Tinni Trihartini Maskoen
Departemen Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran, Rumah Sakit Hasan Sadikin Bandung

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Journal : Jurnal Anestesi Perioperatif

Perbandingan Penggunaan Jarum Sudut Tumpul dengan Jarum Tuohy untuk Transversus Abdominis Plane Block terhadap Penyebaran Anestetik Lokal pada Operasi Ginekologi Darmoko, Aris; Yadi, Dedi Fitri; Maskoen, Tinni Trihartini
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1452.744 KB)

Abstract

Transversus abdominis plane block (TAPB) merupakan salah satu teknik anestesia regional untuk memblokade nyeri saat dilakukan sayatan kulit di dinding abdomen. Penelitian ini bertujuan membandingkan penggunaan jarum sudut tumpul dengan jarum tuohy untuk TAPB terhadap penyebaran anestetik lokal pada operasi ginekologi. Jenis penelitian eksperimental dengan uji acak terkontrol buta tunggal dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung periode Juli–Agustus 2014. Penelitian ini dilakukan terhadap 30 wanita berusia 18–60 tahun dengan status fisik American Society of Anesthesiologists (ASA) I–II yang menjalani operasi ginekologi dalam anestesi umum. Penelitian ini dibagi menjadi dua kelompok yaitu jarum sudut tumpul dan jarum tuohy. Teknik TAPB dilakukan di kedua sisi abdomen menggunakan 20 mL bupivakain 0,125%. Sebelum dan sesudah TAPB dilakukan pencitraan ultrasonografi untuk membandingkan penyebaran anestetik lokal. Analisis statistika menggunakan Uji Mann-Whitney dan uji Z. Hasil penelitian ini menunjukkan penyebaran anestetik lokal pada kelompok jarum sudut tumpul 50% dan pada kelompok jarum tuohy 26,7% secara statistika berbeda bermakna (p<0,05). Simpulan, pada operasi ginekologi dengan teknik TAPB penggunaan jarum sudut tumpul lebih baik dibanding dengan jarum tuohy terhadap penyebaran anestetik lokal.Kata kunci: Jarum tuohy, jarum sudut tumpul, penyebaran anestetik lokal, transversus abdominis plane blockComparison between Short Bevel Needle and Tuohy Needle Use in Transversus Abdominis Plane Block on Local Anesthetic Spread During  Gynecological SurgeriesTranversus abdominis plane block (TAPB) is one of the regional anesthesia techniques which enable multimodal analgesia involving skin incision in abdominal wall. This study aimed to compare the use of short bevel needle and tuohy needle for TAPB on the spread of local anesthetics in gynecological surgeries through a experimental randomized single blind trial. This study was conducted in Dr. Hasan Sadikin General Hospital Bandung on July–August 2014 to 30 woman between 18–60 years with the American Society of Anesthesiologists (ASA) physical status I–II underwent gynecological surgery under general anesthesia. The subjects were divided into 2 groups, short bevel needle and tuohy needle groups. The block was given on both sides of the abdomen using 20 mL of bupivacaine 0.125%. Before and after TAPB, an ultrasonography was performed to assess the spread of local anesthetics. Mann Whitney and Z test were used for statistical analysis. The results showed the spread of local anesthetic with short bevel needle was 50%, and with tuohy needle was 26.7%, the difference based on statistical analysis was significant (p<0.05). In conclusions, the use of dull angle needle is better than tuohy needle in the spread of local anesthetics in TAPB in patients undergo gynecological surgeries.Key words: Local anesthetic spreading, transversus abdominis plane block, short bevel needle,  tuohy needle DOI: 10.15851/jap.v3n2.575
Efektivitas Analgesik 24 Jam Pascaoperasi Elektif di RSUP Dr. Hasan Sadikin Bandung Tahun 2017 Prabandari, Dita Aryanti; Indriasari, Indriasari; Maskoen, Tinni Trihartini
Jurnal Anestesi Perioperatif Vol 6, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (798.105 KB) | DOI: 10.15851/jap.v6n2.1221

Abstract

Nyeri akut pascaoperasi masih merupakan permasalahan dalam pelayanan kesehatan di seluruh dunia. Hampir 50% pasien pascaoperasi elektif mengalami nyeri yang berujung terhadap peningkatan kejadian nyeri kronik dan penurunan kepuasan pasien terhadap pelayanan kesehatan. Penelitian ini bertujuan memberikan gambaran mengenai analgesik yang digunakan di RSUP Dr. Hasan Sadikin Bandung dan efektivitasnya terhadap nyeri pascaoperasi. Penelitian ini menggunakan metode deskriptif observasional prospektif cross-sectional yang dilakukan pada pasien usia 18–65 tahun dengan status fisik American Society of Anaesthesiologist (ASA) kelas I–III di ruang perawatan pada jam ke-24 pascaoperasi selama tahun 2017 sebanyak 476 pasien. Subjek penelitian dikelompokkan berdasar atas jenis operasi yang menyebabkan nyeri ringan, sedang dan berat. Jenis analgesik pascaoperasi yang digunakan dan skala nyeri menggunakan numeric rating scale (NRS) dicatat. Efektif bila skala nyeri menggunakan NRS pada jam ke-24 pascaoperasi <4 dan tidak efektif bila NRS ≥4. Hasil penelitian didapatkan jenis analgesik terbanyak yang digunakan pada pasien pascaoperasi elektif adalah kombinasi petidin dan ketorolak i.v. dan derajat nyeri pada jam ke-24 pascaoperasi elektif yang dialami pasien adalah nyeri ringan NRS 1–3 (57,8%), nyeri sedang NRS 4–6 (26,9%), dan nyeri berat NRS 7–10 (2,7%). Simpulan penelitian ini adalah efektivitas analgesik pascaoperasi di RSUP Dr. Hasan Sadikin Bandung masih belum baik karena masih terdapat sepertiga pasien mengalami nyeri NRS ≥4 dari target rumah sakit 100% bebas nyeri.Kata kunci: Analgesik pascaoperasi, derajat nyeri pascaoperasi, efektivitas analgesik pascaoperasi Effectiveness of Analgesics 24 Hours Post-Post-Elective Surgery in Dr. Hasan Sadikin General Hospital in 2017Acute post-operative pain is still a worldwide issue in healthcare services. Nearly 50% of post-elective surgery patientspost- experience post-post-operative pain, causing increased chronic pain and decreased patient satisfaction towards healthcare services. This study aimed to provide  description on the types of analgesics used in Dr,Hasan Sadikin General Hospital and their effectiveness on post-operative pain. This  was a cross-sectional descriptive observational prospective study performed on 476 patients aged 18–65 years old with a physical status American Society of Anaesthesiologist (ASA) class I–III, treated in the ward 24 hours post- surgery in 2017. Subjects were classified based on the type of surgery that induced mild, moderate, and severe pain. The types of post-operative analgesics used and post-surgery Numeric Rating Scale (NRS) were documented. Analgesics was considered effective if the 24 hour post-surgery NRS was <4 and ineffective if the NRS was ≥4. This study showed that the type of analgesicsa mostly used for post-operative pain  was the combination of pethidine and ketorolac i.v. Pain scales experienced by patients at 24 hours post- surgery were mild withNRS 1–3 (57.8%), moderate pain with NRS 4–6 (26.9%), and severe pain with NRS 7–10 (2.7%). In conclusion, the post-operative analgesics provided in Dr. Hasan Sadikin General Hospital has not met the 100% pain free target set by the hospital target because some patients still experience pain with NRS ≥4.  . Hence, the effectiveness is still not adequate. Key words: Effectivity of post- operative analgesia, post- operative analgesia, post- operative pain scale
Perbandingan Penggunaan Jarum Sudut Tumpul dengan Jarum Tuohy untuk Transversus Abdominis Plane Block terhadap Penyebaran Anestetik Lokal pada Operasi Ginekologi Aris Darmoko; Dedi Fitri Yadi; Tinni Trihartini Maskoen
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1452.744 KB)

Abstract

Transversus abdominis plane block (TAPB) merupakan salah satu teknik anestesia regional untuk memblokade nyeri saat dilakukan sayatan kulit di dinding abdomen. Penelitian ini bertujuan membandingkan penggunaan jarum sudut tumpul dengan jarum tuohy untuk TAPB terhadap penyebaran anestetik lokal pada operasi ginekologi. Jenis penelitian eksperimental dengan uji acak terkontrol buta tunggal dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung periode Juli–Agustus 2014. Penelitian ini dilakukan terhadap 30 wanita berusia 18–60 tahun dengan status fisik American Society of Anesthesiologists (ASA) I–II yang menjalani operasi ginekologi dalam anestesi umum. Penelitian ini dibagi menjadi dua kelompok yaitu jarum sudut tumpul dan jarum tuohy. Teknik TAPB dilakukan di kedua sisi abdomen menggunakan 20 mL bupivakain 0,125%. Sebelum dan sesudah TAPB dilakukan pencitraan ultrasonografi untuk membandingkan penyebaran anestetik lokal. Analisis statistika menggunakan Uji Mann-Whitney dan uji Z. Hasil penelitian ini menunjukkan penyebaran anestetik lokal pada kelompok jarum sudut tumpul 50% dan pada kelompok jarum tuohy 26,7% secara statistika berbeda bermakna (p<0,05). Simpulan, pada operasi ginekologi dengan teknik TAPB penggunaan jarum sudut tumpul lebih baik dibanding dengan jarum tuohy terhadap penyebaran anestetik lokal.Kata kunci: Jarum tuohy, jarum sudut tumpul, penyebaran anestetik lokal, transversus abdominis plane blockComparison between Short Bevel Needle and Tuohy Needle Use in Transversus Abdominis Plane Block on Local Anesthetic Spread During  Gynecological SurgeriesTranversus abdominis plane block (TAPB) is one of the regional anesthesia techniques which enable multimodal analgesia involving skin incision in abdominal wall. This study aimed to compare the use of short bevel needle and tuohy needle for TAPB on the spread of local anesthetics in gynecological surgeries through a experimental randomized single blind trial. This study was conducted in Dr. Hasan Sadikin General Hospital Bandung on July–August 2014 to 30 woman between 18–60 years with the American Society of Anesthesiologists (ASA) physical status I–II underwent gynecological surgery under general anesthesia. The subjects were divided into 2 groups, short bevel needle and tuohy needle groups. The block was given on both sides of the abdomen using 20 mL of bupivacaine 0.125%. Before and after TAPB, an ultrasonography was performed to assess the spread of local anesthetics. Mann Whitney and Z test were used for statistical analysis. The results showed the spread of local anesthetic with short bevel needle was 50%, and with tuohy needle was 26.7%, the difference based on statistical analysis was significant (p<0.05). In conclusions, the use of dull angle needle is better than tuohy needle in the spread of local anesthetics in TAPB in patients undergo gynecological surgeries.Key words: Local anesthetic spreading, transversus abdominis plane block, short bevel needle,  tuohy needle DOI: 10.15851/jap.v3n2.575
Efektivitas Analgesik 24 Jam Pascaoperasi Elektif di RSUP Dr. Hasan Sadikin Bandung Tahun 2017 Dita Aryanti Prabandari; Indriasari Indriasari; Tinni Trihartini Maskoen
Jurnal Anestesi Perioperatif Vol 6, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (69.545 KB) | DOI: 10.15851/jap.v6n2.1221

Abstract

Nyeri akut pascaoperasi masih merupakan permasalahan dalam pelayanan kesehatan di seluruh dunia. Hampir 50% pasien pascaoperasi elektif mengalami nyeri yang berujung terhadap peningkatan kejadian nyeri kronik dan penurunan kepuasan pasien terhadap pelayanan kesehatan. Penelitian ini bertujuan memberikan gambaran mengenai analgesik yang digunakan di RSUP Dr. Hasan Sadikin Bandung dan efektivitasnya terhadap nyeri pascaoperasi. Penelitian ini menggunakan metode deskriptif observasional prospektif cross-sectional yang dilakukan pada pasien usia 18–65 tahun dengan status fisik American Society of Anaesthesiologist (ASA) kelas I–III di ruang perawatan pada jam ke-24 pascaoperasi selama tahun 2017 sebanyak 476 pasien. Subjek penelitian dikelompokkan berdasar atas jenis operasi yang menyebabkan nyeri ringan, sedang dan berat. Jenis analgesik pascaoperasi yang digunakan dan skala nyeri menggunakan numeric rating scale (NRS) dicatat. Efektif bila skala nyeri menggunakan NRS pada jam ke-24 pascaoperasi <4 dan tidak efektif bila NRS ≥4. Hasil penelitian didapatkan jenis analgesik terbanyak yang digunakan pada pasien pascaoperasi elektif adalah kombinasi petidin dan ketorolak i.v. dan derajat nyeri pada jam ke-24 pascaoperasi elektif yang dialami pasien adalah nyeri ringan NRS 1–3 (57,8%), nyeri sedang NRS 4–6 (26,9%), dan nyeri berat NRS 7–10 (2,7%). Simpulan penelitian ini adalah efektivitas analgesik pascaoperasi di RSUP Dr. Hasan Sadikin Bandung masih belum baik karena masih terdapat sepertiga pasien mengalami nyeri NRS ≥4 dari target rumah sakit 100% bebas nyeri.Kata kunci: Analgesik pascaoperasi, derajat nyeri pascaoperasi, efektivitas analgesik pascaoperasi Effectiveness of Analgesics 24 Hours Post-Post-Elective Surgery in Dr. Hasan Sadikin General Hospital in 2017Acute post-operative pain is still a worldwide issue in healthcare services. Nearly 50% of post-elective surgery patientspost- experience post-post-operative pain, causing increased chronic pain and decreased patient satisfaction towards healthcare services. This study aimed to provide  description on the types of analgesics used in Dr,Hasan Sadikin General Hospital and their effectiveness on post-operative pain. This  was a cross-sectional descriptive observational prospective study performed on 476 patients aged 18–65 years old with a physical status American Society of Anaesthesiologist (ASA) class I–III, treated in the ward 24 hours post- surgery in 2017. Subjects were classified based on the type of surgery that induced mild, moderate, and severe pain. The types of post-operative analgesics used and post-surgery Numeric Rating Scale (NRS) were documented. Analgesics was considered effective if the 24 hour post-surgery NRS was <4 and ineffective if the NRS was ≥4. This study showed that the type of analgesicsa mostly used for post-operative pain  was the combination of pethidine and ketorolac i.v. Pain scales experienced by patients at 24 hours post- surgery were mild withNRS 1–3 (57.8%), moderate pain with NRS 4–6 (26.9%), and severe pain with NRS 7–10 (2.7%). In conclusion, the post-operative analgesics provided in Dr. Hasan Sadikin General Hospital has not met the 100% pain free target set by the hospital target because some patients still experience pain with NRS ≥4.  . Hence, the effectiveness is still not adequate. Key words: Effectivity of post- operative analgesia, post- operative analgesia, post- operative pain scale