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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

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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 Efektivitas antara Gabapentin 600 mg dan Gabapentin 900 mg Kombinasi dengan Ketorolak 30 mg/8 Jam sebagai Analgesia Pascabedah pada Total Abdominal Histerektomi dengan Anestesi Umum Mumya Camary; Mhd. Ihsan; Dadik Wahyu Wijaya
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Gabapentin berkembang untuk penanganan nyeri akut pascabedah. Tujuan penelitian adalah menilai efektivitas gabapentin 600 mg dan 900 mg per oral kombinasi ketorolak 30 mg/8 jam intravena sebagai analgesia pascabedah pada total abdominal histerektomi dengan anestesi umum. Penelitian uji klinis acak tersamar ganda dilakukan di Rumah Sakit Umum Pusat H. Adam Malik Medan, RSUD Dr. Pirngadi Kota Medan, RS. Haji Medan, dan RS. Putri Hijau selama bulan Oktober 2015–Januari 2016. Terdapat 30 subjek penelitian, usia 18–60 tahun, status fisik American Society of Anesthesiologists (ASA) I–II yang menjalani operasi total abdominal histerektomi dengan anestesi umum. Subjek dibagi menjadi 3, yaitu kelompok A mendapat plasebo, kelompok B mendapat gabapentin 600 mg, dan kelompok C mendapat gabapentin 900 mg kombinasi ketorolak 30 mg/8 jam. Uji Kruskal Wallis digunakan untuk menilai efektivitas skor visual analogue scale (VAS) pascabedah serta uji chi-kuadrat untuk menilai kebutuhan rescue analgetia petidin selama 24 jam pascabedah. Pada perbandingan nilai VAS antara gabapentin 600 mg dan gabapentin 900 mg kombinasi dengan ketorolak 30 mg/8 jam tidak ditemukan perbedaan nilai yang signifikan antara kedua kelompok studi (p>0,05). Simpulan, efek gabapentin 600 mg dengan gabapentin 900 mg kombinasi ketorolak 30 mg/8 jam sebagai analgesia pascabedah tidak berbeda efektivitasnya dalam mengurangi nilai VAS dan kebutuhan rescue analgetia petidin selama 24 jam pascabedah.Kata kunci: Gabapentin, kebutuhan rescue analgetia, visual analogue scaleEffectiveness of Gabapentin 600 mg and 900 mg Combined Ketorolak as Postoperative Analgesics for Hysterectomy under General AnesthesiaAbstractGabapentin is developed recently to manage postoperative acute pain. The purpose of this study was to assess the efficacy of 600 mg and 900 mg oral gabapentin combined with 30 mg/8 hours intravenous ketorolak as the postoperative analgesics for total abdominal hysterectomy under general anesthesiaon visual analogue scale (VAS) and the need of pethidin in 24 hours postoperatively. A double blind controlled trial was performed to 30 subjects in H. Adam Malik Hospital Medan, Dr. Pirngadi Hospital Medan,Haji Hospital Medan,and Putri Hijau Hospital Medan. The study was performed during the period of October 2015 to January 2016. Patients were 18 to 60 years old with PS-ASA I–II who underwent total abdominal hysterectomy under general anesthesia. Subjects were divided into 3 groups.: Group A who received placebo, group B who received 600 mg of gabapentin, and group C who received 900 mg of gabapentin combined with 30 mg/8 hours ketorolak. The efficacy was assessed with post operative visual analogue scale (VAS) using Kruskal Wallis test, and the need for rescue analgesics pethidin in 24 hours postoperatively using chi-square test. The VAS scores of the group that received600 mg gabapentin and the group that received 900 mg gabapentin combined with 30 mg/hour ketorolak were not significantly different (p>0.05). In conclusion, the effects of 600 mg gabapentin and 900 mg gabapentin combined with 30 mg/8 hours ketorolak as the postoperative analgesics for total abdominal hysterectomy under general anesthesia are not different in terms of decreasing VAS score and the need for rescue analgesia pethidine in 24 hours postoperativelyKey words: Gabapentin, the need of analgesia rescue, visual analogue score DOI: 10.15851/jap.v4n3.898

Perubahan kadar albumin dan prealbumin etelah suplementasi ekstrak ikan gabus metode freeze dryer pada pasien sepsis Ahmad Fiza Putera; Achsanuddin Hanafie; Dadik Wahyu Wijaya
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 2 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Septic is the second highest cause of death in Intensive Care Unit and 10 highest cause of death in the world overall. Mortality and Morbidity of sepsis in relation with hypoalbuminemia, with the number incidence 60-70%. The principal of nutritional management in septic patient is how to manage calories and high protein to balance the catabolic process. Extract of snakehead fish is the source of high protein in compare with other sources. The purpose of this study is to know the level of albumin and prealbumin after the sumplementation of extract of snakehead fish with the freezy dryer methode. Methodes : The Randomized Control Trial double blinded which done in Mei-June 2016 in Rumah Sakit Umum Pusat Haji Adam Malik Medan. The total of 38 Patients whose included in inclusive and exclusive criteria for this research. Level of albumin and preabulmin was measuring after the suplementation extract of snakehead fish with the methode of freezy dryer as suplementation of protein as a enteral nutrition in 3 days intervention. In a group with suplementation extract of snake head fish with the methode of freezy dryer increased the level of albumin 0.26 gr/dL (p<0.001) and the level of prealbumin 9.36 mg/dL (p<0.001). In difference with the group given placebo, the level of albumin decreased 0.32 gr/dL (p<0.001) and the decreased of prealbumin 4.58 mg/dL (p<0.001).Result : Extract of snakehead fish with the freezy dryer extraction could increase 0.26 mg/dL albumin level and 11.26 mg/dL prealbumin level.Conclussion : suplementation of snakehead fish with the freezy dryer methode could increase albumin and prealbumin level efectively.Keyword : additional protein intake, hypoalbuminemia, nutrition, sepsis

Perbandingan efek klonidin 2g/Kg intravena dan lidokain 2% 1.5 mg/Kg intravena untuk mencegah kenaikan tekanan intra okuler (TIO) selama tindakan intubasi endotrakheal Muhammad Jalaluddin Assuyuthi Chalil; Nazaruddin Umar; Dadik Wahyu Wijaya; Aslim Sihotang
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 47, No 1 (2014): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Background: Endotracheal intubation is routinely performed during general anaesthesia in patients undergoing intraocular surgery. However, intubation is associated with an increase in intraocular pressure (IOP).Aim: To compare the effect of clonidine and lidocain to prevent the increase of IOP during endotracheal intubation. Method: Forty patients with no pre-existing eye diseaseundergoing elective non-ophthalmic surgeriesundergeneral anesthesiawererandomly allocated to two groups of 20 each.In Group A, patients received clonidine 2μg/kg/iv, and in group B lidocain2% 1.5mg/kg/iv for premedication.The hemodynamic profile (systolic and diastolic blood pressure, mean arterial pressure, heart rate) and IOP (using Schioetz tonometer) were measured before premedication (pre anesthesia), before intubation, immediately after intubation, and every 1 minute for 2 minutes.Result:There was a significant decrease in IOP and hemodynamic profile within both groups before and after endotracheal intubation compare to pre anesthesia periode (P <0.05). But the decreasewas not different between two groups (P >0.05). Conclusion: We conclude that both drugs have the same ability in blunting the hemodynamic response and attenuating the IOP, and preventing the increase in IOP caused by endotracheal intubation.Key word : clonidine, endotracheal intubation, intra-ocular pressure, lidocain

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