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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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Deksametason Intravena dalam Mengurangi Insidens Nyeri Tenggorok Pascabedah Wijaya, Andi Ade; Garditya, Rama; Marsaban, Arif H. M.
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Anestesia umum dengan pipa endotrakeal digunakan untuk memberikan ventilasi tekanan positif dan mencegah aspirasi, namun penggunaannya dapat menimbulkan komplikasi nyeri tenggorok pascabedah. Penelitian ini dilakukan membandingkan efektivitas deksametason intravena dengan triamsinolon asetonid topikal dalam mengurangi nyeri tenggorok pascabedah. Penelitian ini merupakan uji klinis acak tersamar ganda yang dilakukan selama bulan Maret–April 2013 di Rumah Sakit Cipto Mangunkusumo pada pasien yang menjalani pembedahan dalam anestesia umum menggunakan pipa endotrakeal. Subjek dibagi menjadi dua kelompok, kelompok deksametason sebanyak 61 orang dan kelompok triamsinolon sebanyak 60 orang. Sebelum induksi, pasien dalam grup deksametason diberikan 10 mg deksametason intravena dan pasta plasebo dioleskan pada balon pipa endotrakeal. Pasien dalam grup triamsinolon diberikan 2 mL NaCl 0,9% intravena dan pasta triamsinolon asetonid dioleskan pada balon pipa endotrakeal. Skor nyeri tenggorok pascabedah dievaluasi sesaat setelah pembedahan berakhir, 2 jam dan 24 jam pascabedah. Hasil penelitian, tidak didapatkan perbedaan bermakna pada kedua kelompok  kejadian nyeri tenggorok pascabedah sesaat setelah pembedahan berakhir (27,9% pada kelompok A dan 18,3% pada kelompok B, p=0,214). Triamsinolon asetonid topikal memiliki efektivitas yang sama dengan deksametason intravena dalam mengurangi insidens nyeri tenggorok pascabedah.  Kata kunci:  Deksametason, intubasi endotrakeal, nyeri tenggorok pascabedah, pasta triamsinolon asetonidComparison between Topical Triamcinolone Acetonide and Intravenous Dexamethasone in Reducing Postoperative Sore Throat IncidenceTracheal intubation is often used to give positive-pressure ventilation and prevent aspiration during general anesthesia. However, the use of this airway device can cause postoperative sore throat (POST). This study was conducted to compare the effectiveness of prophylactic intravenous dexamethasone and triamcinolone acetonide paste in reducing POST. This study was a double-blind randomized clinical trial conducted during April–May 2013 in Cipto Mangunkusumo General Hospital on patients scheduled for surgery under general anesthesia using endotracheal tube. Subjects were randomly allocated into two groups; 61 patients in dexamethasone group and 60 patients in triamcinolone group. Before induction, the dexamethasone group received 10 mg of intravenous dexamethasone and placebo paste on the endotracheal tube cuff. Triamcinolone group received 2 mL of intravenous normal saline and triamcinolone acetonide paste on the endotracheal tube cuff. POST scores were evaluated immediately after the operation, 2-hours, and 24-hours after the operation. There was no significant difference in the incidence of POST immediately after the operation between the two groups (27.9% in group dexamethasone vs 18.3% in group triamcinolone, p=0.214). Topical triamcinolone acetonide is equally effective compared to prophylactic intravenous dexamethasone in reducing the incidence of POST.  Key words: Dexamethasone, endotracheal intubation, posts operative sore throat, triamcinolone acetonide paste
Perbandingan Ketepatan Pengukuran Tekanan Balon Pipa Endotrakeal setelah Intubasi antara Metode Palpasi pada Pilot Balon dan Teknik Melepas Spuit secara Pasif Mutiara, Gunawan; Suwarman, -; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Metode palpasi pada pilot balon merupakan teknik yang tidak akurat untuk menentukan tekanan balon pipa endotrakeal (endotracheal tube/ETT). Tujuan penelitian ini membandingkan ketepatan pengukuran tekanan balon ETT antara metode palpasi pada pilot balon (MP) dan teknik melepas spuit secara pasif (MSP). Penelitian dilakukan pada bulan Juni 2014 di Rumah Sakit Dr. Hasan Sadikin Bandung, menggunakan metode kuantitatif eksperimen dengan rancangan uji acak silang tersamar tunggal. Subjek penelitian adalah 94 orang pasien berusia 18−65 tahun dengan status fisik American Society of Anesthesiologists (ASA) I–III, yang menjalani pembedahan dengan anestesi umum secara intubasi endotrakeal. Saat akan dilakukan intubasi, balon ETT dikembangkan dengan dua teknik yang berbeda kelompok metode palpasi (n=48) dan kelompok teknik melepas spuit secara pasif (n=46). Data hasil penelitian dianalisis menggunakan uji-t tidak berpasangan dan uji chi-kuadrat. Hasil penelitian didapatkan tekanan rata-rata pada kelompok MP 57,7±26,0 cmH2O dan MSP 28,7±4,5 cmH2O, sedangkan untuk ketepatan pengukuran pada kelompok MSP 56,5% dan kelompok MP 6,2% (p<0,001). Simpulan penelitian ini menunjukkan bahwa metode palpasi merupakan teknik pengukuran tekanan balon ETT yang tidak adekuat.Kata kunci: Metode palpasi pada pilot balon, teknik melepas spuit secara pasif, endotracheal tubeComparison between Pilot Balloon Palpation Method and Passive Release Technique on the Accuracy of Measurements of  Endotracheal Tube Cuff Pressure Estimation of cuff pressure by palpating the pilot balloon is not accurate to determine the cuff pressure of endotracheal tube (ETT). Hence, this study we conducted to compare the accuracy of indirect measurements between pilot balloon palpation method (MP) and passive release technique (MSP). This was a single blind randomized crossover study performed in june 2014 at Dr. Hasan Sadikin General Hospital Bandung, in which patients received each technique and as a control group. Subjects were 94 patients aged 18−65 years old with American Society of Anesthesiologists (ASA) physical status I−III who underwent surgery requiring tracheal intubation. These subjects were randomized into two groups. After induction of anesthesia, the cuff was inflated with two different techniques: pilot balloon palpation technique (n=48) and passive release technique (n=46). Data were statistically analyzed using independent t-test and chi-square test. The mean cuff pressures of group MP was 57.7±26.0 cmH2O and for group MSP was 28.7±4.5 cmH2O,  whereas the precision of measurements in the MSP group was 56.5% and 6.2% in the MP group (p<0.001). It is conclude that the palpation method for cuff inflation are inadequate. Therefore, it is suggested that the endotracheal tube cuff pressure must be kept within the optimal range using a standard manometer. Key words: Endotracheal cuff pressure, passive release technique, pilot balloon palpation method  DOI: 10.15851/jap.v3n3.608
Efektivitas Magnesium Sulfat 30 mg/kgBB Intravena Dibanding dengan Fentanil 2 mcg/kgBB Intravena dalam Menekan Respons Kardiovaskular pada Tindakan Laringoskopi dan Intubasi Yehezkiel, -; Wiryana, Made; Sujana, Ida Bagus Gde; Sidemen, I Gusti Putu Sukrana
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Laringoskopi dan intubasi merupakan tindakan rutin yang berisiko menyebabkan respons kardiovaskular berupa peningkatan tekanan darah dan laju denyut jantung terutama pada pasien risiko tinggi seperti kelainan jantung. Penelitian ini bertujuan mengetahui efektivitas MgSO4 30 mg/kgBB intravena dibanding dengan fentanil 2 mcg/kgBB  intravena dalam menekan respons kardiovaskular pada  tindakan laringoskopi dan intubasi sehingga dapat menjadi obat altenatif. Penelitian ini dilakukan secara uji klinis  acak terkontrol tersamar ganda terhadap 42 pasien dengan status fisik American Society of Anesthesiologist (ASA) I–II yang dilakukan operasi dengan anestesi umum intubasi trakea di RSUP Sanglah Denpasar Bali pada Agustus–September 2014. Subjek dibagi menjadi dua kelompok, MgSO4 30 mg/kgBB (n=21) dan fentanil 2 mcg/kgBB (n=21) secara acak. Perubahan tekanan darah dan laju denyut jantung yang terjadi sebelum dan setelah tindakan dicatat sebagai data penelitian. Data penelitian dianalisis dengan uji repeated ANOVA, dengan p&lt;0,05 dianggap bermakna. Analisis statistik menunjukkan bahwa tidak terdapat perbedaan bermakna antara kedua kelompok perlakuan. Simpulan, pemberian MgSO4 30 mg/kgBB sama efektif dengan fentanil 2 mcg/kgBB dalam menekan respons kardiovaskular pada tindakan laringoskopi dan intubasi.Kata kunci: Fentanil, intubasi, laringoskopi, magnesium sulfat, respons kardiovaskularComparison of Intravena Magnesium Sulfate 30 mg/kgBW and Intravena Fentanil 2 mcg/kgBW  Effectiveness for Attenuating Cardiovascular Response in Laryngoscopy and Tracheal IntubationLaryngoscopy and intubation are routine actions which cause the risk of cardiovascular responses, including increased blood pressure and heart rate, especially in high-risk patients such as patients with heart disorders. The aim of this study was to determine the effectiveness of intravenous MgSO4 30 mg/kgBW compared to that of intravenous fentanyl 2 mcg/kgBW in reducing cardiovascular responses to laryngoscopy and intubation to assess its possibility as an alternative drug. This study was a clinical trial with randomized double-blind controlled to 42 patients with physical status of the American Society of Anesthesiologists (ASA) I–II who underwent tracheal intubation under general anesthesia in Sanglah Denpasar Hospital Bali in the period of  August–September 2014. Subjects were divided into two groups, MgSO4 30 mg/kgBW (n=21) and fentanyl 2 mcg/kgBW (n=21) groups. Changes in blood pressure and heart rate that occured before and after the action were recorded as research data. Data were analyzed with repeated ANOVA test, with p&lt;0.05 considered significant. Statistical analysis showed that there was no significant difference between the two treatment groups. it is concluded that the administration of MgSO4 30 mg/kgBW is as effective as fentanyl 2 mcg/kgBW in reducing cardiovascular responses to laryngoscopy and intubation.Key words: Cardiovascular response, fentanyl, intubation, laryngoscopy, magnesium sulfate DOI: 10.15851/jap.v3n2.574
Perbandingan Epidural Volume Extension 5 mL dan 10 mL Salin 0,9% pada Spinal Anestesi dengan Bupivakain 0,5% 10 mg Hiperbarik terhadap Tinggi Blok Sensorik dan Pemulihan Blok Motorik pada Seksio Sesare Putra, Reza Indra; Pradian, Erwin; Kadarsah, Rudi Kurniadi
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 (420.27 KB) | DOI: 10.15851/jap.v4n1.740

Abstract

Epidural volume extension (EVE) merupakan bentuk modifikasi dari kombinasi spinal epidural dengan injeksi salin normal ke dalam rongga epidural setelah dosis intratekal. Teknik EVE meningkatkan tingkat blok sensorik yang diakibatkan efek volume saat volume cairan pada rongga epidural yang menekan dural sac dan menyebabkan penyebaran sefalad dari anestetik lokal. Tujuan penelitian ini adalah mengkaji perbedaan pengaruh EVE 5 mL dan 10 mL salin 0,9% dengan menggunakan bupivakain 0,5% 10 mg terhadap tinggi blok sensorik dan pemulihan blok motorik pada pasien seksio sesarea. Penelitian dilakukan pada pertengahan September–November 2014 di Rumah Sakit Dr. Hasan Sadikin Bandung. Dilakukan uji klinis acak terkontrol pada 30 pasien yang menjalani seksio sesarea (SC) dan dibagi menjadi dua kelompok, yaitu kelompok yang menerima EVE 10 mL dan kelompok yang menerima EVE 5 mL pada pasien yang akan dilakukan SC dengan menggunakan anestesi kombinasi spinal epidural. Penilaian ketinggian blok sensorik menggunakan uji pinprick serta penilaian pemulihan blok motorik menggunakan uji bromage score. Data hasil diuji dengan uji-t. Hasil penelitian menunjukkan pemulihan blok motorik pada subjek penelitian yang menggunakan EVE 10 mL lebih cepat pulih dibanding dengan menggunakan EVE 5 mL (p<0,001). Simpulan pada penelitian ini menunjukkan pemberian EVE 10 mL pada pasien seksio sesarea memiliki pemulihan blok motorik lebih cepat dengan ketinggian blok sensorik yang sama.Kata kunci: Blok motorik, blok sensorik, epidural volume extensionComparison between 5 mL Epidural Volume Extension and 10 mL Epidural Volume Extension by 0.9% Saline in Spinal Anesthesia with 10 mg 0.5% Hyperbaric Bupivacaine on High and Recovery Sensory Block Motor in Caesarean SectionAbstractEpidural volume extension (EVE) is a modified form of combined spinal epidural with normal saline injected into the epidural space after the intrathecal dose. EVE techniques increases the level of sensory block resulting from the volume effects when the volume of fluid in the epidural space suppresses the dural sac and causes the cephalad spread of local anesthetic. The aim of this research was to assess differences in the effects of 5 mL EVE and 10 mL EVE by 0.9% saline with 10 mg 0.5% bupivacaine on sensory block height and motor block recovery in caesarean section patients. This research was carried out from mid September to November 2014 in Dr. Hasan Sadikin General Hospital Bandung. This was a randomized controlled clinical trial conducted on 30 patients who underwent caesarean section (SC) and divided randomly into two groups, namely group receiving 10 mL EVE and group receiving 5 mL EVE with a spinal epidural combination anesthesia. The assessment of sensory block height was performed using the pinprick test while bromage score test were used for motor block recovery. The data was analyzed using t test. The results showed a faster recovery of motor block in the research subjects using 10 mL EVE compared to those using 5 mL EVE (p<0.001). The conclusion from this study is that the administration of 10 mL EVE in patients who underwent caesarean section leads to a faster motor block recovery with the same sensory block height.Key words: Block motor, sensory block, epidural volume extension DOI: 10.15851/jap.v4n1.740
Insidensi dan Faktor Risiko Hipotensi pada Pasien yang Menjalani Seksio Sesarea dengan Anestesi Spinal di Rumah Sakit Dr. Hasan Sadikin Bandung Rustini, Rini; Fuadi, Iwan; Surahman, Eri
Jurnal Anestesi Perioperatif Vol 4, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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

Abstract

Hipotensi merupakan komplikasi yang sering terjadi setelah tindakan anestesi spinal pada pasien seksio sesarea. Hipotensi terjadi akibat blokade simpatis terhadap aktivitas vasomotor pembuluh darah serta penekanan aorta dan vena kava inferior oleh uterus yang membesar terutama pada saat pasien telentang. Tujuan penelitian ini adalah mengetahui insidensi hipotensi dan faktor risiko yang berhubungan dengan kejadian hipotensi pada pasien yang menjalani seksio sesarea dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian observasional potong lintang (cross sectional) ini dilakukan pada 90 subjek pasien yang menjalani seksio sesarea dengan anestesi spinal pada periode bulan April–Mei 2015. Pengolahan data dengan analisis univariabel untuk melihat gambaran proporsi variabel masing-masing yang disajikan secara deskriptif. Hasil penelitian menunjukkan insidensi hipotensi 49%. Faktor risiko yang menyebabkan hipotensi maternal menunjukkan hasil yang tidak signifikan berhubungan dengan kejadian hipotensi (p>0,05). Perbedaan insidensi hipotensi maternal setelah tindakan anestesi spinal dan faktor risiko yang memengaruhinya dengan penelitian sebelumnya karena perbedaan jumlah sampel penelitian, perbedaan definisi hasil yang digunakan, perbedaan tempat penelitian, dan perbedaan metode pengumpulan data.Kata kunci: Anestesi spinal, faktor risiko, hipotensi, insidensi, seksio sesareaIncidence and Risk Factors of Hypotension in Patients Undergoing Cesarean Section with Spinal Anesthesia in Dr. Hasan Sadikin General Hospital BandungAbstractThe most common serious complication associated with spinal anesthesia for C-section is hypotension. These hemodynamic changes result from a blockade of sympathetic vasomotor activity that is accentuated by the compression of the aorta and inferior vena cava by the gravid uterus when the patient is in the supine position. The purpose of this study was to describe the incidence of hypotension in patients undergoing cesarean section with spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung and to obtain a description of risk factors associated with the incidence of hypotension. A cross–sectional observational study was conducted on 90 subjects consisting of patients undergoing cesarean section with spinal anesthesia during the period of April–May 2015. The data processing performed was the univariable analysis to see the picture of the proportion of each variable, which were presented descriptively. The results showed 49% incidence of hypotension. There was an insignificant association between the risk factors of maternal hypotension after spinal anesthesia for cesarean section insignificant association with the incidence of hypotension (p>0.05). Differences in the incidence of maternal hypotension after spinal anesthesia and risk factors as stated in this study when compared to previous studies are due to differences sample size, definitions, place, and data collection methods.Key words: Cesarean section, hypotension, incidence, risk factors, spinal anesthesia DOI: 10.15851/jap.v4n1.745
Perbandingan Efek Lidokain dengan Magnesium Sulfat Intravena terhadap Nilai Numeric Rating Scale dan Kebutuhan Analgesik Pascabedah Kolesistektomi Perlaparoskopi Lewi, Ratu; Suwarman, Suwarman; Sitanggang, Ruli Herman
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 (387.787 KB) | DOI: 10.15851/jap.v4n1.741

Abstract

Lidokain dan magnesium sulfat mempunyai efek antihiperalgesia yang dapat digunakan sebagai obat tambahan untuk mengurangi nyeri pascaoperasi dan mengurangi kebutuhan analgesik opioid. Tujuan penelitian ini membandingkan efek lidokain dan magnesium sulfat intravena nilai numeric rating scale (NRS) dan kebutuhan analgesik pertolongan. Penelitian eksperimental dengan double blind randomized controlled trial dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Januari–Maret 2015 terhadap 30 pasien yang menjalani kolesistektomi per laparoskopi. Pasien dikelompokkan menjadi 2. Kelompok lidokain mendapatkan 1 mg/kgBB intravena dilanjutkan dengan 1 mg/kgBB/jam dan kelompok magnesium sulfat mendapatkan 30 mg/kgBB intravena dilanjutkan dengan 10 mg/kgBB/jam. Data hasil penelitian dianalisis menggunakan Uji Mann-Whitney, uji-t, dan dianggap bermakna bila p<0,05. Hasil analisis statistik menunjukan bahwa lidokain mengurangi nilai NRS secara bermakna dibanding dengan magnesium sulfat pada jam ke-4 pascaoperasi (p<0,05), dengan kebutuhan analgesik pertolongan fentanil pada kelompok lidokain rata-rata 66,4±15,2 µg dan pada kelompok magnesium sulfat rata-rata 86,0±7,8 µg. Simpulan, lidokain intravena mengurangi NRS pascaoperasi lebih baik dan mengurangi kebutuhan opioid lebih banyak dibanding dengan magnesium sulfat pada pasien operasi kolesistektomi per laparoskopi.Kata kunci: Kebutuhan analgesik opioid, lidokain, magnesium sulfat, nyeri pascaoperasi, numeric rating scale Comparison between the Effect of Intravenous Lidocaine and Magnesium Sulphate on Numeric Rating Scale and Postoperative Analgetic Requirement for Laparoscopic CholecystectomiAbstractPostoperative pain management after laparoscopic cholecystectomy is one measure of successful anesthesia and surgery. Lidocaine and magnesium sulphate have anti-hyperalgesia effects applicable as an additional medication to attenuate postoperative pain and reduce the need for opioid analgesics. A total of 30 of patients aged 18–65 years with ASA physical status I–II who underwent laparoscopic cholecystectomy in Dr. Hasan Sadikin General Hospital Bandung were included in a double-blind, randomized, controlled clinical trial. Patients were randomly assigned into 2 groups. The L group, treated with 1 mg/kgBW intravenous followed by 1 mg/kgBW/h intravenous, and M group, treated with 30 mg/kgBW intravenous followed by 10 mg/kgBW/h. Data were analyzed using Mann-Whitney Test and t-test, p<0.05 was considered significant. Statistical analysis showed that lidocaine significantly reduced NRS value compared to magnesium sulphate at 4 hours postoperatively (p<0.05), with the average rescue analgesic fentanyl requirement in the lidocaine group and the magnesium sulphate group of 66.4±15.2 mg and 86.0±7.8 g, respectively. In conclusions, intravenous lidocaine administration may reduce the postoperative NRS value and opioid analgetic requirement more than the intravenous magnesium sulphate administration in patients undergoing laparoscopic cholecystectomy.Key words: An opioid analgetic rescue, lidocaine, magnesium sulphate postoperative pain, numeric rating scale DOI: 10.15851/jap.v4n1.741
Pengaruh Duduk 5 Menit Dibanding dengan Langsung Dibaringkan pada Pasien yang Dilakukan Anestesi Spinal dengan Bupivakain Hiperbarik 0,5% 10 mg terhadap Perubahan Tekanan Arteri Rata-rata dan Blokade Sensorik Fauzan, Raditya; Tavianto, Doddy; Sitanggang, Ruli Herman
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 (362.981 KB) | DOI: 10.15851/jap.v4n1.746

Abstract

Anestesi spinal sering kali mengakibatkan hipotensi karena blokade simpatis yang tinggi. Penelitian ini bertujuan melihat pengaruh duduk 5 menit dibanding dengan langsung dibaringkan setelah pemberian anestesi spinal dengan bupivakain 0,5% hiperbarik 10 mg terhadap tekanan arteri rata-rata dan ketinggian blokade sensorik. Penelitian dilakukan dengan metode acak terkontrol tersamar tunggal pada 36 orang pasien dengan status fisik American Society of Anesthesiologist (ASA) I–II yang menjalani operasi perut bagian bawah dan ekstermitas bawah di Rumah Sakit Umum Dr. Hasan Sadikin Bandung pada bulan Maret–Mei 2015. Analisis statistik tekanan arteri rata-rata menggunakan Uji Mann-Whitney dan ketinggian blokade sensorik dengan Uji Kolmogorov Smirnov. Penurunan tekanan arteri rata-rata kelompok 1 (duduk selama 5 menit) lebih sedikit dibanding dengan kelompok 2 (langsung dibaringkan) dengan perbedaan yang bermakna (p<0,05). Ketinggian blokade sensorik rata-rata kelompok 1 terbanyak pada T10 (14 dari 18) dan kelompok 2 pada T6 (8 dari 18). Simpulan, posisi duduk selama 5 menit setelah anestesi spinal dengan bupivakain 0,5% hiperbarik 10 mg menyebabkan penurunan tekanan arteri rata-rata lebih kecil dan ketinggian blokade sensorik lebih rendah dibanding dengan posisi langsung dibaringkan.Kata kunci: Anestesi spinal, bupivakain 0,5% hiperbarik, blokade sensorik, posisi badan, tekanan arteri rata-rataEffects of 5-Minute Sitting Compared to Immediately Lying Down After 10 mg of 0.5% Hiperbaric Bupivacaine Administration on Mean Arterial Pressure and Level of Sensory Blockade in Patients Receiving Spinal AnesthesiaAbstractSpinal anesthesia frequently results in hypotension due to high sympathetic blockade. The aim of this study was to examine effect of sitting for 5 minutes compared to immediately lying down after 10 mg of 0.5% hiperbaric bupivacaine administration with regards to the mean arterial pressure and level sensory blockade in patients who underwentd spinal anesthesia. This was a single blind randomized controlled trial in 36 patients with American Society of Anesthesiologists (ASA) I–II undergoing lower abdominal and lower extremities surgery under spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung during the period of March to May 2015. Data were statistically analyzed using Mann Whitney test for mean arterial pressure and Kolmogorov Smirnov test for level sensory blockade. The results showed a decrease of mean arterial pressure in group 1 (sitting 5 minutes) which was lower than group 2 (immediately lying down) with significant difference (p<0.05). Level of sensory blockade in group 1 at T 10 (14 from 18) was higher than in group 2 at T6 (8 from 18, p=0.001). It is concluded in this study that sitting for 5 minutes after spinal anesthesia using 10 mg 0.5%. bupivacaine hiperbaric decreases the intraoperative sensory of blockade height and mean arterial pressure.Key words: Bupivacaine, body potition, mean arterial preassure, sensory blockade, spinal anesthesia 
Perbandingan Antiseptik Chlorhexidine Alkohol dengan Povidone Iodine terhadap Penurunan Pertumbuhan Koloni Bakteri pada Kateter Epidural yang Dipasang di Kamar Operasi Rumah Sakit Dr. Hasan Sadikin Bandung Barzah, Andie Muhari; Pradian, Erwin; Bisri, Tatang
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 (569.915 KB) | DOI: 10.15851/jap.v4n1.742

Abstract

Chlorhexidine alkohol dan povidone iodine digunakan sebagai zat antiseptik pada anestesi epidural. Aseptik dan antiseptik sebelum tindakan epidural harus dilakukan secara optimal untuk menurunkan komplikasi infeksi pascatindakan. Tujuan penelitian ini menilai perbedaan penurunan pertumbuhan koloni bakteri pada kateter epidural di Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian single blind randomized controlled trials pada 76 pasien yang dilakukan anestesi epidural di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan November 2014–Februari 2015. Subjek penelitian dibagi menjadi 2 kelompok, yaitu chlorhexidine alkohol dan povidone iodine. Dilakukan pemeriksaan kultur apus kulit sebelum dan sesudah tindakan aseptik dan antiseptik kemudian dilakukan pemeriksaan kultur kateter epidural pada hari ke-3 setelah pemasangan. Data hasil penelitian dianalisis dengan menggunakan uji-t, chi-kuadrat, dan Uji Mann-Whitney. Hasil penelitian ini didapatkan kultur positif bakteri dari pemeriksaan sebelum tindakan aseptik dan antiseptik 33 dari 38 pada chlorhexidine alkohol dan 35 dari 38 pada povidone iodine. Kultur positif bakteri menjadi 4 dari 38 pada chlorhexidine alkohol dan povidone iodine setelah pemberian aseptik dan antiseptik. Kultur pascapemasangan kateter epidural positif bakteri 7 dari 38 pada chlorhexidine alkohol dan 5 dari 38 pada povidone iodine (p<0,05). Simpulan penelitian ini menunjukkan zat antiseptik chlorhexidine alkohol lebih lebih rendah pertumbuhan kumannya bila dibanding dengan povidone iodine pada kateter epidural.Kata kunci: Antiseptik, chlorhexidine alkohol, povidone iodineComparison between Chlorhexidine-Alcohol and Povidone Iodine in Reducing Catheter Tip Bacterial Colonization in Dr. Hasan Sadikin General Hospital BandungAbstractChlorhexidine-alcohol and povidone iodine are commonly used as antiseptic solutions in epidural anesthesia. Aseptic and antiseptic procedures must be performed before any epidural procedure to lower infection complications after the procedure. The objective of this study was to investigate the lowest bacterial growth on epidural catheter after chlorhexidine-alcohol or povidone iodine application as the antiseptic solution in Dr. Hasan Sadikin General Hospital Bandung. This was a single blind randomized controlled trial on 78 patients underwent epidural anesthesia in the period of November 2014–February 2015. The subjects were divided in to 2 groups, each consisted of 38 patients. Aseptic and antiseptic procedures were performed using chlorhexidine-alcohol or povidone iodine with skin swab culture collected before and after the procedure. Epidural catheter culture was performed in the 3rd days after the installment. Data were analyzed using t-test, chi-square test, and Mann Whitney test. The result of this study showed positive bacterial cultures prior to aseptic and antiseptics, 33 from 38 in chlorhexidine-alcohol and 35 from 38 in povidone iodine. Positive bacterial cultures became 4 from 38, both in chlorhexidine-alcohol and povidone iodine. Positive bacterial culture on the 3rd days after epidural catheter placement was 7 from 38 after chlorhexidine-alcohol and 5 from 38 after povidone iodine (p< 0.05). It is concluded that the ability of chlorhexidine-alcohol to reduce bacterial growth on epidural catheter is lower than povidone-iodine with regards to reducing infection after catheter epidural installment.Key words: Antiseptic, chlorhexidine-alcohol, povidone iodine DOI: 10.15851/jap.v4n1.742
Perbandingan Bupivakain Infiltrasi Subkutis dengan Kombinasi Bupivakain Intramuskular Rectus Abdominis dan Subkutis terhadap Mulai Pemberian dan Kebutuhan Analgetik Rescue Pascaoperasi Laparatomi Ginekologi Falah, Said Badrul; Oktaliansah, Ezra; Redjeki, Ike Sri
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 (419.802 KB) | DOI: 10.15851/jap.v4n1.747

Abstract

Penanganan nyeri pascaoperatif kurang baik akan membuat pasien trauma terhadap pembedahan dan menimbulkan komplikasi lain. Penelitian ini bertujuan membandingkan pemberian bupivakain secara kombinasi intramuskular (IMSK) dan subkutis dengan pemberian subkutis saja (SK) terhadap mulai pemberian dan kebutuhan analgetik rescue pascaoperasi laparatomi ginekologi. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung bulan September–Desember 2014 terhadap 46 wanita (18–60 tahun) status fisik American Society of Anesthesiology (ASA) I–II yang menjalani pembedahan laparatomi ginekologi secara uji acak terkontrol buta ganda dalam anestesi umum. Pasien dibagi menjadi dua, yaitu 23 orang menerima bupivakain kombinasi pada otot rectus abdominis dan subkutis dan 23 orang menerima bupivakain infiltrasi subkutis saja. Penilaian skala nyeri menggunakan nilai numeric rating scale dan dilakukan pencatatan pada jam ke-1, 2, 3, 4, 5, 6, 8, 12, dan 24 pascaoperasi. Pemberian analgetik rescue dilakukan bila nilai NRS ≥4. Data dianalisis dengan uji-t, chi-kuadrat, dan Mann-Whitney. Pada penelitian ini ditemukan waktu mulai pemberian analgetik rescue pada kelompok IMSK lebih lama (p<0,01) dan kebutuhan analgetik tambahan dalam 24 jam lebih sedikit (p<0,01) dibanding dengan kelompok SK. Simpulan, pemberian bupivakain secara kombinasi intramuskular dan subkutis lebih baik dibanding dengan pemberian subkutis saja terhadap waktu mulai pemberian dan kebutuhan analgetik rescue dalam 24 jam pascaoperasi laparatomi ginekologi.Kata kunci: Bupivakain, numeric rating scale, otot rectus abdominisComparison between Subcutis Bupivacaine Infiltration and Combined Intramuscular Rectus Abdominal and Subcutis Bupivacaine to on Total Need of Rescue Analgesics after Gynecologic LaparatomyAbstractInappropriate management of post-operative pain will cause trauma to the patient regarding the surgical experience and may possibly cause other complications. This study aimed to compare the administration of intramuscular and subcutis bupivacaine to subcutis only bupivacaine on the start and need for rescue analgesics. This study was conducted in Dr. Hasan Sadikin General Hospital Bandung during the period of September–December 2014 on 46 females aged 18–60 years old with American Society of Anesthesiology (ASA) I–II who underwent gynecological laparatomy under general anesthesia. This was a randomized controlled study. Patients were dividedinto two groups of 23 patients with the first group received combination infiltration and the other received only subcutis administration. The pain scale used was the numerical rating scale measured -1, 2, 3, 4, 5, 6, 8, 12, and 24 hours after surgery. Rescue analgesics was given if NRS was more than 4. Data were analyzed using t-test, chi-square test, and Mann-Whitney test. Observations were performed on time span until there was a need for analgesics for the first time and additional analgesic needed in 24 hours. In this study, the time span until the first dose analgesics was needed was longer and the amount of required analgesics during 24 hours was lower in the combination group (p<0.01). In conclusion, the combination strategy has a better outcome regarding the time span to the start of rescue analgetic and 24 hours analgesic needs.Key words: Bupivacaine, numeric rating scale, abdominal recti muscle 
Perbandingan Angka Keberhasilan Pemasangan Laryngeal Mask Airway (LMA) Jenis Klasik pada Usaha Pertama antara Teknik Balon Dikempiskan dan Dikembangkan Sebagian pada Pasien Dewasa Harahap, Yustisa Sofirina; Tavianto, Doddy; Surahman, Eri
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

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