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Perbandingan Efek Induksi Propofol dengan Ketamin terhadap Penurunan Nilai Neutrofil pada Pasien dengan Tindakan Anestesi Umum Putra, Angga Permana; Arifin, Hasanul; Mursin, Chairul M.
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (719.611 KB) | DOI: 10.15851/jap.v5n1.999

Abstract

Leukosit merupakan bagian dari imunitas bawaan. Penurunan nilai neutrofil dapat dipakai sebagai parameter yang sederhana untuk mengukur berat ringannya stres dan inflamasi sistemik pada pasien. Beberapa penelitian mengemukakan pengaruh obat-obat anestesi terhadap leukosit dan penelitian yang lain melihat dari pengaruh obat-obat anestesi terhadap fungsi dari subset leukosit terutama neutrofil. Tujuan penelitian ini mengetahui perbedaan efek induksi propofol dengan ketamin terhadap penurunan nilai neutrofil pada pasien dengan tindakan anestesi umum di Instalasi Bedah Pusat RSUP H. Adam MalikMedan mulai Mei–Juni 2016. Penelitian uji klinis dengan  randomized control trial double blind dilakukan pada 32 pasien ASA I dan II dibagi dalam 2 kelompok yang menjalani operasi dengan anestesi umum. Pasien pada kelompok propofol (A) diberikan induksi dengan propofol 2 mg/kgBB. Kelompok ketamin diinduksi ketamin 2 mg/kgBB. Kemudian diukur nilai neutrofil (%) pada saat sebelum induksi (T1), 10 menit setelah intubasi (T2), dan 60 menit setelah insisi kulit (T3). Dengan SPSS ver.23, Uji T-independen dan Mann-Whitney U didapatkan hasil T1 neutrofil nilai p=0,636, T2 neutrofil nilai p=0,846, T3 neutrofil nilai p=0,403. Simpulan, terdapat perbedaan efek induksi antara propofol dan ketamin terhadap penurunan nilai neutrofil. Terdapat pengaruh ketamin terhadap penurunan nilai neutrofil, tetapi tidak ada pengaruh propofol terhadap penurunan nilai neutrofil.Kata kunci: Ketamin, leukosit, neutrofil, propofolComparison of Induction Effect between Propofol and Ketamine against Impairment of Neutrophils in Patient with General AnesthesiaLeukocyte is a part of innate immunity elements. Neutrophil impairment of can be used as a simple parameter to measure the severity of stress and systemic inflammation in patients. Some research suggests the influence of anesthetic drugs on leukocytes and other studies look at the effect of anesthetic drugs on leukocyte subset functions, especially neutrophils. This study aimed to reveal the difference in the induction effect of propofol and ketamine against impairment of neutrophils in patients with general anesthesia. This was a double blind randomized control trial conducted in 32 patients ASA I and II who were divided into two groups. These patients underwent general anesthesia at the Central Operating Theater of H. Adam Malik General Hospital during May–June 2016. Group propofol (A) received 2 mg/kgBW propofol, while group ketamine (B) received 2 mg/kgBW ketamine. Neutrophils were measured before induction (T1), 10 minutes after intubation (T2), and 60 minutes after intubation (T3). By using T-independent and Mann-Whitney U test in SPSS ver.23, it was found that the the p-values for T1. T2, and T3 neutrophils were 0.636,0.846, and 0.403. respectively. In conclusion, there is a difference in induction effect between propofol and ketamine against impairment of neutrophils with no effect is found for propofol.Key words: Ketamine, leukocyte, neutrophils, propofol  
Perbedaan Nilai Agregasi Trombosit Akibat Pengaruh Penggunaan Analgesia Ketorolak dan Ibuprofen Intravena Pascaoperasi di RSUP Haji Adam Malik Medan Fithri, Dewi Yuliana; Wijaya, Dadik Wahyu; Arifin, Hasanul
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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

Abstract

Obat anti-inflamasi nonsteroid (OAINS) merupakan analgetik yang sering digunakan pada pascaoperasi bedah ortopedi. Penelitian ini bertujuan melihat apakah terdapat perbedaan nilai agregasi trombosit akibat pengaruh penggunaan analgestik ketorolak dengan ibuprofen intravena setelah operasi. Penelitian ini merupakan penelitian uji klinis dengan uji acak tersamar buta ganda yang membandingkan perbedaan pengaruh ketorolak  30 mg intravena/6 jam dengan ibuprofen 800 mg intravena/6 jam. Populasi penelitian ini adalah pasien yang menjalani tindakan pembedahan elektif dengan anestesi umum di RSUP Haji Adam Malik Medan pada bulan Agustus 2016. Pasien dibagi menjadi 2 kelompok dengan tiap-tiap kelompok berjumlah 20 pasien. Ketorolak atau ibuprofen sebagai analgetik diberikan setelah 30 menit selesai operasi, kemudian dilanjutkan per 6 jam sampai dengan 2 hari selesai operasi. Uji statistik menggunakan tes Wilcoxon untuk sebelum perlakuan dan Uji Mann-Whitney untuk sesudah perlakuan pada kedua kelompok. Data karakteristik subjek homogen. Agregasi trombosit pada kelompok ketorolak dengan kelompok ibuprofen berbeda bermakna setelah 10 menit ekstubasi dengan 8 jam setelah pemberian obat terakhir. Tidak terdapat perbedaan bermakna antara kelompok ketorolak dan kelompok ibuprofen setelah 10 menit ekstubasi (p>0,05), namun terdapat perbedaan bermakna pada 8 jam setelah akhir pemberian obat. Simpulan, ketorolak menurunkan persentase agregasi trombosit lebih besar daripada ibuprofen setelah 8 jam pemberian obat terakhir. Differences in Platelet Aggregation Values in Postoperative Intravenous Ketorolac and Ibuprofen Analgesics at Haji Adam Malik Central General Hospital MedanNon-steroidal anti-inflammatory drugs (NSAIDs) are analgesics used for postoperative orthopedic surgery. This study aimed to underrstand the effect of intravenous ketorolac and ibuprofen on platelet aggregation values. This was a double-blind randomized controlled trial that compared the effects of intravenous ketorolac and ibuprofen. The population of this study were patients undergoing elective surgery under general anesthesia at Haji Adam Malik Central General Hospital Medan in August 2016. Patients were divided into 2 groups (n: 20): ketorolac group andibuprofen group. Both group received analgesic 30 minutes after surgery up to 2 days postoperative. The statistical tests used were Wilcoxon test for pre-treatment and Mann-Whitney test for post-treatment in each group. Subject characteristic data were homogenous. Platelet aggregation of ketorolac and ibuprofen groups differed significantly between 10 minutes after extubation and 8 hours after the last drug administration. There was no significant difference between the ketorolac and ibuprofen groups after 10 minutes of extubation (p>0.05); however there was a significant difference at 8 hours after the end of drug administration. In conclusion, ketorolac decreases platelet aggregation percentage greater than ibuprofen after 8 hours of the last drug administration. 
Perbandingan Efek Sevofluran dengan Halotan terhadap Jumlah Neutrofil Hafniana, Hafniana; Arifin, Hasanul
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (655.793 KB) | DOI: 10.15851/jap.v5n3.1169

Abstract

Neutrofil berperan penting dalam respons imun nonspesifik. Penurunan nilai neutrofil dapat dipakai sebagai parameter sederhana untuk mengukur tingkat stres dan inflamasi sistemik. Penelitian ini bertujuan mengetahui efek agen inhalasi sevofluran dan halotan terhadap penurunan neutrofil. Penelitian ini merupakan uji klinis dengan acak tersamar buta ganda yang membandingkan efek sevofluran dengan halotan terhadap  jumlah neutrofil pada 36 pasien ASA I dan II yang menjalani operasi elektif dengan anestesi umum di RSUP Haji Adam Malik Medan periode September 2016. Pasien dibagi dua kelompok, yaitu kelompok yang mendapat agen inhalasi sevofluran dan kelompok yang mendapat inhalasi halotan. Jumlah neutrofil dihitung pada kedua kelompok pada saat sebelum operasi, setelah induksi, dan 90 menit setelah inhalasi. Jumlah neutrofil pada kedua kelompok tidak mengalami penurunan sebelum operasi dan setelah induksi (p>0,005), namun mengalami penurunan pada 90 menit setelah inhalasi (p<0,005) pada tiap-tiap kelompok, namun uji beda antara kelompok sevofluran dan halotan tidak bermakna pada tiga kali pengukuran.  Simpulan, tidak terdapat perbedaan antara sevofluran dan halotan terhadap penurunan jumlah neutrofil.Comparison of  Sevoflurane and Halothane Effects on Neutrophil CountsNeutrophil has an important role in non-spesific immune responses. The declining value of neutrophil can be used as a parameter to measure the level of stress and systemic inflammation. This study aimed to determine the effects of sevoflurane and halothane inhalation agents on the number of neutrophil. This was a double-blind randomized comparing the effects of sevoflurane and halothane on the number of neutrophil in 36 ASA 1 and II patients underwent elective surgery under general anesthesia at Haji Adam Malik Central General Hospital  Medan during September 2016. Patients were divided into two groups: the group that received sevoflurane inhalation and the group that received halothane inhalation. The number of neutrophils was counted in both groups before surgery, after induction, and 90 minutes after inhalation. Both groups did not experience a decrease in neutrophil counts before surgery and after induction (p>0.005), but suffered a decline in the number of neuthrophils 90 minutes after inhalation (p>0.005). The difference between the sevoflurane and halothane groups was not meaningful in the three times of measurement. In conclusion, there is no difference between sevoflurane and halothane terms of declined number of neutrophils. 
Perbandingan Nilai SpO2 dan EtCO2 pada Anestesi Umum dengan Teknik Low Flow dan High Flow Arifin, Hasanul; Andri, Mufti
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (578.207 KB) | DOI: 10.15851/jap.v4n3.896

Abstract

 Metode anestesi umum dengan obat anestesi inhalasi yang saat ini banyak dilakukan adalah teknik high-flow anesthesia (HFA). Penelitian ini bertujuan mengetahui perbandingan penilaian SpO2 dan EtCO2 antara teknik anestesi low flow dan high flow. Penelitian ini merupakan uji klinis acak tersamar tunggal pada 54 pasien dewasa, usia 21–50 tahun, status fisik menurut American Society of Anesthesiologist (ASA) 1 yang akan menjalani operasi elektif dengan anestesi umum dan intubasi di Rumah Sakit H. Adam Malik Medan. Sampel dibagi menjadi dua kelompok, yaitu kelompok A mendapat teknik low flow anesthesia (FGF 1 L/menit) dan kelompok B mendapat teknik high flow anesthesia (FGF 4 L/menit). Dilakukan penilaian SpO2, EtCO2 setiap 10 menit selama anestesi. Uji statistik menggunakan Uji Mann-Whitney U dan t-test pada perangkat lunak SPSS 23. Penelitian ini menunjukkan SpO2 selama anestesi pada kelompok low flow anesthesia 98,63%±0,39%, high flow anesthesia 98,70%±0,37%. EtCO2 selama anestesi pada kelompok low flow anesthesia 33,73 mmHg±0,54 mmHg, high flow anesthesia 32,77 mmHg±0,39 mmHg. Nilai SpO2 dan EtCO2 selama anestesi pada kedua kelompok tidak terdapat perbedaan yang bermakna (p>0,05). Simpulan, menunjukkan tidak ada perbedaan nilai SpO2 dengan EtCO2 kedua jenis teknik anestesi.Kata kunci: EtCO2 , high flow anesthesia, isofluran, low flow anesthesia, SpO2Difference in Spo2 and EtC02 Values between Low Flow and High Flow AnesthesiaCurrent general anesthesia method through the use of inhalational anesthetics uses the high-flow anesthesia (HFA) approach. This study aimed to compare the SpO2 and EtCO2 in low flow anesthesia and high flow anesthesia. This is a single blind, randomized clinical trial on 54 adult patients, 21–50 years, with physical status ASA 1 who underwent elective surgery under general anesthesia through intubation at H. Adam Malik Medan General Hospital during the period of October 2014 to April 2015. Samples were divided into two groups of 27 subjects. Group A received low flow anesthesia (FGF 1 liter/minute) and group B received high flow anesthesia (FGF 4 liters/minute). The SpO2 and EtCO2 were observed every 10 minutes during anesthesia. Analysis was performed using Mann-Whitney U test and t-test in SPSS 23 software. This study showed that the mean SpO2 during anesthesia for the low flow anesthesia group was 98.63% ± 0.39, and 98.70%±0.37 for the high flow anesthesia. The mean EtCO2 values during anesthesia were 33.73 mmHg± 0.54 and 32.77 mmHg±0.39 for the low flow anesthesia group and high flow anesthesia, respectively. There was no significant difference in SpO2 and EtCO2 values during anesthesia in both groups (p>0.05). Hence, it is concluded that there is no significant difference in SpO2 and EtCO2 values between low flow and high flow anesthesia techniques.Key words: EtCO2, high flow anesthesia, isoflurane, low flow anesthesia, SpO2  
Sensitivitas dan Spesifisitas Cystatin C dan Kreatinin Serum dalam Mendiagnosis Cedera Ginjal Akut pada Pasien Sepsis yang Dirawat di Ruang Rawat Intensif RSUP H. Adam Malik Medan Arifin, Hasanul; Kurniawan, Heru
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (503.34 KB)

Abstract

Kreatinin serum memiliki banyak keterbatasan dalam mendiagnosis cedera ginjal akut (CGA) terutama dalam ruang lingkup unit perawatan intensif sehingga kurang sensitif untuk menggambarkan tingkat disfungsi ginjal pada pasien sakit kritis. Dari sekian banyak penanda biologis baru yang tersedia, terdapat 4 penanda biologis yang saat ini secara luas digunakan para klinisi di seluruh dunia untuk mendeteksi CGA, antara lain neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, KIM-1, dan interleukin-18. Tujuan penelitian ini adalah mengetahui sensitivitas dan spesifisitas cystatin C dan kreatinin serum dalam mendiagnosis cedera ginjal akut pada pasien sepsis yang dirawat di ruang rawat intensif. Jenis penelitian ini adalah uji diagnostik dengan jumlah sampel 24 pasien dan dikerjakan di ruang rawat intensif Rumah Sakit H. Adam Malik (RSHAM) periode Februari–Maret 2014. Populasi dalam penelitian ini adalah semua pasien dewasa dengan sepsis, sepsis berat, dan syok sepsis di ruang rawat intensif. Uji statistik dilakukan dengan metode receiving operator characteristics (ROC) melalui perangkat lunak SPSS 17. Hasil penelitian ini menunjukkan bahwa cystatin C serum lebih superior dibanding dengan kreatinin serum dalam mendeteksi CGA pada pasien sepsis di ruang rawat intensif. Cystatin C memiliki sensitivitas, nilai prediksi positif, nilai prediksi negatif, dan area under curve -receiving operator characteristics (AUC-ROC) yang lebih tinggi dibanding dengan kreatinin serum. Namun, dari nilai spesifisitas dijumpai nilai yang sama pada kedua penanda biologis. Cystatin C serum memiliki nilai cut-off 1,03 mg/L, sedangkan kreatinin serum mempunyai nilai cut-off 1,0 mg/dL. Simpulan, cystatin C dapat dijadikan penanda biologis alternatif untuk deteksi CGA pada pasien sepsis di RRI (Ruang Rawat Intensif) dengan nilai diagnostik yang lebih baik.Kata kunci: Cedera ginjal akut, cystatin C serum, kreatinin serumSensitivity and Specificity of Serum Cystatin C and Creatinine for Diagnosing Acute Kidney Injury in Sepsis Patients Treated in Intensive Care Unit at H. Adam Malik Hospital MedanSerum creatinine has many limitations when being used to diagnose acute kidney injury (AKI), especially in the scope of intensive care unit due to its low sensitivity to depict the kidney dysfunctional level of critically-ill patients. Out of numerous new available biological markers, four biological markers are widely used all over the world to detect AKI, e.g. neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, KIM-1, and interleukin-18. The purpose of this study was to determine the sensitivity and specificity of serum cystatin C and creatinine in establishing the diagnosis of acute kidney injury in sepsis patients treated in intensive care room. This study was a diagnostic test to 24 patients and conducted in intensive care room of H. Adam Malik Hospital during the period of February–March 2014. Population in this study is all adult patients with sepsis, severe sepsis, and septic shock in the intensive care room. A statistical test was conducted using receiving operator characteristics (ROC) method using SPSS 17 software. The result of this study showed that serum cystatin C was more superior than serum creatinine in detecting acute kidney injury in sepsis patients treated in intensive care room. In this study, cystatin C had higher sensitivity, positive prediction score, negative prediction score, and area under curve -receiving operator characteristics (AUC-ROC) than serum creatinine. As of specificity, there was no significant difference between these two biological markers. Serum cystatin C had a cut-off point of 1.03 mg/dL, and serum creatinine had 1.0 mg/dL. In conclusion, cystatin C can be an alternative biological marker to detect AKI in sepsis patients treated in intensive care room with a better diagnostic value.Key words: Acute kidney injury, serum creatinine, serum cystatin C DOI: 10.15851/jap.v4n2.819
Perbandingan Penilaian Visual Analog Scale dari Injeksi Subkutan Morfin 10 mg dan Bupivakain 0,5% pada Pasien Pascabedah Sesar dengan Anestesi Spinal Fadinie, Wulan; Arifin, Hasanul; Wijaya, Dadik Wahyu
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (497.157 KB)

Abstract

Obat anestesi lokal dan opioid dapat disuntikkan langsung pada luka untuk mengurangi nyeri pascabedah. Penelitian bertujuan menilai intensitas nyeri menggunakan visual analog scale (VAS) dapat menjadi metode yang sangat efektif dalam penilaian nyeri pascabedah. Membandingkan nilai VAS pada saat istirahat dan batuk dari infiltrasi lokal morfin 10 mg dengan bupivakain 0,5% 2 mg/kgBB pada pascabedah sesar dengan metode uji klinis acak tersamar ganda pada 100 sampel. Kriteria inklusi adalah perempuan hamil, usia 20–40 tahun, dengan status fisik menurut American Society of Anesthesia (ASA) kelas I–II yang menjalani bedah sesar elektif dan emergensi di RSUP Haji Adam Malik, RSU dr. Pirngadi, RS Putri Hijau, RS Haji, dan RSU Sundari pada bulan Juli 2014. Sampel dibagi menjadi kelompok A dengan infiltrasi lokal morfin 10 mg dan kelompok B dengan infiltrasi lokal bupivakain 0,5% 2 mg/kgBB. Nilai VAS dianalisis secara statistik dengan Mann-Whitney. Nilai VAS lebih rendah pada kelompok A, yaitu 4,72 (SB=1,54) dibanding dengan kelompok B, yaitu 2,14 (SB=1,21). Simpulan, infiltrasi lokal morfin 10 mg lebih baik dibanding dengan bupivakain 0,5% 2 mg/kgBB.Kata kunci: Bupivakain, infiltrasi lokal, manajemen nyeri, morfin, visual analog scaleComparison of Visual Analog Scale Assestment of Subcutaneous Injection of 10 mg Morphine and 0.5% Bupivacaine in Post-Caesarean Section under Spinal AnesthesiaAbstractLocal anesthetic agent and opioid can subcutaneously be injected into the wound to reduce postoperative pain. This study was conducted to evaluate pain intensity using visual analog scale (VAS), which can be a very effective method of postoperative pain assessment, and to compare VAS when resting and coughing between local infiltration of 10 mg morphine and 2 mg/kgBW 0.5% bupivacaine after caesarian section. This study was a double blinded randomized clinical trial on 100 subjects. The inclusion criteria were pregnant women, aged 20–40 years, with physical ASA I–II status who underwent elective and emergency caesarean section in Haji Adam Malik Hospital, dr. Pirngadi Hospital, Putri HijauHospital, Haji Hospital, and Sundari Hospital during the period of July 2014. Subjects were divided into group A with 10 mg morphine infiltration and group B with 2 mg/kgBW 0.5% bupivacaine local infiltration. The resulting VAS scores were analyzed statistically using Mann-Whitney. ItLower VAS scores were found in group A 4.72 (SB=1.54) when compared to group B 2.14 (SB=1.21). In conclusion, local infiltration of 10 mg morphine is better compared to 2 mg/kgBW 0.5% bupivacaine.Key words: Bupivacaine, local infiltration, morphine, pain management, visual analog scale DOI: 10.15851/jap.v4n2.826
Perdarahan Epidural Spontan Akut pada Kombinasi Terapi Rivaroxaban, Clopidogrel dan Lumbrokinase Irina, Sinta; Umar, Nazaruddin; Arifin, Hasanul; Rehatta, Nancy Margareta; Saleh, Siti Chasnak
Jurnal Neuroanestesi Indonesia Vol 5, No 2 (2016)
Publisher : Departement of Anesthesiology and Intensive Care Dr. Hasan Sadikin Hospital Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v5i2.69

Abstract

Perdarahan intrakranial spontan pada terapi antikoagulan rivaroxaban mulai sering ditemukan, apalagi bila dikombinasi dengan antiplatelet clopidogrel maupun fibrinolitik lumbrokinase merupakan hal yang sering ditemukan pada penderita trombosis. Perdarahan intrakranial spontan terbanyak adalah perdarahan intracerebral. Perdarahan spontan epidural (EDH) akut merupakan hal yang jarang ditemukan, biasanya terjadi karena ada penyakit yang mendasarinya. Penatalaksanaan pada kasus ini berdasarkan patofisiologinya dan melibatkan multidisiplin ilmu lainnya. Seorang laki-laki, 26 tahun berat badan 80 kg yang didiagnosa deep vein thrombosis (DVT) mengalami penurunan kesadaran mendadak, pupil anisokor 4 mm/1mm ketika sedang beraktivitas. Tidak dijumpai riwayat cedera kepala. Setelah diresusitasi didapatkan hasil head CT-scan dengan EDH temporoparietal dextra 50 cc, dilakukan dekompresi craniektomi dan evakuasi EDH. Setelah 10 jam pasca operasi terjadi gejolak hemodinamik dan dilakukan head CT-scan ulang dan didapatkan EDH 80 cc dan minimal perdarahan intracerebral. Dilakukan redo craniektomi. Pasca operasi dirawat di ICU dengan koreksi faktor koagulasi. Pasien kembali komposmentis GCS 15 dengan gejala sisa hemiparese sinistra sementara.Acute Spontaneus Epidural Hemorrhage due to Combination Therapy Rivaroxaban, Clopidogrel and LumbrokinaseSpontaneous intracranial hemorrhage on anticoagulant therapy rivaroxaban lately often found, especially when combined with clopidogrel antiplatelet or fibrinolytic lumbrokinase is often found in patients with thrombosis. Spontaneous intracranial hemorrhage is most widely occured is intracerebral hemmorrhage. Spontaneous epidural hemorrhage (EDH) acute is a uncommon, usually occur because there is an underlying disease. Treatment on the case based on patophysiology and involves a multidisciplinary peer other sciences. A young man, 26 years old weight 80 kg which was diagnosed with deep vein thrombosis (DVT) awareness of sudden decline, the pupil anisokor 4 mm/1mm while activity. No head trauma history. After resuscitation, head Ct-scan with EDH temporoparietal dextra 50 cc, carried out the evacuation EDH and decompression craniektomi. After 10 hours of post-operative haemodynamic turmoil happened and done a head ct-scan and obtained EDH 80 cc and minimal intracerebral hemorrhage. Do redo craniektomi. Post-operative hospitalized in ICU with correction factor for coagulation. The patient recovers conciousness into composmentis GCS 15 with sequelae hemiparese sinistra temporary.
Equianalgesic Oxycodone, Continuous Intravenous Morphine in Post- Long Bone Surgery Franz Josef Tarigan; Hanafie, Achsanuddin; Arifin, Hasanul; Wijaya, Dadik Wahyu
Sumatera Medical Journal Vol. 2 No. 3 (2019): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/sumej.v2i3.1240

Abstract

Oxycodone and morphine are powerful analgesic drugs used for post-operative pain management. There is no studies have been conducted to assess the dose equivalency between the two drugs. To get an equianalgesic dose of Oxycodone and Morphine. This study was using a double-blind randomized clinical trials, 48 samples, ages 21-60 years, PS ASA I-II, which will get an elective orthopedic surgery using general anesthesia tech-niques. Oxycodone (group A) : Morphine (group B) (Initial 5mg than continuous 1 mg/hour : initial dose 4mg than continuous 0,5 mg/hour). Average drug dose for group that takes morphine and oxycodone (3.90 ± 0.46 mg : 1.46 ± 0.51 mg). No significant difference between the average dose (p <0.05). Equianalgesic dosein group Oxycodone and Morphine is 1.4 mg: 3.9mg.
Perbandingan Penilaian Visual Analog Scale dari Injeksi Subkutan Morfin 10 mg dan Bupivakain 0,5% pada Pasien Pascabedah Sesar dengan Anestesi Spinal Wulan Fadinie; Hasanul Arifin; Dadik Wahyu Wijaya
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (497.157 KB)

Abstract

Obat anestesi lokal dan opioid dapat disuntikkan langsung pada luka untuk mengurangi nyeri pascabedah. Penelitian bertujuan menilai intensitas nyeri menggunakan visual analog scale (VAS) dapat menjadi metode yang sangat efektif dalam penilaian nyeri pascabedah. Membandingkan nilai VAS pada saat istirahat dan batuk dari infiltrasi lokal morfin 10 mg dengan bupivakain 0,5% 2 mg/kgBB pada pascabedah sesar dengan metode uji klinis acak tersamar ganda pada 100 sampel. Kriteria inklusi adalah perempuan hamil, usia 20–40 tahun, dengan status fisik menurut American Society of Anesthesia (ASA) kelas I–II yang menjalani bedah sesar elektif dan emergensi di RSUP Haji Adam Malik, RSU dr. Pirngadi, RS Putri Hijau, RS Haji, dan RSU Sundari pada bulan Juli 2014. Sampel dibagi menjadi kelompok A dengan infiltrasi lokal morfin 10 mg dan kelompok B dengan infiltrasi lokal bupivakain 0,5% 2 mg/kgBB. Nilai VAS dianalisis secara statistik dengan Mann-Whitney. Nilai VAS lebih rendah pada kelompok A, yaitu 4,72 (SB=1,54) dibanding dengan kelompok B, yaitu 2,14 (SB=1,21). Simpulan, infiltrasi lokal morfin 10 mg lebih baik dibanding dengan bupivakain 0,5% 2 mg/kgBB.Kata kunci: Bupivakain, infiltrasi lokal, manajemen nyeri, morfin, visual analog scaleComparison of Visual Analog Scale Assestment of Subcutaneous Injection of 10 mg Morphine and 0.5% Bupivacaine in Post-Caesarean Section under Spinal AnesthesiaAbstractLocal anesthetic agent and opioid can subcutaneously be injected into the wound to reduce postoperative pain. This study was conducted to evaluate pain intensity using visual analog scale (VAS), which can be a very effective method of postoperative pain assessment, and to compare VAS when resting and coughing between local infiltration of 10 mg morphine and 2 mg/kgBW 0.5% bupivacaine after caesarian section. This study was a double blinded randomized clinical trial on 100 subjects. The inclusion criteria were pregnant women, aged 20–40 years, with physical ASA I–II status who underwent elective and emergency caesarean section in Haji Adam Malik Hospital, dr. Pirngadi Hospital, Putri HijauHospital, Haji Hospital, and Sundari Hospital during the period of July 2014. Subjects were divided into group A with 10 mg morphine infiltration and group B with 2 mg/kgBW 0.5% bupivacaine local infiltration. The resulting VAS scores were analyzed statistically using Mann-Whitney. ItLower VAS scores were found in group A 4.72 (SB=1.54) when compared to group B 2.14 (SB=1.21). In conclusion, local infiltration of 10 mg morphine is better compared to 2 mg/kgBW 0.5% bupivacaine.Key words: Bupivacaine, local infiltration, morphine, pain management, visual analog scale DOI: 10.15851/jap.v4n2.826
Perbandingan Nilai SpO2 dan EtCO2 pada Anestesi Umum dengan Teknik Low Flow dan High Flow Hasanul Arifin; Mufti Andri
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (578.207 KB) | DOI: 10.15851/jap.v4n3.896

Abstract

 Metode anestesi umum dengan obat anestesi inhalasi yang saat ini banyak dilakukan adalah teknik high-flow anesthesia (HFA). Penelitian ini bertujuan mengetahui perbandingan penilaian SpO2 dan EtCO2 antara teknik anestesi low flow dan high flow. Penelitian ini merupakan uji klinis acak tersamar tunggal pada 54 pasien dewasa, usia 21–50 tahun, status fisik menurut American Society of Anesthesiologist (ASA) 1 yang akan menjalani operasi elektif dengan anestesi umum dan intubasi di Rumah Sakit H. Adam Malik Medan. Sampel dibagi menjadi dua kelompok, yaitu kelompok A mendapat teknik low flow anesthesia (FGF 1 L/menit) dan kelompok B mendapat teknik high flow anesthesia (FGF 4 L/menit). Dilakukan penilaian SpO2, EtCO2 setiap 10 menit selama anestesi. Uji statistik menggunakan Uji Mann-Whitney U dan t-test pada perangkat lunak SPSS 23. Penelitian ini menunjukkan SpO2 selama anestesi pada kelompok low flow anesthesia 98,63%±0,39%, high flow anesthesia 98,70%±0,37%. EtCO2 selama anestesi pada kelompok low flow anesthesia 33,73 mmHg±0,54 mmHg, high flow anesthesia 32,77 mmHg±0,39 mmHg. Nilai SpO2 dan EtCO2 selama anestesi pada kedua kelompok tidak terdapat perbedaan yang bermakna (p>0,05). Simpulan, menunjukkan tidak ada perbedaan nilai SpO2 dengan EtCO2 kedua jenis teknik anestesi.Kata kunci: EtCO2 , high flow anesthesia, isofluran, low flow anesthesia, SpO2Difference in Spo2 and EtC02 Values between Low Flow and High Flow AnesthesiaCurrent general anesthesia method through the use of inhalational anesthetics uses the high-flow anesthesia (HFA) approach. This study aimed to compare the SpO2 and EtCO2 in low flow anesthesia and high flow anesthesia. This is a single blind, randomized clinical trial on 54 adult patients, 21–50 years, with physical status ASA 1 who underwent elective surgery under general anesthesia through intubation at H. Adam Malik Medan General Hospital during the period of October 2014 to April 2015. Samples were divided into two groups of 27 subjects. Group A received low flow anesthesia (FGF 1 liter/minute) and group B received high flow anesthesia (FGF 4 liters/minute). The SpO2 and EtCO2 were observed every 10 minutes during anesthesia. Analysis was performed using Mann-Whitney U test and t-test in SPSS 23 software. This study showed that the mean SpO2 during anesthesia for the low flow anesthesia group was 98.63% ± 0.39, and 98.70%±0.37 for the high flow anesthesia. The mean EtCO2 values during anesthesia were 33.73 mmHg± 0.54 and 32.77 mmHg±0.39 for the low flow anesthesia group and high flow anesthesia, respectively. There was no significant difference in SpO2 and EtCO2 values during anesthesia in both groups (p>0.05). Hence, it is concluded that there is no significant difference in SpO2 and EtCO2 values between low flow and high flow anesthesia techniques.Key words: EtCO2, high flow anesthesia, isoflurane, low flow anesthesia, SpO2