Ardana Tri Arianto
Bagian Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Sebelas Maret/RSUD Dr Moewardi Surakarta

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Perbedaan Skala Nyeri antara Blok Pleksus Servikalis Superfisialis Levobupivakain dan Fentanil Intravena Pascaoperasi Mastoidektomi Kaligis, Stephanus Andy Prakasa; Arianto, Ardana Tri; Thamrin, Muhammad Husni
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 (497.814 KB) | DOI: 10.15851/jap.v6n2.1224

Abstract

Penelitian tentang penggunaan blok pleksus servikalis superfisialis sebagai analgetik pascaoperasi mastoidektomi masih sangat terbatas baik di Indonesia maupun luar negeri. Tujuan penelitian mengetahui efektivitas blok pleksus servikalis superfisialis sebagai analgetik pascaoperasi mastoidektomi. Penelitian ini berdisain uji klinik acak tersamar tunggal pada 30 pasien yang dilakukan operasi mastoidektomi dan memenuhi kriteria inklusi di Rumah Sakit Dr. Moewardi Surakarta periode Oktober 2017–Februari 2018. Sampel dibagi menjadi 3 kelompok, yaitu kelompok fentanil intravena, blok pleksus cervicalis superfisialis dengan levobupivakain, dan blok pleksus cervicalis superfisialis dengan salin. Semua pasien mendapatkan perlakuan anestesi umum sesuai standar dan dinilai skala nyeri berkala pascaoperasi. Selain itu, juga dinilai efek mual-muntah pascaoperasi, kebutuhan opioid selama operasi, dan efek samping tindakan blok. Skala nyeri pascaoperasi mulai jam ke-2 sampai ke-24 pada kelompok fentanil intravena (nyeri ringan 80–90%) dan levobupivakain (nyeri ringan 90–100%) lebih rendah dibanding dengan kelompok salin (nyeri ringan 10–50%; nyeri sedang 50–70%) (p<0,05). Pada kelompok salin bahkan terjadi nyeri berat sebanyak 40% pada jam ke-2. Skor PONV pada kelompok fentanil, levobupivakain, dan salin mayoritas mual ringan (60%; 40%; dan 50%). Tidak ada komplikasi yan g terjadi terkait blok pleksus servikalis superfisialis. Simpulan, tidak ada perbedaan skala nyeri yang bermakna antara blok pleksus servikalis superfisialis levobupivakain dan fentanil intravena pascaoperasi mastoidektomi. Kata kunci: Blok pleksus servikalis superfisialis, fentanil, levobupivakain, mastoidektomi Difference in Pain Scale between Levobupivacaine Superficial Cervical Plexus Block and Intravenous Fentanyl for Post-Post-Mastoidectomy PainResearch on the use of superficial cervical plexus block as an analgesic after mastoidectomy is still very limited both in Indonesia and abroad. The purpose of this study was to determine the efficacy of superficial cervical plexus block as an analgesics for post-post-mastoidectomy pain. This was a single blinded randomized clinical trial study performed on 30 patients underwent mastoidectomy who met the inclusion criteria in Dr. Moewardi General Hospital Surakarta October 2017–February 2018. Subjects were divided into 3 groups: levobupivacaine block, saline block, and intravenous fentanyl groups. All patients received standard general anesthesia treatment and  were evaluated periodically for the post-operative pain scale. The post-operative effects post-including  nausea-vomiting, opioid need during surgery, and side effects of  the block were also assessed. The pos-toperative pain scales 2 to 24 hours after surgery in the intravenous fentanyl (mild pain 80–90%) and levobupivacaine group (mild pain 90–100%) were lower than those in the saline group (mild pain 10–50%, moderate pain 50–70%) (p<0.05). In the saline group, severe pain was even identified 2 hours after the surgery in  as high as 40% of the subjects. Comparison of the pain scale between fentanyl and levobupivacaine groups from 2 to 24 hours after surgery did not show any significant difference. PONV scores in the fentanyl, levobupivacaine, and saline groups reflected mild nausea (60%, 40%, and 50% respectively). No complication occurred in superficial cervical plexus block application. In conclusion, there is no significant difference in pain scale between the superficial cervical plexus block using levobupivacaine and intravenous fentanyl in terms of  post-post-mastoidectomy pain. Key words: Fentanyl, levobupivacaine, mastoidectomy, superficial cervical plexus block 
Ketotifen Mempengaruhi Jumlah Fibroblas dan Kepadatan Sel Kolagen Luka Insisi Tikus Wistar Hadian, Ingga; Alfianto, Untung; Arianto, Ardana Tri
Cermin Dunia Kedokteran Vol 45, No 2 (2018): Urologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (120.642 KB) | DOI: 10.55175/cdk.v45i2.173

Abstract

Hambatan degranulasi sel mast diharapkan mempercepat penyembuhan luka yang ditandai dengan meningkatnya jumlah sel fibroblas dan kepadatan sel kolagen. Ketotifen mampu mengurangi degranulasi sel mast dan mengurangi pelepasan histamin, protease sel mast, myeloperoxidase, leukotriens, PAF dan macam-macam prostaglandin, juga menghambat agregasi polimorfonuklear serta mengurangi respon inflamasi dan mempercepat migrasi fibroblas di fase proliferasi.  Penelitian ini true eksperimental laboratorik dengan desain Randomized Controlled Trial, bertujuan untuk mengetahui perbedaan jumlah sel fibroblas dan kepadatan sel kolagen pada tikus Wistar yang diberi ketotifen oral dosis 0.3 mg/kg dibandingkan plasebo pada penyembuhan luka insisi. Disimpulkan bahwa ketotifen meningkatkan jumlah sel fibroblas dan kepadatan sel kolagen  pada penyembuhan luka insisi tikus Wistar.
Perbedaan Kejadian Agitasi Pasien Pediatri Pasca Anestesi Umum dengan Sevofluran atau Isofluran Arif Ramadhan, Alriztya; Tri Arianto, Ardana; Budi Santosa, Sugeng
Cermin Dunia Kedokteran Vol 47, No 1 (2020): Bedah
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (96.251 KB) | DOI: 10.55175/cdk.v47i1.337

Abstract

Latar belakang:Agitasi adalah masalah utama yang paling sering ditemukan di bagian anestesi pediatri. Agitasi pasca operasi sering terjadi pada anak yang menjalani anestesi dengan sevofluran. Tujuan : Menganalisis pengaruh pemberian sevofluran dan isofluran terhadap angka kejadian agitasi pasien pediatri yang menjalani anestesi umum. Metode :Penelitian double blind randomized control trial di kamar instalasi bedah sentral RSUD Dr. Moewardi Surakarta pada 36 sampel yang telah memenuhi kriteria. Sampel dibagi menjadi kelompok mendapat anestesi umum dengan sevofluran (18 sampel) atau isofluran (18 sampel). Kejadian agitasi pasca operasi dinilai menggunakan skor Pediatric Anesthesia Emergence Delirium (PAED) pada menit ke 10, 20, dan 30. Analisis statistik menggunakan uji independent t. Hasil : Kedua kelompok memiliki karakteristik dasar homogen. Uji beda rerata skor PAED antara kedua kelompok menghasilkan nilai p = 0,505 (10 menit), p = 0,624 (20 menit), dan p = 0,240 (30 menit). Simpulan: Kejadian agitasi pasien pediatri pasca anestesi isofluran dan sevofluran tidak berbeda signifikan (p > 0,05). Background : Agitation is a main problem in pediatric anesthesia. Post surgery agitation in pediatric patients occurred more frequently after sevoflurane anesthesia. Purpose : To analyze the incidence of emergency agitation after sevoflurane and isoflurane general anesthesia in pediatric patients. Method : A double blind randomized control trial on 36 pediatric patients in the Central Surgery Unit of RSUD Dr. Moewardi Surakarta. samples were  divided into sevoflurane general anesthesia (18 patients) and isoflurane general anesthesia (18 patients). Post surgery agitation was recorded with Pediatric Anesthesia Emergence Delirium (PAED) score in 10, 20, and 30 minutes. Statistical analysis was performed using independent t test. Result : Both groups had comparable basic characteristics. The difference in mean PAED score between the two groups had the p value of 0,505 (10 minutes), 0,624 (20 minutes), and 0,240 (30 minutes) (p > 0,05). Conclusion : The incidence of post surgery emergence agitation in children after sevoflurane general anesthesia and isoflurane general anesthesia is not  significantly different.
Perbedaan Kebutuhan Morfin PCA Pasca Laparatomi antara Infiltrasi Ketamin Dan Infiltrasi Levobupivakain Heri Dwi Purnomo; Ardana Tri Arianto; Arif Wahyu Widayat
Jurnal Anestesi Perioperatif Vol 9, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n3.2493

Abstract

Penanganan nyeri akut yang tidak adekuat merupakan faktor risiko terjadin nyeri kronik dan komplikasi lainnya. Metode yang efektif dan efisien mengontrol nyeri akut yang berat adalah infiltrasi tepi luka operasi. Penelitian ini bertujuan untuk mengetahui efektivitas infiltrasi ketamin dan levobupivakain dalam mengurangi kebutuhan morfin patient controlled analgesia (PCA) pascalaparatomi. Penelitian ini merupakan uji klinik acak tersamar tunggal yang dilakukan di RSUD Dr. Moewardi Surakarta pada bulan Agustus 2018. Sampel terdiri atas 30 subjek yang dilakukan operasi laparatomi dengan anestesi umum yang dibagi menjadi 3 kelompok, yaitu kelompok infiltrasi levobupivakain, infiltrasi ketamin, dan infiltrasi saline. Semua pasien mendapatkan morfin PCA pascaoperasi. Setelah itu dinilai jumlah penggunaan morfin dan efek mual-muntah pascaoperasi, dan efek samping tindakan infiltrasi. Penggunaan morfin PCA pada kelompok ketamin rerata 2,20+1,32 mg, pada kelompok levobupivakain penggunaan morfin rerata 5,80+1,03 mg, dan pada kelompok NaCl penggunaan morfin rerata 10,00+1,76 mg. Uji statistik Kruskal Wallis didapatkan perbedaan yang signifikan penggunaan morfin PCA antara pasien kelompok ketamin, levobupivakain dan NaCl (p<0,05). Simpulan penelitian ini bahwa infiltrasi ketamin mengurangi nyeri pascalaparatomi lebih baik dibanding dengan infiltrasi levobupivakain dan saline.Differences in Post-laparotomy PCA Morphine Needs between Ketamine Infiltration and Levobupivacaine Infiltration Inadequate acute pain management is a risk factor for chronic pain and other complications. Laparotomy is a painful procedure with severe acute pain. Patient controlled analgesia (PCA) morphine use in acute pain control is promoted for efficiency and effectiveness. Wound infiltration is also effective in reducing acute pain. This study aimed to determine the effectiveness of ketamine and levobupivacaine wound infiltration in reducing the need for post-laparotomy PCA morphine. This study used a single-blind randomized clinical trial at RSUD Dr. Moewardi Surakarta on 30 subjects who underwent laparotomy and met the inclusion criteria. The samples were divided into three groups: wound infiltration with levobupivacaine, wound infiltration with ketamine, and wound infiltration with saline. All patients received standard general anesthetic treatment and were then evaluated for the total use of PCA morphine. It also assessed the effects of postoperative nausea-vomiting and the side effects of wound infiltration. The average PCA morphine use in the ketamine group was 2.20+1.32 mg. In the Levobupivacaine group was 5.80+1.03 mg, and in the NaCl group was 10.00+1.76 mg. Kruskal Wallis statistical test obtained p-value=0.000 (p<0.05), which means that there was a significant difference in PCA morphine use after 24 hours between the three groups. No complication occurred with the three-group wound infiltration. Thus, there is a significant difference in the use of PCA morphine between wound infiltration with ketamine and wound infiltration with levobupivacaine and with saline infiltration. Ketamine wound infiltration can be used effectively to reduce post-laparotomy pain.
Perbedaan Efektivitas Iodine Povidone 1% dan Listerine® sebagai Preparat Perawatan Mulut terhadap Pencegahan Ventilator Associated Pneumonia Ardana Tri Arianto; Bambang Novianto Putro; Indra Chuandy
Jurnal Anestesi Perioperatif Vol 9, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n3.2434

Abstract

Perawatan mulut merupakan salah satu cara mencegah ventilator associated pneumonia (VAP) pada pasien yang menggunakan ventilasi mekanik. Penelitian ini bertujuan mengetahui prevalensi VAP dan efektivitas preparat antiseptik pada perawatan mulut pasien terintubasi terhadap pencegahan VAP. Penelitian menggunakan uji klinis acak tersamar tunggal pada 36 pasien dengan ventilasi mekanik pasien yang dirawat di ICU RS Dr. Moewardi bulan Februari–Mei 2017. Sampel dibagi menjadi 2 kelompok, yaitu kelompok iodine povidone 1% dan Listerine®. Awalnya dilakukan penilaian kebersihan mulut dengan simplified oral hygiene index. Setelahnya, dilakukan perawatan mulut menggunakan salah satu preparat. Setelah 48 jam, dilakukan penilaian ulang kebersihan mulut dan skor clinical pulmonary indicator score (CPIS). Timbul VAP bila skor CPIS ≥6. Data dianalisis dengan uji Mann Whitney dan independetn t-test. Kelompok iodine povidone 1% memiliki perubahan skor kebersihan mulut dengan selisih yang lebih kecil (0,195) dibanding dengan Listerine® (0,3605). Hal ini menunjukkan bahwa Listerine® lebih efektif menjaga kebersihan mulut (p=0,024). Listerine® secara signifikan lebih efektif dalam mencegah VAP bila dibanding dengan iodine povidone 1% (p=0,001). Tidak ada perbedaan signifikan pada subjek yang meninggal akibat VAP positif dengan negatif (p=0,280). l Simpulan listerine® memiliki efektivitas lebih tinggi mencegah VAP dibanding dengan iodine povidone 1%.Differences in Effectiveness of Iodine Povidone 1% and Listerine® as Oral Care Preparations in Preventing Ventilator-Associated PneumoniaOral care is one way to prevent VAP in patients using mechanical ventilation. x This study aimed to determine the prevalence of VAP and the effectiveness of antiseptic preparations in the oral care of intubated patients to prevent ventilator associated pneumonia (VAP). The study used a randomized, single-blind clinical trial in 36 mechanically ventilated patients admitted to the ICU of Dr. Moewardi in February –May 2017. The samples were divided into two groups, namely the 1% povidone-iodine group and Listerine®. Initially, oral hygiene was assessed using the simplified oral hygiene index. After that, oral care was performed using one of the preparations. After 48 hours, oral hygiene and clinical pulmonaryindicator score (CPIS) scores were reassessed. VAP occurred when the CPIS score was 6. The Mann-Whitney test and independent t-test analyzed the data. The 1% povidone-iodine group changed oral hygiene scores with a minor difference (0.195) than Listerine® (0.3605). It indicated that Listerine® was more effective in maintaining oral hygiene (p=0.024). Listerine® was significantly more effective in preventing VAP when compared with 1% iodine povidone (p=0.001). There was no significant difference in mortality of VAP positive or negative subjects (p=0.280). In conclusion, the use of Listerine® as an oral care preparation is significantly more effective in preventing VAP compared to 1% iodine povidone.
Perbedaan Skala Nyeri antara Blok Pleksus Servikalis Superfisialis Levobupivakain dan Fentanil Intravena Pascaoperasi Mastoidektomi Stephanus Andy Prakasa Kaligis; Ardana Tri Arianto; Muhammad Husni Thamrin
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 (497.814 KB) | DOI: 10.15851/jap.v6n2.1224

Abstract

Penelitian tentang penggunaan blok pleksus servikalis superfisialis sebagai analgetik pascaoperasi mastoidektomi masih sangat terbatas baik di Indonesia maupun luar negeri. Tujuan penelitian mengetahui efektivitas blok pleksus servikalis superfisialis sebagai analgetik pascaoperasi mastoidektomi. Penelitian ini berdisain uji klinik acak tersamar tunggal pada 30 pasien yang dilakukan operasi mastoidektomi dan memenuhi kriteria inklusi di Rumah Sakit Dr. Moewardi Surakarta periode Oktober 2017–Februari 2018. Sampel dibagi menjadi 3 kelompok, yaitu kelompok fentanil intravena, blok pleksus cervicalis superfisialis dengan levobupivakain, dan blok pleksus cervicalis superfisialis dengan salin. Semua pasien mendapatkan perlakuan anestesi umum sesuai standar dan dinilai skala nyeri berkala pascaoperasi. Selain itu, juga dinilai efek mual-muntah pascaoperasi, kebutuhan opioid selama operasi, dan efek samping tindakan blok. Skala nyeri pascaoperasi mulai jam ke-2 sampai ke-24 pada kelompok fentanil intravena (nyeri ringan 80–90%) dan levobupivakain (nyeri ringan 90–100%) lebih rendah dibanding dengan kelompok salin (nyeri ringan 10–50%; nyeri sedang 50–70%) (p<0,05). Pada kelompok salin bahkan terjadi nyeri berat sebanyak 40% pada jam ke-2. Skor PONV pada kelompok fentanil, levobupivakain, dan salin mayoritas mual ringan (60%; 40%; dan 50%). Tidak ada komplikasi yan g terjadi terkait blok pleksus servikalis superfisialis. Simpulan, tidak ada perbedaan skala nyeri yang bermakna antara blok pleksus servikalis superfisialis levobupivakain dan fentanil intravena pascaoperasi mastoidektomi. Kata kunci: Blok pleksus servikalis superfisialis, fentanil, levobupivakain, mastoidektomi Difference in Pain Scale between Levobupivacaine Superficial Cervical Plexus Block and Intravenous Fentanyl for Post-Post-Mastoidectomy PainResearch on the use of superficial cervical plexus block as an analgesic after mastoidectomy is still very limited both in Indonesia and abroad. The purpose of this study was to determine the efficacy of superficial cervical plexus block as an analgesics for post-post-mastoidectomy pain. This was a single blinded randomized clinical trial study performed on 30 patients underwent mastoidectomy who met the inclusion criteria in Dr. Moewardi General Hospital Surakarta October 2017–February 2018. Subjects were divided into 3 groups: levobupivacaine block, saline block, and intravenous fentanyl groups. All patients received standard general anesthesia treatment and  were evaluated periodically for the post-operative pain scale. The post-operative effects post-including  nausea-vomiting, opioid need during surgery, and side effects of  the block were also assessed. The pos-toperative pain scales 2 to 24 hours after surgery in the intravenous fentanyl (mild pain 80–90%) and levobupivacaine group (mild pain 90–100%) were lower than those in the saline group (mild pain 10–50%, moderate pain 50–70%) (p<0.05). In the saline group, severe pain was even identified 2 hours after the surgery in  as high as 40% of the subjects. Comparison of the pain scale between fentanyl and levobupivacaine groups from 2 to 24 hours after surgery did not show any significant difference. PONV scores in the fentanyl, levobupivacaine, and saline groups reflected mild nausea (60%, 40%, and 50% respectively). No complication occurred in superficial cervical plexus block application. In conclusion, there is no significant difference in pain scale between the superficial cervical plexus block using levobupivacaine and intravenous fentanyl in terms of  post-post-mastoidectomy pain. Key words: Fentanyl, levobupivacaine, mastoidectomy, superficial cervical plexus block 
Comparison of Magnesium Sulfat Gargle and Ketamine Gargle on The Incidence of Sore Throat and Cough After Extubation Ardana Tri Arianto; Sugeng Budi Santosa; Anindita Anindita
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 2, No 1 (2022): April 2022
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v2i1.55897

Abstract

Background : Postoperative sore throat (POST) or postoperative sore throat is one of the most common complications in patients receiving endotracheal intubation. The incidence of sore throat is reduced by administering mouthwash analgesics. The purpose of this study was to determine the difference in the effectiveness of magnesium sulfate gargle and ketamine gargle on the incidence of sore throat and cough after endotracheal extubation.Methods : The research was conducted at the Central Surgical Installation of RSUD Dr. Moewardi Surakarta, started in August 2020. This study is an experimental double-blind randomized control trial in patients undergoing general anesthesia after endotracheal extubation. Mann Whitney U test was used to process the data. The research group was divided into two groups, namely magnesium sulfate gargle (M) and ketamine gargle (K).Results : This study found a significant difference in sore throat when using magnesium sulfat gargle and ketamine gargle on the NRS scale. From the results of the study, there was a significant difference between magnesium sulfate and ketamine gargle at NRS 1 (p = 0.01) and NRS 6 (p = 0.022). In the incidence of cough, there were 7 patients in the magnesium sulfat group who had cough (30.4%) and 7 patients in the ketamine group who had cough (30.4%), the statistical test got p = 1,000 (p> 0.050).Conclusion : There is a significant difference in the incidence of sore throat which is lower in the administration of magnesium sulfate gargle compared to ketamine gargle and there is no significant difference between the administration of magnesium sulfate gargle and ketamine gargle on the incidence of cough after endotracheal extubation.
Perbandingan Efektivitas Anestesi Spinal dengan Bupivacain 12,5 Mg dan Bupivacain 5 Mg yang ditambah Fentanyl 50 Mcg pada Seksio Sesarea Fritzky Indradata; Heri Dwi Purnomo; Muh. Husni Thamrin; Sugeng Budi Santoso; Ardana Tri Arianto; RTH Supraptomo
Jurnal Anestesi Obstetri Indonesia Vol 4 No 1 (2021): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v4i1.55

Abstract

Latar Belakang: Anestesi spinal mempunyai efek samping berupa hipotensi dan mual muntah. Tujuan: penelitian ini adalah membandingkan efek anestesi spinal bupivacain dosis normal 12,5 mg dan bupivacain dosis rendah 5 mg dengan fentanyl 50 mg pada seksio sesarea terhadap perubahan hemodinamik, ketinggian blok, onset, durasi dan efek samping. Subjek dan Metode: Penelitian double blind randomized control trial pada 36 pasien yang memenuhi kriteria. Pasien dibagi menjadi dua kelompok, yang masing-masing terdiri 18 pasien, kelompok 1 dilakukan anestesi spinal dengan bupivacain hiperbarik 5 mg ditambah adjuvan fentanyl 50 mcg, sedangkan kelompok 2 diberikan bupivacain hiperbarik 12,5 mg. Penilaian meliputi saat mula kerja blokade sensorik, mula kerja blokade motorik, durasi, tekanan darah, laju nadi, dan saturasi oksigen, lama kerja dan efek samping. Data hasil penelitian diuji secara statistik dengan uji chi-square. Hasil: Terdapat perbedaan signifikan pada onset dan durasi blokade sensorik dan motorik, bupivacain 12,5 mg lebih baik dibandingkan bupivacain 5 mg + fentanyl 50 mcg (p<0.05). Tidak ada perbedaan signifikan pada perubahan tanda vital dan efek samping (p>0.05). Simpulan: Bupivacain 12,5 mg menghasilkan onset lebih cepat dan durasi lebih lama dibandingkan bupivacain 5 mg + fentanil 50 mcg pada anestesi spinal untuk seksio sesarea Comparison of The Effectiveness Spinal Anesthesia with Bupivacaine 12,5 Mg and Bupivacaine 5 Mg added Fentanyl 50 Mcg in Caesarean Section Abstract Background: Spinal anesthesia has side effects such as hypotension and nausea and vomiting. Objective: The aim of this study was to compare the effects of spinal anesthesia with normal doses of 12,5 mg of bupivacaine and 5 mg of low-dose bupivacaine with fentanyl 50 mg in the cesarean section on hemodynamic changes, block height, onset, duration, and side effects. Subjects and Methods: Double-blind randomized control trial in 36 patients who met the criteria. Patients were divided into two groups, each consisting of 18 patients, group 1 underwent spinal anesthesia with 5 mg of hyperbaric bupivacaine plus 50 mcg of fentanyl adjuvant, while group 2 was given 12,5 mg of hyperbaric bupivacaine. Assessments include the initiation of sensory block action, onset of motor block action, duration, blood pressure, pulse rate, and oxygen saturation, duration of action, and side effects. The research data were statistically tested with the chi-square test. Results: There were significant differences in the onset and duration of sensory and motor blockade, bupivacaine 12,5 mg was better than bupivacaine 5 mg + fentanyl 50 mcg (p <0.05). There was no significant difference in changes in vital signs and side effects (p> 0.05). Conclusion: Bupivacaine 12,5 mg resulted in a faster onset and longer duration than bupivacaine 5 mg + fentanyl 50 mcg in spinal anesthesia for cesarean section.
Perbedaan Respons Hemodinamik antara Penggunaan Levobupivakain dan Penambahan Klonidin 1 dan 2 Mcg/kgBB pada Scalp Block Ardana Tri Arianto; Sugeng Budi Santosa; Syarif Afif
Jurnal Anestesi Perioperatif Vol 10, No 1 (2022)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v10n1.2495

Abstract

Penambahan adjuvan pada levobupivakain dapat memperkuat dan memperpanjang efek analgesia pada blok saraf tepi. Klonidin memiliki aksi yang sinergis dengan agen lokal anestesi. Tujuan penelitian ini adalah mengetahui efektivitas penambahan klonidin 1 mcg/kgBB dan 2 mcg/kgBB pada scalp block sebagai analgetik kraniotomi. Penelitian dilakukan pada 30 pasien yang menjalani kraniotomi di RS Dr. Moewardi Surakarta selama periode bulan Mei–Agustus 2020 Desain penelitian yang digunakan adalah uji klinis tersamar acak ganda dengan analisis statistik menggunakan uji one-way ANOVA atau Kruskal Wallis. Subjek dibagi menjadi tiga kelompok, kelompok I: scalp block dengan levobupivakain 0,25%, kelompok II: scalp block ditambah klonidin 1 mcg/kgBB, kelompok III: scalp block ditambah klonidin 2 mcg/kgBB. Penilaian terhadap tekanan darah, MAP, laju nadi dilakukan sebelum intubasi, pemasangan pin, insisi kulit, dan insisi duramater. Hasil penlitian didapatkan perbedaan signifikan penambahan klonidin pada levobupivakain 0,25% dengan kelompok kontrol terutama pada laju nadi dan diastole. Klonidin 2 mcg/kgBB pada beberapa waktu menunjukkan perbedaan signifikan dibanding dengan penambahan dosis klonidin 1 mcg/kgBB. Simpulan, penambahan klonidin pada scalp block levobupivakain efektif menurunkan respons hemodinamik terutama laju nadi dan tekanan darah diastole Differences in Hemodynamic Response to 1 and 2 mcg/kgBW Clonidine Addition to Scalp BlockAdding adjuvants to levobupivacaine can enhance and prolong the analgesic effect of peripheral nerve blocks. Clonidine has a synergistic action with local anesthetic agents. This study aimed to determine the effectiveness of adding clonidine 1 mcg/kgBW and 2 mcg/kgBW on scalp blocks as craniotomy analgesics. The study included 30 patients who underwent a craniotomy at Dr. Moewardi Hospital Surakarta in May-August 2020. The study design was a double-blind, randomized clinical trial with statistical analysis using one-way ANOVA or Kruskal Wallis trials. Subjects were divided into three groups: group I, scalp block with 0.25% levobupivacaine; group II, scalp block plus clonidine 1 mcg/kgBW; and group III, scalp block plus clonidine 2 mcg/kgBW. Assessment of blood pressure, MAP, and pulse rate was performed before intubation, pin placement, skin incision, and dura mater incision. The study results showed a significant difference in adding clonidine to 0.25% levobupivacaine with the control group, especially in the pulse rate and diastole. Clonidine 2 mcg/kgBW several times showed a significant difference compared to adding a dose of 1 mcg/kgBW clonidine. In conclusion, adding clonidine to levobupivacaine scalp block effectively reduces hemodynamic responses, especially pulse rate and diastolic blood pressure.
Perbedaan Waktu Pulih Sadar Anestesi Umum Sevofluran dengan Premedikasi Midazolam dan tanpa Premedikasi Midazolam Purwoko Purwoko; Ardana Tri Arianto; Djoko Tjahyo Nugroho
Jurnal Anestesi Perioperatif Vol 10, No 2 (2022)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v10n2.2492

Abstract

Pemberian premedikasi midazolam memberikan efek sedasi yang panjang sehingga menimbulkan pulih sadar yang lebih lama. Tujuan penelitian ini adalah mengetahui perbedaan waktu pulih sadar anestesi umum sevofluran dengan dan tanpa premedikasi midazolam. Penelitian ini merupakan double blind randomized control trial pada 36 sampel yang telah memenuhi kriteria inklusi dan dilakukan di kamar instalasi bedah sentral RSUD Dr. Moewardi Surakarta pada bulan September–Oktober 2017. Sampel dilakukan operasi dengan anestesi umum inhalasi sevofluran. Sampel dibagi menjadi kelompok yang mendapatkan premedikasi midazolam 0,05 mg/kgBB i.v (kelompok A) dan tanpa premedikasi midazolam (kelompok B). Setelah selesai operasi, waktu pulih sadar dicatat menggunakan score Aldrete. Analisis statistik dilakukan menggunakan independent t-test (α=0,05 dan p<0,05). Waktu pulih sadar pada kelompok midazolam rerata 1381,00+237,80 detik, sedangkan pada kelompok kontrol rerata 597,89+179,89 detik (=0,000). Perbedaan rerata waktu pulih sadar antara kelompok premedikasi midazolam dan kontrol adalah 783,11 (640,28–925,94) detik. Waktu pulih sadar pada kelompok midazolam rerata 1381,00+237,80 detik,  sedangkan pada kelompok kontrol rerata 597,89+179,89 detik. Perbedaan selisih rerata waktu pulih sadar antara midazolam dan kontrol adalah 783,11 (640,28–925,94) detik. Terdapat perbedaan bermakna waktu pulih sadar antara kelompok midazolam dan kelompok kontrol. Simpulan, premedikasi midazolam pada anestesi umum sevofluran efektif dalam memperpanjang waktu pulih sadar.Recovery Time Differences in Sevoflurane General Anesthesia with Midazolam and without Midazolam PremedicationMidazolam premedication reduces anxiety, and anterograde partial amnesia provides anesthesia induction and reduces unwanted changes in postoperative behavior. Midazolam has a prolonged sedative effect leading to a longer recovery time. The researcher was interested in investigating recovery time differences between sevoflurane general anesthetic with midazolam and without midazolam premedication. This study was a double-blind, randomized controlled trial on 36 samples that met the inclusion criteria and was conducted at the Central Surgical Unit of RSUD Dr. Moewardi Surakarta. The sample was planned to undergo surgery under the general anesthetic sevoflurane inhalation. The sample was divided into two groups: one group received midazolam premedication 0.05 mg/kg i.v. (group A) and a control group without midazolam premedication (group B). After surgery, recovery time was recorded using the Aldrete score. The statistical analysis used an independent t-test (α=0.05 and p<0.05). The mean recovery time in the group premedicated with midazolam was 1381.00+237.80 seconds, while in the control group, it was 597.89+179.89 seconds, p=0.000 (p<0.05). The difference in the mean recovery time between the midazolam premedication group and the control group was 783.11 (640.28–925.94) seconds. There was a significant difference in recovery time between groups with midazolam and without midazolam premedication. This study showed that midazolam premedication to sevoflurane general anesthetic was effective in prolonging recovery time (p=0.000).