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Factors Influencing the Success Rate of Cardiopulmonary Resuscitation Hanif, Aisyah Amanda; Rachman, Iwan Abdul; Yuwono, Hendro Sudjono
Althea Medical Journal Vol 2, No 4 (2015)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (553.013 KB)

Background: Cardiopulmonary resuscitation (CPR) is a series of actions performed on cardiac arrestÂ patients. Not all patients receiving CPR can survive. The outcome of CPR is influenced by several factors.Â This study was conducted to determine the success rate of CPR and the factors influencing it in Dr. HasanÂ Sadikin General Hospital in 2013.Methods: This study was conducted by using 168 patient medical records who underwent CPR and met theÂ inclusion criteria in the Resuscitation Room of Dr. Hasan Sadikin General Hospital from January to DecemberÂ 2013. The collected data consisted of age, gender, pre-arrest diagnosis, initial rhythm, response time andÂ clinical outcome of CPR. The results were expressed in frequencies and percentage. The data were analyzedÂ using the chi-square test.Results: The Success rate of CPR was 15.5%. The success rate was higher in patients with cardiac prearrestÂ diagnoses (8.33%, p=0.024). The most common initial rhythm was unshockable rhythms (83.92%),Â yet patients with shockable heart rhythms had higher success rates (40.74%, p<0.001). All of the survivingÂ patients had response time within the first minute from cardiac arrest.Conclusions: Success rate of CPR in the resuscitation room of Dr. Hasan Sadikin General Hospital duringÂ 2013 is still low. The factors influencing the survival rate are the pre-arrest diagnosis and initial heartrhythm. [AMJ.2015;2(4):615â9]Â DOI:Â 10.15850/amj.v2n4.657

Perbandingan Ketepatan Ukuran Classic Laryngeal Mask Airway antara Metode Berat Badan dan Lebar Lidah Rahman, Abdul; Fuadi, Iwan; Rachman, Iwan Abdul
Jurnal Anestesi Perioperatif Vol 6, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Classic laryngeal mask airway (CLMA) merupakan alat yang digunakan untuk manajemen jalan napas, baik untuk pengganti ventilasi sungkup wajah maupun intubasi endotrakeal. Pemilihan ukuran yang tepat penting untuk efektivitas penggunaan CLMA. Saat ini pemilihan ukuran berdasar atas metode berat badan. Menurut sebuah studi terbaru metode pengukuran lebar lidah lebik baik daripada metode berat badan. Tujuan penelitian ini adalah mengetahui ketepatan ukuran CLMA antara metode berat badan dan lebar lidah yang dinilai dengan skor fiberoptik dan oropharyngeal leak pressure di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini dilakukan pada bulan Februari 2018 menggunakan uji eksperimental analitik crossection setiap subjek mendapat dua perlakuan yang berbeda antara kedua metode. Uji statistik menggunakan uji chi-square untuk skor fiberoptik dan uji t berpasangan untuk oropharyngeal leak pressure. Hasil penelitian skor fiberoptik lebih optimal daripada metode lebar lidah. Oropharyngeal leak pressure pada metode berat badan rerata 23,00±1,732 CmH20 sedangkan metode lebar lidah rerata 19,13±1,684 CmH20. Secara statistik diperoleh nilai p<0,05. Simpulan, metode pengukuran lebar lidah adalah alternatif yang mudah dan baik dalam pemilihan ukuran CLMA pasien dewasa.Kata kunci: Classic laryngeal mask airway, pemilihan ukuran CLMA, metode berat badan, metode lebar lidahComparison of Classic Laryngeal Mask Airway Size Accuracy between Body Weight Method and Tongue width MethodClassic laryngeal mask airway (CLMA) is an airway management device that can be used to replace bag valve mask ventilation or endotracheal intubation. Choosing the right size of CLMA is important for the effectiveness of CLMA. Currently, the size of CLMA is selected based on the body weight. However, a recent study suggested that tongue width is a better indicator for size selection than the body weight. The purpose of this study was to assess the accuracy of CLMA size selection using the body weight method and tongue-width method. The assessment was performed using the fiberoptic score and oropharyngeal leak pressure. This was an experimental analytic cross-sectional study conducted in Dr. Hasan Sadikin General Hospital Bandung in February 2018. Each subject in this study received two different treatments using the two methods. The results were analyzed using chi-square for the fiberoptic score and paired t test for the oropharyngeal leak pressure. The fiberoptic score was more optimum when tongue width method was used when compared to the weight method. The oropharyngeal leak pressure in the weight method group was 23.00±1.732 CmH20 while the pressure in the tongue-width method was 19.13±1.684 CmH20 (p value <0.05). In conclusion, the tongue width measurement is an easy and good alternative in the selecting the CLMA size in adult patients.Key words: Classic laryngeal mask airway, size selection CLMA, body weight method, tongue width method

Perbandingan Efek Analgesia antara Fentanil dan Oksikodon Intravena untuk Pengelolaan Nyeri Pascabedah Laparotomi Kolesistektomi Thomas Thomas; Iwan Fuadi; Iwan Abdul Rachman
Jurnal Anestesi Perioperatif Vol 9, No 1 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n1.2386

Nyeri pascabedah harus diatasi dengan baik menggunakan analgetik yang memiliki efek analgesia adekuat dengan efek samping minimal. Penelitian ini bertujuan mengetahui perbedaan nyeri pascabedah laparotomi kolesistekomi yang dinilai dengan numeric rating score (NRS) antara pasien yang menggunakan continuous intravenous patient controlled analgesia (IV-PCA) fentanil dan oksikodon. Penelitian dilakukan pada periode Agustus–November 2020 di RSUP dr. Hasan Sadikin Bandung. Penelitian randomized control trial (RCT) dilakukan terhadap 32 subjek status fisik ASA I–II yang terbagi menjadi dua kelompok, yaitu kelompok yang mendapat continuous IV-PCA fentanil 0,5 µg/kgBB/jam dan kelompok dengan continuous IV-PCA oksikodon 30 µg/kgBB/jam. Nyeri pascabedah dinilai dengan NRS pada jam pertama, ke-6, ke-12, dan ke-24. Analisis statistik data numerik dengan Uji Mann-Whitney, data kategorik dengan uji chi-square dan alternatif Uji Fisher’s Exact. Nilai NRS pada kelompok oksikodon lebih rendah dibanding dengan fentanil pada jam pertama hingga jam ke-24 (p=0,001). Kebutuhan rescue analgetik pada jam pertama dan ke-6 juga lebih rendah pada kelompok oksikodon (p=0,012; p=0,022, berurutan). Penelitian dengan rasio fentanil:oksikodon 1:60 ini tidak menunjukkan perbedaan efek samping kejadian mual, muntah, pusing, sakit kepala, dan pruritus antara kedua kelompok. Pemberian analgesia oksikodon intravena pada pasien pascabedah laparotomi kolesistektomi lebih baik dibanding dengan fentanil intravena.Comparison of Analgesia Effect between Intravenous Fentanyl and Oxycodone for Postoperative Pain Management after Laparotomy CholecystectomyPostoperative pain must be addressed properly with adequate analgetic drugs and minimal side effects. This study aimed to determine the differences in postoperative cholecystecomy laparotomy pain assessed by NRS in patients receiving continuous PCA fentanyl or oxycodone. This was a randomized clinical trial on 32 subjects between August-November 2020 at dr. Hasan Sadikin Hospital Bandung. These subjects were divided into two groups: the group that received continuous intravenous infusion of PCA fentanyl 0.5 µg/kgBW/hour and the group with continuous intravenous infusion of PCA oxycodone 30 µg/kgBW/hr. Thepostoperative pain was assessed by NRS at the 1st, 6th, 12th, and 24th hours. Statistical analysis of numerical data was performed using the Mann-Whitney test while the categorical data were analyzed using Chi-Square test with alternative uji Fisher’s Exact test. Results showed that NRS was lower in the oxycodone group than in the fentanyl group at the first to 24 hours (p=0.001). The need for analgesic rescue at the first and sixth hours was also lower in the oxycodone group (p=0.012; p=0.022, respectively). The observation of opioid side effects on fentanyl:oxycodone with a ratio of 1:60 did not present any difference in the incidence of nausea, vomiting, dizziness, headache, and pruritus in both groups. The administration of intravenous oxycodone in postoperative cholecystectomy laparotomy patients gives better analgesia effect than intravenous fentanyl.

Perbandingan Ketepatan Ukuran Classic Laryngeal Mask Airway antara Metode Berat Badan dan Lebar Lidah Abdul Rahman; Iwan Fuadi; Iwan Abdul Rachman
Jurnal Anestesi Perioperatif Vol 6, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Classic laryngeal mask airway (CLMA) merupakan alat yang digunakan untuk manajemen jalan napas, baik untuk pengganti ventilasi sungkup wajah maupun intubasi endotrakeal. Pemilihan ukuran yang tepat penting untuk efektivitas penggunaan CLMA. Saat ini pemilihan ukuran berdasar atas metode berat badan. Menurut sebuah studi terbaru metode pengukuran lebar lidah lebik baik daripada metode berat badan. Tujuan penelitian ini adalah mengetahui ketepatan ukuran CLMA antara metode berat badan dan lebar lidah yang dinilai dengan skor fiberoptik dan oropharyngeal leak pressure di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini dilakukan pada bulan Februari 2018 menggunakan uji eksperimental analitik crossection setiap subjek mendapat dua perlakuan yang berbeda antara kedua metode. Uji statistik menggunakan uji chi-square untuk skor fiberoptik dan uji t berpasangan untuk oropharyngeal leak pressure. Hasil penelitian skor fiberoptik lebih optimal daripada metode lebar lidah. Oropharyngeal leak pressure pada metode berat badan rerata 23,00±1,732 CmH20 sedangkan metode lebar lidah rerata 19,13±1,684 CmH20. Secara statistik diperoleh nilai p<0,05. Simpulan, metode pengukuran lebar lidah adalah alternatif yang mudah dan baik dalam pemilihan ukuran CLMA pasien dewasa.Kata kunci: Classic laryngeal mask airway, pemilihan ukuran CLMA, metode berat badan, metode lebar lidahComparison of Classic Laryngeal Mask Airway Size Accuracy between Body Weight Method and Tongue width MethodClassic laryngeal mask airway (CLMA) is an airway management device that can be used to replace bag valve mask ventilation or endotracheal intubation. Choosing the right size of CLMA is important for the effectiveness of CLMA. Currently, the size of CLMA is selected based on the body weight. However, a recent study suggested that tongue width is a better indicator for size selection than the body weight. The purpose of this study was to assess the accuracy of CLMA size selection using the body weight method and tongue-width method. The assessment was performed using the fiberoptic score and oropharyngeal leak pressure. This was an experimental analytic cross-sectional study conducted in Dr. Hasan Sadikin General Hospital Bandung in February 2018. Each subject in this study received two different treatments using the two methods. The results were analyzed using chi-square for the fiberoptic score and paired t test for the oropharyngeal leak pressure. The fiberoptic score was more optimum when tongue width method was used when compared to the weight method. The oropharyngeal leak pressure in the weight method group was 23.00±1.732 CmH20 while the pressure in the tongue-width method was 19.13±1.684 CmH20 (p value <0.05). In conclusion, the tongue width measurement is an easy and good alternative in the selecting the CLMA size in adult patients.Key words: Classic laryngeal mask airway, size selection CLMA, body weight method, tongue width method

Efek Granisetron Intravena terhadap Perubahan Tekanan Darah pada Seksio Sesarea dengan Anestesi Spinal Jaya Supriyanto; Suwarman Suwarman; Iwan Abdul Rachman
Jurnal Anestesi Perioperatif Vol 8, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n2.2041

Hipotensi merupakan komplikasi paling sering pada seksio sesarea dengan anestesi spinal. Pencegahan hipotensi dapat dilakukan dengan pemberian cairan, obat-obatan, pengurangan dosis obat anestesi lokal, dan intervensi mekanik. Granisetron sebagai antagonis reseptor 5hydroxytryptamine3 (5HT3) dapat digunakan untuk mencegah hipotensi pada seksio sesarea dengan anestesi spinal. Penelitian ini bertujuan mengetahui pengaruh pemberian granisetron 1 mg intravena terhadap perubahan tekanan darah pada seksio sesarea dengan anestesi spinal. Penelitian ini dilakukan periode Desember 2019–Februari 2020 di RSUP Dr. Hasan Sadikin Bandung. Metode penelitian ini adalah uji klinis tersamar ganda pada 34 pasien ASA II yang menjalani seksio sesarea dengan anestesi spinal. Subjek penelitian dibagi secara acak menjadi 2 kelompok, yaitu kelompok kontrol diberikan NaCl 0,9% dan kelompok granisetron diberikan granisetron 1 mg intravena pada 5 menit sebelum anestesi spinal. Tekanan darah diperiksa setiap 1 menit selama 20 menit setelah anestesi spinal, kemudian setiap 2,5 menit sampai operasi selesai. Data dianalisis dengan uji t, Uji Mann Whitney, dan Uji kolmogorov-smirnov, nilai p<0,05 dianggap bermakna. Kejadian hipotensi pada kelompok kontrol (79%) lebih tinggi dari kelompok granisetron (29%). Penurunan tekanan darah pada kelompok kontrol lebih besar dibanding dengan kelompok granisetron dengan perbedaan signifikan (p<0,05). Simpulan, pemberian granisetron 1 mg intravena dapat mengurangi kejadian hipotensi pada seksio sesarea dengan anestesi spinal.Effect of Intravenous Granisetron on Blood Pressure in Cesarean Section under Spinal AnesthesiaHypotension is the most frequent complication in cesarean section with spinal anesthesia. The prevention of hypotension includes fluid and drugs administration, lower local anesthetic doses, and mechanic interventions. Granisetron is a 5HT3 receptor antagonist that can be used to prevent hypotension in cesarean section with spinal anesthesia. This study aimed to determine the effects of intravenous administration of 1 mg granisetron on blood pressure in patients undergoing cesarean section with spinal anesthesia. This study was a double blinded clinical study on 34 patients ASA II undergoing cesarean sections with spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, during the period of December 2019 to February 2020. Subjects were divided randomly into 2 groups; a control group that received 0.9% NaCl and a granisetron group that received 1 mg intravenous granisetron 5 minutes before spinal anesthesia. Blood pressure was evaluated every minute for 20 minutes after the spinal anesthesia, and then every 2.5 minutes until the surgery was completed. Data were analyzed using t-test, Mann Whitney test, and Kolmogorov-Smirnov test with p value<0.05 considered significant. Incidence of hypotension in the control group was higher than the granisetron group (79%vs29%) with blood pressure decrease significantly higher in the control group (p<0.05). Thus, administration of intravenous 1 mg granisetron may reduce the incidence of hypotension in cesarean sections with spinal anesthesia.

Pengaruh Pemberian Magnesium Sulfat Intravena Prainduksi terhadap Kebutuhan Analgetik Pasca-Simple Mastectomy Asyer Asyer; Iwan Fuadi; Iwan Abdul Rachman
Jurnal Anestesi Perioperatif Vol 7, No 2 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Nyeri pascabedah masih menjadi masalah dan perhatian di dunia. Pemberian analgetik preventif merupakan salah satu cara untuk mengurangi nyeri pascabedah. Beberapa obat digunakan sebagai terapi analgetik preventif antara lain opioid dan NSAID, namun obat ini mempunyai banyak efek samping. MgSO4 dapat digunakan sebagai analgetik preventif karena bersifat antagonis reseptor NMDA nonkompetitif. Tindakan operasi yang memiliki skor nyeri yang tinggi salah satunya adalah simple mastectomy dengan skor nyeri 4 sampai 8. Penelitian ini bertujuan mengetahui pengaruh MgSO4 i.v. dengan dosis bolus 50 mg/kgBB 20 menit prainduksi terhadap kebutuhan analgetik pasca-simple mastectomy. Penelitian ini merupakan penelitian analitik komparatif dengan data tidak berpasangan secara prospektif dengan uji klinis acak terkontrol buta ganda (RCT double blind) yang dilakukan terhadap 26 subjek penelitian yang menjalani simple mastectomy di RSUP Dr. Hasan Sadikin Bandung pada bulan Agustus sampai Desember 2018. Analisis statistik pada data numerik diuji dengan uji t berpasangan, sedangkan data kategorik diuji dengan uji chi-Square. Subjek dibagi menjadi kelompok M (MgSO4 20% 50 mg/kgBB) dan kelompok C (NaCl 0,9%). Hasil penelitian ini didapatkan kebutuhan opioid pascabedah pada kelompok yang diberikan MgSO4 lebih rendah dibanding dengan kelompok yang mendapatkan NaCl dengan perbedaan bermakna (p<0,05). Simpulan penelitian ini adalah MgSO4 i.v. prainduksi menurunkan kebutuhan opioid dibanding dengan kelompok kontrol pada simple mastectomy. Effect of Intravenous Magnesium Sulfate Pre-induction on Analgesics Consumption in Post-Simple MastectomyPostoperative pain is still a global problem that raises concerns all over the world. Preventive analgesics is one method to reduce postoperative pain. Several drugs are used as preventive analgesics including opioids and NSAIDs. However, these drugs have many side effects. MgSO4 can be used as alternative preventive analgesic as it is a non-competitive NMDA receptor antagonist. One of the surgical procedure that has a high pain score is simple mastectomy with a pain score of 4 to 8. The aim of this study was to determine the effect of MgSO4 i.v. with a bolus dose of 50 mg/kgBW, 20 minutes pre-induction, on the need for post-simple mastectomy analgesics. This was a comparative double blind randomized controlled trial (RCT) analytical study on prospective unpaired data from 26 study subjects who underwent simple mastectomy at Dr. Hasan Sadikin General Hospital Bandung during the period of August to December 2018. Subjects were divided into group M (MgSO4 20% 50 mg/kgBW) and group C (NaCl 0.9%). The results of this study revealed that the need for postoperative opioids in the group given MgSO4 was significantly lower compared to the group receiving NaCl (p<0.05). Therefore, MgSO4 i.v. preinduction has the ability to reduce opioid requirements in simple mastectomy when compared to NaCl.

Perubahan Waktu Reaksi terhadap Stimulus Visual pada PPDS Anestesiologi dan Terapi Intensif RSUP Dr. Hasan Sadikin Bandung Setelah Bertugas Selama 24 Jam Lukman Hidayat; Iwan Fuadi; Iwan Abdul Rachman
Jurnal Anestesi Perioperatif Vol 8, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n2.2034

Waktu reaksi dibutuhkan oleh dokter anestesi karena harus berpikir dan bertindak cepat serta tepat dalam situasi kritis mengancam jiwa pasien. Jaga malam selama 24 jam dapat meyebabkan kelelahan dan gangguan tidur sehingga waktu reaksi menjadi lebih lambat. Tujuan penelitian ini mengetahui perubahan waktu reaksi terhadap stimulus visual pada PPDS Anestesiologi dan Terapi Intensif FK Unpad setelah bertugas selama 24 jam di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini berlangsung pada bulan Oktober–November 2019 merupakan pretest and posttest control group design dilakukan pada 58 peserta dengan menilai waktu reaksi sebelum bertugas dan setelah bertugas selama 24 jam diperiksa menggunakan metode Ruler Drop. Analisis data menggunakan Uji Wilcoxon karena data distribusi tidak normal berdasar atas hasil Uji Kolgomorov Smirnov. Pada penelitian ini diperoleh median waktu reaksi setelah bertugas selama 24 jam menjadi lebih lama dibanding dengan sebelum bertugas. Nilai median waktu reaksi sebelum bertugas adalah 0,20 detik (range 0,10–0,25 detik), sedangkan waktu reaksi setelah bertugas selama 24 jam adalah 0,23 detik (range 0,17–0,32 detik), dengan rerata lama jam tidur selama bertugas 24 jam adalah 2,32±1,552 jam. Simpulan, waktu reaksi lebih lama pada peserta PPDS Anestesiologi dan Terapi Intensif FK UNPAD setelah bertugas selama 24 jam. Change in Visual Stimulus Reaction Time of Anesthesiology and Intensive Care Residents after a 24-Hour ShiftA good reaction time is crucial for anesthesiologists when doing their work because their quick thinking and action are critical in life-threatening situations. A 24-hour shift may cause fatigue and sleep disturbances, lowering cognitive function and reaction time necessary for patient care. This study aimed to assess changes in the visual reaction time of the Anesthesiology and Intensive Care resident doctors FK Unpad after 24-hour shift in Dr. Hasan Sadikin General Hospital Bandung, Indonesia. This pretest and posttest control study was performed July–October 2019 on 58 subjects by evaluating the reaction time before and after a 24-hour shift using the ‘ruler drop’ method. Data were analyzed with Wilcoxon test after data were proven to be non-normally distributed based on the results of the Kolgomorov Smirnov test. The median visual reaction time after a 24-hour shift was observed to be slower that before the shift , with 0.20 seconds reaction time before the shift (range 0.10–0.25 seconds) and 0.23 seconds after the shift (range 0.17–0.32 seconds). The average sleep time among the residents who work in the 24-hour shift was 2.32±1,552 hours. Hence, the visual reaction time is slower after 24-hour shift among residents of Anesthesiology and Intensive Care

PERBANDINGAN KEJADIAN POSTOPERATIVE COGNITIVE DYSFUNCTION (POCD) FASE AKUT PADA JOINT ARTHROPLASTY DENGAN ANESTESI UMUM DAN ANESTESI EPIDURAL PADA PASIEN USIA LANJUT Syahpikal Sahana; Iwan Abdul Rachman; Dewi Yulianti Bisri
Jurnal Anestesi Perioperatif Vol 8, No 1 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Usia lanjut merupakan faktor risiko terjadinya postoperative cognitive dysfunction (POCD). Pemilihan teknik anestesi yang tepat pada usia lanjut akan menurunkan risiko kejadian POCD. Penelitian ini bertujuan untuk membandingkan angka kejadian POCD pada pasien usia lanjut yang menjalani operasi joint arthroplasty antara anestesi umum dan anestesi epidural. Penelitian berlangsung pada bulan Juli–Oktober 2019 di RSUP Dr. Hasan Sadikin Bandung. Penelitian dilakukan menggunakan metode randomized control trial dengan melibatkan 48 pasien yang menjalani tindakan joint arthroplasty. Subjek penelitian dibagi menjadi kelompok anestesi umum (GA) dan anestesi epidural (EA) menggunakan bilangan acak. Penilaian status mental pasien dilakukan menggunakan Mini mental state examination (MMSE) pada saat preoperasi dan tujuh hari pascaoperasi. Perbandingan proporsi kajadian POCD pada kedua kelompok dianalisis dengan menggunakan uji chi-square. Kejadian POCD pada kelompok GA (37,5%) lebih tinggi dari kelompok EA (8,3%) dan secara statistik perbedaan proporsi kejadian POCD pada kedua kelompok bermakna signifikan p=0,016 (p<0,05). Simpulan penelitian bahwa kejadian postoperative cognitive dysfunction (POCD) pada pasien usia lanjut yang menjalani joint arthroplasty dengan anestesi epidural lebih kecil dibanding dengan anestesi umum. Comparison of General Anesthesia on Postoperative Cognitive Dysfunction (POCD) in Joint Arthroplasty with Epidural Anesthesia in Elderly PatientsOld age is a risk factor for postoperative cognitive dysfunction (POCD). Elder people often have to undergo many surgeries, one of which is joint arthroplasty surgery. Selecting appropriate anesthetic techniques for elderly patients to reduce POCD is always controversial. The study aimedto compare the POCD incidence in elderly patients who underwent joint arthroplasty surgery using the general anesthesia and epidural anesthesia. The study was conducted in July–October 2019 at the RSUP Dr. Hasan Sadikin Bandung. This study used a randomized control trial method involving 48 elderly patients who underwent joint arthroplasty using randomized control trial method. Research subjects were divided into the General Anesthesia group (GA) and the Epidural Anesthesia group (EA) using random numbers. Both groups mental status was assessed using the mini mental state examination (MMSE) during preoperative and seven days postoperatively. A comparison of the proportion of POCD incidence in the two groups were analyzed using the chi-square test. The result showed that the proportion of POCD incidence in the GA group (37.5%) was higher than the EA group (8.3%), and the difference was statistically significant p=0.016 (p<0.05). The study concludes that epidural anesthesia in the joint arthroplasty procedure of elderly patients is superior vs. general anesthesia.

PENGARUH PEMBERIAN MINUMAN KARBOHIDRAT (MALTODEXTRIN 12,5%) PRAOPERASI TERHADAP KEJADIAN MUAL DAN MUNTAH PASCAMASTEKTOMI Andre Aditya; Iwan Fuadi; Iwan Abdul Rachman
Jurnal Anestesi Perioperatif Vol 8, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n2.2039

Mual dan muntah pascaoperasi (postoperative nausea and vomiting, PONV) menjadi masalah yang umum terjadi setelah operasi mastektomi dengan angka kejadian berkisar 21–92%. Pemberian minuman karbohidrat (CHO) praoperasi ditawarkan sebagai sebuah solusi menurunkan PONV dan juga merupakan salah satu komponen penting dan disarankan untuk mencapai enhanced recovery after surgery (ERAS). CHO berhubungan dengan penurunan katabolisme dan resistensi insulin pascaoperasi. Penelitian ini bertujuan mengetahui pengaruh pemberian minuman berkarbohidrat (CHO) oral sebelum operasi terhadap tingkat kejadian PONV pascaoperasi mastektomi. Penelitian menggunakan eksperimental uji acak buta tunggal di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada November 2019–Februari 2020. Sebanyak 46 pasien dibagi menjadi dua kelompok, yakni kelompok K (kelompok kontrol, air mineral, n=23 subjek) dan kelompok C (kelompok CHO, n=23 subjek). Analisis data hasil penelitian dilakukan dengan Uji Mann-hitney. Kejadian mual muntah pada kelompok kontrol lebih besar dibanding dengan kelompok CHO pada menit 0–30 (57% vs 22%), pada menit 30–60 (91% vs 61%), dan pada menit 60–120 (78% vs 61%) dengan perbedaan yang bermakna (p<0,05). Simpulan, pemberian minuman karbohidrat praoperasi dapat menurunkan kejadian mual muntah pascamastektomi dibandingkan dengan kelompok kontrol. Effect of Preoperative Oral Carbohydrate Supplementation (Maltodextrin 12.5%) on Post-Mastectomy Nausea and Vomiting Incidence Postoperative nausea and vomiting (PONV) is a common problem after surgery. Mastectomy is one of surgeries with a high-risk for PONV, which is seen in 21–92% of the patients. Preoperative carbohydrate (CHO) drinks are offered to reduce PONV. The provision of CHO is also important as it is recommended to obtain enhanced recovery after surgery (ERAS). CHO is associated with reduced catabolism and postoperative insulin resistance. This study aimed to determine the effect of oral carbohydrate (CHO) drinks before surgery on the incidence of postoperative PONV in mastectomy. This was an experimental single-blind randomized study conducted in Dr. Hasan Sadikin General Hospital (RSHS) Bandung, Indonesia. A total of 46 patients were divided into two groups, namely group K (control group, mineral water, n=23 subjects) and group C (CHO group, n=23 subjects). Data collected were then analyzed using the Mann Whitney test and the results showed that during PONV incidence rates were significantly higher 0–30 minutes after the surgery (57% vs 22%), 30–60 minutes after the surgery (91% vs 61%), and 60–120 minutes (78% vs 61%) (p < 0.05). Therefore, the administration of preoperative carbohydrate drinks can reduce the incidence of postoperative nausea and vomiting in mastectomy.

Factors Influencing the Success Rate of Cardiopulmonary Resuscitation Aisyah Amanda Hanif; Iwan Abdul Rachman; Hendro Sudjono Yuwono
Althea Medical Journal Vol 2, No 4 (2015)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Background: Cardiopulmonary resuscitation (CPR) is a series of actions performed on cardiac arrest patients. Not all patients receiving CPR can survive. The outcome of CPR is influenced by several factors. This study was conducted to determine the success rate of CPR and the factors influencing it in Dr. Hasan Sadikin General Hospital in 2013.Methods: This study was conducted by using 168 patient medical records who underwent CPR and met the inclusion criteria in the Resuscitation Room of Dr. Hasan Sadikin General Hospital from January to December 2013. The collected data consisted of age, gender, pre-arrest diagnosis, initial rhythm, response time and clinical outcome of CPR. The results were expressed in frequencies and percentage. The data were analyzed using the chi-square test.Results: The Success rate of CPR was 15.5%. The success rate was higher in patients with cardiac prearrest diagnoses (8.33%, p=0.024). The most common initial rhythm was unshockable rhythms (83.92%), yet patients with shockable heart rhythms had higher success rates (40.74%, p<0.001). All of the surviving patients had response time within the first minute from cardiac arrest.Conclusions: Success rate of CPR in the resuscitation room of Dr. Hasan Sadikin General Hospital during 2013 is still low. The factors influencing the survival rate are the pre-arrest diagnosis and initial heartrhythm. [AMJ.2015;2(4):615–9] DOI: 10.15850/amj.v2n4.657

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