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Rudi Kurniadi Kadarsah
Departemen Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung
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Korelasi Penanda Anatomis Blokade Saraf Iskiadikus Pendekatan Anterior dengan Panjang Femur dan Tinggi Badan Menggunakan Ultrasonografi Purnamasidi, Maransdyka; Pradian, Erwin; Kurniadi Kadarsah, Rudi
Jurnal Anestesi Perioperatif Vol 1, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Blokade saraf iskiadikus pendekatan anterior dapat digunakan untuk memfasilitasi pembedahan di bawah lutut dan sangat bermanfaat untuk pasien yang tidak dapat diposisikan lateral. Tujuan penelitian ini untuk mencari korelasi penanda anatomis blokade saraf iskiadikus pendekatan anterior dengan panjang femur dan tinggi badan menggunakan ultrasonografi pada subjek penelitian laki-laki. Metode penelitian ini adalah observasional eksperimental dengan pengambilan data secara cross sectional di ruang operasi bedah sentral Rumah Sakit Dr. Hasan Sadikin Bandung pada September–November 2012. Persamaan korelasi panjang femur dan tinggi badan dengan penanda anatomis blokade saraf iskiadikus pendekatan anterior dihitung berdasarkan analisis regresi linear dan uji analysis of variance (ANOVA) untuk menentukan kelayakan persamaan regresi linear, pada taraf kepercayaan 95%. Hasil penelitian menunjukkan korelasi yang kuat antara penanda anatomis blokade saraf iskiadikus pendekatan anterior dan panjang femur (r=0,784) dengan korelasi searah dan bermakna (p<0,05). Terdapat korelasi yang sangat kuat antara penanda anatomis blokade saraf iskiadikus pendekatan anterior dan tinggi badan (r=0,921) dengan korelasi searah dan bermakna (p<0,05). Berdasarkan hasil analisis regresi linear, diperoleh persamaan: Titik “P” = (0,182 x tinggi badan)–24,647cm. Titik “P” (0,275 x panjang femur)–4,764 cm. Simpulan, penelitian ini menunjukkanbahwa terdapat korelasi penanda anatomis blokade saraf iskiadikus pendekatan anterior dengan panjang femur dan tinggi badan menggunakan ultrasonografi.Kata kunci: Blokade saraf iskiadikus, pendekatan anterior, panjang femur, tinggi badan, ultrasonografiAnterior Approach to the Sciatic Nerve Block in Correlation with Femur Length and Patient’s Height Using Ultrasound As a GuidanceAnterior sciatic nerve blocks is an alternative anesthetic technique for below knee surgery and very useful for patients that cannot positioned laterally. This study was conducted to improve correlations between anterior sciatic anatomical marking with femur length and patient’s height using ultrasound as a guidance. The method of this study was a cross sectional experimental observation study in central operating theatre >Dr. Hasan Sadikin Hospital-Bandung within September–November 2012. Correlation formula between femur length or patient’s height and anterior sciatic anatomical marking was calculated using linear regression analytic and analysis of variance (ANOVA) test with interval of confidence 95%. A total of 92 subject, between 25 to 47 years studied. The results of this study showed a strong correlation between anterior sciatic anatomical marking and femur length (r=0.784) p<0.05, a very strong correlation between anterior sciatic anatomical marking and subject’s height (r= 0.921) and p<0.05). Formula based on linear regression analysis: “P” point (0.275 x femur length)–4,764 cm. “P” point = (0.182 x height)–24,647 cm. The >conclusion of this study shows correlation between anterior sciatic anatomical marking with femur length and patient’s height using ultrasound.Key words: Anterior approach, femur length, height, sciatic block, ultrasound DOI: 10.15851/jap.v1n2.118
Mula dan Lama Kerja Levobupivakain untuk Blokade Peribulbar pada Operasi Vitrektomi di Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung Saptadi, Ari; Fuadi, Iwan; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Blokade peribulbar dapat memfasilitasi operasi vitrektomi dengan terciptanya akinesia yang baik. Tujuan penelitian ini meneliti mula kerja dan lama kerja levobupivakain untuk blokade peribulbar pada operasi vitrektomi. Penelitian observasional dilakukan pada 64 pasien di kamar operasi lantai 3 di Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung selama bulan Maret−April 2014. Pengambilan sampel dilakukan dengan metode simple random sampling. Penilaian keberhasilan blokade peribulbar menggunakan sistem Ocular Anasthetic Scoring System (OASS). Pada penelitian ini didapatkan mula kerja rata-rata 23,6±3,7 menit, tercepat 16 menit dan paling lambat 30 menit serta lama kerja rata-rata 5,34±0,5 jam, paling pendek 4,5 jam dan paling panjang 7 jam. Simpulan penelitian ini adalah levobupivakain sebagai anestetik lokal dengan mula kerja dan lama kerja yang cukup baik digunakan pada operasi vitrektomi dengan teknik blokade peribulbar di Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung.Kata kunci: Blokade peribulbar, levobupivakain, mula kerja, lama kerja obat, Ocular  Anasthetic Scoring System (OASS)Onset and Duration of Levobuvacaine in Peribulbar Block for Vitrectomy in National Eye Centre of Eye Hospital Cicendo BandungAbstractPeribulbar block can facilitate good akinesia for vitrectomy. The aim of this study was to observes the onset and duration of levobupivacaine in peribulbar block for vitrectomy. This observational research of 64 patients was conducted at the operating theater in the National Eye Center of Eye Hospital Cicendo Bandung from March−April 2014. Samples were colected using simple random sampling method. The success of the peribulbar block was assessed with Ocular Anasthetic Scoring System (OASS). The results on this study shows that the onset of levobupivacaine action was around 23.6±3.7 minutes with an action duration of 5.34±0.5 hours. It is concluded that the use of levobupivacaine for peribulbar block in eye surgery (vitrectomy) in National Eye Center of Eye Hospital Cicendo Bandung is acceptable.Key words: Peribulbar block, levobupivacaine, onset, duration of drug, ocular achinetic scoring system DOI: 10.15851/jap.v3n1.373  
Keberhasilan Early Goal-Directed Therapy dan Faktor Pengganggu pada Pasien Sepsis Berat di Instalasi Gawat Darurat Rumah Sakit Dr. Hasan Sadikin Bandung yang Akan Menjalani Pembedahan Silviana, Mira; Tavianto, Doddy; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Early goal directed therapy (EGDT) bertujuan menurunkan morbiditas dan mortalitas pada pasien sepsis berat dan syok sepsis namun pelaksanaannya sering menemukan kendala. Tujuan penelitian ini mengevaluasi keberhasilan EGDT pada pasien sepsis berat di Instalasi Gawat Darurat (IGD) Rumah Sakit Dr. Hasan Sadikin Bandung yang menjalani pembedahan serta mencari faktor-faktor yang memengaruhi keberhasilan EGDT. Penelitian dilakukan dengan metode deskriptif observasional pada bulan Juni–Agustus 2014 dengan subjek penelitian pasien IGD berusia >14 tahun dalam kondisi sepsis berat yang menjalani pembedahan. Keberhasilan EGDT ditentukan berdasar atas pedoman surviving sepsis campaign. Hasil penelitian dari 30 pasien didapatkan 27 pasien berhasil dilakukan EGDT, sedangkan 3 pasien meninggal. Faktor yang memengaruhi EGDT, yaitu faktor medis, kecepatan dalam mendiagnosis sepsis berat, lama pemeriksaan penunjang, faktor koagulasi yang memanjang, dan faktor nonmedis, yaitu lamanya keputusan keluarga, prosedur pengurusan administrasi, dan ketersediaan alat. Simpulan, keberhasilan EGDT di Rumah Sakit Dr. Hasan Sadikin dengan faktor medis dan nonmedis sebagai faktor pengganggu yang berperan dalam keberhasilan pelaksanaannya. Kata kunci:  Early goal directed therapy (EGDT), pembedahan, sepsis beratThe Success of Early Goal-Directed Therapy and its Confounding Factors in Patients with Severe Sepsis Admitted to the Emergency Room of Dr. Hasan Sadikin General Hospital for SurgeryEarly goal-directed therapy (EGDT) is conducted to reduce morbidity and mortality in patients with severe sepsis and septic shock. The purpose of this study was to evaluate the success of EGDT in patients with severe sepsis in the emergency room (ER) of Dr. Hasan Sadikin General Hospital Bandung who were going to undergo surgery and the factors that contributed to the success of EGDT. This study was a descriptive observational study that took place in June–August 2014. Subjects were ER patients, aged over 14 years old, who came with severe sepsis condition and were going to undergo surgery. The successful EGDT in this study was determined according to the surviving sepsis campaign (SSC) guideline such as a central venous pressure of 8–12 mmHg, mean arterial pressure of >65 mmHg, and central venous saturation of >70%. In this study, from 30 patients, 27 patients  successfully underwent EGDT and the remaining 3 patients did not survive. Factors that affect the implementation of EGDT were divided into two factors: medical and non-medical factors.  Medical factors were time needed to diagnose patient with severe sepsis, delay in laboratory findings, and abnormality of coagulation factors. The non-medical factors were family consent, procedures related to health insurance, and the availability of central venous catheter. In conclusions, EGDT is successfully achieved in 90% patients with severe sepsis in Dr. Hasan Sadikin General Hospital Bandung.  Factors that contribute to the successful achievement of EGDT include medical and non-medical factors.Key words: Early goal directed therapy, surgery, severe sepsis DOI: 10.15851/jap.v3n2.580
Perbandingan Waktu Awitan dan Lama Kerja Kombinasi Bupivakain 0,5% dan Lidokain 2% dengan Bupivakain 0,5% pada Blokade Infraklavikular untuk Operasi Lengan Bawah Destiara, Andy Pawana; Yadi, Dedi Fitri; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penggunaan kombinasi obat anestesi lokal bupivakain dan lidokain dapat menghasilkan waktu awitan yang cepat dan lama kerja yang panjang. Penelitian ini bertujuan membandingkan waktu awitan dan lama kerja kombinasi bupivakain 0,5% dan lidokain 2% dengan bupivakain 0,5% pada blokade infraklavikular untuk pembedahan lengan bawah. Penelitian menggunakan uji klinis acak terkontrol buta ganda terhadap 36 pasien dewasa usia 18–60 tahun yang menjalani pembedahan lengan bawah dan dilakukan blokade infraklavikular dengan panduan nerve stimulator di Rumah Sakit Dr. Hasan Sadikin Bandung selama periode April–Juni 2015. Pasien dibagi dalam dua kelompok, kelompok bupivakain dan lidokain (BL) dan bupivakain (B). Analisis stastistik menggunakan student’s t-test, chi-square, Eksak Fisher, Kolmogorov Smirnov dan Mann-Whitney U-test. Hasil penelitian didapatkan waktu awitan blokade sensorik dan motorik pada kelompok BL, yaitu 7,1±2 menit dan 10,9±5,3 menit, pada kelompok B, yaitu 19,8±4,5 menit dan 29±7,7 menit. Lama kerja blokade sensorik dan motorik pada kelompok BL, yaitu 540,9±195,1 menit dan 445,6±158,9 menit, pada kelompok B, yaitu 837,6±376,6 menit dan 653,9±304,3 menit. Simpulan, kombinasi bupivakain 0,5% dan lidokain 2% menghasilkan awitan blokade sensorik serta motorik lebih cepat dan lama kerja yang lebih singkat dibanding dengan bupivakain 0,5%.Kata kunci: Blokade infraklavikular, kombinasi bupivakain-lidokain, bupivakain, lama kerja blokade, waktu awitan blokade Comparison of Onset and Duration of Action between 0.5% Bupivacaine and 2% Lidocaine Combination and 0.5% Bupivacaine on Infraclavicular Block for Forearm SurgeryAbstractThe combination of local anesthetic drugs bupivacaine and lidocaine can produce rapid onset and long duration of action. The purpose of this study was to compare the onset and duration of action between 0.5% bupivacaine and 2% lidocaine combination and 0.5% bupivacaine on infraclavicular block for forearm surgery. This study was conducted using a randomized double blind controlled clinical trial on 36 adult patients aged 18–60 years who underwent forearm surgery under infraclavicular block using nerve stimulator guidance in Dr. Hasan Sadikin General Hospital between the period of April to June 2015. Patients were divided into two groups: patients in bupivacaine and lidocaine (BL) group and bupivacaine (B)group. The statistical analysis were performed using the student’s t-test, chi-square, Fisher’s Exact, Kolmogorov Smirnov, and Mann-Whitney U-test. The onsets of sensory and motor blocks in BL group were 7.1±2 min and 10.9±5.3 min, repectively and B group were 19.8±4.5 min and 29±7.7 min, respectively. The durations of sensory and motor blocks in BL group were 540.9±195.1 min and 445.6±158.9 min and B group were 837.6±376.6 min and 653.9±304.3 min. This study reveals that the combination of 0.5% bupivacaine and 2% lidocaine in infraclavikular block had a faster onset of sensory and motor blocks compared to 0.5% bupivacaine and a shorter duration of action compared to 0.5% bupivacaine.Key words: Bupivacaine, combination of bupivacaine–lidocain, duration of block, infraclavicular block, onset of block DOI: 10.15851/jap.v4n3.902
Perbandingan antara Uji Mallampati Modifikasi dan Mallampati Ekstensi Sebagai Prediktor Kesulitan Intubasi Endotrakeal di Rumah Sakit Dr. Hasan Sadikin Bandung Swasono, Girindro Andi; Suwarman, Suwarman; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (732.566 KB) | DOI: 10.15851/jap.v5n3.1168

Abstract

Evaluasi potensi intubasi sulit preoperatif sangat penting. Metode standar untuk menilai potensi intubasi sulit adalah metode Mallampati Modifikasi. Metode Mallampati Ekstensi merupakan metode Mallampati Modifikasi dengan ekstensi titik kranioservikal sehingga derajat bukaan mulut lebih lebar dan saluran napas terlihat lebih baik. Tujuan penelitian ini adalah mengetahui ketepatan penilaian Mallampati Ekstensi dibanding dengan Mallampati Modifikasi sebagai prediktor dalam menilai kesulitan intubasi endotrakeal menggunakan laringoskop Macintosh langsung berdasar atas uji Cormack Lehane. Desain penelitian ini adalah observasional analitik dengan metode potong lintang dan uji diagnostik chi square. Hasil penelitian terhadap 382 subjek pada bulan September 2016 hingga bulan Desember 2016 di Rumah Sakit Dr. Hasan Sadikin Bandung didapatkan jenis kelamin perempuan 69,9% dengan median usia 42 tahun. Frekuensi nilai uji Mallampati Ekstensi lebih banyak pada kelas yang lebih rendah dan berbeda secara signifikan dibanding dengan uji Mallampati Modifikasi. Kesesuaian penilaian kelas uji Mallampati Ekstensi dengan Cormack Lehane terdapat pada 318 subjek. Simpulan, uji Mallampati Ekstensi lebih baik daripada uji Mallampati Modifikasi sebagai prediktor menilai kesulitan intubasi endotrakeal menggunakan laringoskop langsung.Comparison between Modified Mallampati Test and Extended Mallampati Test as Predictor of Difficult Endotracheal Intubationat Dr. Hasan Sadikin Hospital BandungPreoperative evaluation of potentially difficult intubation is very important. The standard method for assessing potentially difficult intubation is the Modified Mallampati method. Extended Mallampati method is a Modified Mallampati method with cranioservical extension point that the degree of mouth opening is wider and airway becomes more visible. The purpose of this study was to determine the accuracy of the Extended Mallampati test compared to the Modified Mallampati test as predictors in assessing the difficulty of endotracheal intubation using direct Macintosh laryngoscope based on Cormack Lehane grading. This was a cross-sectional observational analytical study using chi square diagnostic test involving 382 subjects at Dr. Hasan Sadikin Bandung Hospital during the period of September 2016 to December 2016 with 69.9% women and  median age of 42 years. The frequency of the Mallampati Extension test scores was higher in the lower classes, which was significantly different from the results of the Modified Mallampati test. Better appropriateness of the Mallampati Extension test result with Cormack Lehane grading was found in 318 subjects. In conclusion, the Extended Mallampati test is better than Modified Mallampati test when it is used as a predictor in assessing difficult endotracheal intubation using direct laryngoscopy (Cormack Lehane test).  
Perbandingan Pemberian 20 mL dengan 30 mL Bupivakain 0,5% terhadap Mula Kerja dan Lama Kerja Blokade Saraf Iskiadikus Pendekatan Parasakral Menggunakan Alat Stimulasi Saraf pada Operasi Ekstremitas Bawah Amrizal, Canang Irving; Yadi, Dedi Fitri; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (554.584 KB) | DOI: 10.15851/jap.v5n1.1004

Abstract

Blokade saraf iskiadikus pendekatan parasakral merupakan salah satu pilihan anestesi untuk operasi ekstremitas bawah. Blokade ini memiliki angka keberhasilan yang tinggi dan membutuhkan anestetik lokal yang lebih sedikit. Penelitian ini bertujuan membandingkan pemberian 20 mL dengan 30 mL bupivakain 0,5% terhadap mula kerja dan lama kerja blokade saraf iskiadikus pendekatan parasakral menggunakan alat stimulasi saraf di Rumah Sakit Dr. Hasan Sadikin Bandung dan RSD Dr. Slamet Garut selama periode bulan Oktober–November 2015. Penelitian eksperimental secara randomized controlled trial dilakukan pada 36 pasien dewasa yang menjalani operasi ekstremitas bawah. Pasien dibagi dalam dua kelompok secara acak, tiap-tiap kelompok terdiri atas 18 pasien. Kelompok A mendapatkan bupivakain 0,5% sebanyak 20 mL dan kelompok B mendapatkan 30 mL. Hasil menunjukkan bahwa mula kerja blokade sensorik dan motorik pada kedua kelompok tidak berbeda bermakna (p>0,05). Hasil penelitian menggunakan uji-t dan uji Mann Whitney menunjukkan bahwa lama kerja blokade sensorik dan motorik pada kelompok A lebih singkat bermakna dibanding dengan kelompok B (p<0,05). Simpulan penelitian ini adalah pemberian 20 mL bupivakain 0,5% pada blokade saraf iskiadikus pendekatan parasakral menghasilkan mula kerja blokade sensorik dan motorik yang sama cepat dan lama kerja blokade sensorik dan motorik yang lebih singkat dibanding dengan pemberian 30 mL bupivakain 0,5%.Kata kunci: Blokade saraf iskiadikus, bupivakain, lama kerja blokade, mula kerja blokade, pendekatan parasakralComparison of Onset and Duration of Action between 20 mL with 30 mL of 0.5% Bupivacaine on Ischiadicus Nerve Block with Parasacral Approach Assisted by a Nerve Stimulator for Lower Ekstremity SurgeryIschiadicus nerve block with parasacral approach is an anesthetic option for surgery in the lower extremity. This method offers many advantages such as high rate of successful block and less use of local anesthetic agent. The purpose of this study was to compare the onset and duration of action of ischiadicus nerve block with parasacral approach assisted by a nerve stimulator using 20 mL of 0.5% bupivacaine to 30 mL of 0.5% bupivacaine in Dr. Hasan Sadikin General Hospital Bandung and Dr. Slamet Hospital Garut between the period of October to November 2015. This experimental randomized controlled study was performed on 36 adult patients undergoing lower extremity surgeries. Patients were divided randomly into two groups consisting of 18 patients. Group A was given 20 mL of 0.5% bupivacaine while group B was given 30 mL of 0.5% bupivacaine. The onset and duration of action of sensory and motoric blocks were recorded. The t-test and Mann Whitney test used in this study showed that the duration of sensory and motoric blocks in group A was significantly shorter than that of group B (p<0.05). It is concluded that the ischiadicus nerve block with parasacral approach using 20 mL of 0.5% bupivacaine has the same onset but shorter duration of sensory and motoric blocks compared to 30 mL of 0.5% bupivacaine.Key words: Bupivacaine, duration of block, ischiadicus nerve block, onset of block, parasacral approach 
Angka Mortalitas dan Faktor Risiko pada Pasien Geriatri yang Menjalani Operasi Emergensi Akut Abdomen di RSUP Dr. Hasan Sadikin Bandung Tahun 2014−2015 Priyatmoko, Donny Prasetyo; Sudjud, Reza Widianto; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (777.67 KB) | DOI: 10.15851/jap.v5n2.1109

Abstract

Geriatri memiliki kekhususan yang perlu diperhatikan dalam bidang anestesi dan tindakan operasi karena terdapat kemunduran sistem fisiologis dan farmakologis sejalan dengan penambahan usia. Penelitian di Yunani tahun 2007 menjelaskan bahwa angka mortalitas akibat tindakan operasi setelah usia 65 tahun menjadi 3 kali lipat dibanding dengan usia 18−40 tahun. Angka mortalitas geriatri tahun 2007 pada operasi elektif sebesar 5%, sedangkan operasi emergensi sebesar 10%. Tujuan penelitian ini adalah memperoleh angka mortalitas dan faktor risiko pada pasien geriatri yang menjalani operasi emergensi akut abdomen tahun 2014−2015. Tipe penelitian ini merupakan deskriptif dengan pendekatan retrospektif terhadap 180 subjek penelitian yang diambil di bagian rekam medis sejak Juli−Oktober 2016 pada pasien geriatri yang menjalani operasi emergensi akut abdomen di RSUP Dr. Hasan Sadikin Bandung tahun 2014−2015. Hasil penelitian ini memperlihatkan angka mortalitas sebesar 9% dengan faktor penyebab mortalitas paling dominan adalah syok sepsis sebesar 50%. Faktor predisposisi disebabkan oleh indeks massa tubuh <18,5 kg/m2 sebesar 56,3%, diagnosis primer tumor intestinal sebesar 31,3%, penyakit penyerta diabetes melitus sebesar 31,3%, sepsis sebesar 93,8%, hipoalbumin sebesar 56,3% dan status fisik ASA 4E sebesar 62,5%. Simpulan, faktor presipitasi disebabkan oleh waktu respons penanganan >6 jam sebesar 93,8% dan komplikasi pascaoperasi severe sepsis disertai pneumonia sebesar 50%. Kata kunci: Akut abdomen, angka mortalitas, geriatri, operasi emergensi Mortality Rate and Risk Factor in Geriatric Patients Undergo Emergency Surgery for Acute Abdoment in Dr. Hasan Sadikin Hospital Bandung in 2014−2015Geriatric has special anesthetic and surgical consideration because of reducing physiologic function and pharmacodynamic as the age increase. A study in Greece in 2007 shows that surgery in patient more than 65 year old has three times mortality rate than 18–40 years old patients. Geriatric mortality rate in 2007 undergo elective surgery is 5%, while the emergency surgery 10%. Purpose of this study was to obtain mortality rate and risk factor in geriatric patients underwent emergency surgery for acute abdomen in 2014−2015. This was a descriptive retrospective study of 180 subjects taken from the medical records in July to October, 2016 in geriatric patients underwent emergency surgery for acute abdomen at the Dr. Hasan Sadikin hospital in 2014−2015. Results of this study showed a mortality rate of 9%, with most dominant factors that cause mortality was septic shock (50%). Predisposing factors was the body mass index <18.5 kg/m2 (56.3%), the diagnosis of primary tumor intestinal amounted to 31.3%, comorbidities of diabetes mellitus at 31.3%, sepsis (93.8%), hipoalbumin (56.3%) and ASA physical status 4E (62.5%). In conclution, precipitation factors caused by response time >6 hours (93.8%) and postoperative complications of severe sepsis with pneumonia (50%).Key words: Acute abdomen, emergency surgery, geriatrics, mortality rate
Gambaran Letak Saraf Radialis, Ulnaris, Medianus, dan Muskulokutaneus terhadap Arteri Aksilaris di Aksila Menggunakan Pencitraan Ultrasonografi Listianto, Heni Herliani; Yadi, Dedi Fitri; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Blokade aksiler merupakan pilihan anestesi untuk operasi lengan bawah dan tangan dengan angka keberhasilan beragam berkaitan dengan variasi letak target saraf yang dibuktikan pada penelitian di luar negeri menggunakan pencitraan ultrasonografi (USG). Sampai sekarang tidak ada publikasi penilaian variasi letak saraf-saraf tersebut di Indonesia. Penelitian deskriptif observasional-cross sectional dilakukan pada 75 relawan di Rumah Sakit Dr. Hasan Sadikin Bandung pada November–Desember 2014 untuk mengkaji letak saraf radialis, ulnaris, medianus, dan muskulokutaneus terhadap arteri aksilaris di aksila menggunakan pencitraan USG. Letak saraf pada kedua aksila dicatat menggunakan acuan lingkaran 12 sektor berpusat pada arteri aksilaris. Analisis data menggunakan Uji Sapiro-Wilk, Mann-Whitney dan Wilcoxon, serta diolah dengan SPSS versi 21.0. Analisis 150 hasil pencitraan USG menunjukkan saraf medianus berada di superior, yaitu sektor 12 (75%), 11 (23%), dan 1 (2%). Saraf ulnaris di medial, yaitu sektor 9 (67%), 8 (31%), dan 10 (2%). Saraf radialis di inferomedial, yaitu sektor 7 (78%), 8 (16%), dan 6 (6%). Saraf muskulokutaneus di lateral, yaitu sektor 4 (89%), 5 (8%), dan 3 (3%). Simpulan penelitian adalah letak saraf radialis, ulnaris, medianus, dan muskulokutaneus bervariasi. Variasi letak saraf radialis, ulnaris, dan medianus ditemukan pada lebih dari seperempat subjek, sedangkan hanya sepersepuluh subjek memiliki variasi letak saraf muskulokutaneus.Kata kunci: Arteri aksilaris, letak saraf, medianus, muskulokutaneus, radialis, ulnaris, ultrasonografiUltrasonographic Assessment of Radial, Ulnar, Median and Musculocutaneous Nerves Location to the Axillary Arteryat the AxillaAxillary block is one of anesthesia technics for arm and hand surgery with varied success rates due to location variations of the targeted nerves. This has been proven by many prior studies under surface ultrasonography (USG) in many countries. Until currently, no similar study has been conducted in Indonesia. This descriptive observational–cross sectional study was performed on 75 volunteers in Dr. Hasan Sadikin General Hospital Bandung in November–December 2014 to describe the locations of radial, ulnar, median, and musculocutaneous nerves to the axillary artery using USG. The locations of those nerves at the axilla were converted into a 12-section pie-chart with the axillary artery as the axis. Data were analyzed using Sapiro-Wilk, Mann-Whitney, and Wilcoxon tests and processed using SPPS 21.0 version. Assessment of 150 USG scans revealed that the median nerves are located superior to the axillary artery, i.e. in sector 12 (75%), 11 (23%), and 1 (2%). Ulnar nerves are located in the medial, i.e. in sector 9 (67%), 8 (31%), and 10 (2%). Radial nerves are located in the infero-medial, i.e. in sector 7 (78%), 8 (16%), and 6 (6%). Musculocutaneous nerves are located in the lateral, i.e. in sector 4 (89%), 5 (8%), and 3 (3%). It is concluded from this study that varied locations of radial, ulnar, median nerves are found in a quarterof subjects whereas only one tenth of the subjects have varied muculocutaneous nerves locations.Key words: Axillary artery,median, musculocutaneous, nerve location, radial, ulnar, ultrasonography DOI: 10.15851/jap.v4n2.824
Perbandingan Epidural Volume Extension 5 mL dan 10 mL Salin 0,9% pada Spinal Anestesi dengan Bupivakain 0,5% 10 mg Hiperbarik terhadap Tinggi Blok Sensorik dan Pemulihan Blok Motorik pada Seksio Sesare Putra, Reza Indra; Pradian, Erwin; Kadarsah, Rudi Kurniadi
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 (420.27 KB) | DOI: 10.15851/jap.v4n1.740

Abstract

Epidural volume extension (EVE) merupakan bentuk modifikasi dari kombinasi spinal epidural dengan injeksi salin normal ke dalam rongga epidural setelah dosis intratekal. Teknik EVE meningkatkan tingkat blok sensorik yang diakibatkan efek volume saat volume cairan pada rongga epidural yang menekan dural sac dan menyebabkan penyebaran sefalad dari anestetik lokal. Tujuan penelitian ini adalah mengkaji perbedaan pengaruh EVE 5 mL dan 10 mL salin 0,9% dengan menggunakan bupivakain 0,5% 10 mg terhadap tinggi blok sensorik dan pemulihan blok motorik pada pasien seksio sesarea. Penelitian dilakukan pada pertengahan September–November 2014 di Rumah Sakit Dr. Hasan Sadikin Bandung. Dilakukan uji klinis acak terkontrol pada 30 pasien yang menjalani seksio sesarea (SC) dan dibagi menjadi dua kelompok, yaitu kelompok yang menerima EVE 10 mL dan kelompok yang menerima EVE 5 mL pada pasien yang akan dilakukan SC dengan menggunakan anestesi kombinasi spinal epidural. Penilaian ketinggian blok sensorik menggunakan uji pinprick serta penilaian pemulihan blok motorik menggunakan uji bromage score. Data hasil diuji dengan uji-t. Hasil penelitian menunjukkan pemulihan blok motorik pada subjek penelitian yang menggunakan EVE 10 mL lebih cepat pulih dibanding dengan menggunakan EVE 5 mL (p<0,001). Simpulan pada penelitian ini menunjukkan pemberian EVE 10 mL pada pasien seksio sesarea memiliki pemulihan blok motorik lebih cepat dengan ketinggian blok sensorik yang sama.Kata kunci: Blok motorik, blok sensorik, epidural volume extensionComparison between 5 mL Epidural Volume Extension and 10 mL Epidural Volume Extension by 0.9% Saline in Spinal Anesthesia with 10 mg 0.5% Hyperbaric Bupivacaine on High and Recovery Sensory Block Motor in Caesarean SectionAbstractEpidural volume extension (EVE) is a modified form of combined spinal epidural with normal saline injected into the epidural space after the intrathecal dose. EVE techniques increases the level of sensory block resulting from the volume effects when the volume of fluid in the epidural space suppresses the dural sac and causes the cephalad spread of local anesthetic. The aim of this research was to assess differences in the effects of 5 mL EVE and 10 mL EVE by 0.9% saline with 10 mg 0.5% bupivacaine on sensory block height and motor block recovery in caesarean section patients. This research was carried out from mid September to November 2014 in Dr. Hasan Sadikin General Hospital Bandung. This was a randomized controlled clinical trial conducted on 30 patients who underwent caesarean section (SC) and divided randomly into two groups, namely group receiving 10 mL EVE and group receiving 5 mL EVE with a spinal epidural combination anesthesia. The assessment of sensory block height was performed using the pinprick test while bromage score test were used for motor block recovery. The data was analyzed using t test. The results showed a faster recovery of motor block in the research subjects using 10 mL EVE compared to those using 5 mL EVE (p<0.001). The conclusion from this study is that the administration of 10 mL EVE in patients who underwent caesarean section leads to a faster motor block recovery with the same sensory block height.Key words: Block motor, sensory block, epidural volume extension DOI: 10.15851/jap.v4n1.740
Sindrom Burnout pada Peserta Program Pendidikan Dokter Spesialis Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran Sutoyo, Dessy; Kadarsah, Rudi Kurniadi; Fuadi, Iwan
Jurnal Anestesi Perioperatif Vol 6, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (912.559 KB) | DOI: 10.15851/jap.v6n3.1360

Abstract

Sindrom burnout didefinisikan sebagai kelelahan kronik yang mencakup tiga komponen, yaitu kelelahan emosional, depersonalisasi, dan berkurangnya kepuasan terhadap pencapaian pribadi. Peserta Program Pendidikan Dokter Spesialis (PPDS) berisiko tinggi mengalami kelelahan dan sindrom burnout akibat beban kerja yang tinggi yang dihadapi baik dalam hal melakukan pelayanan dalam bidang anestesi dan beban dalam pendidikannya. Penelitian ini bertujuan mengetahui angka kejadian sindrom burnout pada peserta PPDS Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran (FK Unpad). Penelitian ini menggunakan metode deskriptif dan pendekatan kuesioner yang dilakukan pada peserta PPDS Anestesiologi dan Terapi Intensif FK Unpad yang masih aktif dan memberikan pelayanan di Rumah Sakit Umum Pusat (RSUP) Dr. Hasan Sadikin Bandung pada bulan April 2018 sebanyak 89 orang. Dilakukan penilaian menggunakan kuesioner yang mencakup data demografik, pendidikan dan pekerjaan, pencapaian prestasi pribadi, serta maslach burnout inventory yang sudah diterjemahkan. Hasil penelitian didapatkan angka kejadian sindrom burnout pada peserta PPDS Anestesiologi dan Terapi Intensif FK Unpad adalah 44%. Simpulan penelitian ini adalah angka kejadian sindrom burnout pada peserta PPDS Anestesiologi dan Terapi Intensif FK Unpad cukup tinggi, yaitu 44%.  Kata kunci: Depersonalisasi, kelelahan emosional, maslach burnout inventory, peserta PPDS Anestesiologi dan Terapi Intensif, sindrom burnoutBurnout Syndrome among Anesthesiology Residents in Universitas PadjadjaranBurnout syndrome is defined as chronic exhaustion that is characterized by emotional exhaustion, depersonalization, and a sense of low professional accomplishment. The main component of this syndrome is emotional exhaustion. Residents who are being trained in anesthesiology and intensive therapy  department have s high risk to exhaustion that will lead to burnout syndrome due to stressful environment and high work load in both medical service and medical education. The purpose of this study was to assess the incidence of burnout syndrome among residents in Anesthesiology and Intensive Therapy Department, Faculty of Medicine, Universitas Padjadjaran. This was a cross-sectional descriptive study on 89 residents that was performed in April 2018. Assessment was performed using a questionnaire on demographic, education, personal achievement, and medical service data as well as the translated Maslach Burnout Inventory to reveal the incidence of burnout syndrome among residents of Anesthesiology and Intensive therapy department, faculty of medicine, Universitas Padjadjaran. From the analysis, it was discovered that 44% of the residents experienced burned out syndrom. In conclusion, the incident of burn out syndrome among residents of Anesthesiology and Intensive Therapy Department, Faculty of Medicine, Universitas Padjadjaran is high. Key words: Anesthesiology and intensive care residents, burnout syndrome, depersonalization, emotional exhaustion, Maslach burnout inventory
Co-Authors Amrizal, Canang Irving Andy Pawana Destiara Ari Saptadi Ari Saptadi Budiana Rismawan Canang Irving Amrizal Dedi Fitri Yadi Dessy Sutoyo Destiara, Andy Pawana Doddy Tavianto Donny Prasetyo Priyatmoko Erwin Pradian Erwin Pradian Esther Dian Cahyaningtyas Hintono Girindro Andi Swasono Heni Herliani Listianto Indriasari Indriasari Iwan Fuadi Jansen Laory Listianto, Heni Herliani Lusy Octavia Saputri Maransdyka Purnamasidi Maransdyka Purnamasidi Mira Silviana Mira Silviana, Mira Reza Indra Putra Reza Indra Putra, Reza Indra Reza Widianto Sudjud Reza Widianto Sudjud Reza Widianto Sudjud Sutoyo, Dessy Suwarman Suwarman Suwarman Suwarman, Suwarman Swasono, Girindro Andi