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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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Efek Penambahan Deksametason 5 mg pada Bupivakain 0,5% terhadap Mula dan Lama Kerja Blokade Sensorik Anestesia Epidural untuk Operasi Ortopedi Ekstremitas Bawah - Irwan; Erwin Pradian; Tatang Bisri
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Operasi ortopedi ekstremitas bawah dengan anestesia regional epidural memiliki kelemahan yaitu mula kerja yang lama. Penelitian ini bertujuan melihat efek penambahan 5 mg deksametason pada bupivakain 0,5% terhadap mula kerja dan lama kerja blokade sensoris. Penelitian prospektif eksperimental menggunakan uji klinis acak buta ganda pada 32 pasien dengan American Society of Anesthesiologist (ASA) I–II yang menjalani operasi ortopedi ekstremitas bawah dengan anestesi epidural di RSUP Dr. Hasan Sadikin Bandung pada Februari–Mei 2014. Pengambilan sampel dilakukan secara consecutive sampling dan random blok permutasi. Kelompok I, deksametason 5 mg ditambahkan ke dalam bupivakain 0,5% 15 mL. Kelompok II, bupivakain 0,5% ditambah NaCl 0,9% 15 mL. Hasil penelitian diuji secara statistika menggunakan uji-t dan Uji Mann-Whitney. Hasil penelitian menunjukkan mula kerja blokade sensorik kelompok I tidak lebih cepat, yaitu 13,56 menit dibanding dengan kelompok II, yaitu 14,31 menit (p=0,27). Lama kerja blokade sensorik kelompok I lebih lama, yaitu 399,81 menit dibanding dengan kelompok II, yaitu 227,43 menit (p=0,00). Simpulan, penambahan deksametason 5 mg pada bupivakain 0,5% 15 mL tidak mempercepat mula kerja blokade sensorik tetapi memperpanjang lama kerja blokade sensorik bupivakain 0,5% yang diberikan secara epidural.Kata kunci: Anestesi epidural, blokade sensorik, bupivakain, deksametason, lama kerja, mula kerjaEffect of Dexamethasone 5 mg Addition to Bupivacaine 0.5% on Onset and Duration of Sensory Blockade in Epidural Anesthesia for Lower Extremity Orthopedic SurgeryLower extremity orthopedic surgery performed with regional epidural anesthesia was still have weakness which is long onset of time. This study was conducted to determine the onset time and duration time of sensory blockade epidural anesthesia  between the use of dexamethasone 5 mg addition to 0.5% bupivacaine for lower limb orthophedic surgery. The study was using randomized controlled blind method on 32 ASA I–II patients undergoing lower limb orthopedic surgery under epidural anesthesia. Consecutive sampling and random allocation of block of permutation groups was applied. In group I, dexamethasone 5 mg was added to bupivacaine 0.5% 15 mL while in group II NaCl 1 mL was added to bupivacaine 0.5% 15 mL. The results were statistically tested using t-test and Mann-Whitney test. It was shown that the onset time of sensory blockade was not significantly faster when dexamethasone was added in bupivacaine 0.5%, 13.56 minutes versus 14.31 minutes (p=0.27). The duration time of sensory blockade in dexamethasone in bupivacaine 0.5% group was longer 399.81 minutes, compared to the bupivacaine 0.5% group, 227.43 minutes (p=0.00). In conclusions, the addition of dexamethasone 5 mg to bupivacaine 0.5% 15 mL does not produced faster onset time. However, the duration sensory blockade time is longer than bupivacaine 0,5% 15 mL is usedKey words: Bupivacaine, dexamethasone, duration time, epidural anesthesia, onset, sensory blockade DOI: 10.15851/jap.v3n2.577
Gambaran Tata Cara dan Angka Keberhasilan Penyapihan Ventilasi Mekanik di Ruang Perawatan Intensif Rumah Sakit Dr. Hasan Sadikin Bandung Richard Pahala Sitorus; Iwan Fuadi; Ardi Zulfariansyah
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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

Abstract

Penyapihan ventilasi mekanik adalah suatu proses pelepasan bantuan ventilator yang dilakukan secara bertahap atau langsung oleh seorang dokter Intensive Care Unit (ICU). Penelitian ini bertujuan mengetahui gambaran tata cara dan angka keberhasilan penyapihan ventilasi mekanik yang dilakukan di ICU Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung. Metode penelitian ini adalah deskriptif observasional prospektif dan merupakan studi cross sectional. Penelitian ini melibatkan 50 pasien yang dirawat di ICU RSHS Bandung pada bulan Juli–September 2015. Data dicatat dan dikelompokkan sesuai dengan variabel karakteristik tata cara dan angka keberhasilan penyapihan ventilasi mekanik. Hasil penelitian ini menunjukkan tata cara penyapihan ventilasi mekanik yang paling banyak dilakukan adalah once daily trial of T piece sebanyak 22 pasien (44%) kemudian continous positive airway pressure (CPAP) sebanyak 40%, intermittent trial of T-piece sebanyak 10%, dan pressure support ventilation (PSV) 6%. Angka keberhasilan penyapihan ventilasi mekanik sebanyak 44 orang (88%) dan angka kegagalan penyapihan ventilasi mekanik adalah sebanyak 6 orang (12%) sehingga harus dilakukan re-intubasi. Tata cara penyapihan ventilasi mekanik yang paling banyak digunakan di ICU RSHS Bandung adalah once daily trial of T piece dan angka keberhasilan penyapihan ventilasi mekanik sebesar 88%.Kata kunci: Angka keberhasilan, tata cara penyapihan, ventilasi mekanikProcedures and Success Rate of Mechanical Ventilation Weaning in Intensive Care Unit of Dr. Hasan Sadikin General Hospital BandungAbstractMechanical ventilation weaning is a process of withdrawing ventilator assistance gradually or immediately by Intensive Care Unit (ICU) physicians. This study aimed to describe the procedure and the success rate of mechanical ventilation weaning performed at the ICU of Dr. Hasan Sadikin General Hospital (RSHS) Bandung. This was a cross-sectional descriptive prospective observational and study involving 50 patients treated at the ICU of RSHS Bandung during the period of July to September 2015. Data were recorded and classified in accordance with the variable characteristics of the procedure and the success rate of mechanical ventilation weaning. The results indicated that the most widely used mechanical ventilation weaning procedures were T-piece once daily trial in 22 patients (44%), continous positive airway pressure (CPAP) in 40%, T-piece intermittent trial in 10%, and pressure support ventilation (PSV)in 6%. Mechanical ventilation weaning success rate was 88% and the failure rate was 12% (6 patients) which required re-intubation. The most widely used procedure for mechanical ventilation weaning at the ICU of Dr. Hasan Sadikin General Hospital Bandung is T-piece once daily trial and the mechanical ventilation weaning success rate is 88%.Key words: Mechanical ventilation, success rate, weaning procedure  
Patofisiologi Pintasan Jantung Paru Doddy Tavianto; A. Himendra Wargahadibrata; Chairil Gani C.
Jurnal Anestesi Perioperatif Vol 1, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Perubahan fisiologi yang disebabkan oleh pintasan jantung paru (PJP) adalah perubahan pulsatilitas, pola aliran darah, pengaruh paparan darah terhadap permukaan nonfisiologis, kerusakan darah akibat tekanan (shear stress), hemodilusi, dan respons stres yang berlebihan. Peningkatan keamanan penggunaan PJP bergatung pada pengetahuan dan pemahaman yang baik terhadap perubahan homeostatis sirkulasi normal. Kontrol sirkulasi selama PJP dilakukan dengan memerhatikan aliran darah sistemik, tekanan arteri, tekanan vena, dan distribusi aliran darah. Perubahan sirkulasi selama PJP dapat terjadi saat PJP dimulai, pada periode hipotemia, pada fase pemulihan temperatur (rewarming), saat PJP dengan temperatur hangat (warm CPB) dan PJP juga akan mengakibatkan perubahan pada mikrosirkulasi, serta keadekuatan perfusi jaringan.Kata kunci: Efek pintasan jantung paru, patofisiologi, pintasan jantung paru Patophysiology of Cardiopulmonary Bypassphysiologic changes introduced by cardiopulmonary bypass include an alteration in pulsatile, blood flow >pattern, exposure of blood to nonphysiologic surface, blood damage due to shear stress, hemodilution, and overload stress response. The increase of cardiopulmonary bypass safety depends on good knowledge and understanding on normal circulatory hemostatis changes. Circulation control during cardiopulmonary bypass was done by observing systemic blood flow, arterial pressure, venous pressure, and blood< flow distribution. Circulatory changes during cardiopulmonary bypass can happen on set of action, hipotermia periode, rewarming phase, during cardiopulmonary bypass with warm temperature, and also cardiopulmonary bypass can cause changes in microsirculation and adequacy of tissue perfusion.Key words: Effect of cardiopulmonary bypass, pathophysiology, cardiopulmonary bypass DOI: 10.15851/jap.v1n2.125
Akupunktur pada Pasien dengan Efek Samping Obat Pascatindakan Anestesi Spinal Arief Kurniawan; Asep Sekar Ibrahim
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 (694.915 KB) | DOI: 10.15851/jap.v5n3.1165

Abstract

Akupunktur secara luas telah digunakan untuk menginduksi analgesi. Akupunktur dapat digunakan sebagai terapi nyeri, alergi, inflamasi, gangguan metabolik, dan pascastrok. Laporan kasus  ini bertujuan memaparkan manfaat akupunktur sebagai terapi gangguan akibat efek samping obat. Seorang wanita 59 tahun memiliki keluhan  nyeri perut bagian bawah akibat kista ovarium terpuntir. Pasien  alergi terhadap hampir seluruh obat yang pernah diminumnya termasuk antibiotik, analgetik, non steroidal anti inflamatory drugs (NSAID), steroid, dan vitamin. Pasien menjalani kistektomi dengan anestesi spinal menggunakan obat anestetik lokal bupivakain 10 mg di Rumah Sakit Dr. Dustira Cimahi pada 20 Juni 2016. Tiga puluh menit pascabedah pasien mengeluh nyeri di daerah operasi dan muncul efek samping obat dengan keluhan pusing, mual, muka terasa bengkak dan tebal, serta kulit kemerahan seluruh tubuh. Pasien diduga mengalami adverse drug reaction (ADR) akibat bupivakain. Pasien diberi tindakan elektroakupunktur dengan pemasangan jarum akupunktur pada titik insisi, Hegu (LI-4), Neikuan (P-6), Sanyinjiao (SP-6), dan Zusanli (S-36) bilateral dialiri listrik 10 mA pada frekuensi 40 Hz selama 30 menit. Setelah tindakan elektroakupunktur press needle ditempelkan pada titik Hegu sebelah kiri. Keluhan nyeri berangsur menghilang dan akibat efek samping obat tidak dirasakan lagi. Akupunktur dipilih untuk mengatasi nyeri pascaoperasi dan gangguan efek samping obat karena pasien memiliki riwayat alergi obat analgesik dan antialergi. Pada kasus ini akupunktur efektif mengatasi gangguan akibat efek samping obat anestetik lokal pada suntikan spinal. Acupuncture on A Patient with Adverse Drug Reaction after Spinal Anesthesia Acupuncture is widely used to induce analgesia. Acupuncture can be used in the treatment of pain, allergy, inflammation, metabolic disorders, and post-stroke. This case report aimed to describe the benefits of acupuncture as a therapy of adverse reactions to drug. A-59-year woman was presented weith a complaint of lower abdominal pain due to twisted ovarian cyst. She had a history of allergy to almost all drugs i.e. antibiotics, analgesics, non-steroidal anti-inflamatory drugs (NSAIDs), steroids, and vitamins. Patient underwent cystectomy under spinal anesthetic of 10 mg bupivacaine at Dr. Dustira Hospital Cimahi on June 20, 2016. Thirty minutes post-surgery, she started to complain about the pain in the area of the surgery and the signs-symptoms of allergic reactions occurred (dizziness, nausea, swollen and thick feeling of the face, and reddish skin all over the body). Patient was suspected of having adverse drug reactions (ADR) that was most likely the side effects of bupivacaine. She then received electroacupunture to address the postoperative pain and allergic reaction to bupivacaine. Acupuncture needles were placed at the point of incision consisting of Hegu (LI-4), Neikuan (P-6), Sanyinjiao (SP-6), and Zusanli (S-36) bilateral, electrified with 10 mA electricity with a frequency of 40 Hz for 30 minutes. After the electroacupunture was started, the press needle was placed on the left Hegu point. The pain and allergy complaints gradually disappeared. Acupuncture was chosen to treat postoperative pain and adverse drug reactions in this patient because she had a history of allergy to analgesic and anti-allergy drugs. In this particular case, acupuncture has successfully overcome the adverse reactions of local anesthetic drugs in spinal injections.
Perbandingan Penambahan PePerbandingan Penambahan Petidin 0,25 mg/kgBB dengan Klonidin 1 µg/kgBB pada Bupivakain 0,25% untuk Blok Infraorbital pada Labioplasti Anak terhadap Lama Analgesia Pascaoperasi Dewi Ramadani; Iwan Fuadi; Abdul Muthalib Nawawi
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Nyeri pascalabioplasti dapat dicegah dengan blok infraorbital bilateral. Penelitian bertujuan membandingkan lama analgesi blok infraorbital pascalabioplasti anak antara penambahan petidin 0,25 mg/kgBB dan klonidin 1 µg/kgBB pada bupivakain 0,25% menggunakan skala nyeri skor face, leg, activity, cry, consolability (FLACC). Penelitian prospektif, uji klinis acak terkontrol tersamar tunggal dilakukan bulan Maret–September 2013 pada 30 pasien status fisik American Society of Anesthesiologist (ASA) II, usia 3 bulan–1 tahun yang menjalani labioplasti dengan blok infraorbital bilateral di Rumah Sakit Dr. Hasan Sadikin Bandung. Subjek dibagi dua kelompok, masing-masing 15 orang. Kelompok BP menerima blok infraorbital dengan adjuvan petidin dan kelompok BK dengan klonidin. Setelah induksi anestesi, dilakukan blok infraorbital sebanyak 1 mL pada tiap sisi wajah. Analisis data dengan uji t menunjukkan perbedaan lama analgesi pascaoperasi yang sangat bermakna (p<0,01) antara kelompok BP (1.828 menit) dan kelompok BK (1.072 menit). Simpulan penelitian ini adalah penambahan petidin 0,25 mg/kgBB pada bupivakain 0,25% untuk blok infraorbital labioplasti anak memberikan analgesi pascaoperasi lebih lama dibandingkan dengan klonidin 1 µg/kgBB. Kata kunci: Blok infraorbital, bupivakain, klonidin, labioplasti, petidinComparison Addition of  Pethidine 0.25 mg/kgBW  with Clonidine 1 µg/kgBW in Bupivacaine 0.25%  to Infraorbital Block in Paediatric Labioplasty for Duration Post Operative Analgesia Post operative pain for labioplasty can be prevented by bilateral infraorbital block. This study aimed to compare the effectiveness addition of pethidine 0.25 mg/kgBW and clonidine 1 µg/kgBW to bupivacaine 0.25%  for postoperative analgesia using infraorbital block in paediatric labioplasty with a pain scale score face, leg, activity, cry, consolability (FLACC). The study was a single-blind randomized controlled trial from March to September 2013 involving  30 pediatric patients, physical status American Society of Anesthesiologist (ASA) II, ages 3 months–1 year for labioplasty surgery with bilateral infraorbital block  at  Dr. Hasan Sadikin Hospital  Bandung. Subjects were grouped into two groups: 15 subjects using adjuvant pethidine 0.25 mg/kgBW (BP) and 15 subjects using adjuvant clonidine 1 ug/kgBW (BK). After induction of anesthesia, infraorbital block done 1 mL on each side of the face. Data were analyzed by t test, showed a highly significant difference (p<0.01) in BP group compared with BK, the average length of postoperative analgesia 1.828 minutes (30 hours) vs 1072 minutes (18 hours). The conclusions is the addition of pethidine 0.25 mg/kgBW in bupivacaine 0.25%  to infraorbital block in paediatric labioplasty provide postoperative analgesia longer than of clonidine 1 µg/kgBW.Key words: Bupivacaine, clonidine, infraorbital block, labioplasty, pethidine DOI: 10.15851/jap.v2n2.302
Sindrom Burnout pada Peserta Program Pendidikan Dokter Spesialis Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran Dessy Sutoyo; Rudi Kurniadi Kadarsah; Iwan Fuadi
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 (68.207 KB) | DOI: 10.15851/jap.v6n3.1360

Abstract

Sindrom burnout didefinisikan sebagai kelelahan kronik yang mencakup tiga komponen, yaitu kelelahan emosional, depersonalisasi, dan berkurangnya kepuasan terhadap pencapaian pribadi. Peserta Program Pendidikan Dokter Spesialis (PPDS) berisiko tinggi mengalami kelelahan dan sindrom burnout akibat beban kerja yang tinggi yang dihadapi baik dalam hal melakukan pelayanan dalam bidang anestesi dan beban dalam pendidikannya. Penelitian ini bertujuan mengetahui angka kejadian sindrom burnout pada peserta PPDS Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran (FK Unpad). Penelitian ini menggunakan metode deskriptif dan pendekatan kuesioner yang dilakukan pada peserta PPDS Anestesiologi dan Terapi Intensif FK Unpad yang masih aktif dan memberikan pelayanan di Rumah Sakit Umum Pusat (RSUP) Dr. Hasan Sadikin Bandung pada bulan April 2018 sebanyak 89 orang. Dilakukan penilaian menggunakan kuesioner yang mencakup data demografik, pendidikan dan pekerjaan, pencapaian prestasi pribadi, serta maslach burnout inventory yang sudah diterjemahkan. Hasil penelitian didapatkan angka kejadian sindrom burnout pada peserta PPDS Anestesiologi dan Terapi Intensif FK Unpad adalah 44%. Simpulan penelitian ini adalah angka kejadian sindrom burnout pada peserta PPDS Anestesiologi dan Terapi Intensif FK Unpad cukup tinggi, yaitu 44%.  Kata kunci: Depersonalisasi, kelelahan emosional, maslach burnout inventory, peserta PPDS Anestesiologi dan Terapi Intensif, sindrom burnoutBurnout Syndrome among Anesthesiology Residents in Universitas PadjadjaranBurnout syndrome is defined as chronic exhaustion that is characterized by emotional exhaustion, depersonalization, and a sense of low professional accomplishment. The main component of this syndrome is emotional exhaustion. Residents who are being trained in anesthesiology and intensive therapy  department have s high risk to exhaustion that will lead to burnout syndrome due to stressful environment and high work load in both medical service and medical education. The purpose of this study was to assess the incidence of burnout syndrome among residents in Anesthesiology and Intensive Therapy Department, Faculty of Medicine, Universitas Padjadjaran. This was a cross-sectional descriptive study on 89 residents that was performed in April 2018. Assessment was performed using a questionnaire on demographic, education, personal achievement, and medical service data as well as the translated Maslach Burnout Inventory to reveal the incidence of burnout syndrome among residents of Anesthesiology and Intensive therapy department, faculty of medicine, Universitas Padjadjaran. From the analysis, it was discovered that 44% of the residents experienced burned out syndrom. In conclusion, the incident of burn out syndrome among residents of Anesthesiology and Intensive Therapy Department, Faculty of Medicine, Universitas Padjadjaran is high. Key words: Anesthesiology and intensive care residents, burnout syndrome, depersonalization, emotional exhaustion, Maslach burnout inventory
Perbandingan Klonidin 0,5 mg/kgBB Intravena dengan Tramadol 0,5 mg/kgBB Intravena Sebagai Profilaksis Kejadian Menggigil Pascaanestesia Spinal pada Seksio Sesarea Lira Panduwaty; - Suwarman; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Menggigil merupakan  komplikasi  yang sering terjadi pascaanestesi spinal, akibat gangguan kontrol termoregulasi. Klonidin merupakan agonis adrenergik α2 yang memiliki efek antihipertensi, analgetik, sedasi, dan antimenggigil. Tujuan penelitian ini untuk menilai perbandingan klonidin 0,5 μg/kgBB dengan tramadol 0,5 mg/kgBB dalam menurunkan kejadian menggigil pada pasien yang menjalani seksio sesarea dengan anestesi spinal. Metode  penelitian adalah uji klinis acak  terkontrol tersamar ganda pada 58 pasien yang menjalani operasi seksio sesarea di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Januari−April 2014, usia 18−45 tahun, status fisik menurut American Society of Anesthesiologist (ASA) II dan dibagi secara acak menjadi 2 kelompok, yaitu kelompok yang menerima klonidin 0,5 μg/kgBB intravena dan  kelompok  tramadol 0,5 mg/kgBB intravena sebelum dilakukan anestesi spinal dengan bupivakain 12,5 mg. Analisis statistik menggunakan uji-t, uji chi-kuadrat, dan Uji Eksak Fisher. Hasil penelitian menunjukkan kejadian menggigil pada kelompok klonidin lebih sedikit bila dibandingkan dengan kelompok tramadol, baik di kamar operasi (3,44% vs 10,34%) maupun di ruang pemulihan (3,44% vs 17,24%). Simpulan dari penelitian ini  menunjukkan  bahwa  pemberian klonidin 0,5 μg/kgBB intravena sebelum anestesi spinal pada seksio sesarea mengurangi kejadian menggigil dan efek samping.Kata kunci: Klonidin, menggigil, pascaanestesi spinal, tramadol Comparison of Intravenous 0.5 mg/kgBW Clonidine Intravenous and 0.5 mg/kgBW Tramadol as Post Spinal Anesthesia Shivering Prophylactic Agent in Caesarean SectionAbstract Shivering, as a result of impaired thermoregulatory control, is known as a frequent complication of post-spinal anesthesia. Clonidine is an α2-adrenergic agonist that has anti-hypertensive, analgesic, sedation and anti-shivering effects. The purpose of this study is to compare the use of  0.5 μg/kgBW clonidine with 0.5 mg/kgBW tramadol in reducing the incidence of shivering in patients undergoing cesarean section with spinal anesthesia. The method applied was the double-blind randomized controlled clinical trial in 58 patients undergoing caesarean surgery at the Dr. Hasan Sadikin General Hospital Bandung in the period of January−April 2014, age 18−45 years, American Society of Anesthesiologist (ASA) physical status II, and divided into two groups; a group receiving 5 μg/kgBW intravenous clonidine and a group receiving 0.5 mg/kgBW intravenously tramadol prior to spinal anesthesia with bupivacaine 12.5 mg. The statistical analyses used were the t test, chi-square test and Fisher’s Exact test. The incidence of shivering were less in the clonidine group compared to the tramadol group in operating theatre (3.44% vs 10.34) and recovery room (3.44% vs 17.24%). The conclusion of this study showed that the administration of 0.5 μg/kgBW clonidine intravenously before spinal anesthesia for cesarean section reduces the incidence of shivering and side effects.Keywords: Clonidine, post spinal anesthesia, shivering, tramadol DOI: 10.15851/jap.v3n1.378  
Perbandingan Kombinasi Bupivakain 0,5% Hiperbarik dan Fentanil dengan Bupivakain 0,5% Isobarik dan Fentanil terhadap Kejadian Hipotensi dan Tinggi Blokade Sensorik pada Seksio Sesarea dengan Anestesi Spinal Ahmado Okatria; Ezra Oktaliansah; Tatang Bisri
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Anestesi spinal mejadi teknik pilihan untuk seksio sesarea karena lebih aman dan efisien dibanding dengan anestesi umum. Anestesi spinal pada wanita hamil menyebabkan hipotensi lebih berat dan cepat. Hipotensi berhubungan dengan ketinggian blokade simpatis yang dipengaruhi oleh barisitas anestetik lokal. Tujuan penelitian ini adalah membandingkan kejadian hipotensi dengan tinggi blokade sensorik antara kombinasi bupivakain 0,5% hiperbarik 12,5 mg dan fentanil 25 µg dengan bupivakain 0,5% isobarik 12,5 mg-fentanil 25 µg pada anestesi spinal untuk seksio sesarea. Penelitian dilakukan di Central Operating Theatre (COT) Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan April‒Mei 2015 dengan uji klinis acak tersamar ganda terhadap 40 pasien yang menjalani seksio sesarea dengan status fisik American Society of Anesthesiologist (ASA) II. Kejadian hipotensi dan tinggi blokade sensorik dinilai setelah pemberian anestesi spinal. Data penelitian dianalisis menggunakan uji-t, Mann-Whitney, dan chi-kuadrat. Hasil penelitian bermakna jika nilai p<0,05. Kejadian hipotensi antara kelompok hiperbarik dan isobarik adalah 75% vs 100% (p=0,017). Tinggi blokade sensorik rata-rata antara kedua kelompok di T6 vs T4 (p=0,000). Kejadian hipotensi dan blokade sensorik lebih tinggi pada kombinasi bupivakain 0,5% isobarik 12,5 mg dan fentanil 25 µg dibanding dengan bupivakain 0,5% hiperbarik 12,5 mg dan fentanil 25 µg.Kata kunci: Anestesi spinal, bupivakain hiperbarik, bupivakain isobarik, seksio sesareaComparison between Combination of Hyperbaric 0.5% Bupivacain with Fentanyl and 0.5% Isobaric Bupivacain with Fentanyl Use on Incidence of Hypotension and Sensoric Blockade Level in Caesarian Section with Spinal AnesthesiaSpinal anesthesia technic has been the technic of choice for caesarean section due to its safety and efficiency compared to general anesthesia. Spinal anesthesia in pregnancy causes hypotension in a heavier and more rapid manner. Hypotension is associated with the height of the sympathetic block influenced by the baricity of the local anesthetics. This study aimed to compare hypotension incidence and sensory blockade height between combination of 12.5 mg 0.5% hyperbaric bupivacaine with 25 µg fentanyl and 12.5 mg 0.5% isobaric bupivacaine with fentanyl 25 µg in spinal anesthesia for caesarean section. The study was performed at the central operating theatre (COT) of Dr. Hasan Sadikin General Hospital during April‒May 2015 using double blind randomized control trial method on 40 patients underwent caesarean section with American Society of Anesthesiologist (ASA) II physical status. The hypotension incidence and sensory blockade height were assessed after spinal anesthesia and measured by t-test, Mann Whitney, and Chi-square tests. Significancy was declared when p value <0.05. The hypotension incidence between the hyperbaric and isobaric groups were 75% vs. 100% (p value=0.017). The mean sensory blockade height was at T6 vs. T4 (p value=0.000). The hypotension incidence and sensory blockade are significantly higher in isobaric 12.5 mg 0.5% bupivacainewith 25 µg fentanyl compared to those in 12.5 mg hyperbaric 0.5% bupivacaine with fentanyl 25 µg.Key words: Caesarean section, hyperbaric bupivacaine, isobaric bupivacaine, spinal anesthesia  DOI: 10.15851/jap.v4n2.820
Angka Mortalitas dan Faktor yang Memengaruhi pada Pasien Trakeoesofageal Fistula (TEF) yang Menjalani Operasi di RSUP Dr. Hasan Sadikin Bandung Unang Sunarya; Ezra Oktaliansah; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (697.967 KB) | DOI: 10.15851/jap.v5n2.1111

Abstract

Trakeoesofageal fistula (TEF) merupakan kelainan esofagus yang bersifat kongenital ditandai dengan fistula antara trakea dan esofagus yang merupakan koneksi abnormal yang dapat disertai putusnya antara distal dan proksimal esofagus. Insidensi TEF kongenital mencapai 1:2.400‒4.500 kelahiran hidup. Tujuan penelitian ini mengetahui angka mortalitas dan faktor yang memengaruhi pada pasien TEF yang menjalani operasi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2010–2015. Metode penelitian ini bersifat deskriptif yang dilakukan secara retrospektif terhadap 35 rekam medik pasien TEF yang menjalani operasi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2010‒2015. Hasil penelitian ini menunjukkan angka mortalitas pascaoperasi pasien TEF sebesar 19 dari 34 dan mortalitas tertinggi terjadi pada perempuan 7 dari 12, bayi lahir lahir prematur 5 dari 5, berat badan lahir kurang dari 1.500 gram 1 dari 1, TEF tipe C 19 dari 32, riwayat persalinan di bidan/puskesmas 9 dari 11, disertai kelainan kongenital penyerta selain kelainan anorektal, usia saat operasi lebih dari 7 hari 15 dari 17, penyulit preoperatif lebih dari satu, lama operasi lebih dari 3 jam, tidak dilakukan ekstubasi 15 dari 20, kenaikan berat badan lebih dari 10% 14 dari 18, leakage pascaoperasi dan faktor penyulit pascaoperasi lebih dari satu. Simpulan Angka mortalitas pasien TEF yang menjalani operasi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2010–2015 sebanyak 54,3%. Kata kunci: Mortalitas pascaoperasi, operasi, trakeoesofageal fistula Mortality and The Influencing Factors of Trakeoesofageal Fistula (TEF)Patients which Operated in Dr. Hasan Sadikin General Hospital BandungTracheoesophageal fistula (TEF) is a disorder of the esophagus that is characterized by congenital fistula between the trachea and esophagus wich is an abnormal connection that can be accompanied by a break between the distal and proximal esophagus. The incidence of congenital TEF reached 1:2,400‒4,500 live births. The purpose of this study to determine mortality and factors affecting mortality in patients TEF in Dr. Hasan Sadikin General Hospital Bandung in 2010‒2015. This research method was descriptive retrospectively of 35 patients taken from the medical records underwent surgery TEF in Dr. Hasan Sadikin Central Hospital Bandung in 2010‒2015. Results of this study showed a mortality rate of postoperative patients TEF rate of 19 from 34 and the highest mortality among women 7 from 12, premature birth, birth weigth less than 1,500 g, TEF type C 19 from 36, childbirth history at the midwife 9 from 11, congenital abnormalities other than anorectal disease, age at surgery of more than 7 days 15 from 17, preoperative complications more than one, the operating time of more than 3 hours, do not extubation 15 from 20, weight gain more than 10% 14 from 18, the leakage postoperative and more than one complications postoperative factors. In conclusion, mortality of trakeoesofageal fistula (TEF) patients which operated in Dr. Hasan Sadikin General Hospital Bandung in 2010–2015 was 54.3%.Key words: Postoperative mortality, operatif, tracheoesophageal fistula
Perbandingan Pengaruh Premedikasi per Rektal antara Klonidin 5 μg/ kgBB dan Ketamin 10 mg/kgBB pada Anak Usia 2–5 Tahun pada Skala Pemisahan Prabedah dan Skala Kemudahan Induksi Mira Rellytania Sabirin; Ezra Oktaliansah; Ike Sri Redjeki
Jurnal Anestesi Perioperatif Vol 2, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Premedikasi pada anak berguna untuk menurunkan kecemasan prabedah dan memudahkan induksi. Penelitian ini bertujuan untuk mengetahui efektivitas klonidin 5 µg/kgBB dibandingkan dengan ketamin 10 mg/kgBB per rektal sebagai premedikasi pada anak. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada November 2011–Februari 2012 menggunakan uji klinis terkontrol samar buta ganda pada 32 pasien pediatrik usia 2–5 tahun yang akan menjalani operasi elektif dan mendapatkan klonidin 5 µg/kgBB atau ketamin 10 mg/kgBB per rektal 45 menit sebelum induksi anestesi. Kualitas skala pemisahan dari orangtua dan skala kemudahan induksi saat pemasangan sungkup muka selama pemberian inhalasi isofluran dianalisis memakai Uji Mann-Whitney dengan tingkat kepercayaan 95%, dianggap bermakna bila p<0,05. Klonidin 5 µg/kgBB memberikan kualitas yang efektif dan baik dalam hal pemisahan dan penerimaan pemasangan sungkup saat induksi dibandingkan dengan ketamin 10 mg/kgBB dengan perbedaan bermakna (p<0,001). Data ini menunjukkan bahwa klonidin 5 µg/kg rektal merupakan pilihan obat premedikasi alternatif yang efektif dan aman untuk diberikan kepada pasien pediatrik.Kata kunci: Klonidin rektal, ketamin rektal, premedikasi, skala kemudahan induksi, skala pemisahanComparison Between Premedication using Clonidine 5 μg/kgBW and Ketamine 10 mg/kgBW per Rectal in Children Aged 2–5 Years to Preoperative Separation Scale and Acceptance of Mask for Induction ScalePremedication in children is used to reduce pre operative anxiety and to facilitate induction. This study was designed to investigate the efficacy of rectal clonidine 5 µg/kgBW in comparison with rectal ketamine 10 mg/kgBW as a premedication in children. The study was conducted at Dr. Hasan Sadikin Hospital Bandung during the period November 2011–February 2012 with a double-blind randomized clinical controlled trials on 32 paediatric patients aged 2–5 years undergoing elective surgery and received either clonidine 5 µg/kgBW or ketamine 10 mg/kgBW rectally 45 min before induction of anesthesia. The quality of separation scale from the parent and the acceptance of mask for induction scale application during inhalation isoflurane were analyzed using Mann Whitney Test with 95% confidence interval, p value <0.05 is considered as statistically significant. Clonidine 5 µg/kgBW provide effective and good qualities of separation and acceptance of mask for induction compared to ketamine 10 mg/kgBW. These data indicate that rectal clonidine 5 µg/kgBW is effective and safe as an alternative drug for premedication in paediatric patients.Key words: Acceptance of mask for induction scale, clonidine, premedication, rectal, separation scale DOI: 10.15851/jap.v2n1.230

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