric rating scale. Analisis statistik untuk respons penyuntikan dan kepuasan pasien diuji dengan uji chi-square. Hasil penelitian menunjukkan respons tubuh pasien saat insersi jarum spinal berkurang (p<0,01) dan kepuasan pasien meningkat (p<0,01) pada kelompok premedikasi midazolam. Simpulan, premedikasi midazolam 0,04 mg/kgBB yang diberikan 30 menit sebelum anestesi spinal menurunkan respons tubuh pasien saat insersi jarum spinal dan meningkatkan kepuasan pasien terhadap anestesi spinalThe Effect of Midazolam Premedication 0.04 mg/kgBW before Spinal Anesthesia to Body Response during Spinal Needle Insertion and Satisfaction Conscious sedation leads to a more comfortable spinal intervention for patients, making them more cooperative as well as  decreasing body response during spinal needle insertion. Midazolam has anxiolytic, hypnosis-sedative, amnesia, muscle relaxation effects and ability to reduce nausea and vomiting related to a surgery.  The aim of this study was to determine the effect of 0,04 mg/kgBW midazolam premedication administered 30 minutes before spinal anesthesia on body response during spinal needle insertion and patient satisfaction. The prospective experimental study with a randomized, double blinded clinical trial approach was conducted from September to December 2019 in Dr. Hasan Sadikin General Hospital Bandung. Forty-six subjects were randomly divided into 2 groups: a control group (group K, n=23), and a midazolam premedication group (group M, n=23). After premedication with midazolam, the patient`s body response during spinal needle insertion were evaluated using the prick response score and their satisfaction was assessed using the numeric rating scale. Statistical analysis used to analyze  body response during needle insertion and patient satisfaction was the Chi-Square test. Results howed that patient`s body response during spinal needle insertion were reduced (p<0.01) and patient satisfaction increased (p<0.01) in the midazolam premedication group. In conclusion, 0.04 mg/kgBW midazolam premedication administered 30 minutes before spinal anesthesia reduces patient body response during spinal needle insertion and increases patient satisfaction on spinal anesthesia.
TATALAKSANA ICU PASIEN KRISIS MIASTENIA YANG DIPICU OLEH TUBERKULOSIS PARU DENGAN PENYULIT VAP Titik Setyawati; Reza Widianto Sujud; Indriasari Indriasari
Jurnal Anestesi Perioperatif Vol 8, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n2.2052

Abstract

Krisis miastenia adalah eksaserbasi akut miastenia gravis dengan kelemahan yang  melibatkan otot-otot pernapasan sehingga terjadi kegagalan napas akut dan memerlukan dukungan ventilasi mekanik. Krisis miastenia merupakan komplikasi miastenia gravis yang paling berbahaya dan mengancam jiwa bila tidak segera ditangani. Timbulnya krisis miastenia dapat dipicu oleh berbagai faktor, di antaranya infeksi dan penggunaan antibiotik aminoglikosid. Tata laksana Intensive Care Unit (ICU) pasien krisis miastenia meliputi tata laksana terhadap kegawatan respirasi, tata laksana terhadap miastenia gravis, dan tata laksana terhadap faktor peyulit. Intubasi endotrakeal dan dukungan ventilasi mekanis merupakan pilihan utama tata laksana kegawatan respirasi. Plasmaparesis adalah salah satu metode terapi yang terbukti efektif dan efisien selain pemberian agen anticholinesterase, terapi imunomodulator cepat, agen imunosupresif, dan timektomi. Terapi standar untuk menanggulangi tuberkulosis paru dengan obat antituberkulosis berdasar atas pedoman penatalaksanaan tuberkulosis serta terapi ventilator associated pneumonia (VAP) dengan pilihan antibiotik sesuai dengan hasil kultur bakteri. Dukungan nutrisi yang adekuat juga diperlukan untuk menunjang keberhasilan terapi. Dengan assessment dini dan terapi yang adekuat diharapkan dapat memperbaiki prognosis pasien krisis miastenia. Pada laporan kasus ini kami sajikan tata laksana ICU pasien krisis miastenia gravis yang dipicu oleh tuberkulosis paru dengan penyulit VAP yang dirawat di ICU RSHS Bandung pada bulan Oktober–November 2019. ICU Management of  Myasthenic Crisis in  Pulmonary Tuberculosis Patients with  Ventilator Associated Pneumonia ComplicationsMyasthenic crisis is an acute exacerbation of myasthenia gravis with a weakness that involves the respiratory muscles, leading to acute respiratory failure that requires mechanical ventilation support. Myasthenia crisis is the most dangerous and life-threatening complication of myasthenia gravis if not treated immediately. The emergence of myasthenic crisis can be triggered by various factors, including infection and aminoglycoside use. Intensive Care Unit (ICU) management of myasthenic crisis patients includes management of respiratory emergencies, management of myasthenia gravis, and management of complicating factors. Endotracheal intubation and mechanical ventilatory support are the main choices in the management of respiratory emergencies. Plasmaparesis is one of the proven and effective therapeutic methods in addition to anticholinesterase agent, rapid immunomodulatory therapy, immunosuppressive agent, and thymectomy. Standard therapy for treating pulmonary tuberculosis includes anti-tuberculosis drugs, as stated in tuberculosis management guidelines, and Ventilator Associated Pneumonia (VAP) therapy with antibiotic options according to bacterial culture results. Adequate nutritional support is also needed to support the success of therapy. With early assessment and adequate therapy, it is expected that the prognosis of myasthenic crisis patients will be improved. This case report presented  the management of myasthenia gravis crisis triggered by pulmonary tuberculosis with VAP complications in patients treated at the ICU of Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from October to November 2019.
Perbandingan Pemberian Morfin 15 mg Topikal dengan Bupivakain 0,25% Topikal pada Luka Operasi Modified Radical Mastectomy terhadap Waktu Bebas Nyeri dan Jumlah Kebutuhan Opioid Pascaoperasi Irwan Setiadi; M. Andy Prihartono; Erwin Pradian
Jurnal Anestesi Perioperatif Vol 8, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n2.2038

Abstract

Berbagai macam analgetik dapat diberikan untuk mengatasi nyeri pascaoperasi mastektomi, namun tidak ada yang ideal dalam menangani nyeri pascaoperasi. Teknik pemberian topikal adalah teknik terbaru untuk penanganan nyeri akut pascaoperasi modified radical mastectomy. Penelitian ini bertujuan membandingkan waktu bebas nyeri dan jumlah kebutuhan opioid pascaoperasi modified radical mastectomy. Penelitian menggunakan metode uji klinis acak terkontrol buta ganda melibatkan 38 pasien yang menjalani operasi modified radical mastectomy di RSUP Dr. Hasan Sadikin Bandung pada bulan November 2019–Februari 2020. Pasien dibagi menjadi dua kelompok, kelompok morfin 15 mg topikal (kelompok M, n=19) dan kelompok bupivakain 0,25% topikal (kelompok B, n=19). Analisis data menggunakan Uji  Mann Whitney karena distribusi data tidak normal berdasar hasil Uji Shapiro-Wilk. Hasil penelitian didapatkan bahwa waktu bebas nyeri lebih lama pada kelompok M (846,78±411,80 menit) dibanding dengan kelompok B (401,52±123,19 menit) dengan perbedaan yang signifikan (p<0,05). Total kebutuhan opioid kelompok M lebih sedikit, yaitu sebesar 1,15±0,60 gram dibanding dengan kelompok B sebesar 3,84±0,89 gram dengan perbedaan yang signifikan (p<0,05). Simpulan penelitian adalah pemberian morfin topikal memberikan waktu bebas nyeri lebih lama dan jumlah kebutuhan opioid pascaoperasi lebih sedikit dibanding dengan pemberian bupivakain topikal untuk nyeri pascaoperasi modified radical mastectomy.Comparison of Postoperative Pain Free Duration and Amount of Opioid Need between Topical 15 mg Morphine and 0.25% Bupivacaine Applications on Modified Radical Mastectomy Surgical Wound Various analgesic methods are implemented for reducing postoperative mastectomy pain, but none of them are ideal. Topical administration is the latest technic for managing postoperative pain in modified-radical mastectomy. This study aimed to compare pain free duration and the amount of opioid needed to manage pain after modified-radical mastectomy. This randomized double-blind clinical trial study with 38 patients underwent modified radical mastectomy in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, was performed from November 2019 to February 2020. Subjects were divided into two groups, with one group received topical 15 mg morphine group (group M, n=19) and another received topical 0.25% bupivacaine group (group B, n=19). Data were analyzed using Mann Whitney test after they were proven to be non-normally distributed based on the results of the Shapiro-Wilk test. Results showed that the pain free duration was significantly longer in group M (846.78±411.80 minutes) when compared to group B (401.52±123.19 minutes) (p<0.05). The total dose needed for group M was 1,15±0,60 grams, which was significantly less than the dose needed in group B (384±0.89 grams) (p<0.05). In conclusion, topical morphine administration is associated with a longer pain free duration before the first onset of pain requiring opioid with less total amount of opioid needed when compared to bupivacaine for modified radical mastectomy postoperative pain.
ANGKA KEJADIAN, LENGTH OF STAY, DAN MORTALITAS PASIEN ACUTE KIDNEY INJURY DI ICU RSUP DR. HASAN SADIKIN TAHUN 2018 Hidayat Hidayat; Erwin Pradian; Nurita Dian Kestriani
Jurnal Anestesi Perioperatif Vol 8, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n2.2054

Abstract

Angka kejadian acute kidney injury (AKI) di ICU tergolong tinggi dengan penyebab utama adalah sepsis dan menjadi salah satu faktor yang memengaruhi lama rawat dan mortalitas pasien di ICU. Angka kejadian, lama rawat, dan mortalitas AKI pada ICU di Indonesia belum diketahui. Tujuan penelitian ini mengetahui angka kejadian AKI, lama rawat dan mortalitas pasien AKI di ICU RSUP dr Hasan Sadikin pada tahun 2018. Penelitian ini merupakan penelitian deskriptif yang dilakukan pada 148 pasien yang dirawat di ICU RSUP dr. Hasan Sadikin Tahun 2018. Diagnosis AKI ditentukan melalui kriteria KDIGO dengan melihat peningkatan kreatinin serum dan penilaian urine output. Penelitian ini dilakukan mulai September 2019 sampai Februari 2020. Pada penelitian ini diperoleh sebanyak 61 pasien (41,2%) dengan diagnosis AKI, mayoritas pasien didiagnosis AKI tahap 3 yaitu sebanyak 32 pasien (53%). Sebanyak 14,8% pasien mendapatkan renal replacement therapy (RRT. Rerata lama rawat pada pasien AKI di ICU, yaitu 9,4±7,2 hari dan mortalitas sebesar 77%. Simpulan, angka kejadian AKI di ICU RSUP Dr. Hasan Sadikin Bandung tergolong tinggi, yaitu 41,2% serta mortalitas yang juga tinggi, yaitu 77%. Frequency, Length of Stay, And Mortality of Patients with Acute Kidney Injury at ICU Dr. Hasan Sadikin Hospital BandungIncidence of acute kidney injury (AKI) among patients treated in Intensive Care Units (ICU) is relatively high, mainly due to sepsis. The presence of AKI affects the patient’s length of stay (LOS) in the ICU as well as the mortality of ICU patients. In Indonesia, no data is available for the incidence of AKI in ICUs and the LOS and mortality rate of ICU patients with AKI. This study aimed to determine AKI incidence in ICU patients and the length of stay and mortality rate of ICU patients with AKI in Dr. Hasan Sadikin General Hospital in 2018. This was a descriptive study conducted on 148 patients treated at the ICU of Dr. Hasan Sadikin General Hospital 2018. The diagnosis of AKI was confirmed using the  Kidney Disease Improving Global Outcomes (KDIGO) criteria by observing the increase in creatinine serum and assessing the urine output. Data were collected during the period of September 2019 to February 2020 for analysis. Results showed that among 61 patients (41.2%) diagnosed with AKI, the majority were diagnosed with stage 3 AKI (n=32; 52.5%). A total of 14.8% of patients received RRT therapy. The mean LOS of AKI patients in ICU was 9.4±7.2 days and the mortality rate was 77%. Thus, the  incidence of AKI in the ICU of Dr. Hasan Sadikin General Hospital is relatively high (41.2%) with a high mortality rate (77%).
PENGARUH PEMBERIAN MINUMAN KARBOHIDRAT (MALTODEXTRIN 12,5%) PRAOPERASI TERHADAP KEJADIAN MUAL DAN MUNTAH PASCAMASTEKTOMI Andre Aditya; Iwan Fuadi; Iwan Abdul Rachman
Jurnal Anestesi Perioperatif Vol 8, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n2.2039

Abstract

Mual dan muntah pascaoperasi (postoperative nausea and vomiting, PONV) menjadi masalah yang umum terjadi setelah operasi mastektomi dengan angka kejadian berkisar 21–92%. Pemberian minuman karbohidrat (CHO) praoperasi ditawarkan sebagai sebuah solusi menurunkan PONV dan juga merupakan salah satu komponen penting dan disarankan untuk mencapai enhanced recovery after surgery (ERAS). CHO berhubungan dengan penurunan katabolisme dan resistensi insulin pascaoperasi. Penelitian ini bertujuan mengetahui pengaruh pemberian minuman berkarbohidrat (CHO) oral sebelum operasi terhadap tingkat kejadian PONV pascaoperasi mastektomi. Penelitian menggunakan eksperimental uji acak buta tunggal di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada November 2019–Februari 2020. Sebanyak 46 pasien dibagi menjadi dua kelompok, yakni kelompok K (kelompok kontrol, air mineral, n=23 subjek) dan kelompok C (kelompok CHO, n=23 subjek). Analisis data hasil penelitian dilakukan dengan Uji Mann-hitney. Kejadian mual muntah pada kelompok kontrol lebih besar dibanding dengan kelompok CHO pada menit 0–30 (57% vs 22%), pada menit 30–60 (91% vs 61%), dan pada menit 60–120 (78% vs 61%) dengan perbedaan yang bermakna (p<0,05). Simpulan, pemberian minuman karbohidrat praoperasi dapat menurunkan kejadian mual muntah pascamastektomi dibandingkan dengan kelompok kontrol. Effect of Preoperative Oral Carbohydrate Supplementation (Maltodextrin 12.5%) on Post-Mastectomy Nausea and Vomiting Incidence Postoperative nausea and vomiting (PONV) is a common problem after surgery. Mastectomy is one of surgeries with a high-risk for PONV, which is seen in 21–92% of the patients. Preoperative carbohydrate (CHO) drinks are offered to reduce PONV. The provision of CHO is also important as it is recommended to obtain enhanced recovery after surgery (ERAS). CHO is associated with reduced catabolism and postoperative insulin resistance. This study aimed to determine the effect of oral carbohydrate (CHO) drinks before surgery on the incidence of postoperative PONV in mastectomy. This was an experimental single-blind randomized study conducted in Dr. Hasan Sadikin General Hospital (RSHS) Bandung, Indonesia. A total of 46 patients were divided into two groups, namely group K (control group, mineral water, n=23 subjects) and group C (CHO group, n=23 subjects). Data collected were then analyzed using the Mann Whitney test and the results showed that during PONV incidence rates were significantly higher 0–30 minutes after the surgery (57% vs 22%),  30–60 minutes after the surgery (91% vs 61%), and 60–120 minutes (78% vs 61%) (p < 0.05). Therefore, the administration of preoperative carbohydrate drinks can reduce the incidence of postoperative nausea and vomiting in mastectomy. 

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