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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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Efektivitas oksigenasi dan ventilasi saat induksi anestesi umum menggunakan masker bedah dinilai berdasarkan SpO2 dan EtCO2 Linggih Panji Nugraha; Ezra Oktaliansah; Ricky Aditya
Jurnal Anestesi Perioperatif Vol 9, No 2 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n2.2401

Abstract

Anestesiolog memiliki risiko tinggi terpapar aerosol pada saat melakukan tindakan ventilasi maupun intubasi. Anestesiolog harus dapat melakukan ventilasi dengan baik selama induksi anestesi umum. Tujuan penelitian ini adalah mengetahui efektivitas oksigenasi dan ventilasi saat induksi anestesi umum pada pasien yang menggunakan masker bedah dinilai berdasar atas SpO2 dan EtCO2. Penelitian ini merupakan penelitian analisis numerik berpasangan dengan rancangan eksperimental pada pasien yang dilakukan operasi elektif dengan anestesi umum di Instalasi Bedah Sentral RSUP Dr. Hasan Sadikin Bandung pada bulan November–Desember 2020. Selama induksi anestesi, pasien menggunakan masker bedah kemudian dilakukan penilaian SpO2 dan EtCO2 pada saat sebelum induksi dan selama induksi menit ke-1, 2, dan 3. Hasil penelitian mengungkapkan nilai SpO2 dan EtCO2  preinduksi dan pada menit ke-1, 2, dan 3 diperoleh nilai rerata SpO2 dan EtCO2 induksi menit ke-1, ke-2, dan ke-3 tidak lebih inferior dibanding dengan nilai pra induksi (p<0,05) dengan nilai rerata SpO2 dan EtCO2 dalam batas normal.Simpulan penelitian adalah penggunaan masker bedah selama induksi tidak mengurangi efektivitas oksigenasi dan ventilasipada pasien yang dilakukan anestesi umum dinilai berdasar atas SpO2 dan EtCO2. Effectiveness of Oxygenation and Ventilation During General Anesthesia Induction Using Surgical Mask Assessed by SpO2 and EtCO2 Anesthesiologist have high risk for exposure of aerosol during ventilation or intubation. They must do ventilation during induction of general anesthesia effectively. The study was aimed to know how effective the oxygenation and ventilation during induction of general anesthesia while using surgical mask assessed by SpO2 and EtCO2. The research was a numerical analytic with experimental design performed on elective surgery patients done by general anesthesia in central operating theatre Dr. Hasan Sadikin General Hospital Bandung in November–December 2020. During induction of anesthesia, patient were using surgical mask and assessment of SpO2 and EtCO2 was done before induction and during induction in the 1st, 2nd, and 3rd minute induction. The result of the study revealed SpO2 and EtCO2  preinduction and 1st, 2nd, and 3rd minute induction had SpO2 and EtCO2 value in 1st, 2nd, and 3rd minute induction not inferior to pre induction value, with SpO2 and EtCO2 value within normal limit.The study has concluded that using surgical mask during induction does not decrease the effectiveness of oxygenation and ventilation in patient with general anesthesia assessed by SpO2 and EtCO2.
perbandingan excessive daytime sleepiness dengan normal daytime sleepiness terhadap fungsi kognitif serta waktu reaksi peserta ppds anestesiologi dan terapi intensif Army Zaka Anwary; Iwan Fuadi; Ardi Zulfariansyah
Jurnal Anestesi Perioperatif Vol 9, No 2 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n2.2391

Abstract

Excessive daytime sleepiness (EDS) adalah ketidakmampuan untuk tetap terjaga pada siang hari yang menghasilkan rasa kantuk berlebih dan tertidur pada waktu yang tidak tepat. Prevalensi EDS yang tinggi ditemukan pada tenaga medis seperti peserta Program Pendidikan Dokter Spesialis (PPDS) Anestesiologi dan Terapi Intensif. Kondisi EDS dapat memengaruhi fungsi kognitif dan waktu reaksi. Tujuan penelitian ini adalah  membandingkan EDS dengan normal daytime sleepiness (NDS) terhadap fungsi kognitif serta waktu reaksi peserta PPDS Anestesiologi. Penelitian ini merupakan penelitian analitik komparatif numerik dengan rancangan potong lintang yang dilakukan pada peserta PPDS Anestesiologi Fakultas Kedokteran Universitas Padjadjaran di bulan November 2020. Seluruh PPDS Anestesiologi mengisi kuisioner Epworth Sleepiness Scale (ESS) agar terbagi menjadi dua kelompok, kelompok EDS (n=23) dan kelompok NDS (n=23). Fungsi kognitif diukur menggunakan tes Montreal Cognitive Assessment versi Bahasa Indonesia dan waktu reaksi menggunakan perangkat lunak Personal Computer-Psychomotor Vigilance Task. Hasil penelitian menunjukkan fungsi kognitif lebih rendah pada kelompok EDS (26,74±1,096) dibanding dengan kelompok NDS (28,65±1,191) dan waktu reaksi lebih lambat pada kelompok EDS (337,38±62,021) dibanding dengan kelompok NDS (298,81±34,225). Simpulan penelitian adalah peserta PPDS Anestesiologi kelompok EDS memiliki fungsi kognitif lebih rendah dan waktu reaksi lebih lambat dibanding dengan peserta PPDS Anestesiologi kelompok NDS. Comparison between Excessive Daytime Sleepiness and Normal Daytime Sleepiness on Cognitive Function and Reaction Time of Anesthesiology and Intensive Care Residents Excessive daytime sleepiness (EDS) is the inability to stay alert during the day due to sleepiness during daytime, often associated with the tendency of falling asleep during inappropriate times. High prevalence of EDS was found among medical workers, such as anesthesiology residents. The condition is associated with increased secretion of cathecholamines, cortisol, and inflammatory mediators that may affect the prefrontal cortex, area of the brain that acts as a center for cognitive function and reaction time. The study aimed to compare EDS with normal daytime sleepiness (NDS) on cognitive function and reaction time of anesthesiology residents. The research was a numerical comparative analytic study with a cross-sectional design performed on anesthesiology residents of Faculty of Medicine Universitas Padjadjaran in November 2020. All residents in the department were instructed to complete the Epworth Sleepiness Scale (ESS) questionnaire. After completion, the respondents were randomized using simple random sampling into two groups: the EDS group (n=23) and NDS group (n=23). Each group was assessed for cognitive function using the Indonesian version of the Montreal Cognitive Assessment and reaction time using the Personal Computer-Psychomotor Vigilance Task software. Lower cognitive function scores were found in EDS group (26.74±1.096) compared to NDS group (28.65±1.191); slower reaction time were found in EDS group (337.38±62.021) compared to NDS group (298,81±34.225). Both variables had shown significant differences between both groups  (p<0.05). The study had concluded that anesthesiology residents with EDS have lower cognitive scores and slower reaction time compared to anesthesiology residents with NDS.     
A Case Series of COVID-19 with Severe ARDS and Comorbidities who Survived without Invasive Mechanical Ventilation in ICU at Wisma Atlet Kemayoran COVID-19 Field Hospital, Jakarta Made Yudha Asrithari Dewi; Ahmad Irfan
Jurnal Anestesi Perioperatif Vol 9, No 2 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n2.2457

Abstract

Sebagian besar orang yang terinfeksi COVID-19 asimtomatis ataupun bergejala ringan. Namun tidak sedikit juga yang mengalami acute respiratory distress syndrome (ARDS), membutuhkan perawatan ICU bahkan berakhir dengan kematian. Indonesia bahkan telah melampaui angka dunia dengan angka 2,7%. Keadaan ini lebih berisiko dialami oleh pasien dengan komorbid seperti hipertensi (50,1%), diabetes (36,6%), dan obesitas (13,3%). Kebutuhan terapi oksigen dengan ventilasi mekanik hingga tindakan intubasi meningkat pada kebanyakan kasus dengan komorbid. Serial kasus ini melaporkan dua pasien terkonfirmasi COVID-19 dengan komorbid yang memenuhi kriteria intubasi, namun tidak dilakukan. Dalam perjalanannya kedua kasus mengalami perbaikan klinis dan sembuh. Beberapa kemungkinan yang dapat dijelaskan, yaitu terdapat perbedaan antara ARDS pada COVID-19 (CARDS) dan ARDS klasik. Selain itu, prone position yang membantu meningkatkan oksigenasi dan mengatasi hipoksemia melalui beberapa mekanisme. Penggunaan HFNC dini pada pasien COVID-19 dan pemberian regimen kombinasi terapi antibiotik, antivirus, antikoagulan, serta antiinflamasi dinilai dapat menurunkan morbiditas pasien. Tujuan penanganan ARDS ialah menangani hipoksemia dengan meningkatkan oksigenasi. Selain dengan pemberian terapi oksigen untuk meningkatkan FiO2, dapat juga dilakukan dengan prone position. Prone position pada kasus dengan kombinasi HFNC dinilai berhasil karena pasien mampu bertahan tanpa penggunaan ventilasi mekanik dan mengalami perbaikan klinis hingga sembuh. Two Reported Cases of COVID-19 with Severe ARDS and Comorbidities who Survived without Invasive Mechanical Ventilation in ICU at Wisma Atlet Kemayoran COVID-19 Field Hospital, JakartaMost patients with COVID-19 are either asymptomatic or have mild symptoms. However, many also experience acute respiratory distress syndrome (ARDS), requiring ICU, or even lead to death. Indonesia’s case fatality rate of 2.7% has exceeded the global case. Patients with comorbidities such as hypertension (50.1%), diabetes (36.6%), and obesity (13.3%) are at higher risk of experiencing this situation. The need for oxygen therapy with mechanical ventilation or even intubation is increased in most cases with previously mentioned comorbidities. These serial cases reported two confirmed COVID-19 patients with comorbidities that fulfilled intubation criteria; however, the intubation procedures were not performed. Both cases experienced clinical improvement and improved throughout the treatment period. Several possible explanations include that there are differences between ARDS in COVID-19 (CARDS) and classic ARDS. Moreover, the prone position helps in increasing oxygenation and reducing hypoxemia through several mechanisms. Early HFNC in COVID-19 patients and treatment regimen consisting of antibiotics, antivirus, anticoagulant, and anti-inflammatory drugs are considered to reduce morbidity. The goal of ARDS treatment is to treat hypoxemia by increasing oxygenation. In addition, giving oxygen therapy to increase FiO2 can also be done by prone positioning. Combining prone position and HFNC in these cases was considered successful because the patient were able to survive without the use of mechanical ventilation and experienced clinical improvement until they recovered.
gambaran prokalsitonin, skor sofa dan rasionalitas pemberian antibiotik pada pasien luka bakar berat di rsup hasan sadikin Kurnia Ricky Ananta; Erwin Pradian; Nurita Dian Kestriani
Jurnal Anestesi Perioperatif Vol 9, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n3.2579

Abstract

Sepsis masih menjadi penyebab utama kematian pada luka bakar berat karena dampak luka bakar yang luas pada sistem organ. Prokalsitonin dan skor sequential organ failure assessment (SOFA) memiliki kemampuan yang sama dalam menilai prognosis pada pasien sepsis untuk indikator mortalitas, terapi yang lebih awal dan mengevaluasi terapi yang diberikan, agar angka mortalitas dapat menurun. Penggunaan antibiotik yang tepat dan akurat juga dapat dianggap sebagai faktor penting dalam meningkatkan prognosis. Tujuan penelitian ini melihat gambaran prokalsitonin, skor SOFA, dan rasionalitas pemberian antibiotik pada pasien luka bakar berat di RSUP Dr Hasan Sadikin Bandung. Penelitian ini merupakan penelitian observasional analitik yang dilakukan pada 38 pasien yang dirawat di ULB dan ICU RSUP Dr. Hasan Sadikin Bandung Februari–Agustus 2021. Penelitian ini diperoleh hasil bahwa nilai prokalsitonin yang didukung skor SOFA dapat dijadikan acuan untuk mempertimbangkan keberhasilan pemberian antibiotik dan penghentian antibiotik pada pasien luka bakar berat. Pemberian antibiotik pada seluruh pasien luka bakar berat di RSUP Dr. Hasan Sadikin tidak rasional dikarenakan tidak didasari pemeriksaan kultur dan prokalsitonin pada hari pertama pasien terpapar. Pemberian antibiotik profilaksis secara rasional harus didukung oleh tanda-tanda infeksi yang jelas dilihat dari nilai prokalsitonin, skor SOFA, dan kultur untuk menghindari resistensi antibiotikOverview of Procalcitonin, SOFA Score, and Rationality of Antibiotics Administration to Patients with Severe Burns at Dr. Hasan Sadikin General Hospital Bandung, February–August 2021Sepsis is currently the leading cause of death in severe burns due to its wide-ranging effects on organ systems. Procalcitonin and sequential organ failure assessment (SOFA) scores can determine the prognosis of septic patients in terms of mortality indicators, early therapy, and evaluation of the therapy given to reduce mortality and morbidity. Correct and accurate use of antibiotics is also essential in improving the patient's prognosis. This study aimed to determine the procalcitonin, SOFA scores, and the rationality of antibiotics administration to patients with severe burns at Dr. Hasan Sadikin General Hospital Bandung. This analytic observational study was conducted on 38 patients hospitalized in the Burn Unit and ICU of Dr. Hasan Sadikin General Hospital Bandung during February–August in 2021. Procalcitonin values supported by SOFA scores may refer to successful antibiotic administration and ceasing therapy in severe burn injury patients. Antibiotic administration to all patients with severe burns in Dr. Hasan Sadikin General Hospital was irrational as it was not based on cultural examination and procalcitonin on the first day of exposure. Clear signs of infection seen from the procalcitonin value, SOFA score, and culture to avoid antibiotic resistance must support rational prophylactic antibiotic administration.
Perbandingan Efektivitas antara Ketamin Kumur dengan Lidokain Spray untuk Mengurangi Nyeri Tenggorok Paska Ekstubasi Purwoko Purwoko; Muhammad Husni Thamrin; Wahyu Hananto
Jurnal Anestesi Perioperatif Vol 9, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n3.2464

Abstract

Nyeri tenggorok adalah komplikasi yang sering dikeluhkan pasien setelah penggunaan pipa endotrakeal pada tindakan anestesi umum. Kejadian nyeri tenggorok dapat dikurangi dengan pemberian agen analgetik. Tujuan penelitian ini mengetahui perbedaan efektivitas antara ketamin kumur dan lidokain spray untuk mengurangi nyeri tenggorok pascaekstubasi. Penelitian dilakukan di Instalasi Bedah Pusat dan kamar rawat inap RSUD Dr. Moewardi Surakarta, dimulai pada bulan Februari–Maret 2018. Penelitian ini bersifat eksperimental dengan double blind randomized control trial pada pasien yang dilakukan anestesi umum dan dipasang pipa endotrakea. Uji Mann Whitney U digunakan untuk mengolah data. Kelompok penelitian dibagi menjadi dua, yaitu kelompok ketamin kumur (I) dan lidokain spray (II). Ketamin kumur lebih efektif mengurangi nyeri tenggorokan, batuk, dan suara serak dibanding dengan lidokain spray mulai 1 jam pascaoperasi dan 6 jam pascaoperasi (p<0,05), sedangkan pada 24 jam pascaoperasi lidokain spray memiliki efektivitas yang hampir sama dengan ketamin kumur.A Comparative Study on Effectiveness of Ketamine Gargle and Lidocaine Spray for Reducing Sore Throat, Cough, and Hoarseness Post-ExtubationShore throat is a common complication of endotracheal tube placement under general anesthesia. Administering analgesic agents can reduce the incidence of shore throat. The study aimed to determine the difference in effectiveness between ketamine gargle and lidocaine spray to reduce post-extubation sore throat. The study was conducted at the Central Surgical Installation and Inpatient wards of Dr. Moewardi General Hospital Surakarta in February–March 2018. This experimental study used a double-blind, randomized control trial in patients undergoing general anesthesia with endotracheal tube placement. The Mann-Whitney U test was used to process the data. The research group was divided into ketamine gargle (I) and lidocaine spray (II). Ketamine gargle was more effective in reducing sore throat, cough, and hoarseness than lidocaine spray starting 1 hour postoperatively and 6 hours postoperatively (p<0.05). In contrast, at 24 hours, postoperative lidocaine spray was nearly as effective as ketamine gargle.
Blokade Peribulbar pada Geriatri dengan Hipertensi Tidak Terkontrol yang Mengalami Cedera Bola Mata Terbuka Kirby Saputra; Dedi Fitri Yadi; Muhamad Adli
Jurnal Anestesi Perioperatif Vol 9, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n3.2589

Abstract

Cedera bola mata terbuka merupakan kegawatdaruratan pada bedah mata dan memerlukan intervensi segera. Faktor risiko pasien geriatri dengan hipertensi tidak terkontrol pada kasus trauma terbuka bola mata dengan ancaman kebutaan menjadikan tantangan tersendiri dalam penatalaksanaan anestesi. Seorang laki-laki berusia 71 tahun dengan komorbid hipertensi yang tidak terkontrol datang ke IGD Pusat Mata Nasional RS Mata Cicendo dengan cedera bola mata terbuka akibat terkena serpihan kerikil. Pasien dilakukan pembedahan eksplorasi mata emergensi, memakai teknik anestesi blokade peribulbar dengan sedasi ringan. Penyuntikan peribulbar dilakukan pada inferotemporal dan kantus medius dengan campuran levobupivakain 0,5% dan lidokain 2%. Hemodinamik intraoperatif stabil dan skala nyeri pascaoperatif skala nyeri yang minimal. Anestesi blokade peribulbar dengan sedasi dapat menjadi pilihan untuk prosedur trauma mata terbuka pada pasien geriatri dengan penyakit penyerta hipertensi.Peribulbar Blockade in Geriatrics with Uncontrolled Hypertension with Open Eyeball Injury An open eye injury is an emergency in ophthalmic surgery and requires immediate intervention. In cases of open eye trauma with the threat of blindness, risk factors for geriatric patients with uncontrolled hypertension make it a challenge in managing anesthesia. A 71-year-old man with comorbid uncontrolled hypertension came to the ER at the National Eye Center of Cicendo Eye Hospital with an open eye injury due to being hit by gravel debris. The patient underwent emergency eye exploratory surgery with peribulbar block anesthesia technique with light sedation. Peribulbar block injection approach is inferotemporal and medial canthus using a 50:50 mixture of 0.5% levobupivacaine and 2% lidocaine. Intraoperative hemodynamics were stable and with a minimal postoperative pain scale. Peribulbar block anesthesia with sedation may be an option for open eye trauma procedures in geriatric patients with comorbid hypertension.
Perbedaan Efektivitas Iodine Povidone 1% dan Listerine® sebagai Preparat Perawatan Mulut terhadap Pencegahan Ventilator Associated Pneumonia Ardana Tri Arianto; Bambang Novianto Putro; Indra Chuandy
Jurnal Anestesi Perioperatif Vol 9, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n3.2434

Abstract

Perawatan mulut merupakan salah satu cara mencegah ventilator associated pneumonia (VAP) pada pasien yang menggunakan ventilasi mekanik. Penelitian ini bertujuan mengetahui prevalensi VAP dan efektivitas preparat antiseptik pada perawatan mulut pasien terintubasi terhadap pencegahan VAP. Penelitian menggunakan uji klinis acak tersamar tunggal pada 36 pasien dengan ventilasi mekanik pasien yang dirawat di ICU RS Dr. Moewardi bulan Februari–Mei 2017. Sampel dibagi menjadi 2 kelompok, yaitu kelompok iodine povidone 1% dan Listerine®. Awalnya dilakukan penilaian kebersihan mulut dengan simplified oral hygiene index. Setelahnya, dilakukan perawatan mulut menggunakan salah satu preparat. Setelah 48 jam, dilakukan penilaian ulang kebersihan mulut dan skor clinical pulmonary indicator score (CPIS). Timbul VAP bila skor CPIS ≥6. Data dianalisis dengan uji Mann Whitney dan independetn t-test. Kelompok iodine povidone 1% memiliki perubahan skor kebersihan mulut dengan selisih yang lebih kecil (0,195) dibanding dengan Listerine® (0,3605). Hal ini menunjukkan bahwa Listerine® lebih efektif menjaga kebersihan mulut (p=0,024). Listerine® secara signifikan lebih efektif dalam mencegah VAP bila dibanding dengan iodine povidone 1% (p=0,001). Tidak ada perbedaan signifikan pada subjek yang meninggal akibat VAP positif dengan negatif (p=0,280). l Simpulan listerine® memiliki efektivitas lebih tinggi mencegah VAP dibanding dengan iodine povidone 1%.Differences in Effectiveness of Iodine Povidone 1% and Listerine® as Oral Care Preparations in Preventing Ventilator-Associated PneumoniaOral care is one way to prevent VAP in patients using mechanical ventilation. x This study aimed to determine the prevalence of VAP and the effectiveness of antiseptic preparations in the oral care of intubated patients to prevent ventilator associated pneumonia (VAP). The study used a randomized, single-blind clinical trial in 36 mechanically ventilated patients admitted to the ICU of Dr. Moewardi in February –May 2017. The samples were divided into two groups, namely the 1% povidone-iodine group and Listerine®. Initially, oral hygiene was assessed using the simplified oral hygiene index. After that, oral care was performed using one of the preparations. After 48 hours, oral hygiene and clinical pulmonaryindicator score (CPIS) scores were reassessed. VAP occurred when the CPIS score was 6. The Mann-Whitney test and independent t-test analyzed the data. The 1% povidone-iodine group changed oral hygiene scores with a minor difference (0.195) than Listerine® (0.3605). It indicated that Listerine® was more effective in maintaining oral hygiene (p=0.024). Listerine® was significantly more effective in preventing VAP when compared with 1% iodine povidone (p=0.001). There was no significant difference in mortality of VAP positive or negative subjects (p=0.280). In conclusion, the use of Listerine® as an oral care preparation is significantly more effective in preventing VAP compared to 1% iodine povidone.
Efektifitas Pemberian EMLA 5 % Dibandingkan dengan Etil Klorida Spray untuk Mengurangi Nyeri pada Suntikan Jarum Epidural Heri Dwi Purnomo; Fitri Hapsari Dewi; Ariffandy Dwi Citra
Jurnal Anestesi Perioperatif Vol 9, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n3.2484

Abstract

Nyeri pada saat penyuntikan jarum epidural menjadi kekurangan terhadap aplikasi tindakan epidural. Tujuan penelitian ini adalah mengetahui perbedaan efektivitas pemberian EMLA 5% dibanding dengan etil klorida spray untuk mengurangi nyeri pada suntikan jarum epidural dengan skor visual analoge scale (VAS). Penelitian ini merupakan jenis penelitian eksperimental dengan pendekatan uji klinis dengan teknik single blind. Terdapat 30 subjek penelitian menjalani tindakan epidural di RSUD Dr. Moewardi Surakarta dengan status fisik ASA I dan II berusia  20–65 tahun. Sampel meliputi 10 subjek dengan pemberian EMLA 5%, 10 subjek etil klorida spray dan 10 subjek lidokain 2%. Setelah dilakukan randomisasi dilakukan pengukuran intensitas nyeri dengan skor VAS pada kedalaman jarum epidural 0,5–1 cm dan 1–4 cm. Hasil pemberian EMLA 5% memberikan hasil yang lebih baik terhadap nilai VAS saat penyuntikan jarum epidural dibanding dengan etil klorida spray, perbedaan tingkat nyeri ditunjukkan pada kedalaman jarum epidural 0,5–1 cm (p=0,006) dan 1–4 cm p=0,000 (p<0,05). Simpulan, pemberian EMLA 5% efektif mengurangi rasa nyeri pada suntikan epidural.Effectiveness of EMLA 5% Administration Compared to Ethyl Chloride Spray to Reduce Pain in Epidural Needle InjectionsPain at the time of injection of the epidural needle becomes a drawback to applying epidural action. This study aimed to determine the difference in the effectiveness of administrating EMLA 5% compared to ethyl chloride spray to reduce pain on epidural needle injections with a visual analog scale (VAS) score. This study was experimental research with a clinical trial approach with a single-blind technique. There were 30 research subjects undergoing an epidural at Dr. Moewardi Hospital Surakarta with the physical status of ASA I and II, aged between 20–65 years. The samples included ten subjects with 5% EMLA administration, ten subjects with ethyl chloride spray, and ten with 2% lidocaine. After randomization, pain intensity was measured with a VAS score at an epidural needle depth of 0.5–1 cm and 1–4 cm. The administration of EMLA 5% gave better results on the VAS value when injecting the epidural needle compared to ethyl chloride spray; the difference in pain level was shown at the epidural needle depth of 0.5–1 cm (p=0.006) and 1–4 cm p=0.000. In conclusion, administration of 5% EMLA is effective in reducing pain on epidural injections.
Premedikasi Lidokain dengan Torniket Lebih Baik Dibanding dengan Kombinasi Lidokain dan Propofol untuk Mencegah Nyeri Injeksi Propofol Ristiawan Muji Laksono; Isngadi Isngadi; Yudi Hadinata; Karmini Yupono; Ruddi Hartono; Djudjuk Rahmad Basuki
Jurnal Anestesi Perioperatif Vol 9, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n3.2382

Abstract

Propofol merupakan jenis obat induksi intravena yang paling sering digunakan dalam pembiusan umum, namun dapat menimbulkan rasa nyeri pada lokasi injeksi. Tujuan penelitian ini adalah mengetahui perbandingan persentase nyeri pascainjeksi propofol setelah premedikasi lidokain dengan perlakuan torniket selama satu menit dan teknik campuran lidokain fropofol. Penelitian ini merupakan uji klinis tersamar tunggal bersifat eksperimental. Penelitian dilaksanakan di RSUD Dr. Saiful Anwar pada April–Mei 2013. Subjek penelitian adalah 50 pasien yang dibagi menjadi dua kelompok secara acak. Kelompok A (n=25) mendapat perlakuan campuran 40 mg lidokain dalam propofol intravena (i.v.). Kelompok B (n=25) mendapat perlakuan lidokain 40 mg (i.v.) dengan perlakuan torniket selama satu menit, diikuti injeksi propofol. Derajat nyeri diukur menggunakan Verbal Rating Score. Hasil pengukuran dianalisis statistik dengan uji normalitas, homogenitas, dan Mann Whitney menggunakan software SPSS (versi 18, IBM Statistic, USA). Pemberian lidokain dengan perlakuan torniket signifikan dapat merunkan detajat nyeri lebih baik (24/25 tidak nyeri, 1/25 nyeri) dibanding dengan kelompok campuran lodokain dan propofol (10/25 tidak nyeri, 11/25 nyeri ringan, 4/25 nyeri sedang) (p=0,000). Premedikasi lidokain dengan perlakuan torniket lebih baik dalam menurunkan derajat nyeri dibanding dengan pemberian campuran lidokain dan propofol.Premedication Using Lidocaine with Tourniquet Technique is Superior to Combining Lidocaine and Propofol to Prevent Propofol Injection PainPropofol is one of the most used intravenous induction drugs in general anesthesia, but it produces pain at the injection site. This study aimed to compare the post-propofol injection pain after premedication using lidocaine with the tourniquet technique and a mixture of lidocaine in propofol. This study was a single-blind, experimental clinical trial conducted from April to May 2013. The study's subject was 50 patients divided into two groups. Group A (n=25) received a mixture of 40 mg lidocaine in propofol intravenously (i.v.). Group B (n=25) received 40 mg lidocaine (i.v) with a tourniquet technique for one minute, followed by propofol injection. The degree of pain is measured using the Verbal Rating Score. The results were statistically analyzed using the normality, homogeneity, Mann-Whitney test using SPSS (version 18, IBM Statistic, USA) software. The administration of lidocaine with the tourniquet technique was significantly better in reducing the pain levels (24/25 painless, 1/25 mild pain) compared to the mixture of lidocaine in the propofol group (10/25painless, 11/25 mild pain, 4/25 moderate pain) (p= 0,000). The premedication of lidocaine with the tourniquet technique significantly produces lower pain levels than the mixture of lidocaine in propofol. Premedication of lidocaine with a tourniquet technique can prevent pain after injecting propofol.
Perbandingan Kombinasi Parasetamol dan Deksametason dengan Deksametason Praoperasi untuk mengurangi angka kejadian nyeri tenggorok pasca operasi anestesi umum di RSUP Dr. Hasan Sadikin Bandung Jansen Laory; Rudi Kurniadi Kadarsah; Indriasari Indriasari
Jurnal Anestesi Perioperatif Vol 9, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n3.2549

Abstract

Postoperative sore throat (POST) setelah anestesi umum dengan pemasangan pipa endotrakea merupakan komplikasi yang sering terjadi dan tidak diinginkan. Angka kejadian nyeri tenggorok pascaoperasi setelah pemasangan pipa endotrakea adalah 6–76%. Penelitian ini bertujuan membandingkan efek kombinasi parasetamol dan deksametason dengan deksametason tunggal untuk mengurangi angka kejadian POST pada pasien setelah anestesi umum. Penelitian ini merupakan eksperimental dengan melakukan uji klinis rancangan acak lengkap terkontrol buta ganda. Penelitian dilakukan di RSUP Dr. Hasan Sadikin bulan Januari–April 2021. Total 92 pasien yang dijadwalkan operasi elektif dibagi secara acak menjadi 2 kelompok. Kelompok deksametason dan parasetamol (n=46) diberikan deksametason 10 mg dan parasetamol 1.000 mg intravena. Kelompok deksametason (n=46) diberikan deksametason 10 mg intravena dan plasebo. Pada penelitian ini, derajat POST dipantau. Angka kejadian POST didapatkan lebih rendah pada kelompok kombinasi deksametason dan parasetamol dibanding dengan kelompok deksametason dan plasebo pada jam ke-0, 1, dan 6 (p=0,0001, p=0,001, dan p=0,0001). Simpulan penelitian ini adalah kombinasi deksametason parasetamol lebih baik dibanding dengan deksametason tunggal dalam menurunkan angka kejadian POST anestesi umum.Comparison of Combined Paracetamol and Dexamethasone with Preoperative Dexamethasone for Reducing Sore Throat Post General AnesthesiaPostoperative sore throat (POST) following general anesthesia with endotracheal tube insertion is a common and undesirable complication. The incidence of postoperative sore throat after insertion of an endotracheal tube is  6–76%. This study aimed to compare the effect of combined paracetamol and dexamethasone with single-dose dexamethasone to reduce POST incidence in patients after general anesthesia. This experimental study conducted a double-blind, complete randomized controlled clinical trial at RSUP Dr. Hasan Sadikin Bandung during  January–April 2021 Ninety-two patients scheduled for elective surgery were randomly assigned to two groups. The dexamethasone and aracetamol group (n=46) were given dexamethasone 10 mg and paracetamol 1000 mg intravenously. Dexamethasone group (n=46) was given dexamethasone 10 mg intravenously and placebo. In this study, the degree of POST was monitored. Results showed that the incidence of POST was lower in the dexamethasone and paracetamol combination group than in the dexamethasone and placebo group at 0, 1, and 6 hours (p=0.0001, p=0.001, and p=0.0001). This study concludes that the combination of dexamethasone paracetamol is better than single-dose dexamethasone in reducing the incidence of POST general anesthesia.

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