Kapuangan, Christopher
Faculty of Medicine, Universitas Padjadjaran

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Journal : Majalah Anestesia dan Critical Care

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
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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
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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 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 Chi-square. Insersi kanul intravena sekali tusuk dengan penampil vena keberhasilannya 3,095 kali lebih besar dibanding dengan tanpa penampil vena (p<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<0,05). Usia memiliki hubungan signifikan terhadap insersi kanul intravena (p<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: Difficult venous access, kanul intravena, penampil vena, status gizi Comparison of Successful Vein Cannula Insertion between Using Vein 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<0.05). First attempt vein cannula insertion in malnutrition patients has successful rate 0.85 times higher than good nutrition-obese patients (p<0.05). Age has significant relationship with vein cannula insertion (p<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: 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
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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<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<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
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Waktu pulih yang cepat dan lancar telah menjadi kebutuhan yang penting bagi unit pembedahan, khususnya bagi unit yang  memiliki beban jadwal operasi yang  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.   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<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   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  surgical units, especially in units with tight operation schedules. Faster recovery time creates  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)  (p<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