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All Journal Jurnal Anestesi Perioperatif Bali Journal of Anesthesiology Majalah Anestesia dan Critical Care
Kapuangan, Christopher
Faculty of Medicine, Universitas Padjadjaran
Education Health Professions Medicine & Pharmacology Other

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Mual Muntah Pasien Pascavitrektomi: Perbedaan Rumatan Kombinasi Sevofluran 1,2%-Fentanil 1,2 μg/kgBB/jam dengan Rumatan Sevofluran 2% Marsaban, Arif H. M.; Kapuangan, Christopher; Yulian, Anggadria Iqbal
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 (700.098 KB) | DOI: 10.15851/jap.v5n1.996

Abstract

Vitrektomi merupakan operasi yang sering dilakukan dengan insidens mual muntah pascaoperatif yang cukup tinggi. Kombinasi opioid - anestetik inhalasi merupakan pilihan dalam rumatan anestesia umum karena mempunyai efek sinergis. Perbandingan dosis kombinasi fentanil dan sevofluran dengan timbulnya efek samping mual muntah pascaoperatif belum pernah dilaporkan. Penelitian ini bertujuan mengetahui perbedaan insidens mual muntah pascavitrektomi antara rumatan kombinasi sevofluran 1,2%- fentanil 1,2 μg/kgBB/jam dan sevofluran 2%. Penelitian ini merupakan uji klinis acak tersamar tunggal terhadap pasien yang menjalani vitrektomi dengan anestesia umum di Ruang operasi mata Kirana RSUPN Cipto Mangunkusumo Jakarta Mei–Juli 2015. Enam puluh dua pasien yang akan menjalani vitrektomi dengan anestesia umum dirandomisasi ke dalam dua kelompok, yaitu kelompok yang mendapat rumatan kombinasi sevofluran 1,2%-fentanil 1,2 μg/kgBB/jam dan kelompok dengan rumatan sevofluran 2%. Pengukuran mual muntah pascabedah dilakukan dengan metode wawancara langsung. Analisis data dilakukan dengan uji chi-kuadrat dan uji Fisher sebagai uji alternatif. Insidens mual antara kedua kelompok berbeda bermakna pada periode 0–2 jam pascaoperasi (p<0,05), sedangkan pada periode 2–6 jam, insidens mual antara kedua kelompok tidak berbeda bermakna (p>0,05). Simpulan, rumatan anestesia dengan sevofluran 1,2%-fentanil 1,2 μg/kgBB/jam menimbulkan insidens mual dalam 2 jam pertama pascavitrektomi yang lebih rendah dibanding dengan sevofluran 2%.Kata kunci: Fentanil, mual muntah pascavitrektomi, sevoflurane Anesthesia for vitrectomy patient has a high incidence of postoperative nausea and vomiting (PONV).Combination of opioid and inhalation anesthesias has been commonly used for anesthesia maintenance  due to their sinergystic effect. The effect of fentanyl-sevoflurane dosage to PONV incidence in vitrectomy surgery has never been studied. This study aimed to determine the difference in PONV incidence between combination of sevoflurane 1.2%-fentanyl 1.2 μg/kgBW/hour and sevoflurane 2% for anesthesia maintenance. This study was a single blind randomized study in vitrectomy patients with general anesthesia at Kirana Operating Theatre of Dr.Cipto Mangunkusumo National General Hospital during May–July 2015. Sixty two patients who were undergoing vitrectomy surgery with general anesthesia were randomized into sevofluran 1.2%- fentanil 1.2 μg/kgBW/hour group and sevoflurane 2% group. Postoperatively, the incidences of PONV were recorded. Data were collected by anamnesis method and analyzed by chi-square and Fisher test. There was a significant difference of nausea incidence between the two intervention groups within 0–2 hours postvitrectomy period (p<0.05) but no significant difference within 2–6 hours postvitrectomy period (p>0.05). In conclusion, sevoflurane 1.2%-fentanyl 1.2 μg/kgBW/hour has lower incidence of postvitrectomy nausea within the first 2 hour compared to sevoflurane 2%.Key words: Fentanyl, postvitrectomy nausea and vomiting, sevoflurane 
Post-operative Emergence Agitation in Children Undergoing Inhalation General Anesthesia in Cipto Mangunkusumo Hospital: Study on Incidence and Affecting Factors Wijaya, Andi Ade; Kapuangan, Christopher; Aktara, Betardi
Majalah Anestesia dan Critical Care Vol 33 No 2 (2015): Juni
Publisher : Perdatin Pusat

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Abstract

Emergence agitation (EA) during recovery from general anesthesia is often found among pediatric population. The etiology of EA in children is not fully understood. Possible risk factors include pre-school age, recent inhalation anesthetics, poor adaptability, and parental presence during recovery. The aim of the present study was to assess the incidence of EA and the affecting factors in children undergoing inhalation anesthesia in Cipto Mangunkusumo Hospital. There were 78 samples, aged 2–12 years undergoing inhalation anesthesia. Behavior during induction of anesthesia was assessed with Pediatric Anesthesia Behavior (PAB) score. In post anesthesia care unit (PACU) the incidence of EA was assessed with Aono’s four-point scale upon admission (T0), after 5 min (T5), 15 min (T15) and 30 min (T30). The incidence of EA in children undergoing inhalation anesthesia in this study was 39,7%. The incidence was higher in 2–5 years old children with PAB score 2 or 3. Midazolam, type of inhalation anesthetic agents and parental presence during recovery do not appear to have any bearing on the incidence of EA. Age of the children and the behavior during induction of anesthesia have a strong correlation with the incidence of EA.
Perbandingan Keberhasilan Insersi Kanul Intravena antara Penggunaan dan Tanpa Penggunaan Penampil Vena pada Pasien Pediatrik Perdana, Aries; Kapuangan, Christopher; Alantas, Anas; Manggala, Sidharta Kusuma; Wardhani, Yosi Dwi
Majalah Anestesia dan Critical Care Vol 34 No 1 (2017): Februari
Publisher : Perdatin Pusat

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Abstract

Insersi kanul intravena pada bayi, balita atau anak-anak cukup sulit karena kecilnya ukuran pembuluh darah vena dan lokasinya yang dalam di jaringan subkutis. Kesalahan insersi kanul intravena cenderung terjadi pada kasus&nbsp;difficult venous access (DVA). Penelitian ini membandingkan keberhasilan insersi kanul intravena dengan atau tanpa penggunaan penampil vena pada pasien pediatrik. Setelah mendapat persetujuan dari Komite Etik FKUI/RSCM dan konsen dari pasien, dilakukan penelitian uji klinis acak tidak tersamar pada 88 sampel pasien pediatrik. Pasien dirandomisasi menjadi dua kelompok, pada kelompok 1 dilakukan insersi kanul intravena tanpa penampil vena, sedangkan kelompok 2 dilakukan insersi kanul intravena dengan penampil vena. Data yang terkumpul diuji dengan uji&nbsp;Chi-square. Insersi kanul intravena sekali tusuk dengan penampil vena keberhasilannya 3,095 kali lebih besar dibanding dengan tanpa penampil vena (p&lt;0,05). Insersi kanul intravena sekali tusuk pada pasien dengan status gizi kurang-buruk memiliki angka keberhasilan 0,285 kali dibanding dengan status gizi normal lebih (p&lt;0,05). Usia memiliki hubungan signifikan terhadap insersi kanul intravena (p&lt;0,05). Keberhasilan insersi kanul intravena sekali tusuk dengan menggunakan penampil vena lebih baik dibanding dengan tanpa penampil vena. Keberhasilan insersi kanul intravena memiliki hubungan yang signifikan dengan status gizi dan usia. Kata kunci:&nbsp;Difficult venous access,&nbsp;kanul intravena, penampil vena, status gizi Comparison of Successful Vein Cannula Insertion between Using Vein&nbsp;Viewer and without Vein Viewer in Pediatric Patients Vein cannula insertion in infants, toddlers, or children is quite difficult because of the size and location of their veins. Wrong vein cannula insertion are prone to happen in Difficult Venous Access (DVA) cases. This research is comparing the successful vein cannula insertion between using vein viewer and without vein viewer in pediatric patients. After obtained the ethical approval from Ethical Committee of Cipto Mangunkusumo Hospital and informed consent from patients, 88 pediatric patients were enrolled to this randomized controlled trial. Patients were randomized into 2 groups: first group was inserted without vein viewer and second group was inserted using vein viewer. Data was analyzed with Chi-square test. Successful rate in first attempt vein cannula insertion using vein viewer is 3.095 times higher than without vein viewer (p&lt;0.05). First attempt vein cannula insertion in malnutrition patients has successful rate 0.85 times higher than good nutrition-obese patients (p&lt;0.05). Age has significant relationship with vein cannula insertion (p&lt;0.05). Successful rate in first attempt vein cannula insertion using vein viewer is higher than without vein viewer. Successful first attempt in vein cannula insertion has significant relationship with nutrition status and age. Key words:&nbsp;Difficult venous access, nutrition status, vein cannula, vein viewer
Waktu Pulih Anestesia Spinal pada Brakhiterapi Intrakaviter: Perbandingan Levobupivakain 5 mg Hiperbarik + Fentanil 25 mcg dengan Bupivakain 5 mg Hiperbarik + Fentanil 25 mcg Tantri, Aida Rosita; Kapuangan, Christopher; Edwin, Fahmi Agnesha
Majalah Anestesia dan Critical Care Vol 34 No 3 (2016): Oktober
Publisher : Perdatin Pusat

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Abstract

Brakhiterapi intrakaviter merupakan terapi keganasan pada stadium lanjut yang sering digunakan pada bidang ginekologi. Pasien brakhiterapi pada umumnya dilakukan dengan pelayanan rawat jalan sehingga anestesia yang menjadi pilihan selama ini adalah anestesia spinal. Pemilihan obat yang memiliki waktu pulih anestesia spinal yang lebih cepat membuat pasien dapat pulang kerumah lebih cepat. Penelitian ini menelitiwaktu pulih anestesia spinal levobupivakain 5 mg hiperbarik + fentanil 25 mcg dibandingkan dengan bupivakain 5 mg hiperbarik + fentanil 25 mcg pada brakhiterapi intrakaviter rawat jalan. Metode: Setelah mendapatkan izin dari Komite Etik penelitian FKUI RSUPN Ciptomangunkusumo dan persetujuan dari pasien, dilakukan uji klinik acak tersamar ganda di unitradioterapi RSCM. Sebanyak 60 subyek dibagi menjadi dua kelompok perlakuan yaitu levobupivakain 5 mg hiperbarik + fentanil 25 mcg (LV) dan bupivakain 5 mg hiperbarik + fentanil 25 mcg (BV) untuk menilai waktu pulih anestesia spinal. Hasil: Pengukuran waktu pulih dilakukan dengan menilai waktu kesiapan pulang pasien, waktu ambulasi dan waktu pasien dapat miksi spontan. Pada variabel waktu ambulasi, miksi spontan, dan waktu kesiapan pulang didapatkan hasil berbeda bermakna (p&lt;0,05). Simpulan: Waktu pulih anestesia spinal,waktu ambulasi dan waktu miksi pada kelompok levobupivakain 5 mg hiperbarik + fentanil 25 mcg lebih cepat dibandingkan dengan bupivakain 5 mg hiperbarik + fentanil 25 mcg pada brakhiterapi intrakaviter rawat jalan. Kata kunci: Brakhiterapi intrakaviter rawat jalan, levobupivakain, bupivakain, waktu pulih, anestesia spinal Spinal Anesthesia Recovery Time of Brachytherapy Outpatient Clinic: Comparison of 5 mg hyperbaric Levobupivacaine + 25 mcg Fentanyl and 5 mg Hyperbaric Bupivacaine+ 25 mcg FentanylIntracavitary brachytherapy is one modality treatment for advanced stage cervical cancer. These patients were treated in the outpatient clinic and thus the chosen anesthesia was spinal anesthesia. The regimen of spinal anesthesia influences the recovery time. The aim of the study was to compare the recovery time between two spinal anesthesia regimens, Levobupivacaine + 25 mcg fentanyl and 5 mgs Hyperbaric Bupivacaine+ 25 mcg fentanyl for brachytherapy outpatient clinic patient. Method: This was a double blind randomized control trial study. In the radiotherapy unit of RSCM. After approval from The Ethics Committee Faculty of Medicine Universitas Indonesia, Ciptomangunkusumo Hospital and consent from patients, 60 patients weredivided into two groups,Levobupivacaine + 25 mcg fentanyl group and 5 mgs Hyperbaric Bupivacaine+ 25 mcg Fentanyl group. The recovery time of both groups were recorded. Result: The spinal anesthesia recovery time was measured by discharge time, ambulation time, and spontaneous micturition time. all of these three variables were significantly different between the two groups (p&lt;0,05). Conclusion: spinal anesthesia recovery time, ambulation time, spontaneous micturition time of Levobupivacaine + 25 mcg fentanyl group were faster than 5 mgs Hyperbaric Bupivacaine+ 25 mcg fentanyl group in intracavitary brachytherapy patients. Key words: intracavitary brachytherapy outpatient clinic, Levobupivacaine, bupivacaine, spinal anesthesia recovery time
Waktu Pulih Pasien Pascavitrektomi: Perbandingan antara Rumatan Kombinasi Sevofluran 1,2 Vol% - Fentanil 1,2 Mcg/Kg/Jam dengan Rumatan Sevofluran 2 Vol% Marsaban, Arif HM.; Kapuangan, Christopher; Andria, Krisna
Majalah Anestesia dan Critical Care Vol 34 No 2 (2016): Juni
Publisher : Perdatin Pusat

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Abstract

Waktu pulih yang cepat dan lancar telah menjadi kebutuhan yang penting bagi unit pembedahan, khususnya bagi unit yang &nbsp;memiliki beban jadwal operasi yang &nbsp;banyak. Kecepatan waktu pulih diperlukan untuk meningkatkan turn-over-rate unit tersebut. Efek sinergis kombinasi opioid dan gas anestesi telah digunakan secara umum untuk mempertahankan kedalaman anestesia intraoperatif. Hanya saja tidak terlalu banyak data mengenai waktu pulih kombinasi opioid dan gas inhalasi, khususnya kombinasi sevofluran-fentanil.&nbsp;&nbsp; Penelitian ini bertujuan untuk mengetahui perbedaan waktu pulih antara rumatan kombinasi sevofluran 1,2 vol% - fentanil 1,2 mcg/kg/jam dengan rumatan sevofluran 2 vol%. Penelitian ini merupakan uji klinis acak tersamar tunggal terhadap pasien yang menjalani operasi elektif vitrektomi di Rumah Sakit Cipto Mangunkusumo periode bulan Mei–Juli 2015 sebanyak 30 sampel subjek penelitian diambil dengan metode konsekutif. Waktu pulih pascaoperasi dicatat dan data waktu pulih dianalisis dengan uji independent sample t-test. Waktu pulih antara rumatan kombinasi sevofluran 1,2 vol%-fentanil 1,2 mcg/kg/jam dengan rumatan sevofluran 2 vol% memiliki perbedaan yang signifikan (p&lt;0,005 kombinasi rumatan sevofluran 1,2 vol%-fentanil 1,2 mcg/kg/jam memiliki waktu pulih (6,47±1,727 detik) yang lebih singkat dibanding dengan rumatan sevofluran 2 vol% (11,87±1,846 detik). Waktu pulih pascavitrektomi pada kelompok rumatan kombinasi sevofluran 1,2 vol%-fentanil 1,2 mcg/kg/jam lebih singkat secara bermakna dari pada waktu pulih pada kelompok rumatan sevofluran 2 vol%. Kata Kunci: Fentanil, paskavitrektomi, sevofluran, waktu pulih &nbsp; Postvitrectomy Recovery Time: The Comparison between Combination of Sevoflurane 1,2% - Fentanyl 1,2 mcg/kg/hour Maintenance and Sevofluran 2 vol% as Maintenance A fast and smooth anesthesia recovery time is desiredin &nbsp;surgical units, especially in units with tight operation schedules. Faster recovery time creates &nbsp;a high turn over rate. Opioid – volatile anesthetic combination has been used widely to maintain the depth of anesthesia because of their synergistic effect. But there was lack of data about recovery time of opioid-inhalation combination maintenance, particularly sevoflurane-fentanyl combination, whereas sevofluran and fentanyl has been used widely in anesthesia practice. The study aimed to compare the recovery time between combination of sevoflurane 1.2 vol% - fentanyl 1.2 mcg/kg/hour maintenance and sevoflurane 2 vol% maintenance. Methods. This was a single blind randomized study in patients underwentvitrectomy at Cipto Mangunkusumo hospital between May and July 2015. A total of 30 subjects were included in this study. The recovery time after surgery was recorded. Data was analyzed by independent sample t-test. There was a significant difference of recovery time between combination of sevoflurane 1.2 vol% - fentanyl 1.2 mcg/kg/hour as maintenance (6.47±1.727 seconds) and sevoflurane 2 vol% as maintenance (11.87±1.846 seconds) &nbsp;(p&lt;0.005. Postvitrectomy anesthesia recovery time was significantly faster in combination of sevoflurane 1,2 vol% - fentanyl 1,2 mcg/kg/hour maintenance group compared tosevoflurane 2 vol% maintenance group. Key words: Fentanyl, postvitrectomy, recovery time, sevoflurane
Factors associated with the need for intraoperative packed red cells transfusion in pediatric liver transplant patients Kapuangan, Christopher; Utariani, Arie; Hanindito, Elizeus
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (201.652 KB) | DOI: 10.15562/bjoa.v3i1.143

Abstract

Background: Massive hemorrhage is one of the most common problems encountered during a liver transplantation procedure. Correction of the blood loss using packed red cells (PRC) is essential during the procedure to improve outcome. This retrospective study aims to investigate preoperative and intraoperative factors that may predict the PRC need.Materials and Methods: Thirty-four patients who underwent pediatric liver transplantation procedure within 2010-2018 were included in this study. Their medical record was examined and the data was analyzed using a comparison of mean and regression model.Results: The mean bleeding in this study was found to be 906.62±674.30 mL, while the mean PRC transfusion was 566.71±307.30 mL. Correction of blood loss was also compensated with other means such as a crystalloid or colloid fluid.Conclusion: This study statistically demonstrated that pre-operative weight, as well as bleeding volume, significantly affect the PRC transfusion requirement (p &lt;0.05). However, other factors such as hemoglobin and surgical duration may also be clinically significant factors to predict PRC transfusion need.
Co-Authors Aktara, Betardi Alantas, Anas Andi Ade Wijaya Andria, Krisna Arif H. M. Marsaban Edwin, Fahmi Agnesha Elizeus Hanindito Manggala, Sidharta Kusuma Marsaban, Arif HM. Perdana, Aries Tantri, Aida Rosita Utariani, Arie Wardhani, Yosi Dwi Yulian, Anggadria Iqbal