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All Journal Jurnal Anestesi Perioperatif Jurnal Neuroanestesi Indonesia Majalah Anestesia dan Critical Care Jurnal Neuroanestesi Indonesia

Ruli Herman Sitanggang

Departemen Anestesiologi Dan Terapi Intensi Fakultas Kedokteran Universitas Padjadjaran /RSHS Bandung

Author-ID : 382464

Biochemistry, Genetics & Molecular Biology Education Health Professions Library & Information Science Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Angka Mortalitas dan Faktor yang Memengaruhi pada Pasien Trakeoesofageal Fistula (TEF) yang Menjalani Operasi di RSUP Dr. Hasan Sadikin Bandung Sunarya, Unang; Oktaliansah, Ezra; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Trakeoesofageal fistula (TEF) merupakan kelainan esofagus yang bersifat kongenital ditandai dengan fistula antara trakea dan esofagus yang merupakan koneksi abnormal yang dapat disertai putusnya antara distal dan proksimal esofagus. Insidensi TEF kongenital mencapai 1:2.400â4.500 kelahiran hidup. Tujuan penelitian ini mengetahui angka mortalitas dan faktor yang memengaruhi pada pasien TEF yang menjalani operasi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2010â2015. Metode penelitian ini bersifat deskriptif yang dilakukan secara retrospektif terhadap 35 rekam medik pasien TEF yang menjalani operasi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2010â2015. Hasil penelitian ini menunjukkan angka mortalitas pascaoperasi pasien TEF sebesar 19 dari 34 dan mortalitas tertinggi terjadi pada perempuan 7 dari 12, bayi lahir lahir prematur 5 dari 5, berat badan lahir kurang dari 1.500 gram 1 dari 1, TEF tipe C 19 dari 32, riwayat persalinan di bidan/puskesmas 9 dari 11, disertai kelainan kongenital penyerta selain kelainan anorektal, usia saat operasi lebih dari 7 hari 15 dari 17, penyulit preoperatif lebih dari satu, lama operasi lebih dari 3 jam, tidak dilakukan ekstubasi 15 dari 20, kenaikan berat badan lebih dari 10% 14 dari 18, leakage pascaoperasi dan faktor penyulit pascaoperasi lebih dari satu. Simpulan Angka mortalitas pasien TEF yang menjalani operasi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2010â2015 sebanyak 54,3%. Kata kunci: Mortalitas pascaoperasi, operasi, trakeoesofageal fistulaÂ Mortality and The Influencing Factors of Trakeoesofageal Fistula (TEF)Patients which Operated in Dr. Hasan Sadikin General Hospital BandungTracheoesophageal fistula (TEF) is a disorder of the esophagus that is characterized by congenital fistula between the trachea and esophagus wich is an abnormal connection that can be accompanied by a break between the distal and proximal esophagus. The incidence of congenital TEF reached 1:2,400â4,500 live births. The purpose of this study to determine mortality and factors affecting mortality in patients TEF in Dr. Hasan Sadikin General Hospital Bandung in 2010â2015. This research method was descriptive retrospectively of 35 patients taken from the medical records underwent surgery TEF in Dr. Hasan Sadikin Central Hospital Bandung in 2010â2015. Results of this study showed a mortality rate of postoperative patients TEF rate of 19 from 34 and the highest mortality among women 7 from 12, premature birth, birth weigth less than 1,500 g, TEF type C 19 from 36, childbirth history at the midwife 9 from 11, congenital abnormalities other than anorectal disease, age at surgery of more than 7 days 15 from 17, preoperative complications more than one, the operating time of more than 3 hours, do not extubation 15 from 20, weight gain more than 10% 14 from 18, the leakage postoperative and more than one complications postoperative factors. In conclusion, mortality of trakeoesofageal fistula (TEF) patients which operated in Dr. Hasan Sadikin General Hospital Bandung in 2010â2015 was 54.3%.Key words: Postoperative mortality, operatif, tracheoesophageal fistula

Perbandingan Efek Lidokain dengan Magnesium Sulfat Intravena terhadap Nilai Numeric Rating Scale dan Kebutuhan Analgesik Pascabedah Kolesistektomi Perlaparoskopi Lewi, Ratu; Suwarman, Suwarman; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 4, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Lidokain dan magnesium sulfat mempunyai efek antihiperalgesia yang dapat digunakan sebagai obat tambahan untuk mengurangi nyeri pascaoperasi dan mengurangi kebutuhan analgesik opioid. Tujuan penelitian ini membandingkan efek lidokain dan magnesium sulfat intravena nilai numeric rating scale (NRS) dan kebutuhan analgesik pertolongan. Penelitian eksperimental dengan double blind randomized controlled trial dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan JanuariâMaret 2015 terhadap 30 pasien yang menjalani kolesistektomi per laparoskopi. Pasien dikelompokkan menjadi 2. Kelompok lidokain mendapatkan 1 mg/kgBB intravena dilanjutkan dengan 1 mg/kgBB/jam dan kelompok magnesium sulfat mendapatkan 30 mg/kgBB intravena dilanjutkan dengan 10 mg/kgBB/jam. Data hasil penelitian dianalisis menggunakan Uji Mann-Whitney, uji-t, dan dianggap bermakna bila p<0,05. Hasil analisis statistik menunjukan bahwa lidokain mengurangi nilai NRS secara bermakna dibanding dengan magnesium sulfat pada jam ke-4 pascaoperasi (p<0,05), dengan kebutuhan analgesik pertolongan fentanil pada kelompok lidokain rata-rata 66,4Â±15,2 Âµg dan pada kelompok magnesium sulfat rata-rata 86,0Â±7,8 Âµg. Simpulan, lidokain intravena mengurangi NRS pascaoperasi lebih baik dan mengurangi kebutuhan opioid lebih banyak dibanding dengan magnesium sulfat pada pasien operasi kolesistektomi per laparoskopi.Kata kunci: Kebutuhan analgesik opioid, lidokain, magnesium sulfat, nyeri pascaoperasi, numeric rating scaleÂ Comparison between the Effect of Intravenous Lidocaine and Magnesium Sulphate on Numeric Rating Scale and Postoperative Analgetic Requirement for Laparoscopic CholecystectomiAbstractPostoperative pain management after laparoscopic cholecystectomy is one measure of successful anesthesia and surgery. Lidocaine and magnesium sulphate have anti-hyperalgesia effects applicable as an additional medication to attenuate postoperative pain and reduce the need for opioid analgesics. A total of 30 of patients aged 18â65 years with ASA physical status IâII who underwent laparoscopic cholecystectomy in Dr. Hasan Sadikin General Hospital Bandung were included in a double-blind, randomized, controlled clinical trial. Patients were randomly assigned into 2 groups. The L group, treated with 1 mg/kgBW intravenous followed by 1 mg/kgBW/h intravenous, and M group, treated with 30 mg/kgBW intravenous followed by 10 mg/kgBW/h. Data were analyzed using Mann-Whitney Test and t-test, p<0.05 was considered significant. Statistical analysis showed that lidocaine significantly reduced NRS value compared to magnesium sulphate at 4 hours postoperatively (p<0.05), with the average rescue analgesic fentanyl requirement in the lidocaine group and the magnesium sulphate group of 66.4Â±15.2 mg and 86.0Â±7.8 g, respectively. In conclusions, intravenous lidocaine administration may reduce the postoperative NRS value and opioid analgetic requirement more than the intravenous magnesium sulphate administration in patients undergoing laparoscopic cholecystectomy.Key words: An opioid analgetic rescue, lidocaine, magnesium sulphate postoperative pain, numeric rating scaleÂ DOI:Â 10.15851/jap.v4n1.741

Perbandingan Ketepatan Pengukuran Tekanan Balon Pipa Endotrakeal setelah Intubasi antara Metode Palpasi pada Pilot Balon dan Teknik Melepas Spuit secara Pasif Mutiara, Gunawan; Suwarman, -; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (808.656 KB)

Metode palpasi pada pilot balon merupakan teknik yang tidak akurat untuk menentukan tekanan balon pipa endotrakeal (endotracheal tube/ETT). Tujuan penelitian ini membandingkan ketepatan pengukuran tekanan balon ETT antara metode palpasi pada pilot balon (MP) dan teknik melepas spuit secara pasif (MSP). Penelitian dilakukan pada bulan Juni 2014 di Rumah Sakit Dr. Hasan Sadikin Bandung, menggunakan metode kuantitatif eksperimen dengan rancangan uji acak silang tersamar tunggal. Subjek penelitian adalah 94 orang pasien berusia 18â65 tahun dengan status fisik American Society of Anesthesiologists (ASA) IâIII, yang menjalani pembedahan dengan anestesi umum secara intubasi endotrakeal. Saat akan dilakukan intubasi, balon ETT dikembangkan dengan dua teknik yang berbeda kelompok metode palpasi (n=48) dan kelompok teknik melepas spuit secara pasif (n=46). Data hasil penelitian dianalisis menggunakan uji-t tidak berpasangan dan uji chi-kuadrat. Hasil penelitian didapatkan tekanan rata-rata pada kelompok MP 57,7Â±26,0 cmH2O dan MSP 28,7Â±4,5 cmH2O, sedangkan untuk ketepatan pengukuran pada kelompok MSP 56,5% dan kelompok MP 6,2% (p<0,001). Simpulan penelitian ini menunjukkan bahwa metode palpasi merupakan teknik pengukuran tekanan balon ETT yang tidak adekuat.Kata kunci: Metode palpasi pada pilot balon, teknik melepas spuit secara pasif, endotracheal tubeComparison between Pilot Balloon Palpation Method and Passive Release Technique on the Accuracy of Measurements ofÂ Endotracheal Tube Cuff Pressure Estimation of cuff pressure by palpating the pilot balloon is not accurate to determine the cuff pressure of endotracheal tube (ETT). Hence, this study we conducted to compare the accuracy of indirect measurements between pilot balloon palpation method (MP) and passive release technique (MSP). This was a single blind randomized crossover study performed in june 2014 at Dr. Hasan Sadikin General Hospital Bandung, in which patients received each technique and as a control group. Subjects were 94 patients aged 18â65 years old with American Society of Anesthesiologists (ASA) physical status IâIII who underwent surgery requiring tracheal intubation. These subjects were randomized into two groups. After induction of anesthesia, the cuff was inflated with two different techniques: pilot balloon palpation technique (n=48) and passive release technique (n=46). Data were statistically analyzed using independent t-test and chi-square test. The mean cuff pressures of group MP was 57.7Â±26.0 cmH2O and for group MSP was 28.7Â±4.5 cmH2O,Â whereas the precision of measurements in the MSP group was 56.5% and 6.2% in the MP group (p<0.001). It is conclude that the palpation method for cuff inflation are inadequate. Therefore, it is suggested that the endotracheal tube cuff pressure must be kept within the optimal range using a standard manometer. Key words: Endotracheal cuff pressure, passive release technique, pilot balloon palpation methodÂ Â DOI:Â 10.15851/jap.v3n3.608

Pengaruh Duduk 5 Menit Dibanding dengan Langsung Dibaringkan pada Pasien yang Dilakukan Anestesi Spinal dengan Bupivakain Hiperbarik 0,5% 10 mg terhadap Perubahan Tekanan Arteri Rata-rata dan Blokade Sensorik Fauzan, Raditya; Tavianto, Doddy; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 4, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Anestesi spinal sering kali mengakibatkan hipotensi karena blokade simpatis yang tinggi. Penelitian ini bertujuan melihat pengaruh duduk 5 menit dibanding dengan langsung dibaringkan setelah pemberian anestesi spinal dengan bupivakain 0,5% hiperbarik 10 mg terhadap tekanan arteri rata-rata dan ketinggian blokade sensorik. Penelitian dilakukan dengan metode acak terkontrol tersamar tunggal pada 36 orang pasien dengan status fisik American Society of Anesthesiologist (ASA) IâII yang menjalani operasi perut bagian bawah dan ekstermitas bawah di Rumah Sakit Umum Dr. Hasan Sadikin Bandung pada bulan MaretâMei 2015. Analisis statistik tekanan arteri rata-rata menggunakan Uji Mann-Whitney dan ketinggian blokade sensorik dengan Uji Kolmogorov Smirnov. Penurunan tekanan arteri rata-rata kelompok 1 (duduk selama 5 menit) lebih sedikit dibanding dengan kelompok 2 (langsung dibaringkan) dengan perbedaan yang bermakna (p<0,05). Ketinggian blokade sensorik rata-rata kelompok 1 terbanyak pada T10 (14 dari 18) dan kelompok 2 pada T6 (8 dari 18). Simpulan, posisi duduk selama 5 menit setelah anestesi spinal dengan bupivakain 0,5% hiperbarik 10 mg menyebabkan penurunan tekanan arteri rata-rata lebih kecil dan ketinggian blokade sensorik lebih rendah dibanding dengan posisi langsung dibaringkan.Kata kunci: Anestesi spinal, bupivakain 0,5% hiperbarik, blokade sensorik, posisi badan, tekanan arteri rata-rataEffects of 5-Minute Sitting Compared to Immediately Lying Down After 10 mg of 0.5% Hiperbaric Bupivacaine Administration on Mean Arterial Pressure and Level of Sensory Blockade in Patients Receiving Spinal AnesthesiaAbstractSpinal anesthesia frequently results in hypotension due to high sympathetic blockade. The aim of this study was to examine effect of sitting for 5 minutes compared to immediately lying down after 10 mg of 0.5% hiperbaric bupivacaine administration with regards to the mean arterial pressure and level sensory blockade in patients who underwentd spinal anesthesia. This was a single blind randomized controlled trial in 36 patients with American Society of Anesthesiologists (ASA) IâII undergoing lower abdominal and lower extremities surgery under spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung during the period of March to May 2015. Data were statistically analyzed using Mann Whitney test for mean arterial pressure and Kolmogorov Smirnov test for level sensory blockade. The results showed a decrease of mean arterial pressure in group 1 (sitting 5 minutes) which was lower than group 2 (immediately lying down) with significant difference (p<0.05). Level of sensory blockade in group 1 at T 10 (14 from 18) was higher than in group 2 at T6 (8 from 18, p=0.001). It is concluded in this study that sitting for 5 minutes after spinal anesthesia using 10 mg 0.5%. bupivacaine hiperbaric decreases the intraoperative sensory of blockade height and mean arterial pressure.Key words: Bupivacaine, body potition, mean arterial preassure, sensory blockade, spinal anesthesiaÂ

Hubungan antara Durasi Puasa Preoperatif dan Kadar Gula Darah Sebelum Induksi pada Pasien Operasi Elektif di Rumah Sakit Dr. Hasan Sadikin Bandung Hartanto, Budi; Suwarman, -; Sitanggang, Ruli Herman
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 (444.209 KB)

Puasa preoperatif merupakan keharusan sebelum dilakukan tindakan anestesi. Alasan utamanya adalah untuk mengurangi volume lambung, tingkat keasaman lambung, dan mengurangi risiko aspirasi paru. Namun, puasa preoperatif sering kali lebih lama daripada yang direkomendasikan karena berbagai sebab. Tujuan penelitian ini mengetahui durasi puasa preoperatif pada pasien operasi elektif dan hubungan antara durasi puasa preoperatif dan kadar gula darah sebelum induksi pasien operasi elektif di Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian observasional dilakukan selama 1â31 Juni 2014 dengan melakukan wawancara pasien sebelum induksi anestesi dan pengukuran kadar gula darah menggunakan glukometer. Analisis korelasi menggunakan Uji Mann-Whitney. Hasil penelitian pada 371 pasien didapatkan lama puasa dari makanan padat, durasi minimum adalah 4 jam, maksimum 20,5 jam, dan rata-rata 10,42 jam. Pada puasa dari minuman, durasi puasa minimum adalah 2 jam, maksimum 18 jam dengan rata-rata 8,06 jam. Terdapat 8 pasien dengan kadar gula darah kurang dari 70 mg/dL dengan rentang kadar gula darah 59â70 mg/dL dan rentang durasi puasa 6â18 jam. Tiga di antaranya orang lanjut usia di atas 60 tahun. Sebanyak 253 pasien berpuasa makanan padat >8 jam dan 357 pasien berpuasa minuman >2 jam. Simpulan, tidak terdapat hubungan antara durasi puasa dan kadar gula darah sebelum induksi.Kata kunci: Durasi puasa preoperatif, kadar gula darah, operasi elektifCorrelation between Preoperative Fasting Duration and Blood Glucose Level before Induction in Elective Surgery Patients in Dr. Hasan Sadikin General Hospital BandungPreoperative fasting is a requisite before anesthesia. The main reason for preoperative fasting is to reduce gastric volume and acidity and, thus, decrease the risk of pulmonary aspiration. However, preoperative fasting is usually prolonged beyond the recommended time for various reasons. Despite the many adverse effects of prolonged fasting, patients sometimes fast for a prolonged time when the surgery is delayed for different reasons. The aim of this study was to assess the duration of preoperative fasting for elective surgery and its correlation with blood glucose after preoperative fasting in Dr. Hasan Sadikin General Hospital Bandung. An observational study was conducted from 1- 31 June 2014. Patients were interviewed before induction, and blood glucose level was measured using a glucometer. A correlation analysis was performed using Mann-whitney test. All 371 elective surgery patients admitted during the study period were included. The minimum, maximum, and mean fasting hours for food were 4, 20.5, and 10.42, respectively. The minimum, maximum, and mean fasting hours for fluid were 2, 18, and 8.06, respectively. Only 8 patients had blood a glucose level below 70 mg/dL with blood glucose levels range from 59 to 70 mg/dL and duration of fasting range from 6 to 18 hours. Three of elderly patients, who was above 60 years old, participated in this study. There were 253 patients (68.2%) fasted from solid food more than 8 hours and there were 357 (96.2%) fasted from clear fluid more than 2 hours. It is concluded that there is no correlation between duration of fasting and blood sugar level before induction.Key words: Duration of preoperative fasting, elective surgery, blood glucose levelÂ DOI:Â 10.15851/jap.v4n2.822

Perbandingan Pemberian Lidokain 2% 1,5 mg/kgBB Intravena dengan Propofol 0,3 mg/kgBB Intravena Setelah Anestesi Umum Dihentikan terhadap Kejadian Batuk Saat Ekstubasi Bangun Gunawan, Aris; Pradian, Erwin; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Pipa endotrakeal (endotracheal tube; ETT) sering digunakan pada prosedur anestesi umum. Batuk saat ekstubasi merupakan komplikasi yang sering terjadi karena iritasi jalan napas akibat pelepasan ETT. Penggunaan lidokain intravena dan propofol intravena telah terbukti mampu menurunkan angka kejadian batuk saat ekstubasi. Tujuan penelitian ini membandingkan angka kejadian batuk saat ekstubasi bangun pemberian lidokain 2% 1,5 mg/kgBB intravena dengan propofol 0,3 mg/kgBB intravena dalam anestesi umum yang diberikan 3 menit setelah sevofluran dan N2O dihentikan pada akhir operasi. Penelitian ini dilaksanakan dari bulan Desember 2016 sampai dengan FebruariÂ 2017 di Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian ini dilakukan dengan metode eksperimental dengan teknik acak terkontrol buta tunggal terhadap 72 subjek yang terdiri atas kelompok lidokain (n=36) dan kelompok propofol (n=36). Analisis statisika menggunakan uji chi-square dengan bantuan aplikasi statistical product and service solution (SPSS) versi 20.0 for windows taraf signifikasi 5% dan dianggap bermakna bila p<0,05. Pada hasil penelitian ini didapatkan angka kejadian batuk pada pemberian lidokain 2% 1,5 mg/kgBB lebih rendah dibanding denganÂ pemberian propofol 0,3 mg/kgBB (p<0,05) dengan persentase 19,4% dan 44,4%. Simpulan penelitian ini adalah pemberian lidokain 2% 1,5 mg/kgBB intravena lebih baik dibanding dengan propofol 0,3 mg/kgBB intravena untuk menurunkan kejadian batuk pada saat ekstabasi.Kata kunci: Batuk, ekstubasi, lidokain, propofolÂ Comparison between Intravenous Administration of 2% Lidocaine 1,5 mg/kgBW and Propofol 0,3 mg/kgBW after Discontinuation of General Anesthesia against Cough Incidence During Awake ExtubationEndotracheal tube (ETT) is often used in general anesthesia procedures. Coughing at the time ofÂ extubation is a complication that often occurs due to respiratory irritation due to the release of ETT. The use of intravenous lidocaine and intravenous propofol has been shown to decrease the incidence of coughing at the time of extubation. This study aimed to compare the incidence of coughing during awake extubation between 2% of lidocaine 1.5 mg/kgBW intravenously with propofol administered 0.3 mg/kgBW intravenously in general anesthesia 3 minutes after sevoflurane and N2O was stopped at the end of the surgery. This study was conducted from December 2016 until February 2017 in Dr. Hasan Sadikin General Hospital Bandung. The research was done with experimental method with a single blindÂ randomized controlled trial and was carried out on 72 subjects consisting of lidocaine group (n=36) and propofol group (n=36). Statistic analysis using chi-square test with statistical product and service solution (SPSS) version 20.0 for windows with significance level 5% and considered significant if p<0,05. In the results of this study, the incidence of coughing in group of 2% of lidocaine 1.5 mg/kgBW was lower than group of propofol 0.3 mg/kgBW (p<0.05) with the respective percentages of 19.4% and 44.4%. The conclusion of this study was 2% of lidocaine 1.5 mg/kgBW intravenously is better compared to propofol 0.3 mg/kgBW intravenously to decrease the incidence of coughing at the time of extubation.Key words: Coughing, extubation, lidocaine, propofol

Gambaran Kontaminasi Bakteri pada Sirkuit Pernapasan Anestesi di Ruang Operasi Rumah Sakit Dr. Hasan Sadikin Bandung pada Bulan Agustus 2015 Suryadi, Suryadi; Fuadi, Iwan; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Rumah Sakit Dr. Hasan Sadikin Bandung memakai sirkuit pernapasan dalam melakukan tindakan anestesi di ruang operasi. Sirkuit tersebut digunakan berulang dan diganti setiap 24 jam. Penelitian ini dilakukan untuk mengetahui gambaran kontaminasi bakteri pada sirkuit pernapasan anestesi. Penelitian dilakukan dengan metode deskriptif observasional secara crossâsectional. Sebanyak 102 sampel dari 51 sirkuit pernapasan anestesi diperiksa kultur bakteri sebelum dan sesudah digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung selama 3 hari pada bulan Agustus 2015. Pengambilan sampel dilakukan dengan metode apus pada konektor Y sirkuit pernapasan anestesi sebelum dan sesudah digunakan dalam 24 jam. Hasil penelitian ini menunjukkan tidak ada kontaminasi bakteri pada sirkuit pernapasan anestesi sebelum digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung. Kontaminasi bakteri pada sirkuit pernapasan anestesi sesudah digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung adalah 25,49%. Gambaran pola bakteri yang teridentifikasi adalah bakteri Micrococcus spp., Bacillus spp., Streptococcus viridans, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis, dan Staphylococcus saprophyticus. Simpulan penelitian ini adalah tidak ditemukan kontaminasi bakteri pada sirkuit pernapasan anestesi sebelum digunakan dan ditemukan kontaminasi bakteri pada sirkuit pernapasan anestesi sesudah digunakan pada ruang operasi Rumah Sakit Dr. Hasan Sadikin Bandung.Kata kunci: Gambaran pola bakteri, kontaminasi bakteri, sirkuit pernapasan anestesiÂ Description of Bacteria Contamination in Anesthesia Breathing Circuit in Operating Room Dr. Hasan Sadikin Bandung General Hospital in August 2015Breathing circuits have been used repeatedly to perform anesthesia in the operating theater of Dr. Hasan Sadikin General Hospital with a replacement interval of every 24 hours. This study was conducted to determine the contamination of bacteria in the anesthesia breathing circuits. This was an observational descriptive crossâsectional study on 102 samples from 51 anesthesia breathing circuits. These samples were cultured before and after the use of breathing circuit in the operating room of Dr. Hasan Sadikin General Hospital for 3 days in August 2015. Sampling was performed using swab method at the Y connector of anesthesia breathing circuit before and after use within a period of 24 hours. The results showed that no bacterial contamination was found in the anesthesia breathing circuit before use in the operating theatre of Dr. Hasan Sadikin Hospital Bandung. Bacterial contamination of anesthesia breathing circuit after use was 25.49%. The bacteria identified were Micrococcus spp., Bacillus spp., Streptococcus viridans, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis and Staphylococcus saprophyticus. It is concluded that no bacterial contamination of anesthesia breathing circuit before use; however, bacterial contamination was found after the use of anesthesia breathing circuits in the operating theatre of Dr. Hasan Sadikin General Hospital Bandung.Key words: Anesthesia breathing circuits, bacterial contamination, description of the bacteriaÂ

Perbandingan Pemberian Efedrin 30 mcg/kgBB dengan Efedrin 70 mcg/kgBB Intravena terhadap Skala Nyeri dan Efek Hipotensi pada Penyuntikan Propofol di Rumah Sakit Dr. Hasan Sadikin Bandung Afifuddin, Afifuddin; Sitanggang, Ruli Herman; Oktaliansah, Ezra
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Penyuntikan propofol menyebabkanÂ nyeri dan perubahan tekanan darah. Efedrin merupakan obat yang digunakan untuk mengurangi efek yang tidak diinginkan saat penyuntikan propofol. Penelitian ini bertujuan membandingkan pemberian efedrin 30 mcg/kgBB intravena dengan efedrin 70 mcg/kgBB intravena terhadap skala nyeri dan efek hipotensi pada penyuntikan propofol. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan September hingga November 2015 terhadap 60 orangÂ pasien denganÂ American Society of AnesthesiologistÂ (ASA) kelas I dan II, usia 18 hingga 60 tahun yang menjalani operasi elektif dengan anestesi umum secara uji acak kontrol buta ganda. Pasien dibagi menjadi dua kelompok, 30 orang menerima efedrin 30 mcg/kgBB dan 30 orang menerima efedrin 70 mcg/kgBB, diberikan 1 menit sebelum penyuntikan propofol. Analisis statistik menggunakan uji Mann-Whitney. Hasil penelitian menunjukkan skala nyeri pada kelompok efedrin 30 mcg/kgBB dan efedrin 70 mcg/kgBB tidak berbeda bermakna (p>0,05), dan perubahan tekanan darah sistole dan diastole efedrin 30 mcg/kgBB dengan efedrin 70 mcg/kgBB berbeda bermakna (p<0,05). Simpulan, efedrin 30 mcg/kgBB dan efedrin 70 mcg/kgBB menurunkan skala nyeri saat penyuntikan propofol, dan efedrin 70 mcg/kgBB mencegah efek hipotensi lebih baik dibanding dengan efedrin 30 mcg/kgBB.Â Â Comparison of 30 mcg/kgBW and 70 mcg/kgBW Intravenous Ephedrine on Pain Scale and Hypotension After Propofol Injection inÂ Dr. Hasan Sadikin General Hospital BandungInjection of propofol causes pain and blood pressure changes. Propofol can cause pain at the injection site and decrease the blood pressure while ephedrine is considered to minimize those adverse effect. The purpose of the study was to compare the effects of 30 mcg/kgBW and 70 mcg/kgBW intravenous ephedrine on pain score and blood pressure changes after propofol injection. This double-blind randomized control trial was conducted in Dr. Hasan Sadikin General Hospital Bandung, September to November 2015, on 60 patients with American Society of Anesthesiologist (ASA) physical status I and II, aged 18 to 60 years old. Patients were divided into 2 groups of 30 persons; the first group received 30 mcg/kgBW ephedrine and the second group received 70 mcg/kgBW ephedrine one minute before propofol injection. Statistical analysis was performed using the Mann-Whitney test. This study showed no significant difference in pain score between the group that received 30 mcg/kgBW ephedrine and 70 mcg/kgBW (p>0,05), but there were significant differences in blood pressure changes (p<0,05). It can be concluded that 30 mcg/kgBW and 70 mcg/kgBW ephedrine could reduce pain score following propofol injection with 70 mcg/kgBW ephedrine reduces the hypotension effect better than the 30 mcg/kgBW dose. Â

Perbandingan Pemberian Deksametason 10 mg dengan 15 mg Intravena sebagai Adjuvan Analgetik terhadap Skala Nyeri Pascabedah pada Pasien yang Dilakukan Radikal Mastektomi Termodifikasi Erlangga, M. Erias; Sitanggang, Ruli Herman; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Deksametason merupakan kortikosteroid yang memiliki efek anti-inflamasi paling kuat. Penelitian ini bertujuan membandingkan deksametason 10 mg dengan deksametason 15 mg intravena prabedah terhadap nyeri pascabedah dan kebutuhan analgetik opioid. Penelitian ini merupakan uji acak terkontrol buta ganda pada 60 wanita dengan status fisik American Society of Anesthesiologist (ASA) IâII yang menjalani pembedahan radikal mastektomi termodifikasi dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung periode Desember 2013âApril 2014. Pasien dibagi menjadi dua kelompok, yaitu 30 orang menerima deksametason 10 mg dan 30 orang menerima deksametason 15 mg yang diberikan 30 menit prabedah. Penilaian skala nyeri menggunakan nilai numeric rating scale (NRS) pada saat istirahat dan mobilisasi, pada jam ke-1, 2, 4, 12, dan 24 pascabedah. Pemberian analgetik tambahan opioid dilakukan bila nilai NRS>3. Analisis statistika data hasil penelitian menggunakan uji-t, chi-kuadrat, dan Mann-Whitney. Hasil penelitian menunjukan nilai NRS saat istirahat pada kelompok deksametason 10 mg dengan deksametason 15 mg tidak berbeda bermakna (p>0,05), sementara nilai NRS saat mobilisasi pada kelompok deksametason 10 mg lebih tinggi dibanding dengan kelompok deksametason 15 mg (p<0,05). Pemberian analgetik tambahan pascabedah tidak terdapat perbedaan secara bermakna antara kedua kelompok (p>0,05). Simpulan penelitian ini adalah pemberian deksametason 15 mg dapat diberikan karena mempunyai efek analgesia yang lebih baik.Kata kunci: Deksametason, numeric rating scale, nyeri pascabedahComparison between 10 mg and 15 mg of Intravenous Dexamethasone as Analgesia Adjunct on Post Operative Pain in Patients Undergo Modified Radical Mastectomy Dexamethasone is a glucocorticoid with the strongest anti-inflammatory property. The aim of this study was to compare the effect of 10 mg and 15 mg of intravenous dexamethasone on post operative pain and opioid analgetic need. This was a randomized double-blind study involving 60 females with physical status ASA IâII whom underwent modified radical mastectomy under general anesthesia at Dr. Hasan Sadikin General Hospital during December 2013âApril 2014. Patients were divided into 2 groups where 30 patients received 10 mg dexamethasone and 30 patients received 15 mg dexamethasone 30 minutes prior to surgery. Pain assessment was performed using numeric rating scare (NRS) at rest and during activity, documented on the 1st, 2nd, 4th, 12th and 24th hour post operative. Additional analgesia was given if NRS >3. Data were analyzed statistically using Studentâs t test, chi-square and Mann Whitney U test. Result showed that the difference between NRS at rest for 10 mg and 15 mg dexamethasone (p>0.05) was not significant, while the difference in NRS during activity at all time measurements were statistically significant (p<0.05). There was no statistical significant difference in additional opioid administered between the two groups (p>0.05). This study concludes that 15 mg dexamethasone has a better analgesia effect to reduce analgesic dose.Key words: Dexamethasone, numeric rating scale, post operative painÂ DOI:Â 10.15851/jap.v3n3.607

Angka Mortalitas pada Pasien yang Menjalani Bedah Pintas Koroner berdasar Usia, Jenis Kelamin, Left Ventricular Ejection Fraction, Cross Clamp Time, Cardio Pulmonary Bypass Time, dan Penyakit Penyerta Ariaty, Geeta Maharani; Sudjud, Reza Widianto; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Penyakit jantung koroner (PJK) adalah salah satu penyakit pada sistem kardiovaskularÂ yangÂ seringÂ terjadiÂ danÂ merupakanÂ problemaÂ kesehatanÂ utamaÂ diÂ negara maju. Bedah pintas koroner merupakan salah satu penanganan intervensi PJK. Beberapa faktor risiko berhubungan dengan peningkatan mortalitas pascabedah pintas koroner. Tujuan penelitian ini adalah mengetahui angka mortalitas pada pasien yang menjalani bedah pintas koroner berdasar atas usia, jenis kelamin, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time, dan penyakit penyerta di RSUP Dr. Hasan Sadikin Bandung tahun 2014â2016. Metode yang digunakan pada penelitian ini adalah deskriptif observasional dengan pendekatan retrospektif berdasar atas data rekam medis yang dilakukan bulan April 2017. Dari penelitian diperoleh hasil angka mortalitas pascabedah pintas koroner sebesar 15,15%. Angka mortalitas pasien yang menjalani bedah pintas koroner dipengaruhi beberapa faktor diantaranya usia, jenis kelamin, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time dan penyakit penyerta.Â Mortality Rate of Patients Underwent Coronary Artery Bypass Graft Surgery based on Age, Gender, Left Ventricular Ejection Fraction, Cross Clamp Time, Cardiopulmonary Bypass Time, and Coexisting DiseaseCoronary heart disease (CHD) is one of the most common cardiovascular diseases and is a major health problem in developed countries. Coronary artery bypass graft surgery (CABG) is one of the intervention treatments of CHD. Several risk factors are associated with increased postoperative CABG mortality. The purpose of this study was to determine the mortality rate of patients undergoing coronary bypass surgery based on age, gender, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time, and coexisting disease at Dr. Hasan Sadikin Bandung General Hospital during 2014-2016. This study was an analytical descriptive study using retrospective approach based on medical record data during April 2017. It was shown that the mortality rate for post-coronary bypass was 30 patients (15.15%). Hence, themortality rate of patients undergoing coronary bypass surgery is affected by several factors including age, gender, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time, and coexisting disease.Â

Co-Authors - Elvidiansyah - Elvidiansyah - Suwarman - Suwarman - Suwarman A. Himendra Wargahadibrata A. Himendra Wargahadibrata Afifuddin Afifuddin Afifuddin Afifuddin, Afifuddin Akhmad Rhesa Sandy Annisa Isfandiary Ismandiya Annisa Isfandiary Ismandiya, Annisa Isfandiary Anthon Vermana Ritonga Anthon Vermana Ritonga Ara Guntara Ara Guntara Ardi Zulfariansyah Ardi Zulfariansyah Ariaty, Geeta Maharani Aris Gunawan Arnanto, Yodi Suryo Budi Hartanto Budi Hartanto Budiana Rismawan Cindy E. Boom Cindy E. Boom Dadang Mulyawan Dadang Mulyawan Dear Mohtar Wirawijaya Dedi Fitri Yadi Dewi Yulianti Bisri Doddy Tavianto Erias, Muhammad Erik Efendi Erik Efendi Erwin Pradian Erwin Pradian Ezra Oktaliansah Geeta Maharani Ariaty Gunawan Mutiara Gunawan Mutiara, Gunawan Gunawan, Aris Harly, Patra Rijalul Harniati, Siti Ike Sri Redjeki Indriasari Indriasari Iwan Fuadi Lira Panduwaty Lira Panduwaty M. Andy Prihartono M. Erias Erlangga M. Erias Erlangga, M. Erias Mahathir Harry Permana Muhammad Erias Nurita Dian Kestriani Oka Endarto Oktofina K. Mose Oktofina K. Mose Raditya Fauzan Raditya Fauzan, Raditya Ratu Lewi Ratu Lewi, Ratu Reza Widianto Sudjud Reza Widianto Sudjud Robert Sihombing Ronald Tikuali Salukanan Salukanan, Ronald Tikuali SATRIYAS ILYAS Selly Oktarina Rosita Selly Oktarina Rosita Sihombing, Robert Suryadi Suryadi Suryadi Suryadi Suwarman Suwarman Suwarman Suwarman, Suwarman Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tinni T. Maskoen Tinni T. Maskoen Udin Sabarudin Udin Sabarudin Viana Wijayanti Viana Wijayanti Wirawijaya, Dear Mohtar Wirawijaya Wullur, Caroline Yodi Suryo Arnanto

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