Jurnal Anestesi Perioperatif最新文献

{"title":"Efek Eutectic Mixture of Local Anesthetics (EMLA) terhadap Nyeri Penyuntikan Jarum Spinal","authors":"Yuanda Rizawan Putra, Doddy Tavianto, D. Bisri","doi":"10.15851/jap.v7n3.1833","DOIUrl":"https://doi.org/10.15851/jap.v7n3.1833","url":null,"abstract":"Eutectic mixtures of local anaesthetics (EMLA) dapat mengurangi nyeri akibat penyuntikan jarum spinal. Penelitian bertujuan mengetahui efek EMLA terhadap nyeri saat penyuntikan jarum spinal. Metode penelitian adalah eksperimental secara acak terkontrol buta ganda pada pasien yang menjalani operasi elektif dalam anestesi spinal di ruang operasi sentral RSUP Dr. Hasan Sadikin Bandung dari bulan September hingga Oktober 2019. Data penilaian skor nyeri dilakukan setelah penyuntikan jarum spinal menggunakan Numeric pain rating score yang dianalisis dengan Uji Mann-Whitney. Hasil perhitungan statistik diperoleh Skor nyeri setelah aplikasi EMLA lebih rendah dibanding dengan skor nyeri (1 vs 4) dengan perbedaan yang sangat bermakna (p<0,001). Simpulan penelitian ini menunjukkan EMLA dapat mengurangi nyeri saat penyuntikan jarum spinal. Eutectic Mixture of Local Anesthetics (EMLA) Effect on Spinal Neddle Injection Pain Eutectic mixtures of local anesthetics can reduce pain caused by spinal injections. The purpose of this study was to understand the effect of EMLA on spinal injection pain. This was an experimental randomized single blind study involving all patients who underwent spinal anesthesia from September–October 2019 in Dr. Hasan Sadikin General Hospital. Pain score assessment was performed right after spinal injection using the numeric pain rating score. Data were then analyzed with Mann-Whitney test. Results showed that injection pain score in patients using EMLA was lower (1 vs 4) than patients who did not use EMLA (p<0.001). Therefore, EMLA can reduce spinal injection pain.","PeriodicalId":30635,"journal":{"name":"Jurnal Anestesi Perioperatif","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47746598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perbandingan Tramadol dengan Lidokain untuk Mengurangi Derajat Nyeri Penyuntikan Propofol","authors":"O. Endarto, Ruli Herman Sitanggang, Budiana Rismawan","doi":"10.15851/jap.v7n2.1740","DOIUrl":"https://doi.org/10.15851/jap.v7n2.1740","url":null,"abstract":"Propofol adalah obat anestesi intravena yang sering digunakan untuk tidakan medis karena memiliki onset dan durasi cepat. Nyeri saat penyuntikan propofol merupakan permasalahan yang sering dikeluhkan pasien dan berbagai metode telah dilakukan untuk mengurangi derajat nyeri penyuntikan propofol, namun masih didapatkan nyeri. Lidokain menjadi standar emas untuk mengurangi derajat nyeri penyuntikan propofol, tetapi masih memiliki efek samping seperti penekanan fungsi jantung sehingga dipilih tramadol yang tidak menekan fungsi jantung dan dapat menurunkan kebutuhan obat antinyeri selama maupun setelah operasi. Penelitian ini bertujuan membandingkan pemberian tramadol dengan lidokain untuk mengurangi derajat nyeri penyuntikan propofol. Metode penelitian menggunakan uji klinis acak buta tunggal terhadap 60 pasien yang menjalani operasi elektif. Pasien dibagi menjadi 2 kelompok, yaitu perlakuan tramadol (kelompok T) dan perlakuan lidokain (kelompok L) disertai pembendungan vena permukaan menggunakan tourniquet, kemudian diberikan tramadol atau lidokain. Setelah 1 menit tourniquet dilepaskan dan diikuti dengan penyuntikan ¼ dosis total propofol untuk induksi selama 5 detik, lalu dilakukan penilaian derajat nyeri menggunakan verbal rating score. Hasil penelitian menunjukkan penurunan derajat nyeri penyuntikan propofol pada kedua kelompok dan tidak terdapat perbedaan bermakna  (p>0,05), namun melalui uji statistik dengan tingkat kepercayaan sebesar 95% menyatakan tramadol memiliki risiko relatif kemungkinan terjadi nyeri ringan lebih kecil dibanding dengan lidokain menurunkan derajat nyeri penyuntikan propofol. Simpulan, Tramadol memiliki kekuatan yang sama dengan lidokain dalam menurunkan derajat nyeri penyuntikan propofol.Comparison between Tramadol and Lidocaine in Reducing Pain Triggered by Propofol InjectionPropofol is a commonly used intravenous anesthetics in medical procedure. Pain during propofol injection is a commonly reported adverse effect of this injection. Various methods have been proposed to reduce pain but often fail. Lidocaine is the gold standard for reducing pain during injection of propofol but has a suppressive effect on the heart. Tramadol does not have a suppressive effect and reduce the need for anti-pain medication during and after surgery thereforeTramadol is chosen for this purpose. This study aimed to compare the administration of tramadol and lidocaine to reduce the level of pain during propofol injection. This was a single blind randomized clinical trial on 60 patients underwent elective surgery. Patients were divided into 2 groups: the first group received tramadol (group T) and the second group received lidocaine (group L). Tourniquet was used on each patient before injection of tramadol or lidocaine was given and it was removed after 1 minute. Pain severity was assessed 5 seconds after propofol injection using the verbal rating score. This study discovered that pain during propofol injection was reduced with the use of tr","PeriodicalId":30635,"journal":{"name":"Jurnal Anestesi Perioperatif","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42200640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pengaruh Pemberian Magnesium Sulfat Intravena Prainduksi terhadap Kebutuhan Analgetik Pasca-Simple Mastectomy","authors":"Asyer Asyer, Iwan Fuadi, I. Rachman","doi":"10.15851/jap.v7n2.1708","DOIUrl":"https://doi.org/10.15851/jap.v7n2.1708","url":null,"abstract":"Nyeri pascabedah masih menjadi masalah dan perhatian di dunia. Pemberian analgetik preventif merupakan salah satu cara untuk mengurangi nyeri pascabedah. Beberapa obat digunakan sebagai terapi analgetik preventif antara lain opioid dan NSAID, namun obat ini mempunyai banyak efek samping. MgSO4 dapat digunakan sebagai analgetik preventif karena bersifat antagonis reseptor NMDA nonkompetitif. Tindakan operasi yang memiliki skor nyeri yang tinggi salah satunya adalah simple mastectomy dengan skor nyeri 4 sampai 8. Penelitian ini bertujuan mengetahui pengaruh MgSO4 i.v. dengan dosis bolus 50 mg/kgBB 20 menit prainduksi terhadap kebutuhan analgetik pasca-simple mastectomy. Penelitian ini merupakan penelitian analitik komparatif dengan data tidak berpasangan secara prospektif dengan uji klinis acak terkontrol buta ganda (RCT double blind) yang dilakukan terhadap 26 subjek penelitian yang menjalani simple mastectomy di RSUP Dr. Hasan Sadikin Bandung pada bulan Agustus sampai Desember 2018. Analisis statistik pada data numerik diuji dengan uji t berpasangan, sedangkan data kategorik diuji dengan uji chi-Square. Subjek dibagi menjadi kelompok M (MgSO4 20% 50 mg/kgBB) dan kelompok C (NaCl 0,9%). Hasil penelitian ini didapatkan kebutuhan opioid pascabedah pada kelompok yang diberikan MgSO4 lebih rendah dibanding dengan kelompok yang mendapatkan NaCl dengan perbedaan bermakna (p<0,05). Simpulan penelitian ini adalah MgSO4 i.v. prainduksi menurunkan kebutuhan opioid dibanding dengan kelompok kontrol pada simple mastectomy. Effect of Intravenous Magnesium Sulfate Pre-induction on Analgesics Consumption in Post-Simple MastectomyPostoperative pain is still a global problem that raises concerns all over the world. Preventive analgesics is one method to reduce postoperative pain. Several drugs are used as preventive analgesics including opioids and NSAIDs. However, these drugs have many side effects. MgSO4 can be used as alternative preventive analgesic as it is a non-competitive NMDA receptor antagonist. One of the surgical procedure that has a high pain score is simple mastectomy with a pain score of 4 to 8. The aim of this study was to determine the effect of MgSO4 i.v. with a bolus dose of 50 mg/kgBW, 20 minutes pre-induction, on the need for post-simple mastectomy analgesics. This was a comparative double blind randomized controlled trial (RCT) analytical study on prospective unpaired data from 26 study subjects who underwent simple mastectomy at Dr. Hasan Sadikin General Hospital Bandung during the period of August to December 2018. Subjects were divided into group M (MgSO4 20% 50 mg/kgBW) and group C (NaCl 0.9%). The results of this study revealed that the need for postoperative opioids in the group given MgSO4 was significantly lower compared to the group receiving NaCl (p<0.05). Therefore, MgSO4 i.v. preinduction has the ability to reduce opioid requirements in simple mastectomy when compared to NaCl. ","PeriodicalId":30635,"journal":{"name":"Jurnal Anestesi Perioperatif","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49514006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laporan Kasus: Anestesi Blok Peribulbar pada Pasien dengan Gagal Jantung Kongestif yang Dilakukan Enukleasi","authors":"Muhamad Adli, C. Wullur","doi":"10.15851/jap.v7n2.1775","DOIUrl":"https://doi.org/10.15851/jap.v7n2.1775","url":null,"abstract":"Seorang pria berusia 73 tahun datang ke Instalasi Gawat Darurat Pusat Mata Nasional Rumah Sakit Mata Cicendo pada bulan November 2018 dengan keluhan nyeri mata yang mengeluarkan darah dan disertai dengan keluhan sesak. Pemeriksaan mata menunjukkan prolaps okuli dan direncanakan untuk dilakukan enukleasi. Ahli kardiologi mendiagnosis sebagai hypertensive heart disease, congestive heart failure functional class IV, moderate mitral regurgitation, moderate aortic regurgitation. Laporan kasus ini bertujuan memaparkan keberhasilan tata laksana anestesi pada pasien usia lanjut dengan gagal jantung kongestif yang dilakukan enukleasi dalam blok peribulbar. Teknik blok peribulbar dipilih agar tidak memperberat masalah kardiovaskular serta untuk meminimalisir depresi kardiak. Teknik ini dilakukan dengan menyuntikkan obat anestesi lokal levobupivakain 0,5% pada inferotemporal, medial kantus, dan superonasal. Operasi berlangsung tanpa keluhan nyeri dan fluktuasi hemodinamik yang signifikan. Pascaoperasi pasien sadar penuh dengan skala nyeri NRS 60 menit pascaoperasi 0. Hal ini menunjukkan bahwa teknik anestesi blok peribulbar memberikan hasil memuaskan pada tindakan enukleasi. Enucleation under Peribulbar Block Anesthesia in Patients with Congestive Heart Failure: A Case ReportA 73-year-old male patient was presented to the emergency department of the National Eye Center Cicendo Hospital with a painful and bloody eye as well as shortness of breath. Eye examination revealed ocular prolapse and patient was scheduled for enucleation. The cardiologist diagnosed the patient with hypertensive heart disease, congestive heart failure functional class IV, moderate mitral regurgitation, and moderate aortic regurgitation. Patient then underwent treatment for six days. This case report aimed to describe the successful management of anesthesia in elderly patients with congestive heart failure who underwent peribulbar block for enucleation procedure. To prevent further cardiac problems and to minimize the risk of cardiac depression in this patient, the anesthetic technique chosen was peribulbar block with the injection of local anesthetic drug levobupivacaine 0.5% at the inferotemporal, medial canthus, and superonasal. The surgary took place without complaints of intraoperative pain and without significant hemodynamic fluctuations. Postoperatively, the patient was fully conscious and sixty minutes postoperative pain scale (Numeric Rating Scale) in this patient was 0. This shows that the peribulbar block anesthesia technique can provide satisfactory results for enucleation procedure.","PeriodicalId":30635,"journal":{"name":"Jurnal Anestesi Perioperatif","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48399135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perbandingan Intensitas Nyeri dan Kadar Prostaglandin Kombinasi Tramadol dan Deksketoprofen dengan Tramadol dan Parasetamol Intravena pada Pasien Bedah Ortopedi Ekstremitas Bawah","authors":"Clara Valentia Josephine, M. Ahmad, Hisbullah Hisbullah, A. Wahab","doi":"10.15851/jap.v7n2.1691","DOIUrl":"https://doi.org/10.15851/jap.v7n2.1691","url":null,"abstract":"Analgesia multimodal adalah prinsip manajemen nyeri pascaoperasi. Penelitian ini merupakan uji klinis rancangan acak tersamar ganda. Tujuan penelitian ini membandingkan efek kombinasi analgesik tramadol dan deksketoprofen dengan tramadol dan parasetamol terhadap intensitas nyeri dan kadar prostaglandin (PGE2) di RSUP Dr. Wahidin Sudirohusodo serta Rumah Sakit Jejaring di Makassar pada bulan Juli–September 2018. Empat puluh enam pasien ASA PS I dan II yang menjalani operasi ortopedi ekstremitas bawah dibagi menjadi dua kelompok. Kelompok D adalah pasien yang menerima 50 mg tramadol dengan 50 mg deksketoprofen dan kelompok P adalah pasien yang menerima 50 mg tramadol dengan 1.000 mg parasetamol intravena. PGE2 dan intensitas nyeri dicatat selama penutupan kulit sebelum pemberian obat 8 dan 16 jam sesudahnya. Data dianalisis menggunakan Uji Mann-Whitney U dan paired t-test yang sesuai. Numeric rating scale (NRS) kelompok tramadol dan deksketoprofen lebih rendah dibanding dengan kelompok tramadol dan parasetamol dengan perbedaan bermakna (p<0,05). Kadar PGE2 menurun pada kelompok tramadol dan deksketoprofen (T1–T2 p=0,009 dan T0–T2 p=0,01), sedangkan kadar PGE2 pada kelompok tramadol dan parasetamol meningkat (T2–T1 p=0,227 dan T0–T2 p=0,706). Simpulan, kombinasi tramadol dan deksketoprofen mengurangi tingkat PGE2 dan intensitas nyeri dibanding dengan kombinasi tramadol dan parasetamol. Dexketoprofen Combination and Tramadol Paracetamol Combination in Lower Limb Orthopedic SurgeryMultimodal analgesia is one of the principles of postoperative pain management. This study aimed to compare the effect of analgesic combination of tramadol dexketoprofen and tramadol paracetamol on pain intensity and prostaglandin (PGE2) level. Forty-six ASA PS I and II patients undergoing lower limb orthopedic surgery were allocated into two groups. Group D received 50 mg tramadol with 50 mg dexketoprofen and group P received 50 mg tramadol with 1,000 mg paracetamol intravenously. The PGE2 and pain intensity were recorded during skin closure prior to drug administration, 8 and 16 hours afterwards. Data were analyzed as appropriate using Mann-Whitney U and paired t-test. The NRS of two groups were significantly different where the NRS of the Tramadol Dexketoprofen group was lower than that of the tramadol and paracetamol group (NRS T1 p=0.049, NRS T2 p=0.035). The PGE2 levels decreased in the tramadol dexketoprofen groups (T1–T2 p=0.009 and T0–T2 p=0.01), whereas PGE2 levels in tramadol paracetamol group increased (T2–T1 p=0.227 and T0–T2 p=0.706). In conclusion, tramadol dexketoprofen combination reduces the PGE2 level and pain intensity as opposed to tramadol paracetamol combination. ","PeriodicalId":30635,"journal":{"name":"Jurnal Anestesi Perioperatif","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44050025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluasi Kepatuhan Pelaksanaan Standar Prosedur Operasional Manajemen Nyeri pada Pasien Luka Bakar di RSUP Dr. Hasan Sadikin Bandung","authors":"Yudhanarko Yudhanarko, S. Suwarman, Ricky Aditya","doi":"10.15851/jap.v7n2.1713","DOIUrl":"https://doi.org/10.15851/jap.v7n2.1713","url":null,"abstract":"Nyeri didefinisikan sebagai pengalaman sensorik dan emosional yang tidak menyenangkan terkait dengan kerusakan jaringan aktual atau potensial. Manajemen nyeri pada luka bakar merupakan bagian yang tidak terpisahkan dari terapi luka bakar. Nyeri pada luka bakar merupakan nyeri akut, penanganan yang tidak baik akan menyebabkan komplikasi, salah satunya nyeri kronik. Rumah Sakit Umum Pusat (RSUP) Dr. Hasan Sadikin Bandung telah membuat Standar Prosedur Operasional (SPO) manajemen nyeri yang berguna untuk meningkatkan kepatuhan dalam pelaksanaan manajemen nyeri. Penelitian ini bertujuan mengevaluasi kesesuaian teknik pengkajian, tindak lanjut dan evaluasi ulang nyeri pada pasien luka bakar dengan SPO manajemen nyeri. Penelitian menggunakan metode deskriptif observasional retrospektif terhadap 99 rekam medis pasien luka bakar yang memenuhi kriteria inklusi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2018. Hasil penelitian didapatkankan bahwa pengkajian nyeri yang dilakukan sesuai dengan SPO menggunakan numeric rating scale atau Wong Baker faces pain scale ditemukan pada 99 pasien (100%). Tindak lanjut hasil pengkajian nyeri luka bakar yang dilakukan sesuai dengan SPO sebanyak 71 pasien (72%). Evaluasi ulang setelah tindak lanjut pengkajian nyeri yang sesuai SPO pada 93 pasien (94%). Simpulan, pengkajian nyeri di RSUP Dr. Hasan Sadikin Bandung sudah sesuai dengan SPO manajemen nyeri, namun tindak lanjut dan evaluasi ulang pada nyeri luka bakar belum sesuai dengan SPO manajemen nyeri.Evaluation of Compliance to Standard Operating Procedures for Pain Management in Patients with Burns in Dr. Hasan Sadikin General Hospital BandungPain is defined as an unpleasant sensory and emotional experience related to actual or potential tissue damage. Pain management for burns is an integral part of burn therapy. Pain in burns is an acute pain and poor management will lead to health complications including chronic pain. Dr. Hasan Sadikin General Hospital Bandung has made a standard operating procedure (SOP) for pain management to improve compliance to pain management standard. This study aimed to evaluate the compliance to the standards in assessment techniques, follow-up, and re-evaluation of pain in patients with burn according to the applicable pain management SOP. This was a retrospective descriptive observational study on 99 medical records of burn patients who met the inclusion criteria in Dr. Hasan Sadikin General Hospital Bandung in 2018. The results of the study revealed that the pain assessment for these patient was carried out according to the SOP which refers to the use of a numeric rating scale or Wong Baker face pain scale in 99 patients (100%). In the follow-up, 71 were performed according to the SOP (72%) while the re-evaluation was performed in compliance with the SOP in 93 patients (94%). In conclusion, pain assessment in Dr. Hasan Sadikin General Hospital Bandung is performed in accordance with SOP on pain management but not all patients receive fo","PeriodicalId":30635,"journal":{"name":"Jurnal Anestesi Perioperatif","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48382070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pengaruh Lantunan Ayat Al-Quran terhadap Kebutuhan Opioid Tambahan Pascaseksio Sesarea","authors":"Silvi Winasty, Indriasari Indriasari, Nurita Dian Kestriani","doi":"10.15851/jap.v7n2.1756","DOIUrl":"https://doi.org/10.15851/jap.v7n2.1756","url":null,"abstract":"Lantunan ayat Al-Quran dapat menstimulasi β endorfin yang dihasilkan hipofisis anterior otak. Penelitian ini bertujuan mengetahui pengaruh  lantunan ayat Al-Quran terhadap intensitas nyeri dan kebutuhan opioid tambahan pascaseksio sesarea dengan regional spinal. Metode penelitian adalah eksperimental  secara acak terkontrol buta tunggal pada 32 ibu hamil berusia >18 tahun dan beragama islam di RSUP Dr. Hasan Sadikin Bandung pada bulan April–Mei 2019. Data jumlah penggunaan opioid tambahan pascaoperasi  selama 24 jam yang diberikan dengan patient controlled analgesia (PCA) dianalisis dengan Uji Mann-Whitney. Hasil perhitungan statistik diperoleh penggunaan opioid tambahan pada kelompok lantunan Al-Quran lebih sedikit  dibanding dengan kelompok kontrol  (21,87 mcg vs 107,87 mcg) dengan perbedaan yang sangat bermakna (p<0,0001). Simpulan penelitian ini menunjukkan bahwa lantunan ayat Al-Quran sebagai terapi tambahan penatalaksanaan nyeri pascaseksio sesarea menurunkan  penggunaan opioid tambahan.Effect of Quran Recital on Additional Opioid Requirement in Post-Cesarean SectionThe recitation of Al-Quran could stimulate β endorfins which is produced by anterior pituitary. This study aimed to identify the effect of listening to Al-Quran recitation on pain intensity and additional opioid requirement in patients after spinal cesarean section surgery. This was a randomized single blind controlled experiment on 32 pregnant moslem women over 18 years old treated in Dr. Hasan Sadikin General Hospital Bandung in April 2019-May 2019. The amount of additional 24-hours post-operative opioid requirement using Patient Controlled Analgesia (PCA) was analyzed by the Mann-Whitney Test. Results showed that the use of additional fentanyl in the Al-Quran recitation group was significantly less than in the controlled group(21.87 mcg vs 107.87 mcg) (p<0.0001). Therefore, Al-Quran recitation as an additional therapy in the management of pain is able to reduce the dose of additional fentamyl needed in postcaesarean section patients.","PeriodicalId":30635,"journal":{"name":"Jurnal Anestesi Perioperatif","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43519992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tata laksana Pasien Gravida 29–30 Minggu dengan Gagal Napas ec. Hypokalemic Periodic Paralysis yang Diperberat dengan Community Acquired Pneumonia","authors":"Mariko Gunadi, S. Suwarman, Nurita Dian Kestriani S","doi":"10.15851/jap.v7n2.1774","DOIUrl":"https://doi.org/10.15851/jap.v7n2.1774","url":null,"abstract":"Penatalaksanaan sakit kritis pada wanita hamil memiliki karakteristik yang unik karena  perubahan fisiologi selama kehamilan dan janin yang berkembang dalam uterus yang mendapat implikasi yang signifikan. Pada kasus ini, seorang perempuan 27 tahun yang sedang hamil gemeli usia kehamilan 29–30 minggu datang ke Instalasi Gawat Darurat (IGD) Rumah Sakit Dr. Hasan Sadikin Bandung dengan keluhan utama kelemahan keempat anggota gerak. Hasil pemeriksaan laboratorium didapatkan kadar kalium sangat rendah dan didiagnosis dengan hypokalemic periodic paralysis. Pasien mengalami gagal napas  sehingga dilakukan intubasi dan diberikan bantuan ventilasi mekanik, kemudian dirawat di Intensive Care Unit (ICU). Gagal napas disertai penyulit community acquired pneumonia. Tata laksana ventilasi mekanik pada wanita hamil di ICU bersifat suportif dengan teknik sama seperti pada pasien tidak hamil, namun memiliki target khusus yang berbeda. Monitoring fetal heart rate (FHR) dapat mencerminkan kesejahteraan janin dan kondisi ibu. Tujuan penulisan laporan kasus ini adalah mengetahui pentingnya target pemberian ventilasi mekanik dan melakukan monitoring FHR pada pasien hamil di ICU. Management of Respiratory Failure Due to Hypokalemic Periodic Paralysis Complicated with Community Acquired Pneumonia in 29–30 Weeks of GestationManagement of critically ill pregnant women in Intensive Care Unit (ICU) has unique characteristics due to the physiological changes during pregnancy and the presence of growing fetus in the uterine which may present significant implications. This study presented a case of a 27 years old woman with 29–30 weeks of gestation of twin pregnancy who came to Emergency Room (ER) with the chief complaint of weakness in both lower and upper extremities. Laboratory investigations showed a very low potassium level and the patient was diagnosed with hypokalemic periodic paralysis. Patient then experienced respiratory failure at the ER, intubated, and mechanically ventilated and was sent to the ICU. Community-acquired pneumonia was complicating the respiratory failure. Basically, mechanical ventilation management for pregnant patient in ICU is supportive in nature and uses the same techniques employed for the non-pregnant patient. However, the goals are different as it is important to monitor fetal heart rate (FHR) in pregnant woman as this does not only reflect the fetal well-being but also the maternal condition. This case report is intended to show the importance of mechanical ventilation goal and FHR monitoring in pregnant patients in ICU.","PeriodicalId":30635,"journal":{"name":"Jurnal Anestesi Perioperatif","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42568850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketepatan dan Kecukupan Profilaksis Venous Thromboembolism berdasar Pedoman American College of Chest Physicians di Ruang Rawat Intensif Rumah Sakit DR. Hasan Sadikin Bandung Periode Januari–Desember 2016","authors":"Tirto Hartono, Ezra Oktaliansah, Ardi Zulfariansyah","doi":"10.15851/jap.v7n2.1739","DOIUrl":"https://doi.org/10.15851/jap.v7n2.1739","url":null,"abstract":"Pasien sakit kritis adalah pasien dengan kondisi mengancam nyawa yang membutuhkan penanganan khusus di ruang rawat intensif (intensive care unit; ICU). Hampir semua pasien kritis yang dirawat di ICU memiliki beberapa faktor risiko yang meningkatkan venous thromboembolism (VTE). Venous thromboembolism merupakan komplikasi yang tersembunyi pada pasien sakit kritis yang dapat meningkatkan angka morbiditas dan mortalitas. Venous thromboembolism dapat dicegah dengan tromboprofilaksis yang sesuai dan adekuat. Pedoman pencegahan VTE dikembangkan dalam beberapa dekade salah satunya oleh American College of Chest Physicians (ACCP). Tujuan penelitian ini mengetahui kepatuhan berdasar ketepatan dan kecukupan pemberian tromboprofilaksis terhadap pedoman ACCP. Penelitian deskiripsi observasional retrospektif dilakukan pada Oktober–Desember 2018 terhadap 284 pasien yang dirawat di Unit Perawatan Intensif Rumah Sakit Dr. Hasan Sadikin Bandung periode Januari–Desember 2016. Secara keseluruhan proporsi pasien di ICU yang mendapatkan tromboprofilaksis, yaitu 36,1%. Angka kepatuhan pemberian profilaksis VTE di ICU berdasar pedoman ACCP adalah 21,5%. Pemberian profilaksis VTE yang tidak adekuat terdapat pada 12,4% pasien, sedangkan pemberian profilaksis yang tidak sesuai terdapat pada 2,2% pasien. Simpulan, kepatuhan pemberian tromboprofilaksis terhadap pedoman yang diterbitkan ACCP masih rendah. Adequacy and Accuracy of Venous Thromboembolism Prophylaxis based on American College of Chest Physicians Guideline at Intensive Care Unit of Dr. Hasan Sadikin General Hospital BandungCritically ill patients are patients with life-threatening conditions that require special treatment in the intensive care unit. Almost all critical patients admitted to the ICU have several risk factors that increase the occurrence of Venous thromboembolism (VTE). Venous thromboembolism is a hidden complication in critically ill patients that can increase morbidity and mortality. Venous thromboembolism can be prevented with appropriate and adequate thromboprophylaxis. Several thromboprophylaxis guidelines have been developed during the last decades, including the American College of Chest Physicians (ACCP) guideline. The purpose of this study was to determine the compliance to ACCP guideline by measuring the the accuracy and adequacy of thromboprophylaxis. This retrospective observational descriptive study was conducted from October–December 2018 on 284 patients treated in the Intensive Care Unit of Dr. Hasan Sadikin General Hospital Bandung. The overall proportion of patients in ICU who received thromboprophylaxis was 36.1%. The compliance rate of VTE prophylaxis in ICU based on ACCP guideline was 21.5%. Inadequate VTE prophylaxis was seen in 12.4% of patients while inappropriate prophylaxis was identified in 2.2% of patients. Hence, the compliance to standards on thromboprophylaxis based on the ACCP guideline is still low in this hospital. ","PeriodicalId":30635,"journal":{"name":"Jurnal Anestesi Perioperatif","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46237743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perbandingan Angka Keberhasilan Intubasi dan Waktu Intubasi antara Menggunakan Bougie dan Purwarupa Camera–Bougie pada Maneken Simulasi Kesulitan Intubasi","authors":"Gavrila Diva Amelis, Dhany Budipratama, Ezra Oktaliansah","doi":"10.15851/JAP.V7N1.1585","DOIUrl":"https://doi.org/10.15851/JAP.V7N1.1585","url":null,"abstract":"Penatalaksanaan jalan napas merupakan hal fundamental bagi ahli anestesi. Kegagalan penatalaksanaan jalan napas mengakibatkan kematian. Berbagai modalitas tersedia untuk penatalaksanaan jalan napas  sulit, mulai dari alat sederhana seperti stylet dan bougie hingga alat canggih seperti video laryngsocope dan fiberoptic. Fiberoptik masih menjadi standar baku kesulitan intubasi, namun penggunaannya masih terbatas karena harganya mahal dan penggunaannya sulit. Purwarupa camera–bougie  merupakan modalitas baru yang diharapkan dapat mengatasi keterbatasan tersebut dan menjembatani antara bougie yang sederhana dan fiberoptik yang sangat canggih. Tujuan penelitian adalah membandingkan angka keberhasilan intubasi dan waktu intubasi antara bougie dan purwarupa camera–bougie pada maneken simulasi kesulitan intubasi di RSUP Dr. Hasan Sadikin Bandung. Penelitian analitik eksperimental ini dilakukan pada 41 peserta didik Program Pendidikan Dokter Spesialis (PPDS) Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadaran/RSUP Dr. Hasan Sadikin Bandung semester 5 sampai dengan 11 yang melakukan intubasi dengan bougie dan purwarupa camera–bougie secara bergantian dengan metode randomisasi permutasi blok pada maneken simulasi kesulitan intubasi. Penelitian dilakukan dari tanggal 16–24 Oktober 2018. Keberhasilan dan waktu intubasi dicatat dan dianalisis secara statistik dengan Uji Mc. Nemar dan Wilcoxon. Keberhasilan intubasi dengan bougie sebesar 39% dan purwarupa camera-bougie 100% (p<0,001). Waktu intubasi dengan  bougie dan purwarupa camera-bougie sebesar 18,81 (12,19) detik dan  7,0 (1,47) detik (p<0,001). Simpulan, purwarupa camera–bougie meningkatkan keberhasilan intubasi dan memperpendek waktu intubasi pada maneken simulasi kesulitan intubasi.Comparison of Success Rate and Duration of Intubation between Bougie and Bougie–Camera Prototype in Simulated Difficult Airway ManikinAirway management is fundamental for anesthesiologist. Fiberoptic is still the gold standard for difficult intubation but its expensive price and complicated handling limit its use. Bougie–camera prototype is one of the new modalities that is expected to overcome these limitations and bridge the gap between simple bougie and very sophisticated fiberoptic. The aim of this study was to compare the success rate and duration of intubation between bougie and bougie–camera prototype in simulated difficult airway manikin at Dr. Hasan Sadikin General Hospital Bandung. This experimental analytic study was conducted on 41 fifth semester anesthesiology residents of the Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital who performed intubation with bougie and bougie–camera prototype alternately on  simulated difficult airway mannequin using permutation block randomization method. This study was held during the period of 16–24th of October 2018. The success rate and duration of intubation were recorded and analyzed statistically by Mc. Nemar and Wilcox","PeriodicalId":30635,"journal":{"name":"Jurnal Anestesi Perioperatif","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44433950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}