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Perbandingan antara Sevofluran dan Propofol Menggunakan Total Intravenous Anesthesia Target Controlled Infusion terhadap Waktu Pulih Sadar dan Pemulangan Pasien pada Ekstirpasi Fibroadenoma Payudara Arvianto Arvianto; Ezra Oktaliansah; Eri Surahman
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Penggunaan total intravenous anesthesia (TIVA) dengan propofol terus meningkat karena mudah untuk dikendalikan, onset cepat, durasi singkat, efek samping minimal, serta pemulihan psikomotor dan kognitif lebih cepat. Teknologi target controlled infusion (TCI) diciptakan untuk mempermudah dilakukan TIVA bagi dokter anestesi. Penelitian ini bertujuan mengetahui perbandingan waktu pulih sadar dan pemulangan pasien antara teknik anestesi sevofluran dan TIVA TCI propofol. Penelitian ini dilakukan secara acak terkontrol buta tunggal terhadap 36 orang pasien bedah rawat jalan, wanita usia 18–65 tahun dengan status fisik American Society of Anesthesiologists (ASA) kelas I–II yang menjalani operasi biopsi ekstirpasi fibroadenoma payudara satu sisi di Rumah Sakit Dr. Hasan Sadikin Bandung periode Agustus–November 2015. Sampel dikelompokkan secara random menjadi kelompok sevofluran dan TCI. Kelompok sevofluran mendapatkan anestesi inhalasi sevofluran dan kelompok TCI mendapatkan anestesi TCI propofol dengan metode Schnider Effect Concentration (ec). Waktu pulih sadar dan pemulangan pasien dikumpulkan dan dianalisis menggunakan uji-t, uji Mann-Whitney, dan chi-kuadrat dengan tingkat kepercayaan 95%. Hasil penelitian menunjukkan perbandingan waktu pulih sadar pada kelompok sevofluran, 429±0,763 menit, sedangkan kelompok TCI 9,356±2,331 menit. Simpulan penelitian adalah teknik anestesi sevofluran memberikan waktu pulih sadar yang lebih cepat dan TIVA TCI propofol memberikan waktu pemulangan pasien yang lebih cepat.Kata kunci: Fibroadenoma payudara, sevofluran, TIVA TCI propofol, waktu pulih sadar, waktu pemulangan pasien Comparison of Emergence Time and Discharge Time between Sevoflurane and Propofol Using Total Intravenous Anesthesia with Target Controlled Infusion in Patients Underwent Extirpation of Breast FibroadenomaTotal intravenous anesthesia (TIVA) with propofol is increasingly used, because it is easy to control, has rapid onset, short duration, minimal adverse effects, and rapid recovery of the psychomotor and cognitive functions. This study was conducted to compare the emergence and discharge time between patients receiving sevoflurane and propofol with TCI. A single blind randomized controlled clinical trial was conducted on 36 female patients aged 18–65 years with American Society of Anesthesiologists (ASA) physical status I–II, who underwent breast fibroadenoma extirpation biopsy at the outpatient surgical unit in Dr. Hasan Sadikin General Hospital Bandung. The subjects were randomized and divided into two groups: sevoflurane group receiving inhalation anesthesia with sevoflurane and target controlled infusion (TCI) group receiving propofol TCI Schnider’s Effect Concentration (ec). The mergence time and discharge time were recorded for each group and analysis was performed using Mann Whitney test, t-test and chi-square/Fisher’s exact with 95% confidence interval. This study showed that the emergence time in sevoflurane group and TCI group were 7.429±0.763 minutes and 9.356±2.331 minutes, respectively. The result showed that sevoflurane provides shorter emergence time while TIVA with TCI propofol provides shorter discharge time.Key words: Breast fibroadenoma, emergence time, patients discharging time TIVA TCI propofol, sevoflurane

Efektivitas Penggunaan Prewarming dan Water Warming untuk Mengurangi Penurunan Suhu Intraoperatif pada Operasi Ortopedi Ekstremitas Bawah dengan Anestesi Spinal Emvina Husni Syam; Erwin Pradian; Eri Surahman
Jurnal Anestesi Perioperatif Vol 1, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Laju penurunan suhu inti tubuh dapat dikurangi dengan tindakan pemanasan sebelum operasi (prewarming) selama 30 menit dan menggunakan alas penghangat water warming selama operasi. Tujuan penelitian ini untuk mengetahui efektivitas prewarming dan alas penghangat water warming dalam mengurangi penurunan suhu intraoperatif. Penelitian dilakukan dengan metode acak terkontrol buta tunggal terhadap 30 pasien di ruang operasi bedah sentral Rumah Sakit Dr. Hasan Sadikin Bandung pada Mei–Juli 2013 yang dikelompokkan menjadi tiga, yaitu kelompok yang dilakukan prewarming selama 30 menit dan menggunakan alas penghangat water warming selama operasi, kelompok pasien yang menggunakan alas penghangat water warming selama operasi, dan kelompok kontrol. Pencatatan suhu inti tubuh dilakukan pada membran timpani tiap 15 menit sejak awal induksi sampai operasi selesai. Analisis data hasil penelitian dilakukan dengan uji statistik yaitu uji chi-kuadrat, uji-t, Uji Friedman dan uji analysis of variance (ANOVA) dengan nilai p<0,05 dianggap bermakna. Suhu inti tubuh rata-rata pada kelompok prewarming dan water warming 36,62 °C (p=0,023), kelompok water warming 36,24 °C (p<0,001), dan kelompok kontrol 35,94 °C (p<0,001) yang secara statistik berbeda signifikan. Simpulan penelitian ini adalah penggunaan prewarming dan water warming dapat mengurangi dan memperlambat derajat penurunan suhu selama operasi.Kata kunci: Prewarming, suhu inti tubuh, water warmingEffectiveness of Prewarming and Water Warming to Reduce Intraoperative Temperature Decrease on Spinal Anesthesia for Lower Extremity Orthopedic SurgeryThe decline rate of core body temperature can be reduced by perioperative care such as prewarming (the application of heat to patient’s body prior to surgery) for 30 minutes and by using a water warming pad during surgery. The purpose of this study was to determine the effectiveness of prewarming and water warming pad to reduce intraoperative temperature decrease on spinal anesthesia. This study was conducted by a single-blind randomized controlled trials method involving 30 patients in central operating theatre Dr. Hasan Sadikin Hospital-Bandung within May–July 2013 were classified into three groups, the group of prewarming patients performed for 30 minutes and were using water warming pad during surgery; the group of patients without prewarming and were using water warming pad during surgery; and the control group. Core body temperature on tympanic membrane was recorded every 15 minutes from the initial induction through the end of operation. The result data were analyzed by using chi-square (χ2) test, t test, Friedman Test and ANOVA test, in which the value of p<0.05 was considered significant. Average core body temperature of the prewarming and water warming pad group was 36.62 °C (p=0.023), the water warming pad group was 36.24 °C (p<0.001), and the control group was 35.94 °C (p<0.001), this result statistically significant. The conclusion of this study is prewarming prior to surgery and the use of water warming pad during surgery could reduce temperature decline rate during operation.Key words: Core body temperature, prewarming, water warming DOI: 10.15851/jap.v1n2.119

Insidensi dan Faktor Risiko Hipotensi pada Pasien yang Menjalani Seksio Sesarea dengan Anestesi Spinal di Rumah Sakit Dr. Hasan Sadikin Bandung Rini Rustini; Iwan Fuadi; Eri Surahman
Jurnal Anestesi Perioperatif Vol 4, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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

Kejadian Post Dural Puncture Headache dan Nilai Numeric Rating Scale Pascaseksio Sesarea dengan Anestesi Spinal Dino Irawan; Doddy Tavianto; Eri Surahman
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Kejadian nyeri kepala pascaanestesi spinal (post dural puncture headache; PDPH) berhubungan dengan ukuran lubang dura akibat proses penusukan. Tujuan penelitian ini untuk mengetahui kejadian PDPH pada pasien pascaseksio sesarea dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan Januari–April 2010. Penelitian dilakukan terhadap 115 wanita hamil, status fisik American Society of Anesthesiologist (ASA) II, berusia 18–45 tahun. Penelitian bersifat observasional dengan rancangan cross sectional. Hasil observasi didapatkan kejadian PDPH pada jarum tipe quincke no. 25 sebesar 68,2%, pada jarum tipe quincke no. 27 sebesar 31,8% dan tidak ditemukan pada jarum tipe pencil point no. 27. Nilai numeric rating scale (NRS) dari PDPH pada tipe jarum quincke no. 25 adalah 3–7, pada tipe jarum quincke no. 27 adalah 2–6, dan 0 pada tipe jarum spinal pencil point no. 27. Simpulan penelitian adalah bahwa kejadian PDPH pada pasien seksio sesarea dengan anestesi spinal berdasarkan tipe jarum spinal paling banyak didapatkan pada jarum tipe quincke no. 25, selanjutnya pada jarum tipe quincke no. 27 dan tidak ditemukan pada jarum tipe pencil point no. 27.Kata kunci: Anestesi spinal, numeric rating scale, post dural puncture headacheThe Incidence of Postdural Puncture Headache and Numeric Rating Scale Score After the Caesarean Section with Spinal AnesthesiaAbstractThe incidence of post dural puncture headache (PDPH) is associated with the size of duramater diameter puncture caused by the puncture itself. There are two factors related to this problem, the size of the needle and the shape of the needle’s-end. The purpose of this study was to obtain an overview of incidence of PDPH in patients undergoing caesarean section with regional spinal anesthesia in Dr. Hasan Sadikin Hospital Bandung in January–April 2010. This research was conducted on 115 pregnant woman with physical status of American Society of Anesthesiologist (ASA) II, range of age was 18 to 45 years old. This research was an observational study with cross-sectional design. The incidence of PDPH after the use of Quincke type needle no. 25 was 68.2%, while with Quincke type needle no. 27 was 31.8%, and no PDPH was found on the use of pencil point type needle no. 27. The numeric rating scale (NRS) from PDPH on the use of Quincke type needle no. 25 was 3–7, while on Quincke type needle no. 27 was 2–6, and 0 in pencil point type needle no. 27. As the conclusion, the greatest incidence of PDPH in patients undergoing caesarean section, based on spinal needle type, occurs most with no. 25 Quincke type needles, and less with no. 27 and none with no. 27.Key words: Numeric rating scale, post dural puncture headache, spinal anesthesia DOI: 10.15851/jap.v1n3.197

Prevalensi dan Faktor Risiko Nyeri Punggung Bawah di Lingkungan Kerja Anestesiologi Rumah Sakit Dr. Hasan Sadikin Bandung Meilani Patrianingrum; Ezra Oktaliansah; Eri Surahman
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Nyeri punggung bawah (NPB) merupakan masalah kesehatan yang banyak dialami oleh tenaga kesehatan. Tujuan penelitian ini untuk mengetahui prevalensi dan faktor risiko nyeri punggung bawah di lingkungan kerja anestesiologi dan terapi intensif Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung. Penelitian ini merupakan penelitian deskriptif dengan rancangan studi potong silang. Subjek penelitian meliputi seluruh peserta pendidikan dokter spesialis (PPDS) dan konsulen anestesiologi di RS Dr. Hasan Sadikin Bandung periode bulan April─Juni 2014. Analisis data dilakukan dengan uji chi-kuadrat, Eksak Fisher dan Kolmogorov Smirnov. Hasil penelitian menunjukkan bahwa prevalensi nyeri punggung bawah yang timbul setelah masuk dalam lingkungan kerja anestesiologi di RSHS adalah 35,7%. Faktor risiko yang signifikan adalah kebiasaan merokok (RR 1,35) dan kurang olahraga (RR 80,04). Faktor posisi saat melakukan tindakan anestesi signifikan menimbulkan nyeri punggung bawah. Simpulan, prevalensi nyeri punggung bawah setelah masuk lingkungan kerja anestesiologi RSHS Bandung adalah 35,7% dengan faktor risiko adalah merokok dan kurang olahraga. Faktor posisi selama melakukan tindakan anestesi bersama-sama dengan faktor risiko lain mungkin turut memperberat nyeri punggung bawah. Kata kunci: Anestesi, faktor risiko, nyeri punggung bawah, prevalensiPrevalence and Risk Factors of Lower Back Pain in the Anesthesiology Workplace in Dr. Hasan Sadikin General Hospital BandungAbstractLower back pain (LBP) is a common health problem in many health professionals. The purpose of this study was to determine the prevalence and risk factors causing lower back pain in the anesthesiology workplace at Dr. Hasan Sadikin Hospital General Bandung. This research is a descriptive study with cross-sectional design. Subjects on this research were the anesthesiology residents and consultants in Dr. Hasan Sadikin General Hospital Bandung between April and June 2014. Data analysis was performed by chi-square, Exact Fisher and Kolmogorov Smirnov. The results showed that the prevalence of lower back pain that arises after entering the anesthesiology workplace in Dr. Hasan Sadikin General Hospital Bandung was 37.5%. The significant risk factors were smoking (RR 1.348) and lack of exercise (RR 80.04) while the position factor during conducting anesthesia did not significantly cause lower back pain. The conclusions of this study indicate that the prevalence of low back pain that arises after entering the anesthesiology and intensive therapy workplace in Dr. Hasan Sadikin General Hospital Bandung is 37.5%. In addition, the risk factors that significantly cause lower back pain in the anesthesiology and intensive therapy workplace in Dr. Hasan Sadikin General Hospital Bandung were smoking and lack of exercise. The position factor during conducting anesthesia together with other risk factors may contribute to the arising of lower back pain. Key words: Anesthesia, lower back pain, prevalence, risk factors DOI: 10.15851/jap.v3n1.379

Perbandingan Visual Analog Score antara Teknik Injeksi Air Steril Intrakutan Satu Titik dan Empat Titik untuk Mengurangi Nyeri Persalinan Spontan Faisal Rosady; Erwin Pradian; Eri Surahman
Jurnal Anestesi Perioperatif Vol 2, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Hampir sepertiga para wanita yang menjalani persalinan menderita nyeri persalinan terutama di daerah pinggang belakang yang sifatnya kontinu. Tujuan penelitian ini untuk membandingkan efektivitas antara injeksi satu titik dan empat titik dalam mengurangi nyeri persalinan diukur menggunakan visual analogue scale (VAS). Penelitian ini dilaksanakan bekerjasama dengan Departemen Obstetri dan Ginekologi di Rumah Sakit Dr. Hasan sadikin Bandung terhadap 50 orang wanita primipara yang menjalani persalinan spontan normal pada bulan April–Mei 2012. Disain penelitian ini menggunakan metode klinis acak terkontrol buta tunggal. Data hasil penelitian dianalisis menggunakan uji-t, chi-kuadrat, dan Mann-Whitney dengan tingkat kepercayaan 95% dan dianggap bermakna bila p<0,05. Teknik injeksi satu titik dapat menurunkan skor VAS paling banyak rata-rata dari 85,40 (4,3) menjadi 47,60 (7,2) dibandingkan dengan menggunakan teknik injeksi empat titik, yaitu rata-rata 84,60 (4,3) menjadi 48,4 (8,5) pada menit ke-10. Simpulan penelitian ini tidak terdapat perbedaan penurunan skor VAS antara teknik injeksi air steril intrakutan secara empat titik dibandingkan dengan teknik injeksi satu titik.Kata kunci: Injeksi air steril intrakutan, nyeri persalinan, visual analog scaleComparison of Visual Analogue Score (VAS) between One Point and Four Points Sterile Intracutaneous Water Injection Technique to Reduce Spontaneous Delivery PainAlmost one third of women suffer from continuous lower back pain during labour. Therefore, the aim of this study was to compare the effectivity between single and four injections in reducing labour pain measured by visual analogue scale (VAS). The study was conducted in collaboration with Obstetry and Gynaecology Department in Dr. Hasan Sadikin Hospital Bandung on 50 primipara women presenting at term. This study was a single blind randomised controlled trial. Study data was analyzed using t-test, chi-square test and Mann Whitney U test with 95% confidence interval and p<0.05 as statistically significant. One point injection technique can lower VAS scores from an average of 85.40 (4.3) to 47.60 (7.2) as compared to using four-point injection technique, from an average 84.60 (4.3) to 48.4 (8.5) at the 10th minute. In conclusion, there is no difference between one and four points sterile intracutaneous water injection technique in reducing pain as measured by VAS score.Key words: Intradermal sterile water injections, labour pain, visual analogue scale DOI: 10.15851/jap.v2n1.233

Perbandingan Gabapentin 600 mg dengan Pregabalin 150 mg Preoperatif terhadap Nilai Numeric Rating Scale dan Pengurangan Kebutuhan Opioid Pascaoperasi Modifikasi Radikal Mastektomi Rully Agustine; Ezra Oktaliansyah; Eri Surahman
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Gabapentin dan pregabalin mempunyai efek antihiperalgesia, antialodinia, dan antinosiseptif untuk mengurangi nyeri pascaoperatif. Penelitian ini bertujuan untuk membandingkan gabapentin 600 mg (n=22) dengan pregabalin 150 mg (22) terhadap nyeri pascaoperatif modifikasi mastektomi radikal, yang dilakukan terhadap 44 wanita (18–65 tahun) status fisik American Society of Anesthesiologist (ASA) I-II secara uji acak terkontrol buta ganda dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung pada November 2011 sampai Maret 2012. Analisis statistik menggunakan Uji Mann-Whitney, uji-t dan uji chi-kuadrat dengan tingkat kepercayaan 95% dan bermakna bila p<0,05. Penilaian skala nyeri menggunakan nilai numeric rating scale (NRS). Nilai NRS saat berbaring pada kelompok gabapentin 600 mg dan pregabalin 150 mg adalah sama (p>0,05). Nilai NRS saat mobilisasi pregabalin 150 mg lebih baik daripada gabapentin 600 mg pada tujuh dari sepuluh waktu pengukuran (p<0,05). Pemberian analgetik tambahan pascaoperatif antara kedua kelompok adalah sama (p>0,05). Simpulan, pregabalin 150 mg preoperatif lebih baik dari gabapentin 600 mg dalam menurunkan nilai NRS pascaoperasi. Gabapentin 600 mg dan pregabalin 150 mg mampu menurunkan kebutuhan opioid pascaoperatif. Kata kunci: Gabapentin, kebutuhan analgetik opioid, numeric rating scale, nyeri pascaoperatif, pregabalin Comparison of Pre Operative Gabapentin 600 mg and Pregabalin 150 mg to the Value of Numeric Rating Scale and the Reduction of Post Operative Opioid Requirement after Modified Radical MastectomyGabapentin and pregabalin has anti hiperalgesia, anti allodynia, and anti nocicentive effect that can be used as an additional medication to reduce postoperative pain. This study compared gabapentin 600 mg and pregabalin 150 mg in managing postoperative pain following modified radical mastectomy. The study was done by conducting a double blind randomized controlled trial of 44 patients who underwent modified radical mastectomy operation under general anesthesia, aged 18–65 years, with American Society of Anesthesiologist (ASA) physical status I-II at Dr. Hasan sadikin General Hospital Bandung during November 2011 to March 2012. Patients were divided into two groups 600 mg gabapentin (n=22), and 150 mg pregabalin (n=22). Statistical analysis using Mann-Whitney Test, t-test and chi-square test with 95% confidence interval and considered significant if p<0.05. The quality of pain was assessed by using a numeric rating scale. The NRS value at rest was similar in both groups (p>0.05). NRS during mobilization were significantly different in nine measurements (p<0.05). Total postoperative additional analgesia shown no significant differences in both groups (p>0.05). Oral preoperatif pregabalin 150 mg is better than gabapentin 600 mg for reducing post operative NRS. Gabapentin 600 mg and pregabalin 150 mg reduced postoperative opioid consumption.Key words: Gabapentin, numeric rating scale score, opioid analgesic requirement, post operative, pregabalin DOI: 10.15851/jap.v2n2.305

Perbandingan Angka Keberhasilan Pemasangan Laryngeal Mask Airway (LMA) Jenis Klasik pada Usaha Pertama antara Teknik Balon Dikempiskan dan Dikembangkan Sebagian pada Pasien Dewasa Yustisa Sofirina Harahap; Doddy Tavianto; Eri Surahman
Jurnal Anestesi Perioperatif Vol 4, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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

Gambaran Jenis Bakteri pada Ujung Kateter Epidural di Rumah Sakit Dr. Hasan Sadikin Bandung Indra Nur Hidayat; - Suwarman; Eri Surahman
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Analgesia epidural merupakan metode yang efektif untuk tatalaksana pengelolaan nyeri pascaoperatif. Meskipun jarang, infeksi dapat terjadi setelah proses pemasangan kateter epidural. Penelitian ini bertujuan untuk mengetahui apakah ada bakteri pada ujung kateter epidural dan bakteri apa yang tersering pada ujung kateter epidural. Penelitian ini adalah penelitian deskriptif prospektif yang dilakukan terhadap 52 orang pasien yang menjalani anestesi epidural dan digunakan sebagai analgetik epidural selama bulan Februari 2014 di Rumah Sakit Dr. Hasan Sadikin Bandung. Anastesi epidural dipasang dengan tindakan aseptik dan antiseptik sebelum operasi dan kemudian digunakan sebagai analgetik epidural setelah hari ketiga kateter epidural dicabut dengan tindakan antiseptik dan aseptik sebelumnya kemudian dibuat apus mengunakan swab steril dan diperiksakan kultur bakteri di laboratorium mikrobiologi, Patologi Klinik di Rumah Sakit Dr. Hasan Sadikin Bandung. Hasil penelitian ini didapatkan 14 dari 52 kateter epidural yang dipasang pada bulan Februari 2014 terkontaminasi oleh bakteri. S. epidermidis, S. hominis, dan Acinetobacter baumannii merupakan bakteri yang ditemukan pada ujung kateter epidural. Simpulan, didapatkan hasil 26% dari 52 ujung kateter yang digunakan sebagai analgetik epidural terkontaminasi oleh bakteri. Bakteri yang tersering yang ditemukan di dalam rongga epidural adalah Staphylococcus epidermidis diikuti oleh Staphylococcus hominis dan Acinetobacter baumannii.Kata kunci: Analgesia epidural, kultur bakteri, ujung kateter epiduralBacterial Profile of Epidural Catheters Tips in Dr. Hasan Sadikin General Hospital BandungAbstractEpidural analgesia is an effective method for post-operative pain management. Although rare, the infection may occur after an epidural catheter insertion process. There are very few reported cases; however some cases of infection, such as epidural abscess, is are serious and life threatening cases if not diagnosed early and treated well. The aim of this study was to prove the presence of bacterial contamination on epidural catheters tips and to describe the kind of bacteria found. This descriptive prospective study was conducted on 52 patients who used epidural anesthesia and epidural analgesics during the month of February 2014 in Dr Hasan Sadikin Hospital General Bandung. Epidural anesthesia was performed using antiseptic and aseptic procedures before the surgery, then used as epidural analgesia. After the third day, the catheter was removed using aseptic and antiseptic procedures and the tip catheter was smeared by a sterile swab. Cultures were then grown and examined at the microbiology laboratory of the Clinical Phatogology Department of Dr. Hasan Sadikin General Hospital Bandung. It was revealed that 14 of 52 epidural catheters placed during the month of February 2014 were contaminated by bacteria. S. epidermidis, S. hominis, and Acinetobacter baumannii were found on epidural catheter tips. It is concluded in this study that 26.3% of 52 catheter tips used as an epidural analgesic were contaminated by bacteria. The most common bacteria found in the epidural space is Staphylococcus epidermidis, followed by Staphylococcus hominis and Acinetobacter baumannii.Key words: Analgetic epidural, bacterial cultur, epidural catheter tip DOI: 10.15851/jap.v3n1.377

Perbandingan Kombinasi Tramadol Parasetamol Intravena dengan Tramadol Ketorolak Intravena terhadap Nilai Numeric Rating Scale dan Kebutuhan Opioid Pascahisterektomi Dendi Karmena; Ezra Oktaliansah; Eri Surahman
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Nyeri pascabedah adalah masalah penting dalam pembedahan. Penelitian ini bertujuan membandingkan kombinasi tramadol parasetamol intravena dengan tramadol ketorolak intravena terhadap nilai numeric rating scale (NRS) dan kebutuhan opioid pascabedah histerektomi abdominal. Uji klinik acak terkontrol buta ganda dilakukan terhadap 42 wanita (18–60 tahun) status fisik American Society of Anesthesiologist (ASA) I–II yang menjalani pembedahan histerektomi abdominal dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Agustus–November 2014. Pasien dibagi menjadi dua kelompok, yaitu 21 orang menerima kombinasi tramadol parasetamol intravena dan 21 orang menerima kombinasi tramadol ketorolak intravena yang diberikan saat dilakukan penutupan peritoneum. Penilaian skala nyeri dilakukan dengan menggunakan nilai numeric rating scale baik pada saat istirahat maupun saat mobilisasi. Analisis menggunakan Uji Mann-Whitney. Pada penelitian ini ditemukan nilai NRS pada kelompok tramadol parasetamol dan kelompok tramadol ketorolak tidak berbeda bermakna (p>0,05). Simpulan penelitian ini adalah pemberian kombinasi tramadol parasetamol intravena sebanding dengan kombinasi tramadol ketorolak terhadap nilai NRS dan kebutuhan opioid pascabedah histerektomi abdominal.Kata kunci: Kebutuhan opioid, ketorolak, numeric rating scale, parasetamol, tramadolComparison of Combined Intravenous Tramadol-Paracetamol Versus Tramadol-Ketorolac on Numeric Rating Scale and Opioid Requirement on Post Histerectomy PatientsPostoperative pain is an important problem in surgery. This study aimed to compare the combination of intravenous tramadol paracetamol and tramadol ketorolac to numeric rating scale (NRS) to postoperative opioid requirements in abdominal hysterectomy. Double blind randomized controlled trial was conducted on 42 women (18–60 years) with ASA physical status I–II who underwent abdominal hysterectomy surgery under general anesthesia in Dr. Hasan Sadikin General Hospital Bandung within the period of August–November 2014. Subjects were divided into two groups: 21 subjects received a combination of intravenous tramadol paracetamol and 21 subjects received combination of intravenous tramadol ketorolac that was given when peritoneum was closure. The assessment of postoperative pain was performed using a numeric rating scale both at rest and during mobilization. Correlation analysis is conducted using Mann-whitney test. Result shows that the value of the NRS in group tramadol paracetamol compared to tramadol ketorolac was not significantly different (p>0.05). This study concludes that the combinations of intravenous tramadol paracetamol and tramadol ketorolac are the same in terms of the NRS and postoperative opioid requirement after abdominal hysterectomy.Key words: Ketorolac, numeric rating scale, opioid requirement, paracetamol, tramadol DOI: 10.15851/jap.v3n3.612

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