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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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Articles 484 Documents
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Gambaran Tata Cara dan Angka Keberhasilan Penyapihan Ventilasi Mekanik di Ruang Perawatan Intensif Rumah Sakit Dr. Hasan Sadikin Bandung Sitorus, Richard Pahala; Fuadi, Iwan; Zulfariansyah, Ardi
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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

Abstract

Penyapihan ventilasi mekanik adalah suatu proses pelepasan bantuan ventilator yang dilakukan secara bertahap atau langsung oleh seorang dokter Intensive Care Unit (ICU). Penelitian ini bertujuan mengetahui gambaran tata cara dan angka keberhasilan penyapihan ventilasi mekanik yang dilakukan di ICU Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung. Metode penelitian ini adalah deskriptif observasional prospektif dan merupakan studi cross sectional. Penelitian ini melibatkan 50 pasien yang dirawat di ICU RSHS Bandung pada bulan Juli–September 2015. Data dicatat dan dikelompokkan sesuai dengan variabel karakteristik tata cara dan angka keberhasilan penyapihan ventilasi mekanik. Hasil penelitian ini menunjukkan tata cara penyapihan ventilasi mekanik yang paling banyak dilakukan adalah once daily trial of T piece sebanyak 22 pasien (44%) kemudian continous positive airway pressure (CPAP) sebanyak 40%, intermittent trial of T-piece sebanyak 10%, dan pressure support ventilation (PSV) 6%. Angka keberhasilan penyapihan ventilasi mekanik sebanyak 44 orang (88%) dan angka kegagalan penyapihan ventilasi mekanik adalah sebanyak 6 orang (12%) sehingga harus dilakukan re-intubasi. Tata cara penyapihan ventilasi mekanik yang paling banyak digunakan di ICU RSHS Bandung adalah once daily trial of T piece dan angka keberhasilan penyapihan ventilasi mekanik sebesar 88%.Kata kunci: Angka keberhasilan, tata cara penyapihan, ventilasi mekanikProcedures and Success Rate of Mechanical Ventilation Weaning in Intensive Care Unit of Dr. Hasan Sadikin General Hospital BandungAbstractMechanical ventilation weaning is a process of withdrawing ventilator assistance gradually or immediately by Intensive Care Unit (ICU) physicians. This study aimed to describe the procedure and the success rate of mechanical ventilation weaning performed at the ICU of Dr. Hasan Sadikin General Hospital (RSHS) Bandung. This was a cross-sectional descriptive prospective observational and study involving 50 patients treated at the ICU of RSHS Bandung during the period of July to September 2015. Data were recorded and classified in accordance with the variable characteristics of the procedure and the success rate of mechanical ventilation weaning. The results indicated that the most widely used mechanical ventilation weaning procedures were T-piece once daily trial in 22 patients (44%), continous positive airway pressure (CPAP) in 40%, T-piece intermittent trial in 10%, and pressure support ventilation (PSV)in 6%. Mechanical ventilation weaning success rate was 88% and the failure rate was 12% (6 patients) which required re-intubation. The most widely used procedure for mechanical ventilation weaning at the ICU of Dr. Hasan Sadikin General Hospital Bandung is T-piece once daily trial and the mechanical ventilation weaning success rate is 88%.Key words: Mechanical ventilation, success rate, weaning procedure  
Perbandingan Penilaian Visual Analog Scale dari Injeksi Subkutan Morfin 10 mg dan Bupivakain 0,5% pada Pasien Pascabedah Sesar dengan Anestesi Spinal Fadinie, Wulan; Arifin, Hasanul; Wijaya, Dadik Wahyu
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (497.157 KB)

Abstract

Obat anestesi lokal dan opioid dapat disuntikkan langsung pada luka untuk mengurangi nyeri pascabedah. Penelitian bertujuan menilai intensitas nyeri menggunakan visual analog scale (VAS) dapat menjadi metode yang sangat efektif dalam penilaian nyeri pascabedah. Membandingkan nilai VAS pada saat istirahat dan batuk dari infiltrasi lokal morfin 10 mg dengan bupivakain 0,5% 2 mg/kgBB pada pascabedah sesar dengan metode uji klinis acak tersamar ganda pada 100 sampel. Kriteria inklusi adalah perempuan hamil, usia 20–40 tahun, dengan status fisik menurut American Society of Anesthesia (ASA) kelas I–II yang menjalani bedah sesar elektif dan emergensi di RSUP Haji Adam Malik, RSU dr. Pirngadi, RS Putri Hijau, RS Haji, dan RSU Sundari pada bulan Juli 2014. Sampel dibagi menjadi kelompok A dengan infiltrasi lokal morfin 10 mg dan kelompok B dengan infiltrasi lokal bupivakain 0,5% 2 mg/kgBB. Nilai VAS dianalisis secara statistik dengan Mann-Whitney. Nilai VAS lebih rendah pada kelompok A, yaitu 4,72 (SB=1,54) dibanding dengan kelompok B, yaitu 2,14 (SB=1,21). Simpulan, infiltrasi lokal morfin 10 mg lebih baik dibanding dengan bupivakain 0,5% 2 mg/kgBB.Kata kunci: Bupivakain, infiltrasi lokal, manajemen nyeri, morfin, visual analog scaleComparison of Visual Analog Scale Assestment of Subcutaneous Injection of 10 mg Morphine and 0.5% Bupivacaine in Post-Caesarean Section under Spinal AnesthesiaAbstractLocal anesthetic agent and opioid can subcutaneously be injected into the wound to reduce postoperative pain. This study was conducted to evaluate pain intensity using visual analog scale (VAS), which can be a very effective method of postoperative pain assessment, and to compare VAS when resting and coughing between local infiltration of 10 mg morphine and 2 mg/kgBW 0.5% bupivacaine after caesarian section. This study was a double blinded randomized clinical trial on 100 subjects. The inclusion criteria were pregnant women, aged 20–40 years, with physical ASA I–II status who underwent elective and emergency caesarean section in Haji Adam Malik Hospital, dr. Pirngadi Hospital, Putri HijauHospital, Haji Hospital, and Sundari Hospital during the period of July 2014. Subjects were divided into group A with 10 mg morphine infiltration and group B with 2 mg/kgBW 0.5% bupivacaine local infiltration. The resulting VAS scores were analyzed statistically using Mann-Whitney. ItLower VAS scores were found in group A 4.72 (SB=1.54) when compared to group B 2.14 (SB=1.21). In conclusion, local infiltration of 10 mg morphine is better compared to 2 mg/kgBW 0.5% bupivacaine.Key words: Bupivacaine, local infiltration, morphine, pain management, visual analog scale DOI: 10.15851/jap.v4n2.826
Perbandingan Validitas Sistem Penilaian APACHE II, SOFA, dan CSOFA Sebagai Prediktor Mortalitas Pasien yang Dirawat di Instalasi Rawat Intensif RSUP H. Adam Malik Medan Andrias, Andrias; Hanafie, Achsanuddin; Wijaya, Dadik Wahyu
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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

Abstract

Sistem penilaian APACHE II dan SOFA masih digunakan sebagai instrumen objektif untuk memprediksi mortalitas pasien di Instalasi Rawat Intensif (IRI), namun masih kurang praktis. Sistem penilaian CSOFA dengan parameter serta biaya pengeluaran yang lebih sedikit dan praktis diharapkan memiliki akurasi yang lebih baik. Tujuan penelitian ini mendapatkan alternatif yang lebih sederhana, mudah dan murah, namun tetap memiliki akurasi yang baik sebagai prediktor mortalitas pasien selain APACHE II dan SOFA. Penelitian uji diagnostik cross sectional dilakukan pada bulan Februari–April 2016 di IRI RSUP H. Adam Malik. Subjek penelitian 71 pasien dewasa yang memenuhi kriteria inklusi dinilai APACHE II, SOFA, dan CSOFA setelah dirawat 24 jam pertama, kemudian dilihat mortalitasnya pada akhir masa rawatan. Analisis statistik menggunakan tabel 2x2 serta receiving operating curve (ROC), dihitung juga sensitivitas, spesifisitas, nilai prediksi negatif dan positif, serta likelihood ratio dengan SPSS ver.23. CSOFA memiliki kemampuan yang sangat baik dalam memprediksi mortalitas dengan luas area under ROC (AuROC) 87,6%. APACHE II memiliki kemampuan yang baik dalam memprediksi mortalitas dengan luas AuROC 84,7%. SOFA memiliki kemampuan yang cukup dalam memprediksi mortalitas dengan luas AuROC 79,1%. Simpulan, sistem penilaian CSOFA dapat dijadikan sebagai prediktor mortalitas pasien selain APACHE II dan SOFA di IRI RSUP HAM.Kata kunci: APACHE II, CSOFA, mortalitas, SOFA Comparison of APACHE II, SOFA, and CSOFA Scoring System Validity as Mortality Predictor in ICU Patients in H. Adam Malik General HospitalThe APACHE II and SOFA scoring systems are still used as the objective instruments for predicting mortality in patients admitted to the Intensive Care Unit (ICU); however, the two are still considered less practical. CSOFA, with more practical parameters as well as a lower cost, is expected to provide better accuracy. The purpose of this study was to get a simpler, easier, and cheaper alternative, but with good accuracy, to APACHE II and SOFA as a predictor of mortality in patients admitted to the ICU of H. Adam Malik (HAM) Hospital. A cross-sectional diagnostic test study was conducted in February–April 2016 at the ICU of H. Adam Malik General Hospital. A sample of 71 adult patients that met the inclusion criteria was assessed by APACHE II, SOFA, and CSOFA at the first 24 hours after treatment. The mortality was then observed at the end of treatment. Statistical analysis using 2x2 tables and receiving operating curve (ROC) were used to calculate the sensitivity, specificity, positive, and negative predictive values, as well as the likelihood ratio using SPSS ver.23. CSOFA in this study presented a very good ability in predicting mortality with an Area under ROC (AuROC) of 87.6% while APACHE II had a good ability in predicting mortality with an AuROC of 84.7%. SOFA had sufficient ability in predicting mortality with an AuROC of 79.1%. In conclusion, CSOFA scoring system can be used as a patient mortality predictor as an alternative to APACHE II and SOFA in the ICU.Key words: APACHE II, CSOFA, mortality, SOFA 
Perbandingan Efek Pemberian Analgesia Pre-emtif Parecoxib dengan Parasetamol terhadap Nyeri Pascaoperasi Radikal Mastektomi Menggunakan Numeric Rating Scale Kartapraja, Roni D.; Fuadi, Iwan; Redjeki, Ike Sri
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (488.994 KB)

Abstract

Mastektomi merupakan prosedur operasi pengangkatan kanker payudara yang dapat menimbulkan nyeri akut pascaoperasi, bahkan pada 20–30% pasien berlanjut menjadi sindrom nyeri kronik pascamastektomi sehingga diperlukan penatalaksanaan nyeri secara adekuat agar pasien tidak mengalami episode nyeri yang dapat mengganggu produktivitas. Tujuan penelitian ini membandingkan efek pemberian analgesia pre-emtif parecoxib dengan parasetamol dalam menurunkan nyeri pascaoperasi radikal mastektomi. Penelitian dilakukan secara prospektif single blind randomized controlled trial terhadap 30 pasien dewasa yang menjalani operasi radikal mastektomi di Rumah Sakit Dr. Hasan Sadikin Bandung periode September–November 2014. Subjek dibagi dalam dua kelompok, analgesia pre-emtif parasetamol 1 g dan parecoxib 40 mg diberikan 30 menit sebelum sayatan pertama dilakukan. Setelah operasi selesai dicatat skala nyeri berdasarkan numeric rating scale (NRS) hingga 12 jam pascaoperasi di ruang perawatan. Analisis data menggunakan uji-t dan diolah dengan program statistical package for social science (SPSS) versi 21.0 for windows. Kelompok analgesia pre-emtif parecoxib 40 mg lebih lama membutuhkan analgetik pertolongan dan menurunkan NRS lebih rendah dibanding dengan kelompok analgesia preemtif parasetamol 1 g (p<0,05). Simpulan, parecoxib 40 mg lebih baik dibanding dengan analgesia pre-emtif parasetamol 1 g dalam menurunkan nyeri pascaoperasi radikal mastektomi berdasarkan NRS.Kata kunci: Analgesia pre-emtif, numeric rating scale, nyeri pascaoperasi, parasetamol, parecoxib, radikal mastektomiComparative Effect of Preemptive Analgesia Parecoxib with Paracetamol against Postoperative Radical Mastectomy Pain Using Numeric Rating ScaleMastectomy is a breast cancer surgery procedure that can lead to acute postoperative pain with 20–30% of patients may progress to postmastectomy chronic pain syndrome (PMPS). Therefore, it is necessary provide an adequate pain management so patients will not experience episodes of pain that can disrupt their productivity. The purpose of this study was to compare the effect of preemptive analgesia parecoxib with paracetamol in reducing radical mastectomy postoperative pain.The study was a prospective single blinded randomized controlled clinical trials on 30 adult patients who underwent radical mastectomy surgery in Dr. Hasan Sadikin General Hospital between September and November 2014. Subjects were divided randomly into two groups, 1 gram paracetamol preemptive analgesia and 40 miligram parecoxib which given 30 minutes before the first incision has been made. After the surgery was completed, we record the pain scale using the numeric rating scale (NRS). The data were recorded starting from the recovery room to 12 hours postoperative in the ward. Statistical analysis was performed using the t-test with statistical package for social science (SPSS) version 21.0 for Windows software. The results showed that the 40 miligram parecoxib preemptive analgesia group required longer rescue analgesics and lowerNRS than 1 gram paracetamol preemptive analgesia (p<0.05). In conclusion, 40 miligram parecoxib preemptive analgesia is better than 1 gram paracetamol preemptive analgesia in reducing radical mastectomy postoperative pain according to numeric rating scale.Key words: Numeric rating scale, paracetamol, parecoxib, postoperative pain, preemptive analgesia, radical mastectomy DOI: 10.15851/jap.v4n2.825
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
Perbandingan Pemberian Cairan Liberal dan Restriktif terhadap Mean Arterial Pressure, Laju Nadi, dan Capaian Nilai Post Anesthetic Discharge Scoring System Usia 1–3 Tahun di Bedah Rawat Jalan Somalinggi, Melliana; Sudjud, Reza Widianto; Oktaliansah, Ezra
Jurnal Anestesi Perioperatif Vol 6, No 1 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (913.073 KB) | DOI: 10.15851/jap.v6n1.1289

Abstract

Teknik pemberian cairan liberal yang masih banyak digunakan sering menjadi berlebihan termasuk pada bedah rawat jalan. Puasa yang tepat, operasi yang singkat, serta perdarahan yang minimal pada bedah rawat jalan hanya memerlukan pemberian cairan restriktif. Penelitian ini bertujuan mengetahui mean arterial pressure (MAP) dan laju nadi intraoperatif serta capaian postanesthetic dischange skoring system (PADSS) antara pemberian cairan liberal dan restriktif anak usia 1−3 tahun di bedah rawat jalan. Penelitian bersifat eksperimental acak terkontrol buta tunggal dengan randomisasi secara acak sederhana pada 42 anak usia 1−3 tahun, status fisik American Society of Anesthesiology (ASA) I-II di bedah rawat jalan RSUP Dr. Hasan Sadikin Bandung periode Desember 2016 sampai Mei 2017. Subjek penelitian dikelompokkan menjadi dua, yaitu kelompok liberal diberikan cairan rumatan intraoperatif formula Holiday-Segar, penggantian puasa serta penggantian cairan ‘ruang ketiga’; dan kelompok restriktif diberikan hanya cairan rumatan intraoperatif 2 mL/kgBB/jam. Data dianalisis dengan uji-t dan Uji Mann-Whitney. Dari hasil penelitian didapatkan gambaran MAP dan laju nadi intraoperatif, serta capaian PADSS pada kedua kelompok tidak berbeda bermakna (p>0,05). Simpulan, tidak terdapat perbedaan gambaran MAP dan laju nadi intraoperatif, serta capaian PADSS antara pemberian cairan liberal dan restriktif pada anak usia 1−3 tahun yang menjalani bedah rawat jalan.Kata kunci: Cairan intraoperatif, laju nadi, mean arterial pressure, pediatrik, postanesthetic discharge scoring system
Pola Pneumonia Nosokomial di Unit Perawatan Intensif Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung Periode Januari–Desember 2017 Salukanan, Ronald Tikuali; Zulfariansyah, Ardi; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 6, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (249.88 KB) | DOI: 10.15851/jap.v6n2.1337

Abstract

Pneumonia merupakan salah satu jenis infeksi nosokomial dengan jumlah kasus tertinggi dibanding dengan infeksi nosokomial lain di unit perawatan intensif (ICU) disertai jumlah morbiditas dan mortalitas yang tinggi. Pola pneumonia nosokomial merupakan suatu karakteristik pneumonia nosokomial yang digunakan untuk mengidentifikasi masalah dan dapat menjadi indikator untuk perbaikan terapi. Penelitian bertujuan menggambarkan pola pneumonia nosokomial di unit perawatan intensif RSUP Dr. Hasan Sadikin Bandung periode Januari–Desember 2017. Metode penelitian menggunakan deskriptif observasional yang dilakukan secara retrospektif terhadap 70 objek penelitian yang diambil dari rekam medis dan dilakukan dalam waktu 3 bulan, yaitu Oktober–Desember 2017. Hasil penelitian jumlah kematian akibat pneumonia nosokomial masih tinggi, yaitu 60% terutama pada pasien laki-laki usia ≥ 65 tahun. Komorbid terbanyak pada pneumonia nosokomial, yaitu hipertensi (31,4%) diikuti penyakit neuromuskular (15,7%). Mikrob terbanyak penyebab HAP adalah A. baumannii (38,1%), P. aeroginosa (30,4%), dan K. pneumoniae (15,2%), sedangkan mikrob penyebab terbanyak ventilator associated pneumonia (VAP) adalah A. baumannii (32%), P. aeroginosa (30,5%), dan K. pneumoniae (22%). Mikrob A. baumannii juga menjadi penyebab mortalitas tertinggi dengan persentase 45,4% dan terapi empirik yang sering digunakan adalah kombinasi meropenem–levofloxacin (40%), terapi tunggal meropenem (34,3%), dan kombinasi ceftazidime-levofloxacin (20%). Simpulan, pola pneumonia nosokomial di ICU RSUP Dr. Hasan Sadikin Bandung periode Januari–Desember 2017 masih diperlukan perbaikan program penanganan terhadap infeksi ini untuk mencapai pelayanan yang baik.Kata kunci: Mikrob, mortalitas, pneumonia nosokomial, unit perawatan intensif Nosocomial Pneumonia Pattern in Intensive Care Unit (ICU) of Dr. Hasan Sadikin General Hospital Bandung from January to December 2017Pneumonia is the most common nosocomial infection in intensive care unit with high morbidity and mortality rates. Pattern of nosocomial pneumonia is an infection characteristic that helps the identification of a phenomenon or problem and serves as an indicator or model for predicting future behaviors. These patterns can be used for making a standardized therapy management for the disease. The aim of this study was to describe nosocomial pneumonia pattern in Intensive Care Unit (ICU) in Dr.  Hasan Sadikin Bandung from January to December 2017. A retrospective observational descriptive method on 70 samples from medical records with an observation period of three months starting from October to December 2017. It was shown that the mortality rate of nosocomial pneumonia was 60% with male patients aged ≥ 65 years old as the most affected group. The most common comorbid was hypertension (31.4%) followed by neuromuscular diseases (15.7%). The most common HAP-causing microbes were A. baumannii (38.1%), P. aeroginosa (30.4%), and K. pneumoniae (15.2%) and the most common microbes for VAP were A. baumannii (32%), P. aeroginosa (30.5%), and K. pneumoniae (22%). Acinetobacter baumannii caused most deaths (45.4%). The most common empirical therapy was meropenem–levofloxacin combination (40%), meropenem (34.3%), and ceftazidime–levoflocacin combination (20%). In conclusion, pattern of nosocomial pneumonia in ICU of Dr. Hasan Sadikin General Hospital Bandung reflects a situation that therapy management for this infection needs to be improved for a proper service.Key words: Intensive care unit, microbes, mortality, nosocomial pneumonia 
Perbandingan Laringoskopi Indirek Kaca Laring dengan Laringoskopi Indirek Video Smartphone dalam Menilai Visualisasi Laring dan Kenyamanan Pasien Sulistiono, Paulus; Prihartono, M. Andy; Yadi, Dedi Fitri
Jurnal Anestesi Perioperatif Vol 6, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (873.967 KB) | DOI: 10.15851/jap.v6n2.1254

Abstract

Salah satu pemeriksaan preoperatif yang dapat digunakan sebagai prediktor kesulitan intubasi adalah laringoskopi indirek.  Penelitian ini bertujuan menilai visualisasi laring dan kenyamanan pasien antara laringoskopi indirek kaca laring dan laringoskopi indirek video smartphone. Penelitian menggunakan  metode prospective randomized parallel trial, dilakukan di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan November–Desember 2017. Pasien dibagi menjadi kelompok laringoskopi indirek kaca laring (kelompok LIKL, n=22) dan kelompok laringoskopi indirek video smartphone (kelompok LIVS, n=22). Uji statistik menggunakan Uji Mann-Whitney. Hasil penelitian mengungkapkan visualisasi laring lebih jelas pada kelompok LIVS (1,73 SD±0,77) dibanding dengan kelompok LIKL (2,50 SD±0,86) dengan perbedaan signifikan (p<0,05). Kenyamanan yang lebih baik pada kelompok LIVS (skala di atas 5) dibanding dengan kelompok LIKL (skala di atas 5) dengan perbedaan signifikan (p<0,05). Simpulan penelitian ini adalah visualisasi laring dan kenyamanan pasien pada laringoskopi indirek dengan video smartphone lebih baik bila dibanding dengan laringoskopi indirek kaca laring.Kata kunci: Kaca laring, kesulitan intubasi, laringoskopi indirek, video smartphone  Comparison between Indirect Laryngoscopy Laryngeal Mirror and Indirect Laryngoscopy Smartphone Video in Evaluating Laryngeal Visualization and Patient ComfortIndirect laryngoscopy is an examination modality which can be performed during pre-operative phase as a predictor of difficult intubation. The purpose of this study was to compare indirect laryngoscopy using laryngeal mirror and indirect laryngoscopy using smartphone video in evaluating laryngeal visualization and providing convenience to patients during the examination procedure. This prospective randomized parallel trial was conducted at Dr. Hasan Sadikin General Hospital Bandung from November to December 2017. Patients were assigned to two study groups: those who underwent indirect laryngoscopy using laryngeal mirror (LIKL group, n=22) and those who underwent indirect laryngoscopy using smartphone video (LIVS group, n=22). Mann-Whitney test was utilized as the statistical test method. Result of this study showed that laryngeal visualization was significantly superior in LIVS group compared to LIKL group (1.73 SD±0.77 vs 2.50 SD±0.86, respectively, p value<0.05). Patient comfort was significantly superior in LIVS group compared to LIKL group (comfort score above 5 vs comfort score above 5, respectively, p value <0.05). Therefore, it is concluded that laryngeal visualization using indirect langryngoscopy with smartphone video is more comfortable than the one that uses direct laryngoscopy with laryngeal mirror.Key words: Difficult intubation, indirect laryngoscopy, laryngeal mirror, smartphone video
Perbedaan Skala Nyeri antara Blok Pleksus Servikalis Superfisialis Levobupivakain dan Fentanil Intravena Pascaoperasi Mastoidektomi Kaligis, Stephanus Andy Prakasa; Arianto, Ardana Tri; Thamrin, Muhammad Husni
Jurnal Anestesi Perioperatif Vol 6, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (497.814 KB) | DOI: 10.15851/jap.v6n2.1224

Abstract

Penelitian tentang penggunaan blok pleksus servikalis superfisialis sebagai analgetik pascaoperasi mastoidektomi masih sangat terbatas baik di Indonesia maupun luar negeri. Tujuan penelitian mengetahui efektivitas blok pleksus servikalis superfisialis sebagai analgetik pascaoperasi mastoidektomi. Penelitian ini berdisain uji klinik acak tersamar tunggal pada 30 pasien yang dilakukan operasi mastoidektomi dan memenuhi kriteria inklusi di Rumah Sakit Dr. Moewardi Surakarta periode Oktober 2017–Februari 2018. Sampel dibagi menjadi 3 kelompok, yaitu kelompok fentanil intravena, blok pleksus cervicalis superfisialis dengan levobupivakain, dan blok pleksus cervicalis superfisialis dengan salin. Semua pasien mendapatkan perlakuan anestesi umum sesuai standar dan dinilai skala nyeri berkala pascaoperasi. Selain itu, juga dinilai efek mual-muntah pascaoperasi, kebutuhan opioid selama operasi, dan efek samping tindakan blok. Skala nyeri pascaoperasi mulai jam ke-2 sampai ke-24 pada kelompok fentanil intravena (nyeri ringan 80–90%) dan levobupivakain (nyeri ringan 90–100%) lebih rendah dibanding dengan kelompok salin (nyeri ringan 10–50%; nyeri sedang 50–70%) (p<0,05). Pada kelompok salin bahkan terjadi nyeri berat sebanyak 40% pada jam ke-2. Skor PONV pada kelompok fentanil, levobupivakain, dan salin mayoritas mual ringan (60%; 40%; dan 50%). Tidak ada komplikasi yan g terjadi terkait blok pleksus servikalis superfisialis. Simpulan, tidak ada perbedaan skala nyeri yang bermakna antara blok pleksus servikalis superfisialis levobupivakain dan fentanil intravena pascaoperasi mastoidektomi. Kata kunci: Blok pleksus servikalis superfisialis, fentanil, levobupivakain, mastoidektomi Difference in Pain Scale between Levobupivacaine Superficial Cervical Plexus Block and Intravenous Fentanyl for Post-Post-Mastoidectomy PainResearch on the use of superficial cervical plexus block as an analgesic after mastoidectomy is still very limited both in Indonesia and abroad. The purpose of this study was to determine the efficacy of superficial cervical plexus block as an analgesics for post-post-mastoidectomy pain. This was a single blinded randomized clinical trial study performed on 30 patients underwent mastoidectomy who met the inclusion criteria in Dr. Moewardi General Hospital Surakarta October 2017–February 2018. Subjects were divided into 3 groups: levobupivacaine block, saline block, and intravenous fentanyl groups. All patients received standard general anesthesia treatment and  were evaluated periodically for the post-operative pain scale. The post-operative effects post-including  nausea-vomiting, opioid need during surgery, and side effects of  the block were also assessed. The pos-toperative pain scales 2 to 24 hours after surgery in the intravenous fentanyl (mild pain 80–90%) and levobupivacaine group (mild pain 90–100%) were lower than those in the saline group (mild pain 10–50%, moderate pain 50–70%) (p<0.05). In the saline group, severe pain was even identified 2 hours after the surgery in  as high as 40% of the subjects. Comparison of the pain scale between fentanyl and levobupivacaine groups from 2 to 24 hours after surgery did not show any significant difference. PONV scores in the fentanyl, levobupivacaine, and saline groups reflected mild nausea (60%, 40%, and 50% respectively). No complication occurred in superficial cervical plexus block application. In conclusion, there is no significant difference in pain scale between the superficial cervical plexus block using levobupivacaine and intravenous fentanyl in terms of  post-post-mastoidectomy pain. Key words: Fentanyl, levobupivacaine, mastoidectomy, superficial cervical plexus block 
Perbandingan Blokade Kaudal Bupivakain 0,25% dengan Kombinasi Bupivakain 0,25% dan Klonidin 1 µg/kgBB terhadap Waktu Kebutuhan Analgesik Pascaoperasi Hipospadia Atmoko, Agus Fitri; Yadi, Dedi Fitri; Oktaliansah, Ezra
Jurnal Anestesi Perioperatif Vol 6, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (779.028 KB) | DOI: 10.15851/jap.v6n2.1271

Abstract

Blokade  kaudal merupakan salah satu blokade regional yang digunakan pada pediatrik. Teknik ini digunakan sebagai tata laksana nyeri pascaoperasi urogenital, rektal, inguinal, dan operasi ekstremitas bawah. Penelitian ini bertujuan mengetahui perbandingan waktu kebutuhan analgesik pascaoperasi hipospadia pada blokade kaudal bupivakain 0,25% dengan kombinasi bupivakain 0,25% dan klonidin 1 µg/kgBB. Penelitian menggunakan uji klinis acak terkontrol buta tunggal dilakukan di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung bulan November 2017 sampai Januari 2018. Pasien dibagi menjadi grup bupivakain 0,25% (grup B, n=15) dan grup kombinasi bupivakain 0,25% klonidin 1 µg/kgBB (grup BK, n=15). Uji statistik menggunakan uji-t tidak berpasangan dan Uji Mann-Whitney. Hasil penelitian mengungkapkan waktu kebutuhan analgesik pertama lebih lama pada grup BK (766,46±75,34 menit) dibanding dengan grup B (344,4±59,46 menit) dengan perbedaan signifikan (p<0,05). Simpulan, kombinasi bupivakain 0,25% dan klonidin 1 µg/kgBB pada blokade kaudal menghasilkan waktu kebutuhan analgesik pertama lebih lama dibanding dengan bupivakain 0,25% pascaoperasi hipospadia. Kata kunci: Blokade kaudal, bupivakain, hipospadia, klonidin, waktu kebutuhan analgesik  Comparison of Bupivacaine Caudal Blockade with Bupivacaine Clonidine Caudal Blockade to Timing of Post-operative Hypospadias Analgesic Requirement Caudal blockade was one of the regional blocks used in pediatrics. This technique was used as a post-operative pain management measure in urogenital, rectal, inguinal and lower extremity surgeries. The purpose of this study was to compare the first analgesic requirement between 0.25% bupivacaine caudal blockade and 0.25% bupivacaine and 1 µg/kgBW clonidine caudal blockade combination for post-operative hypospadia. The study used a single blind randomized control trial conducted at Dr. Hasan Sadikin General Hospital (RSHS) Bandung in the period of November 2017 to January 2018. Patients were divided into 0.25% bupivacaine group (B group, n=15) and 0.25% bupivacaine and 1 µg/kgBW clonidine combination group (BK group, n=15). Statistical test using unpaired t test and Mann Whitney test. Results revealed that the time of first analgesic requirement was longer in BK group (766.46±75.34 min) than in B group (344.4±59.46 min) with a significant difference (p<0.05). In conclusion, 0.25% bupivacaine and 1 µg/kgBW clonidine combination in caudal blockade resulting in a time analgesic requirement that is longer than 0.25% bupivacaine for post-operative hypospadias.                Key words: Analgesic requirement time, bupivacaine, caudal blockade, clonidine, hypospadias

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