Garuda - Garba Rujukan Digital

Perbedaan Nilai Agregasi Trombosit Akibat Pengaruh Penggunaan Analgesia Ketorolak dan Ibuprofen Intravena Pascaoperasi di RSUP Haji Adam Malik Medan Fithri, Dewi Yuliana; Wijaya, Dadik Wahyu; Arifin, Hasanul
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Obat anti-inflamasi nonsteroid (OAINS) merupakan analgetik yang sering digunakan pada pascaoperasi bedah ortopedi. Penelitian ini bertujuan melihat apakah terdapat perbedaan nilai agregasi trombosit akibat pengaruh penggunaan analgestik ketorolak dengan ibuprofen intravena setelah operasi. Penelitian ini merupakan penelitian uji klinis dengan uji acak tersamar buta ganda yang membandingkan perbedaan pengaruh ketorolakÂ 30 mg intravena/6 jam dengan ibuprofen 800 mg intravena/6 jam. Populasi penelitian ini adalah pasien yang menjalani tindakan pembedahan elektif dengan anestesi umum di RSUP Haji Adam Malik Medan pada bulan Agustus 2016. Pasien dibagi menjadi 2 kelompok dengan tiap-tiap kelompok berjumlah 20 pasien. Ketorolak atau ibuprofen sebagai analgetik diberikan setelah 30 menit selesai operasi, kemudian dilanjutkan per 6 jam sampai dengan 2 hari selesai operasi. Uji statistik menggunakan tes Wilcoxon untuk sebelum perlakuan dan Uji Mann-Whitney untuk sesudah perlakuan pada kedua kelompok. Data karakteristik subjek homogen. Agregasi trombosit pada kelompok ketorolak dengan kelompok ibuprofen berbeda bermakna setelah 10 menit ekstubasi dengan 8 jam setelah pemberian obat terakhir. Tidak terdapat perbedaan bermakna antara kelompok ketorolak dan kelompok ibuprofen setelah 10 menit ekstubasi (p>0,05), namun terdapat perbedaan bermakna pada 8 jam setelah akhir pemberian obat. Simpulan, ketorolak menurunkan persentase agregasi trombosit lebih besar daripada ibuprofen setelah 8 jam pemberian obat terakhir.Â Differences in Platelet Aggregation Values in Postoperative Intravenous Ketorolac and Ibuprofen Analgesics at Haji Adam Malik Central General Hospital MedanNon-steroidal anti-inflammatory drugs (NSAIDs) are analgesics used for postoperative orthopedic surgery. This study aimed to underrstand the effect of intravenous ketorolac and ibuprofen on platelet aggregation values. This was a double-blind randomized controlled trial that compared the effects of intravenous ketorolac and ibuprofen. The population of this study were patients undergoing elective surgery under general anesthesia at Haji Adam Malik Central General Hospital Medan in August 2016. Patients were divided into 2 groups (n: 20): ketorolac group andibuprofen group. Both group received analgesic 30 minutes after surgery up to 2 days postoperative. The statistical tests used were Wilcoxon test for pre-treatment and Mann-Whitney test for post-treatment in each group. Subject characteristic data were homogenous. Platelet aggregation of ketorolac and ibuprofen groups differed significantly between 10 minutes after extubation and 8 hours after the last drug administration. There was no significant difference between the ketorolac and ibuprofen groups after 10 minutes of extubation (p>0.05); however there was a significant difference at 8 hours after the end of drug administration. In conclusion, ketorolac decreases platelet aggregation percentage greater than ibuprofen after 8 hours of the last drug administration.Â

Perbandingan Penilaian Visual Analog Scale dari Injeksi Subkutan Morfin 10 mg dan Bupivakain 0,5% pada Pasien Pascabedah Sesar dengan Anestesi Spinal Fadinie, Wulan; Arifin, Hasanul; Wijaya, Dadik Wahyu
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 (497.157 KB)

Obat anestesi lokal dan opioid dapat disuntikkan langsung pada luka untuk mengurangi nyeri pascabedah. Penelitian bertujuan menilai intensitas nyeri menggunakan visual analog scale (VAS) dapat menjadi metode yang sangat efektif dalam penilaian nyeri pascabedah. Membandingkan nilai VAS pada saat istirahat dan batuk dari infiltrasi lokal morfin 10 mg dengan bupivakain 0,5% 2 mg/kgBB pada pascabedah sesar dengan metode uji klinis acak tersamar ganda pada 100 sampel. Kriteria inklusi adalah perempuan hamil, usia 20â40 tahun, dengan status fisik menurut American Society of Anesthesia (ASA) kelas IâII yang menjalani bedah sesar elektif dan emergensi di RSUP Haji Adam Malik, RSU dr. Pirngadi, RS Putri Hijau, RS Haji, dan RSU Sundari pada bulan Juli 2014. Sampel dibagi menjadi kelompok A dengan infiltrasi lokal morfin 10 mg dan kelompok B dengan infiltrasi lokal bupivakain 0,5% 2 mg/kgBB. Nilai VAS dianalisis secara statistik dengan Mann-Whitney. Nilai VAS lebih rendah pada kelompok A, yaitu 4,72 (SB=1,54) dibanding dengan kelompok B, yaitu 2,14 (SB=1,21). Simpulan, infiltrasi lokal morfin 10 mg lebih baik dibanding dengan bupivakain 0,5% 2 mg/kgBB.Kata kunci: Bupivakain, infiltrasi lokal, manajemen nyeri, morfin, visual analog scaleComparison of Visual Analog Scale Assestment of Subcutaneous Injection of 10 mg Morphine and 0.5% Bupivacaine in Post-Caesarean Section under Spinal AnesthesiaAbstractLocal anesthetic agent and opioid can subcutaneously be injected into the wound to reduce postoperative pain. This study was conducted to evaluate pain intensity using visual analog scale (VAS), which can be a very effective method of postoperative pain assessment, and to compare VAS when resting and coughing between local infiltration of 10 mg morphine and 2 mg/kgBW 0.5% bupivacaine after caesarian section. This study was a double blinded randomized clinical trial on 100 subjects. The inclusion criteria were pregnant women, aged 20â40 years, with physical ASA IâII status who underwent elective and emergency caesarean section in Haji Adam Malik Hospital, dr. Pirngadi Hospital, Putri HijauHospital, Haji Hospital, and Sundari Hospital during the period of July 2014. Subjects were divided into group A with 10 mg morphine infiltration and group B with 2 mg/kgBW 0.5% bupivacaine local infiltration. The resulting VAS scores were analyzed statistically using Mann-Whitney. ItLower VAS scores were found in group A 4.72 (SB=1.54) when compared to group B 2.14 (SB=1.21). In conclusion, local infiltration of 10 mg morphine is better compared to 2 mg/kgBW 0.5% bupivacaine.Key words: Bupivacaine, local infiltration, morphine, pain management, visual analog scaleÂ DOI:Â 10.15851/jap.v4n2.826

Perbandingan Validitas Sistem Penilaian APACHE II, SOFA, dan CSOFA Sebagai Prediktor Mortalitas Pasien yang Dirawat di Instalasi Rawat Intensif RSUP H. Adam Malik Medan Andrias, Andrias; Hanafie, Achsanuddin; Wijaya, Dadik Wahyu
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Sistem penilaian APACHE II dan SOFA masih digunakan sebagai instrumen objektif untuk memprediksi mortalitas pasien di Instalasi Rawat Intensif (IRI), namun masih kurang praktis. Sistem penilaian CSOFA dengan parameter serta biaya pengeluaran yang lebih sedikit dan praktis diharapkan memiliki akurasi yang lebih baik. Tujuan penelitian ini mendapatkan alternatif yang lebih sederhana, mudah dan murah, namun tetap memiliki akurasi yang baik sebagai prediktor mortalitas pasien selain APACHE II dan SOFA. Penelitian uji diagnostik cross sectional dilakukan pada bulan FebruariâApril 2016 di IRI RSUP H. Adam Malik. Subjek penelitian 71 pasien dewasa yang memenuhi kriteria inklusi dinilai APACHE II, SOFA, dan CSOFA setelah dirawat 24 jam pertama, kemudian dilihat mortalitasnya pada akhir masa rawatan. Analisis statistik menggunakan tabel 2x2 serta receiving operating curve (ROC), dihitung juga sensitivitas, spesifisitas, nilai prediksi negatif dan positif, serta likelihood ratio dengan SPSS ver.23. CSOFA memiliki kemampuan yang sangat baik dalam memprediksi mortalitas dengan luas area under ROC (AuROC) 87,6%. APACHE II memiliki kemampuan yang baik dalam memprediksi mortalitas dengan luas AuROC 84,7%. SOFA memiliki kemampuan yang cukup dalam memprediksi mortalitas dengan luas AuROC 79,1%. Simpulan, sistem penilaian CSOFA dapat dijadikan sebagai prediktor mortalitas pasien selain APACHE II dan SOFA di IRI RSUP HAM.Kata kunci: APACHE II, CSOFA, mortalitas, SOFAÂ Comparison of APACHE II, SOFA, and CSOFA Scoring System Validity as Mortality Predictor in ICU Patients in H. Adam Malik General HospitalThe APACHE II and SOFA scoring systems are still used as the objective instruments for predicting mortality in patients admitted to the Intensive Care Unit (ICU); however, the two are still considered less practical. CSOFA, with more practical parameters as well as a lower cost, is expected to provide better accuracy. The purpose of this study was to get a simpler, easier, and cheaper alternative, but with good accuracy, to APACHE II and SOFA as a predictor of mortality in patients admitted to the ICU of H. Adam Malik (HAM) Hospital. A cross-sectional diagnostic test study was conducted in FebruaryâApril 2016 at the ICU of H. Adam Malik General Hospital. A sample of 71 adult patients that met the inclusion criteria was assessed by APACHE II, SOFA, and CSOFA at the first 24 hours after treatment. The mortality was then observed at the end of treatment. Statistical analysis using 2x2 tables and receiving operating curve (ROC) were used to calculate the sensitivity, specificity, positive, and negative predictive values, as well as the likelihood ratio using SPSS ver.23. CSOFA in this study presented a very good ability in predicting mortality with an Area under ROC (AuROC) of 87.6% while APACHE II had a good ability in predicting mortality with an AuROC of 84.7%. SOFA had sufficient ability in predicting mortality with an AuROC of 79.1%. In conclusion, CSOFA scoring system can be used as a patient mortality predictor as an alternative to APACHE II and SOFA in the ICU.Key words: APACHE II, CSOFA, mortality, SOFAÂ

Perbandingan Efektivitas antara Gabapentin 600 mg dan Gabapentin 900 mg Kombinasi dengan Ketorolak 30 mg/8 Jam sebagai Analgesia Pascabedah pada Total Abdominal Histerektomi dengan Anestesi Umum Camary, Mumya; Ihsan, Mhd.; Wijaya, Dadik Wahyu
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (537.288 KB)

Gabapentin berkembang untuk penanganan nyeri akut pascabedah. Tujuan penelitian adalah menilai efektivitas gabapentin 600 mg dan 900 mg per oral kombinasi ketorolak 30 mg/8 jam intravena sebagai analgesia pascabedah pada total abdominal histerektomi dengan anestesi umum. Penelitian uji klinis acak tersamar ganda dilakukan di Rumah Sakit Umum Pusat H. Adam Malik Medan, RSUD Dr. Pirngadi Kota Medan, RS. Haji Medan, dan RS. Putri Hijau selama bulan Oktober 2015âJanuari 2016. Terdapat 30 subjek penelitian, usia 18â60 tahun, status fisik American Society of Anesthesiologists (ASA) IâII yang menjalani operasi total abdominal histerektomi dengan anestesi umum. Subjek dibagi menjadi 3, yaitu kelompok A mendapat plasebo, kelompok B mendapat gabapentin 600 mg, dan kelompok C mendapat gabapentin 900 mg kombinasi ketorolak 30 mg/8 jam. Uji Kruskal Wallis digunakan untuk menilai efektivitas skor visual analogue scale (VAS) pascabedah serta uji chi-kuadrat untuk menilai kebutuhan rescue analgetia petidin selama 24 jam pascabedah. Pada perbandingan nilai VAS antara gabapentin 600 mg dan gabapentin 900 mg kombinasi dengan ketorolak 30 mg/8 jam tidak ditemukan perbedaan nilai yang signifikan antara kedua kelompok studi (p>0,05). Simpulan, efek gabapentin 600 mg dengan gabapentin 900 mg kombinasi ketorolak 30 mg/8 jam sebagai analgesia pascabedah tidak berbeda efektivitasnya dalam mengurangi nilai VAS dan kebutuhan rescue analgetia petidin selama 24 jam pascabedah.Kata kunci: Gabapentin, kebutuhan rescue analgetia, visual analogue scaleEffectiveness of Gabapentin 600 mg and 900 mg Combined Ketorolak as Postoperative Analgesics for Hysterectomy under General AnesthesiaAbstractGabapentin is developed recently to manage postoperative acute pain. The purpose of this study was to assess the efficacy of 600 mg and 900 mg oral gabapentin combined with 30 mg/8 hours intravenous ketorolak as the postoperative analgesics for total abdominal hysterectomy under general anesthesiaon visual analogue scale (VAS) and the need of pethidin in 24 hours postoperatively. A double blind controlled trial was performed to 30 subjects in H. Adam Malik Hospital Medan, Dr. Pirngadi Hospital Medan,Haji Hospital Medan,and Putri Hijau Hospital Medan. The study was performed during the period of October 2015 to January 2016. Patients were 18 to 60 years old with PS-ASA IâII who underwent total abdominal hysterectomy under general anesthesia. Subjects were divided into 3 groups.: Group A who received placebo, group B who received 600 mg of gabapentin, and group C who received 900 mg of gabapentin combined with 30 mg/8 hours ketorolak. The efficacy was assessed with post operative visual analogue scale (VAS) using Kruskal Wallis test, and the need for rescue analgesics pethidin in 24 hours postoperatively using chi-square test. The VAS scores of the group that received600 mg gabapentin and the group that received 900 mg gabapentin combined with 30 mg/hour ketorolak were not significantly different (p>0.05). In conclusion, the effects of 600 mg gabapentin and 900 mg gabapentin combined with 30 mg/8 hours ketorolak as the postoperative analgesics for total abdominal hysterectomy under general anesthesia are not different in terms of decreasing VAS score and the need for rescue analgesia pethidine in 24 hours postoperativelyKey words: Gabapentin, the need of analgesia rescue, visual analogue scoreÂ DOI:Â 10.15851/jap.v4n3.898

Title

Found 4 Documents
Search

Abstract

Abstract

Abstract

Abstract

Title Search

Found 4 Documents Search

Abstract

Abstract

Abstract

Abstract

Title

Found 4 Documents
Search