Mariko Gunadi
Rumah Sakit Santo Yusuf, Jl. Cikutra No. 7 Bandung,

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Scalp Nerve Block pada Kraniotomi Evakuasi Pasien Moderate Head Injury dengan Subdural Hemorrhage dan Intracerebral Hemorrhage Frontotemporoparietal Dekstra Mencegah Stress Response Selama dan Pascabedah Gunadi, Mariko; Suwarman, -
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Insisi kulit dan kraniotomi selama operasi intrakranial merupakan stimulus berbahaya yang dapat menghasilkan stress response yang menyebabkan peningkatan tekanan intrakranial. Scalp nerve block efektif dalam mengurangi stress response ini, selain itu juga dapat digunakan sebagai analgetik pascabedah. Seorang laki-laki usia 22 tahun dengan moderate head injury, subdural hemorrhage, dan intracerebral hemorrhage at regio fronto-temporo-parietal dextra dilakukan kraniotomi evakuasi dalam combined scalp nerve block - general anesthesia di Rumah Sakit Dr. Hasan Sadikin Bandung pada tanggal 14 Agustus 2012. Setelah dilakukan induksi dan sebelum insisi dilakukan scalp nerve block dengan bupivakain 0,5%. Hemodinamik (tekanan darah dan denyut jantung) setelah insisi kulit dan kraniotomi, serta glukosa darah pascabedah tidak menunjukkan perubahan yang signifikan. Analgetik pascabedah baru diberikan setelah 8 jam sejak dilakukan blok. Hasil ini menunjukkan scalp nerve block menggunakan bupivakain 0,5% mampu menumpulkan stress response dan dapat digunakan sebagai analgetik pascabedah.Kata kunci: Kraniotomi evakuasi, scalp nerve block, stress responseScalp Nerve Block in Craniotomy Evacuation on a Patient with Moderate Head Injury with Subdural Hemorrhage and Right Frontotemporoparietal Intracerebral Hemorrhage Prevents Intra and Post Operative Stress ResponseAbstractSkin incision and craniotomy are recognized as an acute noxious stimulation during intracranial surgery which may result in stress response causing an increase in intracranial pressure. Scalp nerve block may be effective in reducing stress response. It can also be used to provide post-operative analgesia. A twenty two years old male with moderate head injury, subdural hemorrhage, intracerebral hemorrhage at right fronto-temporo-parietal region underwent evacuation craniotomy with combined scalp nerve block and general anesthesia at Dr. Hasan Sadikin Hospital Bandung on August 14th 2012. After induction and before incision of the skin, a scalp nerve block was performed using 0.5% bupivacaine. Hemodynamic (blood pressure and heart rate) changes after incision of the skin and craniotomy were not significant, and so was post-operative blood glucose concentration. Post-operative analgetic was given eight hours after the block. The result demonstrates that scalp nerve block using 0.5% bupivacaine successfully blunts stress response and can be used as post-operative analgesia.Keywords: Craniotomy evacuation, scalp nerve block, stress response DOI: 10.15851/jap.v1n3.199
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