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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 Efektivitas Anestesi Spinal Menggunakan Bupivakain Isobarik dengan Bupivakain Hiperbarik pada Pasien yang Menjalani Operasi Abdomen Bagian Bawah Jeffry F. Longdong; Ike Sri Redjeki; A. Himendra Wargahadibrata
Jurnal Anestesi Perioperatif Vol 1, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penyebaran obat anestesi lokal pada anestesi spinal sangat ditentukan oleh barisitas obat anestesi lokal dan posisi pasien. Penelitian ini dilakukan untuk mengetahui perbandingan anestesi spinal menggunakan bupivakain 0,5% isobarik hiperbarik terhadap lama kerja blokade sensoris dan tinggi blokade sensoris pada operasi abdomen bagian bawah. Penelitian eksperimental secara randomized control trial (RCT) pada 40 pasien dengan status fisik ASA I–II, usia 17–60 tahun yang menjalani operasi abdomen bagian bawah di ruang operasi bedah sentral Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Januari sampai April 2011. Pasien dibagi dalam kelompok isobarik dan kelompok hiperbarik. Tinggi blokade sensoris, lama kerja blokade sensoris dicatat dan dilakukan uji statistik dengan student t-test, chi-kuadrat. Dari hasil penelitian didapatkan lama kerja blokade sensoris pada kelompok isobarik lebih panjang dibandingkan dengan kelompok hiperbarik (242,4 menit SB 28,04 vs 132,95 menit SB 11,33) dengan perbedaan yang bermakna (p<0,001). Tinggi blokade sensoris pada kelompok isobarik lebih rendah dibandingkan dengan bupivakain kelompok hiperbarik. Simpulan dari penelitian ini menunjukkan bupivakain isobarik mempunyai penyebaran lebih rendah dan lama kerja lebih panjang. Kata kunci: Abdomen bagian bawah, analgesia spinal, barisitas ,bupivakain, obat anestesi lokal, teknik anestesiEffectivity of Spinal Anaesthesia Using Isobaric Bupivacaine and Hyperbaric Bupivacaine on Patients Undergoing Lower Abdominal SurgeryDistribution of local anesthetics in spinal anesthesia is most determined by baricity and position. The study was conducted to explore the comparison of effect between spinal anesthesia technique using 0.5% isobaric bupivacaine with 0.5% hyperbaric bupivacaine on duration and level of sensory blocking action in lower abdominal surgery. This experimental study was conducted using randomized control trial (RCT)in 40 patients with physical ASA I–II status, aged 17–60 years, who underwent lower abdominal surgery in central operating theatre Dr. Hasan Sadikin Hospital-Bandung within January to April 2011. The patients were divided into two groups, the hyperbaric group and the isobaric group. The recording included sensory blocking level, sensory blocking duration, and statistical analysis using Student t-test and chi-square test. . Sensory blocking levels in isobaric group were lower than those in hyperbaric group. The conlusion of the study indicates that isobaric bupivacaine has lesser distribution and longer duration of action.Key words: Anesthesia technique, baricity, bupivacaine, local anesthetics, lower abdomen, spinal analgesia  DOI: 10.15851/jap.v1n2.117
Perbedaan Nilai Agregasi Trombosit Akibat Pengaruh Penggunaan Analgesia Ketorolak dan Ibuprofen Intravena Pascaoperasi di RSUP Haji Adam Malik Medan Dewi Yuliana Fithri; Dadik Wahyu Wijaya; Hasanul Arifin
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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

Abstract

Obat anti-inflamasi nonsteroid (OAINS) merupakan analgetik yang sering digunakan pada pascaoperasi bedah ortopedi. Penelitian ini bertujuan melihat apakah terdapat perbedaan nilai agregasi trombosit akibat pengaruh penggunaan analgestik ketorolak dengan ibuprofen intravena setelah operasi. Penelitian ini merupakan penelitian uji klinis dengan uji acak tersamar buta ganda yang membandingkan perbedaan pengaruh ketorolak  30 mg intravena/6 jam dengan ibuprofen 800 mg intravena/6 jam. Populasi penelitian ini adalah pasien yang menjalani tindakan pembedahan elektif dengan anestesi umum di RSUP Haji Adam Malik Medan pada bulan Agustus 2016. Pasien dibagi menjadi 2 kelompok dengan tiap-tiap kelompok berjumlah 20 pasien. Ketorolak atau ibuprofen sebagai analgetik diberikan setelah 30 menit selesai operasi, kemudian dilanjutkan per 6 jam sampai dengan 2 hari selesai operasi. Uji statistik menggunakan tes Wilcoxon untuk sebelum perlakuan dan Uji Mann-Whitney untuk sesudah perlakuan pada kedua kelompok. Data karakteristik subjek homogen. Agregasi trombosit pada kelompok ketorolak dengan kelompok ibuprofen berbeda bermakna setelah 10 menit ekstubasi dengan 8 jam setelah pemberian obat terakhir. Tidak terdapat perbedaan bermakna antara kelompok ketorolak dan kelompok ibuprofen setelah 10 menit ekstubasi (p>0,05), namun terdapat perbedaan bermakna pada 8 jam setelah akhir pemberian obat. Simpulan, ketorolak menurunkan persentase agregasi trombosit lebih besar daripada ibuprofen setelah 8 jam pemberian obat terakhir. Differences in Platelet Aggregation Values in Postoperative Intravenous Ketorolac and Ibuprofen Analgesics at Haji Adam Malik Central General Hospital MedanNon-steroidal anti-inflammatory drugs (NSAIDs) are analgesics used for postoperative orthopedic surgery. This study aimed to underrstand the effect of intravenous ketorolac and ibuprofen on platelet aggregation values. This was a double-blind randomized controlled trial that compared the effects of intravenous ketorolac and ibuprofen. The population of this study were patients undergoing elective surgery under general anesthesia at Haji Adam Malik Central General Hospital Medan in August 2016. Patients were divided into 2 groups (n: 20): ketorolac group andibuprofen group. Both group received analgesic 30 minutes after surgery up to 2 days postoperative. The statistical tests used were Wilcoxon test for pre-treatment and Mann-Whitney test for post-treatment in each group. Subject characteristic data were homogenous. Platelet aggregation of ketorolac and ibuprofen groups differed significantly between 10 minutes after extubation and 8 hours after the last drug administration. There was no significant difference between the ketorolac and ibuprofen groups after 10 minutes of extubation (p>0.05); however there was a significant difference at 8 hours after the end of drug administration. In conclusion, ketorolac decreases platelet aggregation percentage greater than ibuprofen after 8 hours of the last drug administration. 
Angka Kejadian Hipotermia dan Lama Perawatan di Ruang Pemulihan pada Pasien Geriatri Pascaoperasi Elektif Bulan Oktober 2011–Maret 2012 di Rumah Sakit Dr. Hasan Sadikin Bandung Anggita Marissa Harahap; Rudi K. Kadarsah; Ezra Oktaliansah
Jurnal Anestesi Perioperatif Vol 2, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tindakan anestesi dan pembedahan adalah salah satu penyebab kejadian hipotermia. Keadaan ini sangat tidak menguntungkan bagi pasien geriatri dengan gangguan fungsi kardiopulmonal. Penelitian dilakukan dengan metode prospektif observasional dengan rancangan penelitian deskriptif kasus kontrol terhadap 129 orang pasien geriatri pascaanestesi umum dan pascaanestesi regional yang masuk ke ruang pemulihan Rumah Sakit Dr. Hasan Sadikin Bandung pada Oktober 2011 sampai Maret 2012. Angka kejadian hipotermia pada pasien geriatri pascaanestesi di ruang pemulihan sebanyak 113 orang (87,6%). Terdapat hubungan bermakna kejadian hipotermia dengan lama perawatan di ruang pemulihan pada pasien geriatri yang telah menjalani operasi elektif di Rumah Sakit Dr. Hasan Sadikin Bandung (p≤0,05). Lama tinggal di ruang pemulihan rata-rata pada pasien hipotermia adalah 110 menit dan pada pasien yang tidak hipotermia 70 menit. Simpulan penelitian ini menunjukkan bahwa angka kejadian hipotermia pascaoperatif geriatri adalah 87,6% dan pasien dengan hipotermia mendapatkan perawatan lebih lama di ruang pemulihan.Kata kunci: Hipotermia pascaanestesi, lama perawatan, geriatri, ruang pemulihanThe Incidence of Hypothermia and Duration of Care in the Recovery Room on Postoperative Geriatric Patients at Dr. Hasan Sadikin Hospital Bandung During October 2011–March 2012Anesthesia and surgery is one of the causes of the incidence of hypothermia . This situation is not favorable for geriatric patients with impaired cardiopulmonary function. This was a prospective observational study with a descriptive case-control design on 129 geriatric patients post general and regional anaesthesia in the recovery room of Dr. Hasan Sadikin Hospital Bandung during the period of October 2011 to March 2012. The incidence of hypothermia in geriatric patients post anaesthesia in recovery room was 113 people (87.6%). There was a significant relationship between the incidence of hypothermia and the duration of care in the recovery room in geriatric patients who have undergone elective surgery at the Dr. Hasan Sadikin Hospital Bandung (p≤0.05) . Average the length of stay in recovery room was 110 minutes in patients experiencing hypothermia while it was 70 minutes in those whom did not experience hypothermia. In conclusions, the incidence of postoperative hypothermia in geriatric patients was 87.6% and patients whom experienced hypothermia have a longer care in the recovery room.Key words: Geriatric, hypothermia post anesthesia, length of stay DOI: 10.15851/jap.v2n1.236
Pemberian Magnesium Sulfat Intravena Meningkatkan Efek Analgesia Pascaoperasi pada Bedah Mayor Menggunakan Anestesi Umum Hengki Irawan; I Made Subagiartha; I Made Gede Widnyana
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penatalaksanaan nyeri akut pascaoperasi merupakan tugas penting dokter anestesi. Morfin banyak digunakan untuk mengontrol nyeri pascaoperasi. Tujuan penelitian ini untuk mengetahui pengaruh pemberian MgSO4 intravena selama operasi terhadap efek analgesia dan kebutuhan morfin pascaoperasi. Penelitian ini adalah uji klinik blok tersamar ganda. Tiga puluh enam subjek usia 21–55 tahun dialokasikan ke dalam kelompok A yang diberikan MgSO4 30 mg/kgBB intravena 15 menit dilanjutkan 15 mg/kgBB/jam sampai akhir operasi dan kelompok B diberikan NaCl 0,9% dengan volume sama yang menjalani operasi bedah mayor di RSUP Sanglah Denpasar pada Juni–Agustus 2014. Data hasil penelitian dianalisis dengan Uji Mann-Whitney. Nilai visual analog scale (VAS) diam dan bergerak pada jam ke-4 dan ke-8 pada kelompok Mg berbeda bermakna (p<0,05). Perbedaan konsumsi morfin pascaoperasi pada jam ke-4, ke-8, dan ke-24 berbeda bermakna (p<0,05). Simpulan penelitian ini adalah pemberian MgSO4 intravena selama operasi meningkatkan efek analgesia dan menurunkan kebutuhan morfin pascaoperasi.Kata kunci: Analgesia pascaoperasi, anestesi umum, bedah mayor, magnesium sulfatIntravenous Magnesium Sulphate Administration to Improve Post-operative Analgesia Effect in Major Surgery with General AnesthesiaAbstractRelieving acute post-operative pain is an important role of anesthesiologist. Morphine is frequently used to control moderate to severe post operative pain. The objective of this study is to understand the effect of intravenous MgSO4 administration in improving post-operative analgesia effect. This study was a double-blind randomized block clinical trial. The subjects of this study were patients who underwent major surgeries in Sanglah Hospital during the period of June to August 2014. Thirty six subjects age 21–55 years allocated to group A received intravenous MgSO4 30 mg/kgBW intravenous bolus in 15 minutes followed by 15 mg/kgBW/hour until the surgery is finished and group B received NaCl 0.9% with the same volume. Data were then analyzed using  the Mann-Whitney Test. The stationary and mobile VAS scores in the  4th and 8th hour in Mg group were significantly different (p<0.05). Post-operative morphine consumptions in the 4th, 8th, and 24th hour were significantly different between the Mg and NaCl 0.9% groups (p<0.05). It is concluded that the administration of  intravenous MgSO4 during operation increases analgesia effect and reduces post-operative morphine needKey words: General anesthesia, magnesium sulfate, major surgery, post-operative analgesia DOI: 10.15851/jap.v2n3.335
Perbandingan Angka Keberhasilan Pemasangan Laryngeal Mask Airway (LMA) Jenis Klasik pada Usaha Pertama antara Teknik Balon Dikempiskan dan Dikembangkan Sebagian pada Pasien Dewasa Yustisa Sofirina Harahap; Doddy Tavianto; 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 (405.299 KB) | DOI: 10.15851/jap.v4n1.743

Abstract

Laryngeal mask airway (LMA) jenis klasik merupakan alat bantu jalan napas supraglotis yang paling sering digunakan sebagai alternatif pilihan dari intubasi endotrakeal. Tujuan penelitian ini adalah mengetahui perbandingan angka keberhasilan pemasangan LMA jenis klasik pada usaha pertama antara teknik balon dikempiskan dan dikembangkan sebagian pada pasien dewasa. Penelitian dilakukan dengan uji acak lengkap terkontrol tersamar tunggal terhadap 70 pasien yang berusia 18–60 tahun dan status fisik American Society of Anesthesiologists (ASA) I–II yang menjalani operasi terencana dengan anestesi umum, dan tidak terdapat kontraindikasi pemasangan LMA di Instalasi Bedah Sentral Rumah Sakit Dr. Hasan Sadikin Bandung. Dilakukan randomisasi blok permutasi dan dikelompokkan menjadi kelompok teknik balon dikempiskan dan kelompok teknik balon dikembangkan sebagian. Data hasil penelitian dianalisis dengan uji chi-kuadrat dan Uji Mann-Whitney dengan p<0,05 dianggap bermakna. Penelitian ini berlangsung pada Februari–Maret 2015. Hasil penelitian menunjukkan teknik balon dikembangkan sebagian angka keberhasilan lebih tinggi 33 dari 35 dibanding dengan balon dikempiskan 27 dari 35 pada usaha pertama yang berbeda bermakna (p<0,05). Simpulan, teknik pemasangan LMA jenis klasik pada pasien dewasa dengan teknik balon dikembangkan sebagian angka keberhasilannya lebih tinggi daripada balon dikempiskan.Kata kunci: Laryngeal mask airway jenis klasik, teknik balon dikembangkan sebagian, teknik balon dikempiskanComparison of Success Rate between Fully Deflated and Partially Inflated Cuff Technique in Classic Laryngeal Mask Airway (cLMA) Insertion on First Attempt in Adult PatientsAbstractClassic laryngeal mask airway (cLMA) is the most widely used supraglottic airway device and is a satisfactory alternative to endotracheal intubation. The purpose of this study was to compare the success rate of cLMA insertion using fully deflated technique and partially inflated technique in adult patients. This was a complete randomized controlled single blind trial on 70 patients, 18–60 years old, American Society of Anesthesiologists (ASA) I–II, who underwent elective surgery in general anesthesia and in whom the use of LMA was not contraindicated. This study was performed at the Central Operating Theater, Dr. Hasan Sadikin General Hospital,Bandung. After using a permutation block randomization, the subjects were divided into fully deflated technique group and partially inflated technique group. Correct placement in first attempt was confirmed. Data were analyzed using chi-square test and Mann-Whitney test, where a p value of <0.05 was considered significant. The study was held in a period of February toMarch 2015. The results of this study showed that the partially inflated technique was more successful, 33 of 35, than the fully deflated technique, 27 of 35, on the first attempt. In addition, the statistical analysis results also showed that the ratio of success rate between both treatment groups of cLMA insertion was significantly different (p<0.05). The success rate of partially inflated technique of cLMA insertion iss higher than the fully deflated technique in adult patients.Key words: Fully deflated technique, partially inflated technique, the classic laryngeal mask airway (cLMA) DOI: 10.15851/jap.v4n1.743
Efek Lidokain Intravena terhadap Nilai Numeric Rating Scale dan Kebutuhan Fentanil Pascaoperasi dengan Anestesi Umum Theresia C. Sipahutar; Iwan Fuadi; Tatang Bisri
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Lidokain intravena mempunyai efek analgesia, antihiperalgesia, dan antiinflamasi. Penelitian ini bertujuan untuk mengetahui efek pemberian lidokain intravena terhadap nilai numeric rating scale (NRS) dan kebutuhan fentanil pascaoperasi eksisi fibroadenoma mammae. Penelitian ini merupakan uji klinis acak terkontrol buta ganda terhadap 40 orang pasien wanita usia 18–60 tahun dengan status fisik ASA I–II yang dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung periode September 2011–Februari 2012. Sampel dikelompokkan random menjadi kelompok lidokain dan kontrol. Penilaian nyeri menggunakan numeric rating scale. Data dianalisis menggunakan uji chi-kuadrat, uji-t, dan Mann Whitney dengan tingkat kepercayaan 95% dan dianggap bermakna bila p<0,05. Hasil penelitian menunjukkan nilai NRS kelompok lidokain lebih rendah dan berbeda bermakna pada 30 menit (p<0,001), 60 menit (p<0,001), 90 menit (p=0,003), dan 120 menit (p=0,011) pascaoperasi, penggunaan fentanil pertolongan pada kelompok lidokain adalah 0–25 µg dan pada kelompok kontrol 25–75 µg selama 3 jam pascaoperasi. Simpulan penelitian adalah lidokain intravena 1,5 mg/kgBB bolus sebelum induksi dilanjutkan dosis rumatan 1 mg/kgBB/jam sampai 1 jam pascaoperasi mampu menurunkan nilai numeric rating scale dan mengurangi kebutuhan fentanil pascaoperasi.Kata kunci: Kebutuhan fentanil pascaoperasi, lidokain intravena, numeric rating scaleThe Effect of Intravenous Lidocaine on Numeric Rating Scale Value and Postoperative Fentanyl Requirement in General AnesthesiaAbstractLidocain has analgesic, antihyperalgesic and antiinflamatory properties. This was a double blind randomized controlled trial study on 40 female patients, aged 18–60 years old with ASA physical status I–II who underwent excisional biopsy for fibroadenoma mammae at Dr. Hasan Sadikin General Hospital Bandung between September 2011–February 2012. The samples randomly divided into the lidocaine and the control group. Quality of postoperative pain was assessed using the numeric rating scale (NRS). The result were analyzed with chi-square test, t-test, and Mann Whitney Test with 95% confidence interval and considered significant if the p value <0.05. The result showed that in comparison to the control group, the NRS values obtained from the lidocaine group was significantly different in postoperative measurement time, 30 minutes (p<0.001), 60 minutes (p<0.001), 90 minutes (p=0.003) and 120 minutes (p=0.011) and the dose range of fentanyl as a rescue analgesic in 3 hours postoperative period for the lidocaine group was 0–25 µg and 25–75 µg for the control group. This study concluded that administration of 1,5 mg/kgBW lidocaine intravenous before induction and continued with 1 mg/kgBW/hour as maintenance dose until 1 hour postoperative is able to reduce the NRS score and the requirement of postoperative fentanyl.Key words: Intravenous lidocaine, numeric rating scale, post operative fentanyl requierement DOI: 10.15851/jap.v1n3.195
Perbandingan Laringoskopi Indirek Kaca Laring dengan Laringoskopi Indirek Video Smartphone dalam Menilai Visualisasi Laring dan Kenyamanan Pasien Paulus Sulistiono; M. Andy Prihartono; Dedi Fitri Yadi
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 (628.75 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
Penatalaksanaan Anestesi Pasien Transposition of the Great Arteries pada Operasi Mouth Preparation Ade Arya Nugraha; - Suwarman; Ardi Zulfariansyah
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Transposition of the great arteries (TGA) disebabkan kegagalan pemisahan trunkus arteriosus, sehingga aorta keluar dari bagian anterior ventrikel kanan dan arteri pulmonal keluar dari ventrikel kiri. TGA termasuk kelainan jantung bawaan tipe sianotik. Seorang anak perempuan berusia 4 tahun datang untuk perawatan dan pencabutan gigi sebagai persiapan untuk operasi koreksi TGA di Rumah Sakit Dr. Hasan Sadikin Bandung pada Januari 2014. Anamnesis didapatkan riwayat kebiruan sejak bayi dan pada pemeriksaan fisis didapatkan anak yang tampak sianosis, SpO2 70–80%, murmur sistol, dan jari tabuh. Pada pemeriksaan ekokardiografi didapatkan kelainan TGA. Manajemen anestesi pada pasien ini dilakukan dengan menggunakan ketamin dan vekuronium untuk induksi serta pemeliharaan dengan O2 dan air, serta sevofluran. Manajemen anestesi dilakukan dengan target mencegah penurunan miring systemic vascular resistance (SVR) dibandingkan dengan pulmonary vascular resistance (PVR). Simpulan, prinsip pengelolaan perioperatif pembedahan nonkardiak pada pasien TGA adalah menjaga agar tidak terjadi penurunan SVR dan peningkatan PVR.Kata kunci: Kelainan jantung kongenital sianotik, pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), transposition of the great arteries (TGA)Management of Anesthesia in Patients Transposition of the Great Arteries which Undergo Mouth PreparationTransposition of the great arteries (TGA) results from failure of the truncus arteriosus to spiral, so that the aorta arises from the anterior portion of the right ventricle and the pulmonary artery arises from the left ventricle. TGA which is the type of cyanotic congenital heart disease. A girl of 4 years came for treatment and tooth extraction as preparation for the surgical correction of  TGA at the Dr. Hasan Sadikin Hospital –Bandung within January 2014. Patient with a history of blue when she was a baby and on physical examination found the child looking cyanosis, SpO2 70–80%, sistolic murmur and clubbing finger. Abnormalities on echocardiography obtained TGA.  Anesthetic management of this patients was performed using ketamine and vecuronium for induction and maintenance with O2, N2O, and sevoflurane. Cyanotic attacks can occur preoperative, intraoperative, and post operative, which was treated by increasing systemic vascular resistance (SVR) compared to pulmonary vascular resistance. In conclusions, perioperative management principal for non cardiac surgery on transposition of the great arteries (TGA) is to keep SVR from decline and  increase on PVR.Key words: Cyanotic congenital heart defects, pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), transposition of the great arteries (TGA)   DOI: 10.15851/jap.v2n2.320
Perbandingan Kebutuhan Propofol dan Lama Bangun antara Kombinasi Propofol-Ketamin dan Propofol-Fentanil pada Pasien yang Dilakukan Kuretase yang Diukur dengan Bispectral Index (BIS) Wirawan Anggorotomo; Rudi K. Kadarsah; Ezra Oktaliansah
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Pemberian sedasi dan analgesi yang efektif, efisien, aman, mudah didapat, dan juga murah diperlukan untuk mengurangi nyeri serta kecemasan selama kuretase.  Tujuan penelitian ini adalah mengetahui perbedaan kebutuhan propofol dan lama bangun antara propofol-ketamin dan propofol-fentanil pada pasien yang dilakukan kuretase. Dilakukan penelitian uji klinis acak tersamar tunggal pada 60 pasien yang menjalani kuretase di Rumah Sakit Dr. Hasan Sadikin Bandung periode September–November 2014.  Pasien dibagi dalam dua kelompok, yaitu propofol-ketamin (PK) dan propofol-fentanil (PF). Data hasil penelitian  untuk tekanan darah, laju nadi, laju napas, saturasi oksigen, dan skor bispectral index (BIS) dianalisis dengan uji-t dan Uji Mann-Whitney. Hasil penelitian menunjukkan kebutuhan propofol berbeda secara sangat bermakna (p<0,001), pada kelompok PK terdapat 4/30 subjek yang mendapatkan tambahan propofol, sedangkan pada kelompok PF sebanyak 14/30 subjek. Lama bangun pada kelompok PK adalah 25,75±2,47 menit, sedangkan pada kelompok PF adalah 21,08±2,52. Secara statistik hasil tersebut berbeda secara sangat bermakna (p<0,001). Simpulan, kebutuhan propofol pada kelompok PK lebih sedikit dibanding dengan kelompok PF dan lama bangun pada kelompok PK lebih lama dibanding dengan kelompok PF. Kata kunci: Bispectral index, kebutuhan propofol, kuretase, lama bangun Comparison of Propofol Requirements and Emergence Time between Propofol-Ketamine and Propofol-Fentanyl Combinations in Patients Undergoing Curretage using Bispectral Index (BIS) MonitoringAdequate administration of safe, easy-to-obtain, and constantly available sedatives and analgesia, is needed for pain reduction throughout curettage procedures. The goal of this study was to examine differences in propofol requirements and emergence time between propofol-ketamine and propofol-fentanyl combinations in patients undergoing curettage. A single-blind randomized controlled trial study was performed on 60 patients who underwent curettage procedures. The patients were divided into two groups: propofol-ketamine (PK) and propofol-fentanyl (PF). Blood pressure, pulse rate, respiration rate, and oxygen saturation and BIS data were analysed using a t-test and Mann-Whitney test. This study showed that propofol requirements differ significantly (p<0.001) between the two groups where in PK group where 4/30 subjects received additional propofol, compared to PF group 14/30 subjects received additional propofol. The wake up time for PK group was 25.75±2.47 minutes compared to 21.08±2.52 minutes for the PF group. The difference was statistically significant (p<0.001). The conclusions of this study are propofol requirements for PK group is less compared to PF group and the emergence time for PK group is longer compared to PF group. Key words: Bispectral index, curettage, emergence time, propofol requirements DOI: 10.15851/jap.v3n3.611
Mual Muntah Pasien Pascavitrektomi: Perbedaan Rumatan Kombinasi Sevofluran 1,2%-Fentanil 1,2 μg/kgBB/jam dengan Rumatan Sevofluran 2% Arif H. M. Marsaban; Christopher Kapuangan; Anggadria Iqbal Yulian
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 (700.098 KB) | DOI: 10.15851/jap.v5n1.996

Abstract

Vitrektomi merupakan operasi yang sering dilakukan dengan insidens mual muntah pascaoperatif yang cukup tinggi. Kombinasi opioid - anestetik inhalasi merupakan pilihan dalam rumatan anestesia umum karena mempunyai efek sinergis. Perbandingan dosis kombinasi fentanil dan sevofluran dengan timbulnya efek samping mual muntah pascaoperatif belum pernah dilaporkan. Penelitian ini bertujuan mengetahui perbedaan insidens mual muntah pascavitrektomi antara rumatan kombinasi sevofluran 1,2%- fentanil 1,2 μg/kgBB/jam dan sevofluran 2%. Penelitian ini merupakan uji klinis acak tersamar tunggal terhadap pasien yang menjalani vitrektomi dengan anestesia umum di Ruang operasi mata Kirana RSUPN Cipto Mangunkusumo Jakarta Mei–Juli 2015. Enam puluh dua pasien yang akan menjalani vitrektomi dengan anestesia umum dirandomisasi ke dalam dua kelompok, yaitu kelompok yang mendapat rumatan kombinasi sevofluran 1,2%-fentanil 1,2 μg/kgBB/jam dan kelompok dengan rumatan sevofluran 2%. Pengukuran mual muntah pascabedah dilakukan dengan metode wawancara langsung. Analisis data dilakukan dengan uji chi-kuadrat dan uji Fisher sebagai uji alternatif. Insidens mual antara kedua kelompok berbeda bermakna pada periode 0–2 jam pascaoperasi (p<0,05), sedangkan pada periode 2–6 jam, insidens mual antara kedua kelompok tidak berbeda bermakna (p>0,05). Simpulan, rumatan anestesia dengan sevofluran 1,2%-fentanil 1,2 μg/kgBB/jam menimbulkan insidens mual dalam 2 jam pertama pascavitrektomi yang lebih rendah dibanding dengan sevofluran 2%.Kata kunci: Fentanil, mual muntah pascavitrektomi, sevoflurane Anesthesia for vitrectomy patient has a high incidence of postoperative nausea and vomiting (PONV).Combination of opioid and inhalation anesthesias has been commonly used for anesthesia maintenance  due to their sinergystic effect. The effect of fentanyl-sevoflurane dosage to PONV incidence in vitrectomy surgery has never been studied. This study aimed to determine the difference in PONV incidence between combination of sevoflurane 1.2%-fentanyl 1.2 μg/kgBW/hour and sevoflurane 2% for anesthesia maintenance. This study was a single blind randomized study in vitrectomy patients with general anesthesia at Kirana Operating Theatre of Dr.Cipto Mangunkusumo National General Hospital during May–July 2015. Sixty two patients who were undergoing vitrectomy surgery with general anesthesia were randomized into sevofluran 1.2%- fentanil 1.2 μg/kgBW/hour group and sevoflurane 2% group. Postoperatively, the incidences of PONV were recorded. Data were collected by anamnesis method and analyzed by chi-square and Fisher test. There was a significant difference of nausea incidence between the two intervention groups within 0–2 hours postvitrectomy period (p<0.05) but no significant difference within 2–6 hours postvitrectomy period (p>0.05). In conclusion, sevoflurane 1.2%-fentanyl 1.2 μg/kgBW/hour has lower incidence of postvitrectomy nausea within the first 2 hour compared to sevoflurane 2%.Key words: Fentanyl, postvitrectomy nausea and vomiting, sevoflurane 

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