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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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Pengaruh Penambahan Klonidin 75 mcg pada 12,5 mg Levobupivakain 0,5% Secara Intratekal terhadap Lama Kerja Blokade Sensorik dan Motorik untuk Bedah Ortopedi Ekstremitas Bawah Fadlyansyah Ramli; Doddy Tavianto; Tinni T. Maskoen
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Keterbatasan anestesi spinal antara lain ialah lama kerja blokade sensorik dan motorik terbatas. Penelitian ini bertujuan melihat pengaruh penambahan 75 mcg klonidin pada 12,5 mg levobupivakain 0,5% terhadap lama kerja blokade sensorik dan motorik pada anestesi spinal untuk bedah ortopedi ekstremitas bawah. Penelitian bersifat eksperimental prospektif dengan metode acak terkontrol tersamar ganda pada 36 sampel dengan kriteria American Society of Anesthesiologist (ASA) I-II yang menjalani operasi ortopedi ekstremitas bawah dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Juni–Agustus 2014. Kelompok levobupivakain dan klonidin (LK) mendapatkan 12,5 mg levobupivakain 0,5% ditambah klonidin 75 mcg. Kelompok levobupivakain dan salin (LS) mendapatkan  12,5 mg levobupivakain 0,5% ditambah NaCl 0,9% 0,5 mL. Data hasil penelitian diuji secara statistik menggunakan uji-t, Mann-Whitney, dan chi-kuadrat. Hasil penelitian menunjukkan lama kerja blokade sensorik kelompok LK lebih lama secara bermakna yaitu 244,44 (37,84) menit dibandingkan dengan kelompok LS, yaitu 107,89 (17,63) menit (p=0,000). Lama kerja blokade motorik kelompok LK lebih lama secara bermakna yaitu 278,72 (41,75) menit dibandingkan dengan kelompok LS, yaitu 128,39 (18,26) menit (p=0,000). Simpulan, penambahan klonidin 75 mcg pada 12,5 mg levobupivakain 0,5%  secara intratekal memerpanjang lama kerja blokade sensorik dan motorik.Kata kunci: Anestesi spinal, klonidin, levobupivakain, lama kerja blokade sensorik, lama kerja blokade motorikEffect of Clonidine 75 mcg Addition to Intrathecal 12.5 mg 0.5% Levobupivacaine on Sensoric and Motoric  Blockade Duration in Lower Extremity Orthopedic SurgeryAbstractSpinal anesthesia has some limitations that  limits its use, such as limited duration of action in motoric and sensoric.  This research aimed to provide an overview on the effect of adding clonidine 75 mcg to 12.5 mg  0.5% levobupivacaine on the motoric and sensoric blockade action duration in lower extremity orthopedic surgery spinal anesthesia. This experimental prospective research used double blind randomized controlled trial approach on 36 patients with ASA I-II physical status who underwent lower extremity orthopedic surgery using spinal anesthesia in Dr. Hasan Sadikin General Hospital during the period of June to August 2014.  LC group, clonidine 75 mcg was added to 12.5 mg 0.5% levobupivacaine.  On LS group, 12.5 mg 0.5% mg levobupivacaine mixed with 0.5 mL 0.9% NaCl. The data were then statistically tested using t-test, Mann-Whitney, and chi-square. The result showed that the duration of action of sensoric blockade in LK group was significantly longer, i.e. 224.44 (37.84) minutes compared to LS group, i.e. 107.89 (17.63) minutes (p=0.000).  Duration of action of motoric blockade in LK group was significantly longer, i.e. 278,72 (41,75) minutes, compared to LS group, i.e. 128.39 (18.26) minutes (p=0.000). It is concluded that the additiona of clonidine 75 mcg to 12,5 mg 0,5% levobupivacaine significantly prolongs the duration of action of the motoric and sensoric blockade if given intrathecally.Key words: Clonidine, duration of action, duration of action of motoric blockade, levobupivacaine, spinal anesthesia DOI: 10.15851/jap.v3n1.374  
Insidensi dan Faktor Risiko Hipotensi pada Pasien yang Menjalani Seksio Sesarea dengan Anestesi Spinal di Rumah Sakit Dr. Hasan Sadikin Bandung Rini Rustini; Iwan Fuadi; Eri Surahman
Jurnal Anestesi Perioperatif Vol 4, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (384.485 KB) | DOI: 10.15851/jap.v4n1.745

Abstract

Hipotensi merupakan komplikasi yang sering terjadi setelah tindakan anestesi spinal pada pasien seksio sesarea. Hipotensi terjadi akibat blokade simpatis terhadap aktivitas vasomotor pembuluh darah serta penekanan aorta dan vena kava inferior oleh uterus yang membesar terutama pada saat pasien telentang. Tujuan penelitian ini adalah mengetahui insidensi hipotensi dan faktor risiko yang berhubungan dengan kejadian hipotensi pada pasien yang menjalani seksio sesarea dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian observasional potong lintang (cross sectional) ini dilakukan pada 90 subjek pasien yang menjalani seksio sesarea dengan anestesi spinal pada periode bulan April–Mei 2015. Pengolahan data dengan analisis univariabel untuk melihat gambaran proporsi variabel masing-masing yang disajikan secara deskriptif. Hasil penelitian menunjukkan insidensi hipotensi 49%. Faktor risiko yang menyebabkan hipotensi maternal menunjukkan hasil yang tidak signifikan berhubungan dengan kejadian hipotensi (p>0,05). Perbedaan insidensi hipotensi maternal setelah tindakan anestesi spinal dan faktor risiko yang memengaruhinya dengan penelitian sebelumnya karena perbedaan jumlah sampel penelitian, perbedaan definisi hasil yang digunakan, perbedaan tempat penelitian, dan perbedaan metode pengumpulan data.Kata kunci: Anestesi spinal, faktor risiko, hipotensi, insidensi, seksio sesareaIncidence and Risk Factors of Hypotension in Patients Undergoing Cesarean Section with Spinal Anesthesia in Dr. Hasan Sadikin General Hospital BandungAbstractThe most common serious complication associated with spinal anesthesia for C-section is hypotension. These hemodynamic changes result from a blockade of sympathetic vasomotor activity that is accentuated by the compression of the aorta and inferior vena cava by the gravid uterus when the patient is in the supine position. The purpose of this study was to describe the incidence of hypotension in patients undergoing cesarean section with spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung and to obtain a description of risk factors associated with the incidence of hypotension. A cross–sectional observational study was conducted on 90 subjects consisting of patients undergoing cesarean section with spinal anesthesia during the period of April–May 2015. The data processing performed was the univariable analysis to see the picture of the proportion of each variable, which were presented descriptively. The results showed 49% incidence of hypotension. There was an insignificant association between the risk factors of maternal hypotension after spinal anesthesia for cesarean section insignificant association with the incidence of hypotension (p>0.05). Differences in the incidence of maternal hypotension after spinal anesthesia and risk factors as stated in this study when compared to previous studies are due to differences sample size, definitions, place, and data collection methods.Key words: Cesarean section, hypotension, incidence, risk factors, spinal anesthesia DOI: 10.15851/jap.v4n1.745
Kejadian Post Dural Puncture Headache dan Nilai Numeric Rating Scale Pascaseksio Sesarea dengan Anestesi Spinal Dino Irawan; Doddy Tavianto; Eri Surahman
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kejadian nyeri kepala pascaanestesi spinal (post dural puncture headache; PDPH) berhubungan dengan ukuran lubang dura akibat proses penusukan. Tujuan penelitian ini untuk mengetahui kejadian PDPH pada pasien pascaseksio sesarea dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan Januari–April 2010. Penelitian dilakukan terhadap 115 wanita hamil, status fisik American Society of Anesthesiologist (ASA) II, berusia 18–45 tahun. Penelitian bersifat observasional dengan rancangan cross sectional. Hasil observasi didapatkan kejadian PDPH pada jarum tipe quincke no. 25 sebesar 68,2%, pada jarum tipe quincke no. 27 sebesar 31,8% dan tidak ditemukan pada jarum tipe pencil point no. 27. Nilai numeric rating scale (NRS) dari PDPH pada tipe jarum quincke no. 25 adalah 3–7, pada tipe jarum quincke no. 27 adalah 2–6, dan 0 pada tipe jarum spinal pencil point no. 27. Simpulan penelitian adalah bahwa kejadian PDPH pada pasien seksio sesarea dengan anestesi spinal berdasarkan tipe jarum spinal paling banyak didapatkan pada jarum tipe quincke no. 25, selanjutnya pada jarum tipe quincke no. 27 dan tidak ditemukan pada jarum tipe pencil point no. 27.Kata kunci: Anestesi spinal, numeric rating scale, post dural puncture headacheThe Incidence of Postdural Puncture Headache and Numeric Rating Scale Score After the Caesarean Section with Spinal AnesthesiaAbstractThe incidence of post dural puncture headache (PDPH) is associated with the size of duramater diameter puncture caused by the puncture itself. There are two factors related to this problem, the size of the needle and the shape of the needle’s-end. The purpose of this study was to obtain an overview of incidence of PDPH in patients undergoing caesarean section with regional spinal anesthesia in Dr. Hasan Sadikin Hospital Bandung in January–April 2010. This research was conducted on 115 pregnant woman with physical status of American Society of Anesthesiologist (ASA) II, range of age was 18 to 45 years old. This research was an observational study with cross-sectional design. The incidence of PDPH after the use of Quincke type needle no. 25 was 68.2%, while with Quincke type needle no. 27 was 31.8%, and no PDPH was found on the use of pencil point type needle no. 27. The numeric rating scale (NRS) from PDPH on the use of Quincke type needle no. 25 was 3–7, while on Quincke type needle no. 27 was 2–6, and 0 in pencil point type needle no. 27. As the conclusion, the greatest incidence of PDPH in patients undergoing caesarean section, based on spinal needle type, occurs most with no. 25 Quincke type needles, and less with no. 27 and none with no. 27.Key words: Numeric rating scale, post dural puncture headache, spinal anesthesia DOI: 10.15851/jap.v1n3.197
Perbandingan Kedalaman Sedasi antara Deksmedetomidin dan Kombinasi Fentanil-Propofol Menggunakan Bispectral Index Score pada Pasien yang Dilakukan Kuretase Daniel Asa Singarimbun; Indriasari Indriasari; Tinni T. Maskoen
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 (929.029 KB) | DOI: 10.15851/jap.v6n2.1424

Abstract

Kuretase tergolong bedah minor yang menyebabkan nyeri dan ketidaknyamanan pasien sehingga memerlukan tindakan sedasi-analgesi. Tujuan penelitian adalah membandingkan kedalaman sedasi antara deksmedetomidin dan kombinasi fentanil-propofol menggunakan bispectral index score (BIS) pada pasien yang dilakukan kuretase. Penelitian ini merupakan penelitian randomized controlled trial dengan teknik double blind pada 36 pasien dengan status fisik American Society of Anesthesiologists (ASA) I−II yang menjalani kuretase di ruangan Obstetri dan Ginekologi RSUP Dr. Hasan Sadikin Bandung periode Juli sampai Oktober 2017. Kelompok deksmedetomidin mendapatkan loading dose deksmedetomidin 1 mcg/kgBB dalam waktu 10 menit dilanjutkan dosis pemeliharaan 0,5 mcg/kgBB/jam. Kelompol fentanil-propofol mendapatkan loading dose propofol 1 mg/kgBB dalam 10 menit diikuti dosis pemeliharaan 50 mcg/kgBB/jam ditambah fentanil 1 mcg/kgBB dalam 5 menit, lalu dicatat nilai BIS. Data dianalisis dengan uji-t dan Uji Mann-Whitney dengan p<0,05 dianggap bermakna. Analisis data statistik nilai BIS kelompok deksmedetomidin 79,50±2,121 dan fentanil-propofol 85,22±0,732 dengan perbedaan bermakna (p<0,05). Simpulan, penelitian ini menunjukkan kedalaman sedasi pada kelompok deksmedetomidin menghasilkan nilai BIS lebih rendah dibanding dengan fentanil-propofol pada pasien yang dilakukan kuretase. Kata kunci: Bispectral index score(BIS), dexmedetomidine, fentanil, kuretase, propofol Comparison of Sedation Depth between Dexmedetomidine and Fentanyl-Propofol using Bispectal Index Score in Patients Undergoing Curettage Curettage is a minor surgical procedure that can cause pain and anxiety. Therefore, analgesia and sedation are needed. The purpose of this research was to compare the depth of sedation using bispectral index score (BIS) scale between dexmedetomidine and fentanyl-propofol combination in patients undergoing curettage. This was a double blind randomized controlled trial on 36 patients with American Society of Anesthesiologists (ASA) physical status I−II at the delivery room of Dr. Hasan Sadikin General Hospital  from July to October 2017. Subjects were randomized into two groups: dexmedetomidine group receiving a loading dose of 1 mcg/kgBW dexmedetomidine in 10 minutes followed by 50 mcg/kgBW/hour for maintenance and fentanyl-propofol group receiving a loading dose of 1 mg/kgBW propofol in 10 minutes and fentanyl 1 mcg/kg within 5 minutes followed by a maintenance dose of propofol 50 mcg/kgBW/hour. The BIS score in dexmedetomidine group (79.0±2.121) was significantly lower than in fentanyl-propofol group (85.22±0.732) with p<0.05. Hence, the sedation depth observed through BIS score evaluation shows that the score in dexmedetomidine group is lower than in fentanyl-propofol group in patients undergoing curettage. Key words: Bispectral index score (BIS), curettage, dexmedetomidine, fentanyl, propofol 
Perbandingan Angka Keberhasilan Blokade Saraf Iskiadikus Pendekatan Parasakral dengan Labat Menggunakan Stimulator Saraf pada Operasi Daerah Kruris dan Pedis Rika Marlina; Dedi Fitri Yadi; Tinni T. Maskoen
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Blokade saraf iskiadikus digunakan pada operasi daerah kruris dan pedis. Blokade saraf iskiadikus pendekatan Labat membutuhkan rangkaian penanda anatomis, sementara parasakral menggunakan penanda anatomis sederhana. Penelitian bertujuan membandingkan angka keberhasilan blokade saraf iskiadikus pendekatan parasakral dengan Labat. Penelitian uji acak terkendali tersamar ganda dilakukan pada 32 pasien dewasa di Rumah Sakit Dr. Hasan Sadikin Bandung dan Rumah Sakit Dr. Slamet Garut selama Desember 2014–Januari 2015. Tempat penyuntikan kelompok Labat pada 4 cm distal garis proyeksi tegak lurus terhadap pertengahan trokanter mayor dan spina iliaka superior posterior. Tempat penyuntikan kelompok parasakral pada 6 cm distal garis proyeksi antara spina iliaka superior posterior dan tuberositas iskiadikus. Penyuntikan 30 mL bupivakain 0,4% dilakukan bila terdapat respons motorik pada arus 0,3 mA. Perbandingan angka keberhasilan diuji dengan Uji Eksak Fisher, bermakna jika p<0,05. Blokade saraf iskiadikus kelompok parasakral berhasil pada 15 subjek, sedangkan Labat berhasil pada 8 subjek dengan nilai p=0,015. Angka keberhasilan blokade saraf iskiadikus pendekatan parasakral lebih tinggi dibanding dengan Labat menggunakan stimulator saraf pada operasi daerah kruris dan pedis.Kata kunci: Blokade saraf iskiadikus, keberhasilan, penanda anatomis, pendekatan parasakral, pendekatan LabatComparison of Success Rates between Parasacral Approach and Labat Approach Applied in Sciatic Nerve Block Using Nerve Stimulator in Leg and Foot SurgeriesAnesthesiologist uses sciatic block in leg and foot surgeries. Labat sciatic block uses a series of anatomical landmarks, while parasacral uses simple anatomical landmarks. This study compared the success rate of parasacral approach of sciatic block to Labat approach using nerve stimulator in leg and foot surgeries. A double-blind randomized controlled trial study was conducted on 32 adult patients at Dr. Hasan Sadikin General Hospital Bandung and Dr. Slamet General Hospital Garut during the period of December 2014 to January 2015. In Labat group, a line was drawn from greater trochanter to posterior superior iliac spine. Then, from the midpoint of this line, a second line was drawn perpendicularly and extended caudally to 4 cm. The end of this line represented the needle entry. In parasacral group, a line was drawn from posterior superior iliac spine to ischial tuberosity. The needle entry was then marked on this line at 6 cm from the posterior superior iliac spine. Thirty mL of 0.4% bupivacaine was injected when a proper motor response was elicited at 0.3 mA. Comparison of success rates were analyzed using Fisher’s exact Test with p-value<0.05 considered significant. Fifteen blocks in parasacral group were successful compared to 8 blocks in Labat group, with p-value of 0.015. The success rate of parasacral approach of sciatic block is higher than in the Labat approach when using nerve stimulator in leg and foot surgeries. Key words: Sciatic nerve block, success, anatomical landmarks, parasacral approach, Labat approach DOI: 10.15851/jap.v3n3.613
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; Achsanuddin Hanafie; Dadik Wahyu Wijaya
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 
Komplikasi dan Pemantauan Susunan Saraf Pusat pada Operasi Jantung Reza Widianto Sudjud; I Made Adi Parmana
Jurnal Anestesi Perioperatif Vol 1, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

TINJAUAN PUSTAKAPerkembangan tekhnologi dan jumlah operasi jantung di Indonesia semakin meningkat, perkembangan tersebut diikuti juga dengan semakin meningkatnya komplikasi pada susunan saraf pusat, seperti cedera otak. Banyak faktor dan kejadian selama pembedahan jantung yang dapat menyebabkan cedera otak. Kebanyakan cedera ini diakibatkan oleh hipoperfusi yang global atau fokal yang disebabkan oleh emboli  mikro ataupun makro. Insidensi cedera otak tinggi dan pencegahan terjadinya insidensi tersebut harus dipertimbangkan pada setiap prosedur. Alat pemantauan untuk susunan saraf pusat semakin berkembang dan membutuhkan keahlian seorang dokter anestesi untuk menguasai alat pemantauan tersebut. Pemahaman yang lebih lanjut terhadap pembedahan dan perfusi, perbaikan teknologi perfusi dan juga anestesi yang lebih teliti, diharapkan dapat menurunkan tingkat kejadian cedera otak setelah operasi jantung terbuka.Kata Kunci: Komplikasi SSP, anestesi, operasi jantung terbuka Complications and Monitoring of Central Nervous System on Cardiac SurgeryThe development of technology and numbers of heart operations in Indonesia has increased, but it is also followed with the ever increasing complications on the central nervous system, such as brain injury. Many factors and events during a heart surgery that cause brain injury. Most of these are due to a global or focal hypoperfusion caused by micro or macro emboli. The incidence rate of brain injury and prevention occurrence of the incident should be considered for each procedure. Tool monitoring for central nervous system has been growing and requires the expertise of an Anaesthesiologist for control these monitoring tools. Further understanding, improvement of the perfusion technology, and also a more meticulous anesthetic, surgical and perfusion is expected to reduce the incidence rate of brain injury after open heart surgery.Keywords : Complications CNS, anesthesia, open  heart surgery DOI: 10.15851/jap.v1n1.161
Perbandingan Nilai Analisis Gas Darah, Elektrolit, dan Laktat Setelah Pemberian Ringer Asetat Malat dengan Ringer Laktat untuk Early Goal Directed Therapy Pasien Sepsis Muhammad Fikri; Achsanuddin Hanafie; Nazaruddin Umar
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 (720.214 KB) | DOI: 10.15851/jap.v6n1.1291

Abstract

Sepsis merupakan penyebab kedua tertinggi kematian di instalasi rawatan intensif dan merupakan 10 penyebab tertinggi kematian di seluruh dunia. Menurut Survival Sepsis Campaign 2012 penanganan awal pada pasien sepsis dengan pemberian cairan memberikan respons yang lebih baik dengan pemberian 30 mL/kgBB cairan kristaloid. Penelitian ini bertujuan membandingkan jenis cairan kristaloid mana yang merupakan pilihan lebih baik untuk resusitasi atau early goal directed therapy (EDGT) pada pasien sepsis. Penelitian ini merupakan uji klinis acak tersamar ganda yang dilakukan pada periode bulan Desember 2016–Januari 2017 di RSUP Haji Adam Malik Medan. Empat puluh pasien yang memenuhi kriteria inklusi dan tidak termasuk eksklusi dinilai perubahan analisis gas darah, elektrolit (natrium, kalium, klorida), dan laktat sebelum dengan sesudah resusitasi cairan Ringer asetat malat dan Ringer laktat. Dari 40 pasien yang memenuhi kriteria, pemberian Ringer asetat malat yang dibandingkan dengan Ringer laktat pada pasien sepsis, nilai analisis gas darah (AGDA) mengalami perbaikan pada nilai HCO3 (p=0,001), TCO2 (p=0,002), base excess (BE) (p=0,048). Pemberian cairan ringer asetat malat menunjukkan peningkatan nilai analisis gas darah, natrium, dan laktat yang lebih baik daripada Ringer laktat. Simpulan, pemberian cairan Ringer asetat malat pada EGDT pasien sepsis lebih baik dalam menjaga keseimbangan asam basa di dalam tubuh dibanding dengan pemberian Ringer laktat.Kata kunci: Early goal-directed therapy, keseimbangan asam basa, Ringer asetat malat, Ringer laktat, sepsis
Perbandingan Aromaterapi Pepermin dengan Ondansetron Intravena sebagai Terapi Rescue Mual Muntah Pascaoperasi Mastektomi Arna Fransisca; Iwan Fuadi; Dewi Yulianti Bisri
Jurnal Anestesi Perioperatif Vol 7, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (160.107 KB) | DOI: 10.15851/jap.v7n1.1587

Abstract

Mual muntah pascaoperasi merupakan salah satu komplikasi anestesi dan operasi yang menjadi perhatian khusus karena memengaruhi kualitas pelayanan kesehatan, memperpanjang lama perawatan, dan meningkatkan angka morbiditas perioperatif. Pascaoperasi payudara berkaitan dengan angka kejadian mual muntah pascaoperasi yang tinggi. Beberapa konsensus penatalaksanaan mual muntah pascaoperasi merekomendasikan pemberian terapi nonfarmakologi dengan aromaterapi sebagai terapi rescue untuk mengatasi mual muntah pascaoperasi. Tujuan penelitian ini adalah membandingkan aromaterapi pepermin dengan ondansetron sebagai terapi rescue dalam menurunkan kejadian mual muntah pascaoperasi mastektomi. Penelitian ini merupakan penelitian eksperimental yang dilakukan secara prospektif dengan desain penelitian double blind randomized controlled trial dan consecutive sampling terhadap 32 subjek penelitian yang menjalani operasi mastektomi elektif dan memenuhi kriteria inklusi di RSUP Dr. Hasan Sadikin Bandung pada bulan Juli–September 2018. Pada penelitian ini, data ordinal diuji dengan Uji Mann Whitney dan untuk data kategorik diuji dengan uji chi-square. Hasil penelitian ini didapatkan penurunan kejadian mual muntah pascaoperasi yang signifikan pada kelompok pepermin dibanding dengan kelompok ondansetron dengan perbedaan yang bermakna (p<0,05) pada penilaian menit kedua dan menit kelima setelah perlakuan. Simpulan, aromaterapi pepermin efektif menurunkan kejadian mual muntah pascaoperasi mastektomi dan dapat digunakan sebagai alternatif terapi atau terapi tambahan untuk penatalaksanaan mual muntah pascaoperasi.Comparison of Peppermint Aromatherapy with Ondansetron Intravenous as a Rescue for Postoperative Nausea Vomiting after Mastectomy SurgeryPostoperative nausea and vomiting are among anesthesia and surgery  complications that receive special considerations as it affects the quality of healthcare services, prolongs care, and increases perioperative morbidities. The incidence of postoperative nausea and vomiting is high in patients that have undergone breast surgery. The consensus for postoperative nausea and vomiting management recommends non-pharmacological treatments, one of which is through the use of aromatherapy as a rescue to resolve postoperative nausea and vomiting. This study aimed to compare the effects of peppermint aromatherapy and ondansetron as a rescue in reducing the incidence of postoperative nausea and vomiting after elective mastectomies. This was a prospective experimental double blind randomized controlled trial study with consecutive sampling on 32 research subjects underwent elective mastectomies and met the inclusion criteria in Dr. Hasan Sadikin General Hospital in July–September 2018. The ordinal data were tested using the Mann Whitney statistics test and the categorical data using the chi square test. The results show a significant decrease in nausea and vomiting incidence in the peppermint group compared to the ondansetron group with significant difference (p<0.05) in two minutes and five minutes after treatment. In conclusion, peppermint aromatherapy is effective in reducing the incidence of postoperative nausea and vomiting after mastectomies and can be used as an alternative or additional treatment in managing postoperative nausea and vomiting.
Deksametason Intravena dalam Mengurangi Insidens Nyeri Tenggorok Pascabedah Andi Ade Wijaya; Rama Garditya; Arif H. M. Marsaban
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 (1327.812 KB)

Abstract

Anestesia umum dengan pipa endotrakeal digunakan untuk memberikan ventilasi tekanan positif dan mencegah aspirasi, namun penggunaannya dapat menimbulkan komplikasi nyeri tenggorok pascabedah. Penelitian ini dilakukan membandingkan efektivitas deksametason intravena dengan triamsinolon asetonid topikal dalam mengurangi nyeri tenggorok pascabedah. Penelitian ini merupakan uji klinis acak tersamar ganda yang dilakukan selama bulan Maret–April 2013 di Rumah Sakit Cipto Mangunkusumo pada pasien yang menjalani pembedahan dalam anestesia umum menggunakan pipa endotrakeal. Subjek dibagi menjadi dua kelompok, kelompok deksametason sebanyak 61 orang dan kelompok triamsinolon sebanyak 60 orang. Sebelum induksi, pasien dalam grup deksametason diberikan 10 mg deksametason intravena dan pasta plasebo dioleskan pada balon pipa endotrakeal. Pasien dalam grup triamsinolon diberikan 2 mL NaCl 0,9% intravena dan pasta triamsinolon asetonid dioleskan pada balon pipa endotrakeal. Skor nyeri tenggorok pascabedah dievaluasi sesaat setelah pembedahan berakhir, 2 jam dan 24 jam pascabedah. Hasil penelitian, tidak didapatkan perbedaan bermakna pada kedua kelompok  kejadian nyeri tenggorok pascabedah sesaat setelah pembedahan berakhir (27,9% pada kelompok A dan 18,3% pada kelompok B, p=0,214). Triamsinolon asetonid topikal memiliki efektivitas yang sama dengan deksametason intravena dalam mengurangi insidens nyeri tenggorok pascabedah.  Kata kunci:  Deksametason, intubasi endotrakeal, nyeri tenggorok pascabedah, pasta triamsinolon asetonidComparison between Topical Triamcinolone Acetonide and Intravenous Dexamethasone in Reducing Postoperative Sore Throat IncidenceTracheal intubation is often used to give positive-pressure ventilation and prevent aspiration during general anesthesia. However, the use of this airway device can cause postoperative sore throat (POST). This study was conducted to compare the effectiveness of prophylactic intravenous dexamethasone and triamcinolone acetonide paste in reducing POST. This study was a double-blind randomized clinical trial conducted during April–May 2013 in Cipto Mangunkusumo General Hospital on patients scheduled for surgery under general anesthesia using endotracheal tube. Subjects were randomly allocated into two groups; 61 patients in dexamethasone group and 60 patients in triamcinolone group. Before induction, the dexamethasone group received 10 mg of intravenous dexamethasone and placebo paste on the endotracheal tube cuff. Triamcinolone group received 2 mL of intravenous normal saline and triamcinolone acetonide paste on the endotracheal tube cuff. POST scores were evaluated immediately after the operation, 2-hours, and 24-hours after the operation. There was no significant difference in the incidence of POST immediately after the operation between the two groups (27.9% in group dexamethasone vs 18.3% in group triamcinolone, p=0.214). Topical triamcinolone acetonide is equally effective compared to prophylactic intravenous dexamethasone in reducing the incidence of POST.  Key words: Dexamethasone, endotracheal intubation, posts operative sore throat, triamcinolone acetonide paste

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