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Jurnal Anestesi Perioperatif
Published by Universitas Padjadjaran
ISSN : 23377909     EISSN : 23388463     DOI : 10.15851/jap
Core Subject : Health, Education,
Education Health Professions
Jurnal Anestesi Perioperatif (JAP)/Perioperative Anesthesia Journal is to publish peer-reviewed original articles in clinical research relevant to anesthesia, critical care, case report, and others. This journal is published every 4 months with 9 articles (April, August, and December) by Department of Anesthesiology and Intensive Care Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung.
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Articles 441 Documents
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Perbandingan Penambahan Neostigmin 2 mg/kgBB dengan Fentanil 1 µg/kgBB dalam Bupivakain 0,125% sebagai Anestesi Kaudal terhadap Lama Analgesia Alam, Jauharul; Oktaliansah, Ezra; Boom, Cindy Elfira
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Blokade kaudal dengan injeksi tunggal sering digunakan untuk penatalaksanaan nyeri intra dan pascabedah pada pasien pediatrik. Penelitian ini bertujuan mengkaji lama analgesi setelah blokade kaudal injeksi tunggal preoperatif antara penambahan neostigmin 2 µg/kgBB dan fentanil 1 µg/kgBB dalam bupivakain 0,125% (volume 0,5 mL/kgBB) pada pasien anak yang menjalani operasi hipospadia dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Desember 2011–Februari 2012. Metode penelitian adalah penelitian eksperimental secara acak terkontrol buta ganda pada 24 anak berusia 1–7 tahun. Data pengukuran lama analgesi diperoleh dengan Children and Infant Postoperative Pain Scale (CHIPPS) yang dianalisis dengan Uji Mann-Whitney, data laju nadi dan laju napas dianalisis dengan uji-t. Hasil perhitungan statistik diperoleh lama analgesi pada kelompok BN lebih panjang mencapai 675 menit dibandingkan dengan kelompok BF 480 menit dengan hasil yang sangat bermakna (p<0,001). Simpulan penelitian ini menunjukkan bahwa penggunaan kombinasi bupivakain 0,125% dan neostigmin 2 µg/kgBB untuk blokade kaudal injeksi tunggal memberikan lama analgesia yang lebih panjang.Kata kunci: Anestesi kaudal, bupivakain, fentanil, lama analgesia, neostigminComparison between Caudal Blockade with Additional 2 µg/kgBW Neostigmine and 1 µg/kgBW Fentanyl to 0.125% Bupivacaine on the Duration of AnalgesiaAbstractSingle shot injection caudal blockade were used extensively for intra and post operative pain management in pediatric patients. The purpose of this study was to assess duration of analgesia following a single shot injection of caudal blockade with additional 2 µg/kgBW neostigmine and 1 µg/kgBW fentanyl into 0.125% bupivacaine (volume 0.5 mL/kgBW) in pediatric patients who underwent hypospadias surgery at Dr. Hasan Sadikin Hospital Bandung from December 2011 to February 2012. This experimental study was conducted using randomized control trial (RCT) method in 24 pediatric patients, aged 1–7 years. The duration of analgesia data were obtained using Children and Infant Pain Scale (CHIPPS) post operatively and analyzed using Mann-Whitney Test, whereas the heart rate and respiratory rate data were analyzed by t-test. The result of statistical analysis showed significant difference between duration of analgesia in group BN (675 minutes) compared with the BF group (480 minutes) with p<0.001. The conclusion of this study was that combination of 0.125% bupivacaine and 2 µg/kgBW neostigmine as a single shot injection in caudal blockade provides longer duration of analgesia compared to 0.125% bupivacaine and 1 µg/kgBW fentanyl combination.Key words: Bupivacaine, caudal anesthesia, duration of analgesia, neostigmine DOI: 10.15851/jap.v1n3.191
Perbandingan Gabapentin 600 mg dengan 1.200 mg per Oral Preoperatif terhadap Nilai Visual Analogue Scale dan Pengurangan Kebutuhan Petidin Pascaoperasi pada Modifikasi Mastektomi Radikal Zulfariansyah, Ardi; Nawawi, A. Muthalib; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gabapentin mempunyai efek antihiperalgesia, antialodinia, dan antinosiseptif. Penelitian ini bertujuan untuk menilai efek gabapentin 600 mg dan 1.200 mg per oral preoperatif terhadap nilai visual analogue scale (VAS) dan pengurangan kebutuhan petidin pascaoperatif. Penelitian dilakukan secara uji acak terkontrol buta ganda terhadap 38 orang pasien di Rumah Sakit Dr. Hasan Sadikin Bandung pada Mei–September 2010. Pasien dibagi menjadi dua kelompok yaitu kelompok gabapentin 600 mg dan gabapentin 1.200 mg. Penilaian skala nyeri dilakukan dengan menggunakan nilai VAS. Data hasil penelitian dianalisis menggunakan Uji Mann-Whitney dengan tingkat kepercayaan 95% dan dianggap bermakna bila nilai p<0,05. Hasil penelitian didapatkan nilai VAS saat diam dan saat mobilisasi berbeda bermakna (p<0,05). Kelompok gabapentin 1.200 mg lebih sedikit diberikan analgetik petidin tambahan (10,5% vs 15,8%), tetapi perbedaan tersebut tidak bermakna (p=0,631). Simpulan penelitian ini adalah gabapentin 1.200 mg per oral preoperatif lebih baik bila dibandingkan dengan 600 mg dalam mengurangi nilai VAS pasca operatif pada operasi modifikasi radikal mastektomi, namun tidak mengurangi kebutuhan petidin.Kata kunci: Gabapentin 600 mg, Gabapentin 1.200 mg, visual analogue scale, kebutuhan petidin The Comparison between 600 mg and 1,200 mg Gabapentin per Oral Preoperatively on Visual Analog Scale and Reduction of Postoperative Pethidine Requirement on Modified Radical MastectomyAbstract Gabapentin is a GABA analog which has the effect of anti hyperalgesia, anti allodynia, and anti nociceptive. This research was conducted in order to assess the effect of 600mg and 1,200 mg gabapentin given preoperatively to assess visual analogue scale (VAS) score and reduction of pethidine requirement. The study was done by conducting a double blind randomized controlled trial on 38 patients, aged 18–65 years, with ASA physical status I–II. Patients were divided into two groups: 600 mg gabapentin and 1,200 mg gabapentin group. The quality of pain was assessed using VAS score. The results were statistically analyzed using Mann-Whitney Test with 95% confidence interval and considered significant if p value <0.05. From the results, the VAS values obtained at rest and during mobilization were significantly different (p<0.05). The 1,200 mg gabapentin group received less additional pethidine (10.5% vs 15.8%), although no significant difference was shown (p=0.631). The conclusion of this study is that administration of 1,200 mg gabapentin per oral pre operatively is better when compared to 600 mg in reducing post operative visual analog scale score in modified radical mastectomy. However, it do not reduce the need for analgesic significantly.Key words: 600 mg Gabapentin, 1.200 mg Gabapentin, post operative pethidine requirement, visual analog scale DOI: 10.15851/jap.v1n3.196
Perbandingan Efektivitas Pemberian Efedrin Oral Dosis 25 mg dengan 50 mg Preoperatif terhadap Kejadian Hipotensi Pascaanestesi Spinal pada Seksio Sesarea Rosita, Selly Oktarina; Pradian, Erwin; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tablet efedrin dapat mencegah hipotensi dengan efek samping lebih kecil. Penelitian ini bertujuan mengkaji dosis efektif tablet efedrin yang diberikan 30–45 menit sebelum dilakukan anestesi spinal untuk menurunkan kejadian hipotensi. Penelitian bersifat eksperimental acak tersamar tunggal dengan 32 ibu hamil ASA II yang menjalani operasi sesar dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Maret–Mei 2012. Subjek penelitian dikelompokkan menjadi dua, yaitu kelompok 25 mg dan 50 mg. Data dianalisis dengan Uji Mann Whitney dan chi-kuadrat, nilai p<0,05 dianggap bermakna. Analisis statistik menunjukkan bahwa kejadian hipotensi pada kelompok 25 mg dan kelompok 50 mg berbeda bermakna (p=0,049). Pada kelompok tablet efedrin 25 mg kebutuhan efedrin intravena pascaanestesi spinal lebih besar (p=0,040). Simpulan penelitian ini adalah pemberian tablet efedrin 50 mg 30–45 menit sebelum anestesi spinal dapat mencegah hipotensi pascaanestesi spinal lebih baik dibandingkan dengan tablet efedrin 25 mg. Kelompok tablet efedrin 25 mg memerlukan jumlah pemberian efedrin intravena lebih banyak dibandingkan dengan kelompok tablet efedrin 50 mg.Kata kunci: Anestesi spinal, efedrin tablet 25 mg, efedrin tablet 50 mg, seksio sesarea, hipotensi Comparison of the Effectiveness of Preoperative Oral 25 mg and 50 mg Ephedrine on Postspinal Anaesthesia Hypotension in Caesarean SectionAbstractOral ephedrine is one alternative to prevent hypotension with less adverse effects. The purpose of this study was to determine the effective dose of oral ephedrine given 30–45 minutes before spinal anesthesia to reduce incidence of hypotension. The research was a single-blind randomized experimental study involving 32 pregnant women, ASA II, who underwent caesarean section with spinal anesthesia at Dr. Hasan Sadikin Hospital Bandung from March to May 2012. Subjects were divided into two groups, 25 mg ephedrine and 50mg ephedrine groups. Data was analyzed using Mann Whitney and chi-square test, p<0.05 was considered significant. Statistical analysis showed there was a significant difference (p=0.049) in incidence of hypotension between 25 mg group and 50mg group. 25mg group required more intravenous ephedrine after spinal anesthesia (p=0.040). The conclusion of this study was that oral 50mg ephedrine given 30–45 minutes before performing spinal anesthesia will reduce the incidence of hypotension after spinal anesthesia in comparison to oral 25mg ephedrine. In 25mg group, the amount of ephedrine intravenous administered is higher compared with 50mg group.Key words: Spinal anesthesia, 25mg oral ephedrine, 50mg oral ephedrine, caesarean section, hypotension DOI: 10.15851/jap.v1n3.192
Kejadian Post Dural Puncture Headache dan Nilai Numeric Rating Scale Pascaseksio Sesarea dengan Anestesi Spinal Irawan, Dino; Tavianto, Doddy; Surahman, Eri
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kejadian nyeri kepala pascaanestesi spinal (post dural puncture headache; PDPH) berhubungan dengan ukuran lubang dura akibat proses penusukan. Tujuan penelitian ini untuk mengetahui kejadian PDPH pada pasien pascaseksio sesarea dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan Januari–April 2010. Penelitian dilakukan terhadap 115 wanita hamil, status fisik American Society of Anesthesiologist (ASA) II, berusia 18–45 tahun. Penelitian bersifat observasional dengan rancangan cross sectional. Hasil observasi didapatkan kejadian PDPH pada jarum tipe quincke no. 25 sebesar 68,2%, pada jarum tipe quincke no. 27 sebesar 31,8% dan tidak ditemukan pada jarum tipe pencil point no. 27. Nilai numeric rating scale (NRS) dari PDPH pada tipe jarum quincke no. 25 adalah 3–7, pada tipe jarum quincke no. 27 adalah 2–6, dan 0 pada tipe jarum spinal pencil point no. 27. Simpulan penelitian adalah bahwa kejadian PDPH pada pasien seksio sesarea dengan anestesi spinal berdasarkan tipe jarum spinal paling banyak didapatkan pada jarum tipe quincke no. 25, selanjutnya pada jarum tipe quincke no. 27 dan tidak ditemukan pada jarum tipe pencil point no. 27.Kata kunci: Anestesi spinal, numeric rating scale, post dural puncture headacheThe Incidence of Postdural Puncture Headache and Numeric Rating Scale Score After the Caesarean Section with Spinal AnesthesiaAbstractThe incidence of post dural puncture headache (PDPH) is associated with the size of duramater diameter puncture caused by the puncture itself. There are two factors related to this problem, the size of the needle and the shape of the needle’s-end. The purpose of this study was to obtain an overview of incidence of PDPH in patients undergoing caesarean section with regional spinal anesthesia in Dr. Hasan Sadikin Hospital Bandung in January–April 2010. This research was conducted on 115 pregnant woman with physical status of American Society of Anesthesiologist (ASA) II, range of age was 18 to 45 years old. This research was an observational study with cross-sectional design. The incidence of PDPH after the use of Quincke type needle no. 25 was 68.2%, while with Quincke type needle no. 27 was 31.8%, and no PDPH was found on the use of pencil point type needle no. 27. The numeric rating scale (NRS) from PDPH on the use of Quincke type needle no. 25 was 3–7, while on Quincke type needle no. 27 was 2–6, and 0 in pencil point type needle no. 27. As the conclusion, the greatest incidence of PDPH in patients undergoing caesarean section, based on spinal needle type, occurs most with no. 25 Quincke type needles, and less with no. 27 and none with no. 27.Key words: Numeric rating scale, post dural puncture headache, spinal anesthesia DOI: 10.15851/jap.v1n3.197
Pemberian Bolus 7,5 mL Poligelin pada Ruang Epidural untuk Menurunkan Kejadian Postdural Puncture Headache pada Anestesi Spinal Jaya Sutawan, I. B. Krisna; Pradian, Erwin; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Post dural puncture headache (PDPH) mengakibatkan morbiditas pada ibu yang menjalani seksio sesarea dengan anestesi spinal. PDPH disebabkan karena penurunan tekanan intratekal akibat kebocoran cairan serebrospinalis. Bolus poligelin pada ruang epidural diharapkan secara sementara meningkatkan tekanan ruang epidural dan mengurangi kebocoran cairan serebrospinalis sehingga dapat menurunkan kejadian PDPH. Penelitian dilakukan dengan uji klinis single blind randomized controled trial pada 90 wanita hamil yang menjalani seksio sesarea dengan anestesi spinal pada Oktober sampai Desember 2011 Rumah Sakit Dr. Hasan Sadikin Bandung. Sampel dikelompokkan secara random menjadi kelompok bolus 7,5 mL poligelin dan kelompok kontrol, selanjutnya dilakukan penilaian PDPH sampai hari kelima pascaanestesi spinal. Analisis statistik berdasarkan Uji Eksak Fisher, memperlihatkan bahwa angka kejadian PDPH pada kedua kelompok perlakuan menunjukkan perbedaan bermakna secara statistik (p<0,05). Simpulan dari penelitian ini adalah bolus poligelin pada ruang epidural dapat menurunkan angka kejadian PDPH pada pasien yang menjalani operasi seksio sesarea dengan anestesi spinal.Kata kunci: Anestesi spinal, poligelin, post dural puncture headache, ruang epidural  Bolus 7.5 mL Polygeline into the Epidural Space in Reducing the Incidence of Postdural Puncture Headache on Spinal AnesthesiaAbstractPost dural puncture headache (PDPH) may cause morbidity in women undergoing caesarean section with spinal anesthesia. PDPH is caused by a reduction of intrathecal pressure due to leakage of cerebrospinal fluid. Polygeline bolus into the epidural space is expected to temporarily increase the pressure of the epidural space therefore reduces cerebrospinal fluid leakage so that it may reduce the incidence of PDPH. The study conducted was a single-blind randomized clinical trial on 90 pregnant women undergoing caesarean section with spinal anesthesia from October until December 2011 in Dr. Hasan Sadikin Hospital Bandung. Samples were randomly divided into the bolus of 7.5 mL polygeline group and the control group. Evaluation of PDPH was performed until 5th day post-spinal anesthesia. Statistical analysis using Fishers Exact Test, showed that the incidence of PDPH in both treatment groups showed a statistically significant difference (p<0.05). The conclusion of this study is polygeline bolus into the epidural space may decrease the incidence of PDPH in patients undergoing caesarean section with spinal anesthesia.Key words: Epidural space, polygeline, post dural puncture headache, spinal anesthesia DOI: 10.15851/jap.v1n3.193
Hubungan antara Rasio Neutrofil-Limfosit dan Skor Sequencial Organ Failure Assesment pada Pasien yang Dirawat di Ruang Intensive Care Unit Nugroho, Adi; -, Suwarman; Nawawi, A. Muthalib
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Respons fisiologis sistem imunitas terhadap inflamasi sistemik adalah peningkatan jumlah neutrofil dan penurunan jumlah limfosit atau peningkatan rasio neurofil-limfosit (RNL). Penelitian ini bertujuan untuk melihat hubungan inflamasi sistemik yang ditandai peningkatan RNL terhadap kegagalan fungsi organ ditandai dengan skor Sequencial Organ Failure Assessment (SOFA) pada pasien yang dirawat di Intensive Care Unit (ICU). Penelitian ini adalah penelitian observasional dengan rancangan penelitian cross sectional. Penelitian dilakukan dengan mengobsevasi RNL dan skor SOFA pada jam ke-0, jam ke-24, dan jam ke-48 dari 78 pasien yang dirawat di ICU Rumah Sakit Dr. Hasan Sadikin Bandung periode Desember 2012–Februari 2013 yang terbagi ke dalam 3 kategori sepsis A, B, dan C. Data penelitian dianalisis menggunakan analisis bivariabel dengan Uji Korelasi Pearson dan Spearman. Hasil penelitian menunjukkan hubungan antara RNL dan skor SOFA terhadap kategori sepsis masing-masing (p<0,001). Uji Korelasi Pearson didapatkan hubungan antara RNL dan skor SOFA (p<0,05; R=0,63). Simpulan, terdapat hubungan antara keadaan inflamasi sistemik yang ditandai dengan RNL dan kegagalan fungsi organ yang ditandai dengan skor SOFA pada pasien yang dirawat di ICU RS Dr. Hasan Sadikin Bandung.Kata kunci: Intensive care unit, rasio netrofit-limfosit, sequencial organ failure assesment Relationship between Neutrophil Lymphocyte Ratio and Sequential Organ Failure Assesment Score in the Intensive Care Unit patientsAbstractPhysiological response of immune system against systemic inflammation involves an increased level of neutrophils and a reduction of lymphocyte or an increase of neutrophil-lymphocyte ratio (RNL). The aim of this study was to identify the relationship between systemic inflammation, characterized by increasing in RNL on organ malfunction, assessed by Sequential Organ Failure Assessment (SOFA) score in Intensive Care Unit (ICU) patients. This study was a observational study with cross sectional design. This study was conducted by observing RNL and SOFA score at 0, 24th and 48th hour of 78 patients treated in the ICU Dr. Hasan Sadikin Hospital Bandung in December 2012–February 2013. Patients were divided into 3 categories of sepsis A, B and C. This study showed that there was a relationship between RNL, SOFA scores and sepsis categories (p<0.001). Pearson Correlation Test showed that there was relationship between RNL and SOFA scores (p<0.05, R= 0.63). In conclusion, there is a relationship between systemic inflammatory condition, characterized by RNL and organ failure, characterized by the SOFA score, in patients treated in the ICU Dr. Hasan Sadikin Hospital Bandung.Key words: Intensive care unit, neutrophil-lymphocyte ratio, sequential organ failure assesment DOI: 10.15851/jap.v1n3.198
Perbandingan Waktu Induksi, Perubahan Tekanan Darah, dan Pulih Sadar antara Total Intravenous Anesthesia Profopol Target Controlled Infusion dan Manual Controlled Infusion Simanjuntak, Vick Elmore; Oktaliansah, Ezra; Redjeki, Ike Sri
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Target controlled infusion (TCI) memberikan kemudahan bagi dokter anestesi dalam pelaksanaan total intravenous anesthesia (TIVA). Penelitian ini bertujuan untuk membandingkan waktu induksi, perubahan tekanan darah, dan waktu pulih sadar antara TIVA propofol TCI dan manual controlled infusion (MCI) pada ekstirpasi fibroadenoma payudara. Penelitian dilakukan terhadap 32 wanita (18–40 tahun), status fisik ASA I, yang menjalani operasi ekstirpasi fibroadenoma payudara di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Juli–September 2012, secara uji acak terkontrol buta tunggal dalam anestesi umum. Subjek dibagi menjadi dua kelompok yaitu 16 orang dilakukan anestesi umum dengan TIVA propofol TCI dan 16 orang dengan TIVA propofol MCI. Waktu induksi TCI (61,44 detik) lebih singkat daripada MCI (78,5 detik) dan perubahan tekanan darah pada TCI (15,6 %) lebih kecil daripada MCI (24,1%). Tidak berbeda bermakna (p>0,05) dalam hal waktu pulih sadar pada kedua kelompok (TCI 8,95 menit dan MCI 9,90 menit). Simpulan, TIVA propofol TCI memberikan waktu induksi yang lebih singkat dan perubahan tekanan darah yang lebih kecil bila dibandingkan dengan TIVA MCI, namun tidak didapatkan perbedaan dalam hal waktu pulih sadar.Kata kunci: Manual controlled infusion target controlled infusion, waktu induksi, waktu pulih sadar Comparison of Induction Time, Changes in Blood Pressure, and Emergence between Target Controlled Infusion and Manual Controlled Infusion of Propofol Total Intravenous AnesthesiaAbstractTarget controlled infusion (TCI) offers anesthesiologists an easier way to conduct total intravenous anesthesia (TIVA). This study was done to compare the induction time, blood pressure and recovery time between propofol TIVA with TCI and the manual controlled infusion (MCI) in patients undergoing breast fibroadenoma extirpation. This study was done on 32 women (aged 18–40 years old), ASA I physical status, who underwent breast fibroadenoma extirpation in Dr. Hasan Sadikin Hospital Bandung within July–September 2012, by single blind randomized controlled trial in general anesthesia. Subjects were allocated into 2 groups, the TCI and MCI group, each consisted of 16 women. TCI’s induction time (61.44 seconds) were much shorter compared to MCI (78.5 seconds) and the blood pressure changes, TCI (15.6%) showed smaller changes compared to MCI (24.1%). There were no significant difference (p>0.05) in the recovery time in both groups (TCI 8.95 minutes and MCI 9.90 minutes). In conclusion, propofol TIVA with TCI showed a shorter induction time and less blood pressure changes compared to MCI, but there was no significant difference in recovery time. The adverse effect of postoperative nausea and vomitting did not occur in both groups.Keywords: blood pressure changes, induction time, manual controlled infusion, recovery time DOI: 10.15851/jap.v1n3.194
Scalp Nerve Block pada Kraniotomi Evakuasi Pasien Moderate Head Injury dengan Subdural Hemorrhage dan Intracerebral Hemorrhage Frontotemporoparietal Dekstra Mencegah Stress Response Selama dan Pascabedah Gunadi, Mariko; Suwarman, -
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Insisi kulit dan kraniotomi selama operasi intrakranial merupakan stimulus berbahaya yang dapat menghasilkan stress response yang menyebabkan peningkatan tekanan intrakranial. Scalp nerve block efektif dalam mengurangi stress response ini, selain itu juga dapat digunakan sebagai analgetik pascabedah. Seorang laki-laki usia 22 tahun dengan moderate head injury, subdural hemorrhage, dan intracerebral hemorrhage at regio fronto-temporo-parietal dextra dilakukan kraniotomi evakuasi dalam combined scalp nerve block - general anesthesia di Rumah Sakit Dr. Hasan Sadikin Bandung pada tanggal 14 Agustus 2012. Setelah dilakukan induksi dan sebelum insisi dilakukan scalp nerve block dengan bupivakain 0,5%. Hemodinamik (tekanan darah dan denyut jantung) setelah insisi kulit dan kraniotomi, serta glukosa darah pascabedah tidak menunjukkan perubahan yang signifikan. Analgetik pascabedah baru diberikan setelah 8 jam sejak dilakukan blok. Hasil ini menunjukkan scalp nerve block menggunakan bupivakain 0,5% mampu menumpulkan stress response dan dapat digunakan sebagai analgetik pascabedah.Kata kunci: Kraniotomi evakuasi, scalp nerve block, stress responseScalp Nerve Block in Craniotomy Evacuation on a Patient with Moderate Head Injury with Subdural Hemorrhage and Right Frontotemporoparietal Intracerebral Hemorrhage Prevents Intra and Post Operative Stress ResponseAbstractSkin incision and craniotomy are recognized as an acute noxious stimulation during intracranial surgery which may result in stress response causing an increase in intracranial pressure. Scalp nerve block may be effective in reducing stress response. It can also be used to provide post-operative analgesia. A twenty two years old male with moderate head injury, subdural hemorrhage, intracerebral hemorrhage at right fronto-temporo-parietal region underwent evacuation craniotomy with combined scalp nerve block and general anesthesia at Dr. Hasan Sadikin Hospital Bandung on August 14th 2012. After induction and before incision of the skin, a scalp nerve block was performed using 0.5% bupivacaine. Hemodynamic (blood pressure and heart rate) changes after incision of the skin and craniotomy were not significant, and so was post-operative blood glucose concentration. Post-operative analgetic was given eight hours after the block. The result demonstrates that scalp nerve block using 0.5% bupivacaine successfully blunts stress response and can be used as post-operative analgesia.Keywords: Craniotomy evacuation, scalp nerve block, stress response DOI: 10.15851/jap.v1n3.199
Perbandingan Gabapentin 600 mg dengan Pregabalin 150 mg Preoperatif terhadap Nilai Numeric Rating Scale dan Pengurangan Kebutuhan Opioid Pascaoperasi Modifikasi Radikal Mastektomi Agustine, Rully; Oktaliansyah, Ezra; Surahman, Eri
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gabapentin dan pregabalin mempunyai efek antihiperalgesia, antialodinia, dan antinosiseptif untuk mengurangi nyeri pascaoperatif. Penelitian ini bertujuan untuk membandingkan gabapentin 600 mg (n=22) dengan pregabalin 150 mg (22) terhadap nyeri pascaoperatif modifikasi mastektomi radikal, yang dilakukan terhadap 44 wanita (18–65 tahun) status fisik American Society of Anesthesiologist (ASA) I-II secara uji acak terkontrol buta ganda dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung pada November 2011 sampai Maret 2012. Analisis statistik menggunakan Uji Mann-Whitney, uji-t dan uji chi-kuadrat dengan tingkat kepercayaan 95% dan bermakna bila p<0,05. Penilaian skala nyeri menggunakan nilai numeric rating scale (NRS). Nilai NRS saat berbaring pada kelompok gabapentin 600 mg dan pregabalin 150 mg adalah sama (p>0,05). Nilai NRS saat mobilisasi pregabalin 150 mg lebih baik daripada gabapentin 600 mg pada tujuh dari sepuluh waktu pengukuran (p<0,05). Pemberian analgetik tambahan pascaoperatif antara kedua kelompok adalah sama (p>0,05). Simpulan, pregabalin 150 mg preoperatif lebih baik dari gabapentin 600 mg dalam menurunkan nilai NRS pascaoperasi. Gabapentin 600 mg dan pregabalin 150 mg mampu menurunkan kebutuhan opioid pascaoperatif. Kata kunci: Gabapentin, kebutuhan analgetik opioid, numeric rating scale, nyeri pascaoperatif, pregabalin Comparison of Pre Operative Gabapentin 600 mg and Pregabalin 150 mg to the Value of Numeric Rating Scale and the  Reduction of Post Operative Opioid Requirement after Modified Radical MastectomyGabapentin and pregabalin has anti hiperalgesia, anti allodynia, and anti nocicentive effect that can be used as an additional medication to reduce postoperative pain. This study compared gabapentin 600 mg and pregabalin 150 mg in managing  postoperative pain following modified radical mastectomy.  The study was done by conducting a double blind randomized controlled trial of 44 patients who underwent modified radical mastectomy operation under general anesthesia, aged 18–65 years, with American Society of Anesthesiologist (ASA) physical status I-II at Dr. Hasan sadikin General Hospital Bandung during November 2011 to March 2012. Patients were divided into two groups 600 mg gabapentin (n=22), and 150 mg pregabalin (n=22). Statistical analysis using Mann-Whitney Test, t-test and chi-square test with 95% confidence interval and considered significant if p<0.05. The quality of pain was assessed by using a numeric rating scale. The NRS value at rest was similar in both groups (p>0.05). NRS during mobilization were significantly different in nine measurements (p<0.05). Total postoperative additional analgesia shown no significant differences in both groups (p>0.05). Oral preoperatif pregabalin 150 mg is better than gabapentin 600 mg for reducing post operative NRS. Gabapentin 600 mg and pregabalin 150 mg reduced postoperative opioid consumption.Key words: Gabapentin, numeric rating scale score, opioid analgesic requirement, post operative, pregabalin DOI: 10.15851/jap.v2n2.305
Perbandingan Pengaruh Nifedipin 20 mg per Oral 2 Jam Preoperasi dengan Plasebo terhadap Suhu Inti pada Pasien yang Menjalani Operasi Modified Radical Mastectomy dengan Anestesi Umum Trisnadi, Saleh; Suwarman, -; Nawawi, Abdul Muthalib
Jurnal Anestesi Perioperatif Vol 2, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Upaya pencegahan hipotermia dapat dilakukan dengan mengurangi perbedaan antara suhu inti dan perifer sebelum dilakukan pembedahan dengan pemberian vasodilator. Tujuan penelitian ini untuk mengetahui efek penggunaan antara nifedipin 20 mg dan plasebo per oral 2 jam preoperasi selama operasi modifikasi mastektomi radikal terhadap penurunan suhu tubuh. Penelitian  menggunakan metode prospektif, terkontrol, tersamar, buta ganda pada 30 pasien berusia 18–60 tahun, status fisik American Society Of Anesthesiologist (ASA) I dan II, yang menjalani operasi modifikasi mastektomi radikal di Rumah Sakit Dr. Hasan Sadikin Bandung pada Juni sampai Agustus 2012. Secara acak dibagi menjadi 2 kelompok, yaitu kelompok yang mendapat nifedipin 20 mg per oral 2 jam preoperasi dengan plasebo. Dilakukan pencatatan suhu timpani setiap 10 menit dari awal induksi hingga akhir anestesi. Data hasil penelitian diuji secara statistik dengan Uji Mann-Whitney. Suhu inti rata-rata pada kelompok nifedipin adalah 36,37 oC lebih besar dibandingkan dengan kelompok kontrol yaitu 35,61 oC dengan perbedaan bermakna (p<0,05). Simpulan penelitian ini menunjukkan bahwa penggunaan obat nifedipin dapat mencegah hipotermia selama operasi dibandingkan dengan plasebo (kontrol).Kata kunci: Nifedipin, suhu inti tubuh, vasodilatorEffect of 20 mg Nifedipine Orally 2 Hours Before the Operation on Core Temperature in Patients Undergoing Modified Radical Mastectomy Surgery with General AnesthesiaStrategy of prevention the initial redistribution hypothermia is based on the reduction of the heat gradient between the core and perifer before surgery by administering vasodilators. The purpose of this study was to asses the effect of oral nifedipine 20 mg 2 hours before anesthesia in preventing hypothermia in patients undergoing modified radical mastectomy under general anesthesia and to compare the decreased rate of body temperature oral nifedipine with placebo. The research was done with the prospective method, randomized double-blind controlled study in 30 patients aged 18–60 yrs, American Society of Anesthesiologist (ASA) physical status I-II, underwent modified radical mastectomy surgery, were randomly divided into two groups at Dr. Hasan Sadikin General Hospital Bandung during June until August 2012. One group was given oral nifedipine 20 mg 2 hours before general anesthesia and the other group was given placebo. Tymphani temperature was recorded during anesthesia every 10 minutes. Research data was tested statistically by the Mann-Whitney test. The average core temperature in the nifedipine was 36.37 ° C which was higher than the control group 35.61 ° C (p<0.05). It can be concluded that the use of nifedipine can prevent intraoperative hypothermia.Key words: Core temperature, nifedipine, vasodilator DOI: 10.15851/jap.v2n2.306

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