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All Journal Majalah Kedokteran Bandung Jurnal Anestesi Perioperatif Bali Journal of Anesthesiology Jurnal Neuroanestesi Indonesia Majalah Anestesia dan Critical Care
Tatang Bisri
Departemen Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung
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Efek Lidokain Intravena terhadap Nilai Numeric Rating Scale dan Kebutuhan Fentanil Pascaoperasi dengan Anestesi Umum Sipahutar, Theresia C.; Fuadi, Iwan; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Lidokain intravena mempunyai efek analgesia, antihiperalgesia, dan antiinflamasi. Penelitian ini bertujuan untuk mengetahui efek pemberian lidokain intravena terhadap nilai numeric rating scale (NRS) dan kebutuhan fentanil pascaoperasi eksisi fibroadenoma mammae. Penelitian ini merupakan uji klinis acak terkontrol buta ganda terhadap 40 orang pasien wanita usia 18–60 tahun dengan status fisik ASA I–II yang dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung periode September 2011–Februari 2012. Sampel dikelompokkan random menjadi kelompok lidokain dan kontrol. Penilaian nyeri menggunakan numeric rating scale. Data dianalisis menggunakan uji chi-kuadrat, uji-t, dan Mann Whitney dengan tingkat kepercayaan 95% dan dianggap bermakna bila p<0,05. Hasil penelitian menunjukkan nilai NRS kelompok lidokain lebih rendah dan berbeda bermakna pada 30 menit (p<0,001), 60 menit (p<0,001), 90 menit (p=0,003), dan 120 menit (p=0,011) pascaoperasi, penggunaan fentanil pertolongan pada kelompok lidokain adalah 0–25 µg dan pada kelompok kontrol 25–75 µg selama 3 jam pascaoperasi. Simpulan penelitian adalah lidokain intravena 1,5 mg/kgBB bolus sebelum induksi dilanjutkan dosis rumatan 1 mg/kgBB/jam sampai 1 jam pascaoperasi mampu menurunkan nilai numeric rating scale dan mengurangi kebutuhan fentanil pascaoperasi.Kata kunci: Kebutuhan fentanil pascaoperasi, lidokain intravena, numeric rating scaleThe Effect of Intravenous Lidocaine on Numeric Rating Scale Value and Postoperative Fentanyl Requirement in General AnesthesiaAbstractLidocain has analgesic, antihyperalgesic and antiinflamatory properties. This was a double blind randomized controlled trial study on 40 female patients, aged 18–60 years old with ASA physical status I–II who underwent excisional biopsy for fibroadenoma mammae at Dr. Hasan Sadikin General Hospital Bandung between September 2011–February 2012. The samples randomly divided into the lidocaine and the control group. Quality of postoperative pain was assessed using the numeric rating scale (NRS). The result were analyzed with chi-square test, t-test, and Mann Whitney Test with 95% confidence interval and considered significant if the p value <0.05. The result showed that in comparison to the control group, the NRS values obtained from the lidocaine group was significantly different in postoperative measurement time, 30 minutes (p<0.001), 60 minutes (p<0.001), 90 minutes (p=0.003) and 120 minutes (p=0.011) and the dose range of fentanyl as a rescue analgesic in 3 hours postoperative period for the lidocaine group was 0–25 µg and 25–75 µg for the control group. This study concluded that administration of 1,5 mg/kgBW lidocaine intravenous before induction and continued with 1 mg/kgBW/hour as maintenance dose until 1 hour postoperative is able to reduce the NRS score and the requirement of postoperative fentanyl.Key words: Intravenous lidocaine, numeric rating scale, post operative fentanyl requierement DOI: 10.15851/jap.v1n3.195
Korelasi Antara Kadar Laktat, Base Deficit Dan Saturasi Vena Sentral Dengan Skor Multiple Organ Dysfunction Hari Ke-3 Pada Pasien Pascabedah Dengan Hemodinamik Stabil Di Ruang Perawatan Intensif Rumah Sakit Dr. Hasan Sadikin Bandung Nugraha, Ruby Satria; Redjeki, Ike Sri; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 1, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Hingga kini belum ada indikator yang untuk menilai perfusi global yang adekuat. Pasien dengan hemodinamik stabil masih mungkin terjadi perubahan kadar laktat, base deficit, dan saturasi vena sentral, yang dapat digunakan untuk menilai adanya suatu hipoksia jaringan. Penelitian ini bertujuan mencari korelasi yang paling baik diantara ketiga parameter tersebut terhadap skor MOD hari ke-3 pada pasien pascabedah dengan hemodinamik stabil yang dirawat di Ruang Perawatan Intensif (RPI). Penelitian ini suatu penelitian observasional dengan desain potong lintang. Penelitian ini dilakukan pada 50 orang pasien risiko tinggi yang dirawat di RPI, laki-laki dan wanita, usia 18 – 65 tahun yang telah menjalani laparotomi eksplorasi dengan anestesi umum. Semua pasien dilakukan pemeriksaan kadar laktat darah, gas darah arterial dan gas darah vena sentral ketika pasien masuk, dan jam  ke-24. Selanjutnya pada hari ke-3 dilakukan skoring MOD yang mencakup fungsi neurologis, kardiovaskular, respirasi, ginjal, hematologis, dan hepar. Pada penelitian ini didapatkan koefisien korelasi rank Spearman antara laktat 1 dan skor MOD hari ke-3 adalah 0,579 dengan p<0,001,  base deficit 1 dengan skor MOD hari ke-3 adalah 0,811 dengan p<0,001,  sedangkan yang tidak bermakna adalah antara saturasi vena sentral 1 dengan skor MOD hari ke-3, dan antara saturasi vena sentral 2 dengan skor MOD hari ke-3, dengan koefisien koreasi rank Spearman masing-masing adalah 0,328 dan 0,260. Koefisien korelasi yang baik terdapat pada laktat dan base deficit dengan skor MOD hari ke-3, sedangkan saturasi vena sentral memiliki koefisien korelasi yang lemah. Laktat dan base deficit dapat digunakan untuk mendeteksi secara dini adanya gangguan perfusi jaringan pada pasien risiko tinggi pascabedah dengan hemodinamik stabil.Kata kunci: laktat, base deficit, saturasi vena sentral, hipoksia jaringan, disfungsi organ.Correlation Between Lactate Level, Base Deficit, And Central Vein Saturation With Third-Day Multiple Organ Dysfunction Score On Haemodynamically Stable Postoperative Patient In Intensive Care Unit  Dr. Hasan Sadikin Bandung HospitalUntil now, there is no precise indicator to evaluate adequate global perfussion yet. On haemodynamically stable patient is possible to experience change in lactate value, base deficit, and central vein saturation, which can be used to assess tissue hypoxia. The aim of this study is to find the best parameter among those three parameters toward day-third-MOD (Multiple organ dysfunction) score on hemodinamically stable post surgery patients whose been hospitalized in ICU (Intensive care unit).This is a cross-sectional observational study. The subject of this study were 50 high-risk patients whose hospitalized in RPI, male and female between 18 – 65 years old who had been done explorative laparatomy procedures under general anesthesia. Blood lactate, arterial blood gas analysis and central vein blood gas analysis had been analysis on all subjects on admissions and on the 24th hours. On the third day, MOD score that covered neurologic, cardiovascular, respiration, renal, hematologic and liver function had been assessed. This study yielded rank Spearmen coeffisien correlation between blood lactate 1 and day-third-MOD score 0,572 (p<0,001), and base deficit 1 and day-third-MOD score was 0,811 (p<0,001). The value between central vein saturation  1 and day-third-MOD score, and central vein saturation 2 and day-third-MOD score were unsignificant, with rank Spearmen coeffisien correlation were 0,328 and 0,260. Good coeffisien correlation was found between blood lactate and base deficit with MOD score on third day, whilst central vein saturation had  weak coeffisien correlation. Blood lactate level and base deficit can be used to evaluate early tissue perfusion disturbances on hemodinamically stable high risk post surgery patients.Key words: lactate, base deficit, central vein saturation, tissue hypoxia, MOD score. DOI: 10.15851/jap.v1n1.154
Perbandingan Gabapentin 600 mg dengan 1.200 mg per Oral Preoperatif terhadap Nilai Visual Analogue Scale dan Pengurangan Kebutuhan Petidin Pascaoperasi pada Modifikasi Mastektomi Radikal Zulfariansyah, Ardi; Nawawi, A. Muthalib; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gabapentin mempunyai efek antihiperalgesia, antialodinia, dan antinosiseptif. Penelitian ini bertujuan untuk menilai efek gabapentin 600 mg dan 1.200 mg per oral preoperatif terhadap nilai visual analogue scale (VAS) dan pengurangan kebutuhan petidin pascaoperatif. Penelitian dilakukan secara uji acak terkontrol buta ganda terhadap 38 orang pasien di Rumah Sakit Dr. Hasan Sadikin Bandung pada Mei–September 2010. Pasien dibagi menjadi dua kelompok yaitu kelompok gabapentin 600 mg dan gabapentin 1.200 mg. Penilaian skala nyeri dilakukan dengan menggunakan nilai VAS. Data hasil penelitian dianalisis menggunakan Uji Mann-Whitney dengan tingkat kepercayaan 95% dan dianggap bermakna bila nilai p<0,05. Hasil penelitian didapatkan nilai VAS saat diam dan saat mobilisasi berbeda bermakna (p<0,05). Kelompok gabapentin 1.200 mg lebih sedikit diberikan analgetik petidin tambahan (10,5% vs 15,8%), tetapi perbedaan tersebut tidak bermakna (p=0,631). Simpulan penelitian ini adalah gabapentin 1.200 mg per oral preoperatif lebih baik bila dibandingkan dengan 600 mg dalam mengurangi nilai VAS pasca operatif pada operasi modifikasi radikal mastektomi, namun tidak mengurangi kebutuhan petidin.Kata kunci: Gabapentin 600 mg, Gabapentin 1.200 mg, visual analogue scale, kebutuhan petidin The Comparison between 600 mg and 1,200 mg Gabapentin per Oral Preoperatively on Visual Analog Scale and Reduction of Postoperative Pethidine Requirement on Modified Radical MastectomyAbstract Gabapentin is a GABA analog which has the effect of anti hyperalgesia, anti allodynia, and anti nociceptive. This research was conducted in order to assess the effect of 600mg and 1,200 mg gabapentin given preoperatively to assess visual analogue scale (VAS) score and reduction of pethidine requirement. The study was done by conducting a double blind randomized controlled trial on 38 patients, aged 18–65 years, with ASA physical status I–II. Patients were divided into two groups: 600 mg gabapentin and 1,200 mg gabapentin group. The quality of pain was assessed using VAS score. The results were statistically analyzed using Mann-Whitney Test with 95% confidence interval and considered significant if p value <0.05. From the results, the VAS values obtained at rest and during mobilization were significantly different (p<0.05). The 1,200 mg gabapentin group received less additional pethidine (10.5% vs 15.8%), although no significant difference was shown (p=0.631). The conclusion of this study is that administration of 1,200 mg gabapentin per oral pre operatively is better when compared to 600 mg in reducing post operative visual analog scale score in modified radical mastectomy. However, it do not reduce the need for analgesic significantly.Key words: 600 mg Gabapentin, 1.200 mg Gabapentin, post operative pethidine requirement, visual analog scale DOI: 10.15851/jap.v1n3.196
Efek Penambahan Deksametason 5 mg pada Bupivakain 0,5% terhadap Mula dan Lama Kerja Blokade Sensorik Anestesia Epidural untuk Operasi Ortopedi Ekstremitas Bawah Irwan, -; Pradian, Erwin; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Operasi ortopedi ekstremitas bawah dengan anestesia regional epidural memiliki kelemahan yaitu mula kerja yang lama. Penelitian ini bertujuan melihat efek penambahan 5 mg deksametason pada bupivakain 0,5% terhadap mula kerja dan lama kerja blokade sensoris. Penelitian prospektif eksperimental menggunakan uji klinis acak buta ganda pada 32 pasien dengan American Society of Anesthesiologist (ASA) I–II yang menjalani operasi ortopedi ekstremitas bawah dengan anestesi epidural di RSUP Dr. Hasan Sadikin Bandung pada Februari–Mei 2014. Pengambilan sampel dilakukan secara consecutive sampling dan random blok permutasi. Kelompok I, deksametason 5 mg ditambahkan ke dalam bupivakain 0,5% 15 mL. Kelompok II, bupivakain 0,5% ditambah NaCl 0,9% 15 mL. Hasil penelitian diuji secara statistika menggunakan uji-t dan Uji Mann-Whitney. Hasil penelitian menunjukkan mula kerja blokade sensorik kelompok I tidak lebih cepat, yaitu 13,56 menit dibanding dengan kelompok II, yaitu 14,31 menit (p=0,27). Lama kerja blokade sensorik kelompok I lebih lama, yaitu 399,81 menit dibanding dengan kelompok II, yaitu 227,43 menit (p=0,00). Simpulan, penambahan deksametason 5 mg pada bupivakain 0,5% 15 mL tidak mempercepat mula kerja blokade sensorik tetapi memperpanjang lama kerja blokade sensorik bupivakain 0,5% yang diberikan secara epidural.Kata kunci: Anestesi epidural, blokade sensorik, bupivakain, deksametason, lama kerja, mula kerjaEffect of Dexamethasone 5 mg Addition to Bupivacaine 0.5% on Onset and Duration of Sensory Blockade in Epidural Anesthesia for Lower Extremity Orthopedic SurgeryLower extremity orthopedic surgery performed with regional epidural anesthesia was still have weakness which is long onset of time. This study was conducted to determine the onset time and duration time of sensory blockade epidural anesthesia  between the use of dexamethasone 5 mg addition to 0.5% bupivacaine for lower limb orthophedic surgery. The study was using randomized controlled blind method on 32 ASA I–II patients undergoing lower limb orthopedic surgery under epidural anesthesia. Consecutive sampling and random allocation of block of permutation groups was applied. In group I, dexamethasone 5 mg was added to bupivacaine 0.5% 15 mL while in group II NaCl 1 mL was added to bupivacaine 0.5% 15 mL. The results were statistically tested using t-test and Mann-Whitney test. It was shown that the onset time of sensory blockade was not significantly faster when dexamethasone was added in bupivacaine 0.5%, 13.56 minutes versus 14.31 minutes (p=0.27). The duration time of sensory blockade in dexamethasone in bupivacaine 0.5% group was longer 399.81 minutes, compared to the bupivacaine 0.5% group, 227.43 minutes (p=0.00). In conclusions, the addition of dexamethasone 5 mg to bupivacaine 0.5% 15 mL does not produced faster onset time. However, the duration sensory blockade time is longer than bupivacaine 0,5% 15 mL is usedKey words: Bupivacaine, dexamethasone, duration time, epidural anesthesia, onset, sensory blockade DOI: 10.15851/jap.v3n2.577
Perbandingan Parasetamol dengan Ketorolak Intravena Sebagai Analgesia Pre-emtif terhadap Skala Nyeri Pascabedah Labioplasti pada Pasien Pediatrik Boesoirie, Muhamad Adli; Oktaliansah, Ezra; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Parasetamol dan ketorolak merupakan analgetik yang biasa digunakan pada tatalaksana nyeri ringan hingga sedang. Penelitian ini bertujuan membandingkan efek analgesi pre-emtif parasetamol 20 mg/kgBB dengan ketorolak 0,5 mg/kgBB pada pasien pediatrik pascabedah labioplasti yang diukur menggunakan skala nyeri face, legs, activity, crying, consolability (FLACC). Penelitian eksperimental secara uji acak tersamar buta ganda terhadap 66 pasien pediatrik usia 6 bulan–12 tahun dengan status fisik American Society of Anesthesiology (ASA) I–II. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung periode Oktober 2013–Mei 2014. Pasien dibagi menjadi dua kelompok perlakuan, yaitu kelompok parasetamol (P) dan ketorolak (K) yang diberikan 15 menit prabedah. Analisis statistika diuji menggunakan uji-t independen, Mann-Whitney, dan Eksak Fisher. Hasil penelitian menunjukkan bahwa skala FLACC pada kelompok ketorolak pada jam ke-1, 2, 4, 6, dan 24 lebih rendah secara bermakna (p<0,05) dibanding dengan kelompok parasetamol. Simpulan, skala FLACC pemberian ketorolak 0,5 mg/kgBB prabedah pada pasien labioplasti lebih rendah dibanding dengan parasetamol 20 mg/kgBB.Kata kunci: Analgetik, analgesia pre-emtif, ketorolak, labioplasti, parasetamol, skala FLACCComparison between Intravenous Paracetamol and Ketorolac as Preemptive Analgesia on Postoperative Pain Scale in Pediatric Patients Undergo LabioplastyKetorolac and paracetamol are common analgetics used to treat mild to moderate pain. This study compared the efficacy of preemptive analgesia measured using face, legs, activity, crying, consolability (FLACC) scale between groups receiving 20 mg/kgBW paracetamol (P) and 0.5 mg/kgBW ketorolac (K) for pediatric labioplasty procedure. This experimental study is a are double-blind randomized trial against 66 pediatric patients aged 6 months–12 years with the physical status of the American Society of Anesthesiology (ASA) I–II. The study was conducted in Dr. Hasan Sadikin General Hospital Bandung during the period of October 2013–May 2014. The P and K groups received 20 mg/kgBW paracetamol and 0.5 mg/kgBW ketorolac, respectively, 15 minutes preoperatively. Data were analyzed statistically using independent-t, Mann-Whitney, and Fischer’s Exact Test. Results showed that the difference between FLACC scale in P and K groups  was statistically significant (p<0.05). In conclution, FLACC scale in patients who received ketorolac 0.5 mg/kgBW is lower than patients who received paracetamol 20 mg/kgBW.Key words: Analgetics, FLACC scale, ketorolac, labioplasty, paracetamol, preemptive analgesia DOI: 10.15851/jap.v3n1.573
Venous Air Embolism (VAE) during Craniotomy of Supratentorial Meningioma in Supine Position Sutawan, Ida Bagus Krisna Jaya; Bisri, Tatang; Rahardjo, Sri; Lalenoh, Diana
Bali Journal of Anesthesiology Vol 1, No 3 (2017)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v1i3.26

Abstract

AbstractVenous Air Embolism (VAE) is one of the most serious complications in neuroanesthesia case. The highest number of VAE incident is during neurosurgery procedure with sitting position, even tough VAE may occur during craniotomy of supratentorial tumor in the supine position. VAE occurs due to the pressure differential between open vein in the surgical field and right atrium. A 46 years old woman underwent craniotomy for supratentorial meningioma in the supine position. Intraoperative, the patient was experiencing a decrease in end-tidal CO2 pressure about 6 mmHg in 5 minutes. Therefore, management of acute VAE was proceed to the patient, such as informed the surgeon immediately, discontinued N2O and increased flow of O2, modified the anesthesia technique, asked the surgeon to irrigate the surgical field with fluids, gave compression on jugular vein, aspirated the right atrial catheter, prepared drugs to support the hemodynamic, and changed the patient’s position if possible. 
Pengaruh Tes Elevasi Tungkai Secara Pasif terhadap Variasi Pletismograf untuk Penilaian Responsivitas Cairan pada Pasien yang Dilakukan Pembedahan dengan Anestesi Umum Susanto, Bahtiar; Pradian, Erwin; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penilaian responsivitas terhadap cairan sangat berguna untuk optimalisasi cairan perioperatif. Variasi pletismograf (respiratory variations in the pulse oximetry plethysmographic waveform amplitude; ∆POP) dan elevasi tungkai secara pasif (passive leg raising; PLR) merupakan parameter dinamis yang akurat dalam menilai responsivitas terhadap cairan. Tujuan penelitian ini adalah menilai pengaruh elevasi tungkai secara pasif terhadap variasi pletismograf untuk menilai responsivitas terhadap cairan pada pasien setelah induksi anestesi umum. Penelitian ini merupakan uji klinis pada 30 pasien yang menjalani operasi dengan anestesi umum, usia 18–60 tahun, dan status fisik American society of anesthesiologist (ASA) I atau II pada bulan Februari–Maret 2015 di Instalasi Bedah Sentral Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian ini diuji dengan uji-t berpasangan, Wilcoxon, dan uji ANOVA. Setelah dilakukan induksi anestesi umum, variasi pletismograf dicatat sebelum, saat, dan sesudah elevasi tungkai secara pasif. Hasil penelitian menunjukkan efek elevasi tungkai secara pasif akan menurunkan variasi pletismograf. Penurunan variasi pletismograf yang signifikan pada responden yang memiliki responsivitas terhadap cairan 6/30 dengan variasi pletismograf >13% sebelum dilakukan elevasi tungkai secara pasif. Perbedaan ini bermakna secara statistik (p<0,05). Elevasi tungkai secara pasif akan menurunkan variasi pletismograf yang dapat digunakan untuk menilai responsivitas terhadap cairan pada pasien yang menjalani operasi dengan anestesi umum.Kata kunci: Anestesi umum, elevasi tungkai secara pasif, responsivitas terhadap cairan, variasi pletismografEffect of Passive Leg Raising Test on Respiratory Variations in Pulse Oximetry Plethysmographic Waveform in Assessing Fluid Responsiveness of Surgery Patients under General AnesthesiaFluid responsiveness assessments have shown to be an important matter in perioperative fluid optimization. Respiratory variations in pulse oximetry plethysmographic waveform amplitude (∆POP) and passive leg raising have been shown as promising indicators due to the ability to predict fluid responsiveness. The aim of this study was to assess the effect of passive leg raising (PLR) on ∆POP to predict fluid responsiveness in mechanically ventilated patients after induction of general anesthesia. This was a trialon 30 patients referred for surgery under general anesthesia, aged 18–60 years and ASA physical status I or II, during the period of February–March 2015 at the Central Surgical Installation of Dr. Hasan Sadikin General Hospital Bandung. Patients were studied immediately after the induction of general anesthesia. This trial use the paired t test, Wilcoxon test, and ANOVA for statistical analysis. Vital signs and ∆POP were recorded at baseline, before, and after PLR. PLR induced changes in ∆POP with a ∆POP greater than 13% compared to the initial PLR allowed discrimination between responders and nonresponders to 6/30. There was a significant decrease in ∆POP in responders when compared to the nonresponders(p<0.05). ∆POP can be reduced by PLR and fluid responsiveness can be predicted noninvasively in mechanically ventilated patients during general anesthesia.Key words: Fluid responsiveness, general anesthesia, passive leg raising, respiratory variations in the pulse oximetry plethysmographic waveform amplitude DOI: 10.15851/jap.v4n2.821
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
Efek Penggunaan Leg Wrapping terhadap Kejadian Hipotensi Selama Anestesi Spinal pada Pasien Seksio Sesarea Putri, Yunita Susanto; Fuadi, Iwan; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Hipotensi merupakan komplikasi tersering selama anestesi spinal dengan insidensi >80% meskipun telah diberikan cairan preloading, posisi ibu left lateral tilt, dan penggunaan vasopresor. Terdapat teknik lain untuk mencegah terjadi hipotensi, yaitu penggunaan leg wrapping yang dapat memperbaiki aliran balik vena dengan meningkatkan volume darah sentral. Penelitian ini bertujuan menilai efek penggunaan leg wrapping terhadap kejadian hipotensi selama anestesi spinal pada pasien seksio sesarea. Penelitian bersifat eksperimental acak terkontrol buta tunggal dengan randomisasi secara acak sederhana yang melibatkan 40 ibu hamil American Society of Anesthesiologists (ASA) II yang menjalani seksio sesarea dengan anestesi spinal di Central Operating Theatre (COT) lantai 3, Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Juni–Juli 2015. Subjek penelitian dikelompokkan menjadi dua, yaitu 20 subjek dengan leg wrapping dan 20 subjek tanpa leg wrapping. Tekanan darah dan laju nadi diperiksa setiap dua menit sampai bayi lahir. Data dianalisis dengan uji-t tidak berpasangan dan chi-kuadrat, nilai p<0,05 dianggap bermakna. Analisis statistik menunjukkan kejadian hipotensi pada kelompok tanpa leg wrapping 95% (19 orang) dan 0% pada kelompok dengan leg wrapping dengan perbedaan bermakna (p<0,05). Secara keseluruhan, hemodinamik kelompok dengan leg wrapping lebih stabil dibanding dengan kelompok tanpa leg wrapping. Simpulan, penggunaan leg wrapping sebelum dilakukan anestesi spinal pada pasien yang menjalani seksio sesarea menurunkan angka kejadian hipotensi.Kata kunci: Anestesi spinal, hipotensi, leg wrapping, seksio sesareaEffect of Leg Wrapping on Hypotension Incidence in Cesarean Section with Spinal AnesthesiaAbstractHypotension is the most common complication of spinal anesthesia. The incidence remains high despite adequate fluid preloading, left lateral tilt positioning, and vasopressors use. There is a technique that can be used to prevent hypotension, which is referred as leg wrapping. Leg wrapping can improve venous return by increasing central blood volume. This study aimed to compare the hypotension incidence between with and without leg wrapping during spinal anesthesia for caesarean section. The method used was single blind randomized controlled trial with simple randomization, involving 40 pregnant women ASA II, who underwent cesarean section with spinal anesthesia in COT 3rd floor Dr. Hasan Sadikin General Hospital Bandung during the period of June–July 2015. Subjects were grouped into with leg wrapping and without leg wrapping groups with 20 subjects in each group. Blood pressure and heart rate were recorded every two minutes until the baby was born. Data were then analyzed using t-test and chi-square test with p values <0.05 considered significant. The statistical analysis showed that there were significant differences in the incidence of hypotension (p<0.05) in the group without leg wrapping , i.e. 95% (19 people), and the group with leg wrapping, i.e. 0%. Overall, hemodynamics of the leg wrapping group was more stable than the group without leg wrapping. In conclusion, leg wrapping prior to spinal anesthesia in patients undergoing cesarean section will reduce incidence of hypotension.Key words: Cesarean section, hypotension, leg wrapping, spinal anesthesia DOI: 10.15851/jap.v4n3.903
Perbandingan Efek Pencegahan Magnesium Sulfat dengan Petidin Intravena terhadap Kejadian Menggigil Selama Operasi Reseksi Prostat Transuretra dengan Anestesi Spinal Fuadi, Iwan; Bisri, Tatang; Gunadi, Mariko
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gangguan termoregulasi berupa menggigil sering terjadi selama operasi dengan anestesi spinal. Tujuan penelitian ini membandingkan efek pencegahan kejadian menggigil selama operasi reseksi prostat transuretra dalam anestesi spinal antara MgSO4 dan petidin. Penelitian ini merupakan uji klinis acak terkontrol tersamar ganda pada 42 pasien dengan status fisik American Society of Anesthesiologist (ASA) II atau III, usia 60−70 tahun yang menjalani operasi reseksi prostat transuretra di kamar operasi bedah sentral Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Maret–September 2014. Pasien dibagi dalam kelompok MgSO4 dan kelompok  petidin. Data karakteristik, kejadian menggigil, suhu tubuh inti, monitoring tanda vital, dan efek samping dicatat. Hasil penelitian menunjukkan efek pencegahan kejadian menggigil kelompok MgSO4 lebih baik dibanding dengan kelompok petidin dan kejadian menggigil di kamar operasi 4/21 vs 9/21, sedangkan di ruang pemulihan kejadian menggigil sama pada kedua kelompok (1/21). Simpulan penelitian ini menunjukkan pemberian MgSO4 intravena sebelum anestesi spinal secara klinis mengurangi kejadian menggigil selama operasi dan memiliki efek pencegahan menggigil yang lebih baik dibanding dengan petidin.Kata kunci: Anestesi spinal, menggigil, MgSO4, petidinComparison of Anti-Shivering Effect of Intravenous Magnesium Sulfate with Pethidine during Transurethral Resection of the Prostate under Spinal AnesthesiaShivering, as a result of impaired thermoregulatory, is frequent during surgery under spinal anesthesia. The purpose of this study was to compare the anti-shivering effect between intravenous MgSO4 and pethidine during transurethral resection of the prostate under spinal anesthesia.This study was a randomized double-blind controlled trial in 42 patients with American Society of Anesthesiologist (ASA) physical status II or III, aged 60−70 years who underwent transurethral resection of the prostate at the central operating theater of Dr. Hasan Sadikin General Hospital Bandung within March–September 2014. The patients were divided into MgSO4 group and pethidine group. Characteristics of data, the incidence of shivering, body core temperature, vital signs monitoring, and adverse events were recorded. Antishivering effect of MgSO4 was better compared to pethidine, with the incidence of shivering in operating theatre was 4/21 vs 9/21. However, in the recovery room, the incidence of shivering was the same for both groups (1/21). It is concluded that the administration of intravenous MgSO4 before spinal anesthesia clinically reduces the incidence of shivering during surgery and has a better anti-shivering effect compared to intravenous pethidine.Key words: MgSO4, pethidine, shivering, spinal anesthesia DOI: 10.15851/jap.v3n3.609
Co-Authors , Rizki , Suwarman - Irwan, - A. Himendra Wargahadibrata A. Muthalib Nawawi Andie Muhari Barzah, Andie Muhari Ardi Zulfariansyah Bambang Suryono, Bambang Christanto, Sandhi christiana, monica Dedi Fitri Yadi Dewi Yulianti Bisri Diana C. Lalenoh, Diana C. Diana Lalenoh Erias, Muhammad Erwin Pradian Ezra Oktaliansah Firdaus, Riyadh Fithrah, Bona Akhmad Fitri Sepviyanti Sumardi Giovanni, Cindy Hamzah, Hanzah Ida Bagus Krisna Jaya Sutawan Ieva B. Akbar Ike Sri Redjeki Iwan Abdul Rachman Iwan Fuadi Kusuma Harimin, Kusuma Laksono, Buyung Hartiyo Lalenoh, Diana Christine M. Dwi Satriyanto M. Erias Erlangga, M. Erias M. Sofyan Harahap Mariko Gunadi Martinus, Fardian MM Rudi Prihatno, MM Rudi Muh. Rumli Ahmad Muhamad Adli Boesoirie, Muhamad Adli Ningsih, Diana Fitria Nugraha, Ade Aria Oetoro, Bambang J. Okatria, Ahmado Putri, Andika C. Putu Pramana Suarjaya Radian Ahmad Halimi Rahmadsyah, Teuku Rahordjo, Sri Rasman, Marsudi Reza Widianto Sudjud Rose Mafiana Rovina Ruslami, Rovina Ruby Satria Nugraha Ruli Herman Sitanggang Saleh, Siti Chasnak Saputra, Tengku Addi SATRIYAS ILYAS Sri Rahardjo Subekti, Bambang Eko Suryaningrat, IGB Susanto, Bahtiar Sutanto, Sigit Suwarman Suwarman, Suwarman Suwarman, S Syafruddin Gaus Thayeb, Srilina Theresia C. Sipahutar Theresia Monica Rahardjo Wirawijaya, Dear Mohtar Wirawijaya Wullur, Caroline Yunita Susanto Putri