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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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Perbandingan Ketepatan Ukuran Classic Laryngeal Mask Airway antara Metode Berat Badan dan Lebar Lidah Rahman, Abdul; Fuadi, Iwan; Rachman, Iwan Abdul
Jurnal Anestesi Perioperatif Vol 6, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (590.958 KB) | DOI: 10.15851/jap.v6n3.1338

Abstract

Classic laryngeal mask airway (CLMA) merupakan alat yang digunakan untuk manajemen jalan napas, baik  untuk pengganti ventilasi sungkup wajah maupun intubasi endotrakeal. Pemilihan ukuran yang tepat penting untuk efektivitas penggunaan CLMA. Saat ini pemilihan ukuran berdasar atas metode berat badan. Menurut sebuah studi terbaru metode pengukuran lebar lidah lebik baik daripada metode berat badan. Tujuan penelitian ini adalah mengetahui ketepatan ukuran CLMA antara metode berat badan dan lebar lidah yang dinilai dengan skor fiberoptik dan oropharyngeal leak pressure di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini dilakukan pada bulan Februari 2018 menggunakan uji eksperimental analitik crossection setiap subjek mendapat dua perlakuan yang berbeda antara kedua metode. Uji statistik menggunakan uji chi-square untuk skor fiberoptik dan uji t berpasangan untuk oropharyngeal leak pressure. Hasil penelitian skor fiberoptik lebih optimal daripada metode lebar lidah. Oropharyngeal leak pressure pada metode berat badan rerata 23,00±1,732 CmH20 sedangkan metode lebar lidah rerata 19,13±1,684 CmH20. Secara statistik diperoleh nilai p<0,05. Simpulan, metode pengukuran lebar lidah adalah alternatif yang mudah dan baik dalam pemilihan ukuran CLMA pasien dewasa.Kata kunci: Classic laryngeal mask airway, pemilihan ukuran CLMA, metode berat badan, metode lebar lidahComparison of Classic Laryngeal Mask Airway Size Accuracy between Body Weight Method and Tongue width MethodClassic laryngeal mask airway (CLMA) is an airway management device that can be used to replace bag valve mask ventilation or endotracheal intubation. Choosing the right size of CLMA is important for the effectiveness of CLMA. Currently, the size of CLMA is selected based on the body weight. However, a recent study suggested that tongue width is a better indicator for size selection than the body weight. The purpose of this study was to assess the accuracy of CLMA size selection using the body weight method and tongue-width method. The assessment was performed using the fiberoptic score and oropharyngeal leak pressure. This was an experimental analytic cross-sectional study conducted in Dr. Hasan Sadikin General Hospital Bandung in February 2018. Each subject in this study received two different treatments using the two methods. The results were analyzed using chi-square for the fiberoptic score and paired t test for the oropharyngeal leak pressure. The fiberoptic score was more optimum when tongue width method was used when compared to the weight method. The oropharyngeal leak pressure in the weight method group was 23.00±1.732 CmH20 while the pressure in the tongue-width method was 19.13±1.684 CmH20 (p value <0.05). In conclusion, the tongue width measurement is an easy and good alternative in the selecting the CLMA size in adult patients.Key words: Classic laryngeal mask airway, size selection CLMA, body weight method, tongue width method
Survei Penggunaan, Jenis, Teknik, serta Obat Blok Saraf Perifer di Jawa Barat Tahun 2016 Lestari, Ayu Puji; Suwarman, Suwarman; Prihartono, M. Andy
Jurnal Anestesi Perioperatif Vol 6, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (817.911 KB) | DOI: 10.15851/jap.v6n3.1346

Abstract

Blok saraf perifer merupakan salah satu teknik regional anestesi yang memiliki banyak manfaat. Penggunaan blok saraf perifer di Asia, Eropa, Amerika, dan Australia sudah mulai meningkat. Data yang ada saat ini menunjukan bahwa penggunaan, jenis, teknik, dan obat untuk blok saraf perifer di negara lain sangat bervariasi. Di Indonesia khususnya wilayah Jawa Barat belum terdapat data mengenai penggunaan, jenis, teknik, dan obat blok saraf perifer. Tujuan penelitian ini adalah mengetahui penggunaan, jenis, teknik, dan obat yang digunakan untuk blok saraf perifer di Jawa Barat. Penelitian dilakukan selama bulan Maret 2018. Penelitian bersifat deskriptif dengan  menggunakan kuesioner yang dikirimkan kepada 120 dokter spesialis anestesi di Jawa Barat, 66 melalui  jasa pos dan 54 kuesioner diberikan langsung kepada dokter spesialis anestesi yang bekerja di Bandung. Angka respons yang didapatkan sebesar 51,3%. Dari penelitian ini didapatkan dokter spesialis anestesi yang melakukan blok saraf perifer pada tahun 2016 sebesar 44%, blok ankle sebanyak 56%, blok wrist sebanyak 53%, 71% menggunakan blind technique, serta obat paling banyak digunakan adalah bupivakain sebesar 91%. Permasalahan dokter spesialis anestesi di Jawa Barat yang berkaitan dalam pelaksanaan tindakan blok saraf perifer pada tahun 2016 paling banyak disebabkan dokter anestesi yang tidak familiar dengan tindakan blok saraf perifer sebesar 45%.Kata kunci: Blok saraf perifer, Jawa Barat, surveySurvey on Use, Type, Technique, and Drugs Used for Peripheral Nerve Block in West JavaPeripheral nerve block is a beneficial regional anesthesia technique. The use of peripheral nerve block across Asia, Europe, America and Australia has been increasing. Current data have shown a wide variety in the use, technique, and drugs selected for peripheral nerve block. In Indonesia, especially in West Java, no data available yet on the use, technique and drugs selected for peripheral nerve block. This study aimed to explore the use, technique, and drugs selected for peripheral nerve block in West Java. This was a descriptive study using a questionnaire as data collection tool to collect data on peripheral nerve block done in 2016. One hundred and twenty questionnaires were distributed to anesthesiologists in West Java area with 66 were sent via air mail and 54 were given directly to the anesthesiologists who work in Bandung area during the month of March 2018. The response rate was 51.3%. Result shown that in 2016, 44% anesthesiologists performed peripheral nerve blocks. Of these,56% were ankle block and 53% were wrist block with 71% of the respondents chose to usethe blind technique. The most widely used agent was bupivacaine, which was used in 91% of the procedures. The main challengeof peripheral nerve block implementation in West Java is unfamiliarity with the approach that 45% anesthesiologist are not used to use this technique.Key words: Peripheral nerve block, survey, West Java 
Efek Parasetamol Intravena terhadap Regresi Sensorik Anestesi Spinal dengan Bupivakain Hiperbarik 0,5% Jioe, Hadi Sumitro; Reyes, Maribelle A.
Jurnal Anestesi Perioperatif Vol 6, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (242.263 KB) | DOI: 10.15851/jap.v6n3.1367

Abstract

Penggunaan anestesi spinal untuk operasi besar saat ini umum dilakukan dan telah dipraktikkan dalam jangka waktu cukup lama. Parasetamol merupakan obat analgetik yang telah dikenal cukup lama dan saat ini digunakan untuk mengontrol nyeri baik selama operasi maupun pascaoperasi. Parasetamol memiliki efek analgetik pada susunan saraf pusat (SSP) melalui penghambatan jalur siklo-oksigenase dan berpengaruh secara tidak langsung terhadap sistem serotoninergik serta ditemukan dalam konsentrasi yang signifikan dalam cairan serebrospinal setelah pemberian melalui infus. Penelitian ini bertujuan mengevaluasi pengaruh pemberian parasetamol intravena dosis tunggal sebelum operasi terhadap regresi blok anestesi spinal pada pasien yang akan dilakukan operasi besar. Sebanyak 30 pasien dengan klasifikasi American Society of Anesthesiologist (ASA) I dan II dengan rentang usia 18–55 tahun yang dilakukan operasi besar dengan anestesi spinal diikutsertakan ke dalam uji acak terkontrol buta ganda yang dilakukan periode Februari–Juni 2015 di Operating Theatre-East Avenue Medical Center, Quezon City, Philippines. Pasien dialokasikan menjadi 2 grup secara acak dan diberikan infus 100 mL parasetamol 1 gram (Grup A; n=15) atau 100 mL NaCl 0,9% (Grup P; n=15) selama 20 menit sebelum pemberian obat pada anestesi spinal. Penilaian nyeri dinilai menggunakan visual analog scale (VAS), serta dicatat pada saat diberikan bantuan obat analgetik. Data dianalisis dengan uji chi-kuadrat dengan nilai p<0,05 dianggap bermakna. Regresi blok sensorik tertunda secara signifikan pada Grup A pada jam ke-2 (T5–T7; n=11) dibanding dengan grup P pada jam ke-2 (T5–T7; n=2) dengan nilai p<0,05. Simpulan, pemberian infus parasetamol intravena 20 menit sebelum dilakukan anestesi spinal dengan bupivakain hiperbarik 0,5% dapat menunda regresi blok sensorik.Kata kunci: Anestesi spinal, bupivakain hiperbarik, parasetamol intravena, regresi sensorikEffect of Intravenous Paracetamol on Sensory Regression of Spinal Anesthesia with Bupivacaine Heavy 0.5%Spinal anesthesia is a long-accepted anesthesia that is commonly used for major surgery. Paracetamol intravenous infusion is a known analgesics that is recently used for intra-operative as well as post-operative pain control. Paracetamol has an analgesic effect, primarily to the central nervous system (CNS), through the cyclooxygenase pathway, and probably has an indirect influence on the serotoninergic system which is supported by the fact that paracetamol is found in significant concentration in the cerebrospinal fluid (CSF) after infusion. This study was designed to evaluate the effect of single pre-operative intravenous infusion of paracetamol on sensory regression of spinal blockade in patients undergoing major surgery. Thirty ASA I and II patients aged 18–55 years undergoing major surgery under spinal anesthesia were included in this randomized controlled trial double blind study during the period of February–June 2015 at the Operating Theatre – East Avenue Medical Center, Philippines. Patients were randomly allocated to receive either 1 gr/100 mL Paracetamol (Group A; n=15) or 100 mL Normal Saline (Group P; n=15) drip for 20 minutes before administration of spinal anesthesia. The intensity of pain was assessed by Visual Analog Scale (VAS) Score. Time of rescue analgesic administration was also recorded. Data were analyzed by Chi-Square Test with p value of <0.05 considered significant. Sensory regression was delayed in Group A (T5-T7; n=11) when compared to Group P (T5 – T7; n=2), which was statistically significant (p<0.05). Therefore, the administration intravenous Paracetamol 20 minutes prior to spinal anesthesia administration with Bupivacaine Heavy 0.5% can delay regression of sensory blockade.Keywords: Bupivacaine heavy, intravenous paracetamol, sensory regression, spinal anesthesia
Perbandingan Pemberian Informasi Verbal dengan Presentasi Video Terhadap Pengetahuan Prosedur Anestesi Umum pada Pasien yang Akan Menjalani Operasi di RSUP DR Hasan Sadikin Bandung Arnanto, Yodi Suryo; Sitanggang, Ruli Herman; Saragi Sitio, Nurita Dian Kestriani
Jurnal Anestesi Perioperatif Vol 6, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1882.817 KB) | DOI: 10.15851/jap.v6n3.1351

Abstract

Informasi mengenai indikasi, tujuan, prosedur, risiko, manfaat, dan alternatif tindakan anestesi yang akan dilakukan harus disampaikan kepada pasien. Pemberian informasi dilakukan secara verbal atau lisan pada saat proses persetujuan tindakan kedokteran. Kemampuan pasien yang berbeda-beda dalam menerima dan memahami informasi dapat menjadi penyebab tujuan penyampaian informasi tidak tercapai. Penelitian ini bertujuan membandingkan pemberian informasi verbal dengan presentasi video terhadap pengetahuan prosedur anestesi umum pada pasien yang akan menjalani operasi di RSUP Dr. Hasan Sadikin Bandung. Penelitian dilakukan pada 6 Februari–31 Maret 2018 dengan metode cross-sectional randomized study dan melibatkan 40 orang pasien yang akan menjalani operasi di RSUP Dr. Hasan Sadikin Bandung. Dilakukan penilaian pengetahuan subjek mengenai prosedur anestesi umum dengan menggunakan kuesioner. Data numerik dianalisis dengan uji t tidak berpasangan dan data kategorik dianalisis menggunakan uji chi-square. Penelitian ini memberikan hasil bahwa tidak terdapat perbedaan signifikan antara pemberian informasi dan metode verbal maupun presentasi video terhadap pengetahuan prosedur anestesi umum pada pasien (p>0,05). Sebagai simpulan, penelitian ini menunjukkan bahwa presentasi video yang tidak dibuat sesuai dengan kaidah pembelajaran kognitif dan teori multimedia tidak memberikan pengetahuan yang lebih baik dibanding dengan metode verbal.Kata kunci: Pengetahuan prosedur anestesi umum, pemberian informasi verbal, persetujuan tindakan kedokteran, presentasi videoComparison of Verbal and Video Presentation Method of Information Disclosure on Knowledge on General Anesthesia Procedure among Patients Undergoing Surgery in Dr. Hasan Sadikin General Hospital BandungInformation on the indication, purpose, procedure, risks, benefits, and alternatives of any medical action should be disclosed to the patient. Patient should be given verbal information on any medical action he/she was about to undergo during the informed consent process. The variations in patient’s ability to accept and understand information given to them could hinder the purpose of information disclosure during informed consent. The aim of this study was to assess the effect of video presentation on general anesthesia procedure on the knowledge of patients who were going to undergo surgery. This was a randomized cross-sectional study conducted from February 6–March 31, 2018 involving 40 patients who were about to undergo surgery in Dr Hasan Sadikin General Hospital. Afterwards, patient knowledge on the general anesthesia procedure was assessed. The numerical data were analyzed by unpaired t test and categorical data were analyzed using Chi-Square analysis. This study showed that there was no significant difference between verbal and video presentation method of giving information on patient’s knowledge regarding the general anesthesia procedure (p>0.05). In conclusion, a video presentation which is designed without paying attention to the principles of cognitive learning and multimedia theories does not lead to better knowledge compared to the verbal method.Key words: Informed consent, patient’s knowledge about general anesthesia procedure, verbal disclosure, video presentation
Perbandingan Keberhasilan dan Waktu Intubasi Endotrakeal pada Manekin antara Bantal Intubasi Standar dengan Bantal Intubasi Modifikasi Sendy Setiawan Permana; Erwin Pradian; Dedi Fitri Yadi
Jurnal Anestesi Perioperatif Vol 6, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (469.192 KB) | DOI: 10.15851/jap.v6n3.1363

Abstract

Intubasi pipa endotrakeal adalah standar baku manajemen jalan napas. Direct laryngoscopy dengan memposisikan kepala dan leher secara sniffing position menggunakan bantal agar visualisasi glotis optimal merupakan kunci untuk melakukan tindakan intubasi endotrakea. Tujuan penelitian adalah membandingkan keberhasilan dan lama waktu intubasi endotrakea pada manekin menggunakan bantal intubasi standar dengan bantal intubasi modifikasi. Penelitian menggunakan metode crossover randomized study dengan teknik nonprobability sampling oleh 31 orang residen anestesi pada manekin di ruang skill lab Departemen Anestesiologi dan Terapi Intesif FK Unpad  RSUP Dr. Hasan Sadikin Bandung periode Februari 2018. Penelitian dibagi menjadi kelompok bantal intubasi standar (A) melakukan intubasi endotrakeal menggunakan bantal intubasi standar dilanjutkan menggunakan bantal intubasi modifikasi. Kelompok bantal modifikasi (B) melakukan intubasi endotrakeal dengan bantal intubasi modifikasi dilanjutkan menggunakan bantal intubasi standar, dinilai keberhasilan dan lama waktu intubasi. Data dianalisis dengan uji-t dan Uji Mann-Whitney dengan p<0,05 dianggap bermakna. Analisis data statistik menunjukkan angka keberhasilan yang sama pada kedua kelompok, sedangkan lama waktu intubasi endotrakea lebih singkat pada kelompok bantal modifikasi dibanding dengan kelompok bantal standar yang berbeda bermakna (p<0,05). Simpulan penelitian menunjukkan waktu intubasi menggunakan bantal intubasi modifikasi lebih singkat dibanding dengan menggunakan bantal standar, sedangkan keberhasilan intubasi sama pada kedua kelompok.Kata kunci: Bantal intubasi, intubasi endotrakea, sniffing positionComparison of Successful Intubation and Time of Intubation in Mannequin using Standard Intubation Pillow and Modified Intubation PillowEndothracheal intubation is the gold standard in airway management. Direct laryngoscopy by positioning the head and the neck in a sniffing position with the help of a pillow will facilitate optimal visualization of the trachea, which is the key to a successful endotracheal intubation. The purpose of this study was to assess the time needed to intubate mannequin using modified intubation pillow when compared to standard intubation pillow. This was a crossover randomized study using nonprobability sampling technique conducted inn March 2018 on of 31 anesthesia residents who were working on a mannequin in the Skill Laboratory of Anesthesiology and Intensive Therapy Department of Dr. Hasan Sadikin General Central Hospital. Subjects were divided into two groups: group A that used the standard intubation pillow, followed by the modified intubation pillow and group B that used the modified intubation pillow, followed by the standard intubation pillow. The success rate and the time needed to intubate were recorded. Data were analyzed using t-test and Mann-Whitney test with a p score of <0.05 considered to be significant. The statistical analysis showed the same success rate in both groups, while the time needed to intubate was shorter in the modified pillow group with p<0.05. Hence, the use of modified intubation pillow shorten the time needed to intubate, while the success rate is similar when compared to standard pillow.Key words: Endotracheal intubation, intubation pillow, sniffing position 
Perbandingan Parasetamol dengan Ketorolak Intravena Sebagai Analgesia Pre-emtif terhadap Skala Nyeri Pascabedah Labioplasti pada Pasien Pediatrik Muhamad Adli Boesoirie; Ezra Oktaliansah; Tatang Bisri
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1304.678 KB)

Abstract

Parasetamol dan ketorolak merupakan analgetik yang biasa digunakan pada tatalaksana nyeri ringan hingga sedang. Penelitian ini bertujuan membandingkan efek analgesi pre-emtif parasetamol 20 mg/kgBB dengan ketorolak 0,5 mg/kgBB pada pasien pediatrik pascabedah labioplasti yang diukur menggunakan skala nyeri face, legs, activity, crying, consolability (FLACC). Penelitian eksperimental secara uji acak tersamar buta ganda terhadap 66 pasien pediatrik usia 6 bulan–12 tahun dengan status fisik American Society of Anesthesiology (ASA) I–II. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung periode Oktober 2013–Mei 2014. Pasien dibagi menjadi dua kelompok perlakuan, yaitu kelompok parasetamol (P) dan ketorolak (K) yang diberikan 15 menit prabedah. Analisis statistika diuji menggunakan uji-t independen, Mann-Whitney, dan Eksak Fisher. Hasil penelitian menunjukkan bahwa skala FLACC pada kelompok ketorolak pada jam ke-1, 2, 4, 6, dan 24 lebih rendah secara bermakna (p<0,05) dibanding dengan kelompok parasetamol. Simpulan, skala FLACC pemberian ketorolak 0,5 mg/kgBB prabedah pada pasien labioplasti lebih rendah dibanding dengan parasetamol 20 mg/kgBB.Kata kunci: Analgetik, analgesia pre-emtif, ketorolak, labioplasti, parasetamol, skala FLACCComparison between Intravenous Paracetamol and Ketorolac as Preemptive Analgesia on Postoperative Pain Scale in Pediatric Patients Undergo LabioplastyKetorolac and paracetamol are common analgetics used to treat mild to moderate pain. This study compared the efficacy of preemptive analgesia measured using face, legs, activity, crying, consolability (FLACC) scale between groups receiving 20 mg/kgBW paracetamol (P) and 0.5 mg/kgBW ketorolac (K) for pediatric labioplasty procedure. This experimental study is a are double-blind randomized trial against 66 pediatric patients aged 6 months–12 years with the physical status of the American Society of Anesthesiology (ASA) I–II. The study was conducted in Dr. Hasan Sadikin General Hospital Bandung during the period of October 2013–May 2014. The P and K groups received 20 mg/kgBW paracetamol and 0.5 mg/kgBW ketorolac, respectively, 15 minutes preoperatively. Data were analyzed statistically using independent-t, Mann-Whitney, and Fischer’s Exact Test. Results showed that the difference between FLACC scale in P and K groups  was statistically significant (p<0.05). In conclution, FLACC scale in patients who received ketorolac 0.5 mg/kgBW is lower than patients who received paracetamol 20 mg/kgBW.Key words: Analgetics, FLACC scale, ketorolac, labioplasty, paracetamol, preemptive analgesia DOI: 10.15851/jap.v3n1.573
Perbandingan Penilaian Visual Analog Scale dari Injeksi Subkutan Morfin 10 mg dan Bupivakain 0,5% pada Pasien Pascabedah Sesar dengan Anestesi Spinal Wulan Fadinie; Hasanul Arifin; Dadik Wahyu Wijaya
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
Efektivitas Penggunaan Prewarming dan Water Warming untuk Mengurangi Penurunan Suhu Intraoperatif pada Operasi Ortopedi Ekstremitas Bawah dengan Anestesi Spinal Emvina Husni Syam; Erwin Pradian; Eri Surahman
Jurnal Anestesi Perioperatif Vol 1, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Laju penurunan suhu inti tubuh dapat dikurangi dengan tindakan pemanasan sebelum operasi (prewarming) selama 30 menit dan menggunakan alas penghangat water warming selama operasi. Tujuan penelitian ini untuk mengetahui efektivitas prewarming dan alas penghangat water warming dalam mengurangi penurunan suhu intraoperatif. Penelitian dilakukan dengan metode acak terkontrol buta tunggal terhadap 30 pasien di ruang operasi bedah sentral Rumah Sakit Dr. Hasan Sadikin Bandung pada Mei–Juli 2013 yang dikelompokkan menjadi tiga, yaitu kelompok yang dilakukan prewarming selama 30 menit dan menggunakan alas penghangat water warming selama operasi, kelompok pasien yang menggunakan alas penghangat water warming selama operasi, dan kelompok kontrol. Pencatatan suhu inti tubuh dilakukan pada membran timpani tiap 15 menit sejak awal induksi sampai operasi selesai. Analisis data hasil penelitian dilakukan dengan uji statistik yaitu uji chi-kuadrat, uji-t, Uji Friedman dan uji analysis of variance (ANOVA) dengan nilai p<0,05 dianggap bermakna. Suhu inti tubuh rata-rata pada kelompok prewarming dan water warming 36,62 °C (p=0,023), kelompok water warming 36,24 °C (p<0,001), dan kelompok kontrol 35,94 °C (p<0,001) yang secara statistik berbeda signifikan. Simpulan penelitian ini adalah penggunaan prewarming dan water warming dapat mengurangi dan memperlambat derajat penurunan suhu selama operasi.Kata kunci: Prewarming, suhu inti tubuh, water warmingEffectiveness of Prewarming and Water Warming to Reduce Intraoperative Temperature Decrease on Spinal Anesthesia for Lower Extremity Orthopedic SurgeryThe decline rate of core body temperature can be reduced by perioperative care such as prewarming (the application of heat to patient’s body prior to surgery) for 30 minutes and by using a water warming pad during surgery. The purpose of this study was to determine the effectiveness of prewarming and water warming pad to reduce intraoperative temperature decrease on spinal anesthesia. This study was conducted by a single-blind randomized controlled trials method involving 30 patients in central operating theatre Dr. Hasan Sadikin Hospital-Bandung within May–July 2013 were classified into three groups, the group of prewarming patients performed for 30 minutes and were using water warming pad during surgery; the group of patients without prewarming and were using water warming pad during surgery; and the control group. Core body temperature on tympanic membrane was recorded every 15 minutes from the initial induction through the end of operation. The result data were analyzed by using chi-square (χ2) test, t test, Friedman Test and ANOVA test, in which the value of p<0.05 was considered significant. Average core body temperature of the prewarming and water warming pad group was 36.62 °C (p=0.023), the water warming pad group was 36.24 °C (p<0.001), and the control group was 35.94 °C (p<0.001), this result statistically significant. The conclusion of this study is prewarming prior to surgery and the use of water warming pad during surgery could reduce temperature decline rate during operation.Key words:  Core body temperature, prewarming, water warming  DOI: 10.15851/jap.v1n2.119
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

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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 Pemulihan Bising Usus pada Pasien Pascaoperasi Histerektomi per Laparotomi Menggunakan Analgetik Kombinasi Ketamin-Morfin dengan Morfin Intravena Irvan Setiawan; Ezra Oktaliansah; Cindy Elfira Boom
Jurnal Anestesi Perioperatif Vol 2, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Disfungsi gastrointestinal merupakan penyulit pascaanestesi yang sering terjadi. Tujuan penelitian ini untuk membandingkan pemulihan bising usus antara pemberian analgetika kombinasi ketaminmorfin dibandingkan dengan morfin. Penelitian dilakukan dengan uji klinis acak terkontrol buta ganda terhadap 36 pasien dengan status fisik American Society of Anesthesiologist (ASA) I dan II yang menjalani operasi histerektomi per laparotomi di Rumah Sakit Dr. Hasan Sadikin Bandung pada April–Agustus 2012. Kedua kelompok menerima dosis awal morfin 0,03mg/kgBB, lalu kelompok K diberikan infus ketamin 4 μg/kgBB/menit, dan kelompok M diberikan morfin infus 10 μg/kgBB/jam. Analisis data memakai uji-t dan Uji Mann Whitney, tingkat kepercayaan 95% dan bermakna bila p<0,05. Hasil penelitian ini menunjukkan waktu pemulihan bising usus pada kelompok K lebih cepat dibandingkan dengan kelompok M dengan berbeda bermakna (p<0,05). Simpulan, pemulihan bising usus lebih cepat pada pemberian analgetika kombinasi ketamin dan morfin dibandingkan dengan morfin pada pasien pascaoperasi histerektomi per laparotomi.Kata kunci: Ketamin, morfin, pemulihan bising usus Comparison of Bowel Sound Recovery in Postoperative Hysterectomy per Laparotomy Patient Between Combination of Intravenous Ketamine - Morphine and MorphineGastrointestinal dysfunction is the most common post anaesthesia complication. The aim of this study is to compare the recovery of bowel sounds between combination of ketamine-morphine analgesia to morphine alone. This is a randomized controlled study on 36 patients with American Society of Anesthesiologist (ASA) physical status I and II who underwent hysterectomy per laparotomy at Dr. Hasan Sadikin Bandung during April–August 2012. Both groups received an initial dose of morphine 0.03 mg/kgBW, while K group received intravenous ketamine 4 μg/kgBW/min, and the M group received morphine 10 μg/kgBW/hr. The results were analyzed using t-test and Mann Whitney test with a confidence level of 95% and were considered significant if p<0.05. The results of this study showed that the recovery time of bowel sounds in K group was significantly faster than in the M group (p<0.05). In conclusion, recovery of bowel sounds is faster in analgesia using combination of ketamine-morphine than morphine in postoperative hysterectomy per laparotomy patients.Key words: Ketamine, morphine, recovery of bowel DOI: 10.15851/jap.v2n1.238

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