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"Kanker kolon merupakan jenis kanker ketiga terbanyak di dunia. Salah satu penatalaksanaan kanker kolon adalah dengan cara terapi pembedahan hemikolektomi yang memiliki risiko komplikasi berupa pelambatan pemulihan pasca bedah. Karya ilmiah ini bertujuan untuk menganalisis asuhan keperawatan perioperatif yang diberikan pada pasien dengan risiko pelambatan pemuliha pembedahan yang akan menjalani hemikolektomi kanan. Intervensi yang diberikan berupa pengkajian dan monitoring, edukasi perioperative, latihan relaksasi napas dalam, latihan batuk efektif, dan mobilisasi dini pasca operasi. Hasil evaluasi dari implementasi keperawatan menunjukan intervensi yang telah dilakukan secara mandiri dan kolaboratif dapat mencegah pelambatan pemulihan pembedahan. Kata kunci: batuk efektif, edukasi preoperative, mobilisasi dini, napas dalam, pemantauan

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Colon cancer is the third type of cancer in the world. One of the management of colon cancer is by way of hemicolectomy surgery therapy which has the risk of complication in the form of post surgical recovery slowing. This paper aims to analyze perioperative nursing care given to patients at risk of delayed recovery of surgery who will undergo right hemicolectomy. Interventions include review and monitoring, perioperative education, deep breathing relaxation exercises, effective cough exercises, and early mobilization . The results of the evaluation of nursing implementation show that interventions that have been done independently and collaboratively can prevent the delayed recovery of surgery. Keywords: effective cough, preoperative education, early mobilization, deep breathing, monitoring "

"Kolelitiasis adalah masalah kesehatan yang mulai marak ditemukan di kota besar disebabkan oleh meningkatnya konsumsi makanan tinggi lemak oleh masyarakat urban. Salah satu penatalaksanaan bedah pasien kolelitiasis adalah laparoskopi kolesistektomi. Karya Ilmiah Akhir Ners ini bertujuan untuk memberikan gambaran asuhan keperawatan pasien kolelitiasis post laparoskopi kolesistektomi dengan menerapkan intervensi keperawatan mobilisasi dini untuk menangani risiko pemulihan operasi yang tertunda dengan faktor risiko nyeri. Mobilisasi dini dilakukan selama tiga hari dengan hasil nyeri berkurang dan tidak terjadi penundaan pemulihan operasi. Mobilisasi dini dilakukan saat pasien sadar penuh, hemodinamik stabil, bertahap dan dalam batas toleransi pasien. Perawat diharapkan dapat menerapkan mobilisasi dini untuk mencegah pemulihan operasi yang tertunda.

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Cholelithiasis is a health problem that famously found in urban cities due to increased consumption of high fat foods by urban communities. Surgical management for patients with Cholelithiasis is laparoscopic cholecystectomy. The aims of this study is to provide an overview of nursing care plan for patient with cholelithiasis post laparoscopic cholecystectomy by performing early mobilization to prevent risk for delayed surgical recovery with pain risk factor. Early mobilization was performed for three days resulting decreased pain. Early mobilization is performed when the patient is fully conscious, hemodynamically stable, gradual and within the limits of patient tolerance. Nurses are expected to perform early mobilization to prevent delayed surgical recovery."

"Latar belakang. Hipertensi pulmonal merupakan salah satu komplikasi jangka panjang pada stenosis mitral, dan meningkatkan morbiditas serta mortalitas. Peningkatan resistensi vaskular paru terjadi pada fase reaktif hipertensi pulmonal akibat stenosis mitral. Pada hipertensi pulmonal terjadi gangguan keseimbangan sistem otonom, yang berpengaruh pada perubahan laju jantung saat uji latih. Laju jantung pemulihan dihitung dari selisih laju jantung maksimal saat uji latih dengan laju jantung menit pertama fase pemulihan dipengaruhi oleh reaktivasi sistem parasimpatis saat akhir latihan, dan merupakan prediktor mortalitas jangka panjang. Metode. Penelitian ini dilakukan pada 20 pasien stenosis mitral bermakna dengan hipertensi pulmonal yang menjalani pembedahan katup mitral di Pusat Jantung Nasional Harapan Kita dari bulan Agustus hingga November 2014. Dilakukan pengukuran resistensi vaskular paru sebelum operasi dan sebelum pasien dipulangkan. Laju jantung pemulihan diambil dari uji treadmil pada akhir program rehabilitasi kardiak fase 2. Dilakukan analisa statistik untuk mencari hubungan antara resistensi vaskular paru dengan laju jantung pemulihan saat latihan pasca operasi katup mitral. Hasil. Laju jantung pemulihan yang diukur pada menit pertama fase pemulihan uji treadmill adalah 11,5 + 5,9 kali per menit, dan perubahan resistensi vaskular paru pre dan paska operasi sebesar 1,55 + 2,1 WU. Laju jantung pemulihan menit pertama memiliki korelasi sedang dengan perubahan resistensi vaskular paru (r 0,537; p 0,015) . Analisa regresi linier laju jantung pemulihan menit pertama dengan perubahan resistensi vaskular paru pre dan paska operasi mendapatkan nilai koefisien β 1,52 dengan IK 95% 0,338-2,706 dengan nilai p 0,015. Analisa bivariat menyimpulkan bahwa digoxin merupakan variabel perancu (p 0,048). Analisa regresi linier antara perubahanresistensi vaskular paru pasca operasidengan laju jantung pemulihan menit pertama(adjusted analysis sesuai variable perancu)menunjukkan nilai koefisien β 1,244 dengan IK 95% 0,032-2,457 dengan nilai p 0,045. Kesimpulan. Perubahan resistensi vaskular paru pada pasien stenosis mitral dengan hipertensi pulmonal yang menjalani pembedahan berhubungan dengan laju jantung pemulihan menit pertama saat uji latih jantung.

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Background. Pulmonary hypertension is one of the long-term complication of mitral stenosis, resulting increase of morbidity and mortality. Pulmonary vascular resistance (PVR) is increase in reactive phase of pulmonary hypertension due to mitral stenosis. There is impaired autonom regulation following pulmonary hypertension, affecting heart rate changes during exercise test. Heart rate recovery (HRR) is defined as the difference between heart rate at peak exercise and 1 minute of recovery phase. It is affected by reactivation of parasympathetic system after cessation of exercise, and has been known as a long-term mortality predictor.

Method. A study of 20 patients with significant mitral stenosis with pulmonary hypertension who underwent mitral valve surgery in National Cardiovascular Center Harapan Kita was done from August to November 2014. PVR data from echocardiography was measured before surgery and before the patients were discharged. HRR data was taken from the treadmill test at the end of phase 2 cardiac rehabilitation program. Statistical analysis is done to explore the correlation between pulmonary vascular resistance and heart rate recovery after exercise test.

Result. Mean heart rate recovery after exercise test is 11,5 + 5,9 beat perminute, and changes of pulmonary vascular resistance after surgery is 1,55+2,1 WU. There was a correlation between change of PVR and heart rate recovery (r 0,537; p 0,015). Linear regression analysis of the change of PVR and heart rate recovery (unadjusted analysis) showed β coefficient 1,52 with 95% confidence interval 0,338-2,706 and p 0,015. Adjusted analysis to confounding variabel showed β coefficient 1,244 with 95% CI 0,032-2,457 and p 0,045.

Conclusion. Changes of pulmonary vascular resistance after mitral valve surgery in mitral stenosis pastient is positively correlated with heart rate recovery during exercise test."

"Latar Belakang: Pasien yang menjalani bedah katup mitral cenderung mengalami penurunan fungsi ventrikel kanan Vka pasca pembedahan katup. Disfungsi Vka pasca pembedahan katup dapat menetap ataupun mengalami perbaikan di kemudian hari. Banyak faktor yang dapat mempengaruhi perbaikan fungsi Vka pasca operasi. Namun, belum ada studi yang menilai faktor-faktor yang dapat menjadi prediktor perbaikan fungsi Vka pasca operasi katup mitral dalam suatu studi multivariat.Tujuan: Mengidentifikasi faktor-faktor apa saja yang dapat menjadi prediktor perbaikan fungsi Vka pada pasien dengan penyakit katup mitral yang mengalami disfungsi Vka segera setelah pembedahan katup mitral.Metode: Penelitian ini merupakan studi kohort retrospektif yang dilakukan di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita RSJPDHK . Subjek penelitian adalah pasien yang menjalani operasi katup mitral di RSJPDHK sejak Januari 2016 sampai dengan Februari 2017. Data yang diambil yakni karakteristik dasar, data operasi, data obat-obatan pasca operasi, pemeriksaan ekokardiografi sebelum, segera sebelum lepas rawat, dan enam bulan pasca operasi.Hasil penelitian: Sebanyak 100 subjek yang dinilai pada penelitian ini. Terdapat 68 68 subjek yang mengalami kenaikan fungsi Vka, dan 32 subjek 32 yang tidak. Median TAPSE sebelum lepas rawat meningkat secara signifikan enam bulan pasca operasi dari 1,1 0,6-1,5 menjadi 1,4 0,7-2,8 dengan nilai p

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Background In patients undergoing mitral valve surgery, right ventricular function may decline immediately after the surgical procedure. This condition may sometimes remain, but may also improve later on. Many factors have been proposed to account for this phenomenon. As of yet, there are no studies using multivariate analysis to investigate factors that may be predictors of right ventricular function improvement after mitral surgery.

Objective This study aims to identify factors that may be predictors of right ventricular function improvement in patients with right ventricular dysfunction following mitral valve surgery.

Methods This is a retrospective cohort study, taking place at National Cardiovascular Center Harapan Kita NCCHK , Jakarta, Indonesia. Subjects are patients who underwent mitral valve surgery between January 2016 until February 2017. Data taken include basic characteristics, surgical data, drugs prescribed after surgery, and echocardiography data before surgery, predischarge, and six months after surgery.

Results There are 100 subjects who fulfilled the criteria to participate in this study. There are 68 68 cases of right ventricular function improvement and 32 32 cases without improvement. The median of predischarge TAPSE increases significantly six months after surgery, from 1,1 0,6 1,5 to 1,4 0,7 2,8 with p value."

"Komplikasi perioperatif yang dapat terjadi pada pasien pembedahan tulang belakang adalah infeksi, perdarahan, kerusakan saraf dan masalah yang terkait dengan anestesi. Pemanjangan waktu pulih sadar adalah kejadian yang tidak diharapkan dalam anestesi. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang mempengaruhi waktu pulih sadar pada pasien pasca pembedahan tulang belakang. Desain penelitian prospektif kohort digunakan untuk meneliti faktor yang berpengaruh pada variabel independen (usia, suhu tubuh, IMT, status fisik pra anestesi (ASA), nilai MAP, jumlah produksi urin, jumlah perdarahan, lama pembedahan) terhadap variabel dependen waktu pulih sadar. Penelitian ini dilakukan pada 91 responden yang dilakukan prosedur pembedahan tulang belakang dengan general anestesi dan menggunakan obat reversal blokade neuromuskular. Pengumpulan data dilakukan dengan melakukan observasi di ruang pembedahan. Analisa data menggunakan uji regresi linier berganda untuk mengetahui faktor yang paling dominan dari variabel tersebut. Hasil penelitian menunjukkan bahwa variabel independen (ASA, perdarahan, suhu intra pembedahan) memberikan pengaruh sebesar 11,1% terhadap waktu pulih sadar dengan CI 95%. Variabel ASA memiliki nilai prediktor sebesar 60,53%, variabel perdarahan memiliki nilai prediktor sebesar 32,04%, dan variabel suhu intra pembedahan memiliki nilai prediktor sebesar 11,26% terhadap waktu pulih sadar pasien setelah dikontrol oleh variabel lain. Faktor yang paling berpengaruh terhadap waktu pulih sadar pasien pasca pembedahan tulang belakang adalah ASA, faktor perdarahan dan suhu tubuh pasien setelah dikontrol oleh faktor lain

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Perioperative complications in spinal surgery are infection, bleeding, nerve damage and problems related to anesthesia. Prolonged recovery time is an unexpected event in anaesthesia. This study aimed to analyze the factors that affect the recovery time in patients after spinal surgery. Cohort prospective study design was used to examine the factors that influence the independent variables (age, body temperature, BMI, pre-anesthesia physical status (ASA), MAP value, amount of urine production, amount of bleeding, duration of surgery) on the dependent variable recovery time. The total of respondents was 91 people who underwent spinal surgery procedures with general anesthesia and used neuromuscular blockade reversal drugs. The data were collecting by observing the respondents in the operating room. Data analysis used multiple linear regression to determine the most dominant factor of these variables. The results showed that the independent variables (ASA, bleeding, intraoperative temperature) had an effect of 11.1% on time to recover with a 95% CI, the ASA variable had a predictor value of 60.53%, the bleeding variable had a predictor value of 32, 04%, and the intraoperative temperature variable has a predictor value of 11.26% on the patient's recovery time after being controlled by other variables. The most influence factor of patient's recovery time after spinal surgery are ASA, bleeding factors and the patient's body temperature after being controlled by other factors"

"[ABSTRAKLatar Belakang : Kejadian mortalitas dan MACE merupakan komplikasi pasca PCI yang seringkali terjadi. Kemampuan ahli dalam memprediksi komplikasi dengan cara melakukan stratifikasi risiko menggunakan skor risiko. New Mayo Clinic Risk Score (NMCRS) menggunakan tujuh variabel yang mudah didapatkan pada data awal pasien dan memiliki performa yang baik. Belum ada studi untuk karakteristik mortalitas dan MACE pada NMCRS di ICCU RSCM.Tujuan : mengetahui insidens mortalitas dan MACE serta karakteristik NMCRS pada pasien pasca PCI selama perawatan di ICCU RSCM.Metode : Penelitian dengan desain kohort retrospektif terhadap 313 pasien SKA pasca PCI di ICCU RSCM, dalam kurun waktu 1 Agustus 2013? 31 Agustus 2014. Data pasien dari rekam medis dimasukkan ke dalam tujuh variabel skor NMCRS kemudian ditentukan hasil setiap kategori risiko.Hasil : Insidens mortalitas pasien pasca PCI selama perawatan 3,8% (IK 95% 2,6;5) dan MACE pasca PCI selama perawatan 8,3% (IK 95% 6,6;10). Pasien-pasien dengan usia yang semakin tua, fraksi ejeksi ventrikel kiri yang rendah, infark miokard, kreatinin serum yang meningkat, adanya syok kardiogenik pra prosedur, dan adanya penyakit arteri perifer memiliki kejadian mortalitas dan MACE yang lebih tinggi pasca PCI. Skor NMCRS untuk mortalitas menunjukkan kategori risiko sangat rendah 167 pasien (53%), risiko rendah 60 pasien (19%), sedang 47 pasien (15%), tinggi 10 pasien (3%) dan risiko sangat tinggi 29 pasien (9%). Kejadian mortalitas pada kategori risiko sangat rendah 2 kasus (1,2%), rendah 0 pasien, sedang 2 pasien (4,25%), tinggi 1 pasien (10%) dan sangat tinggi 7 kasus (24,13%). Skor NMCRS untuk MACE memberikan hasil kategori sangat rendah 101 pasien (32%), risiko rendah 128 pasien (41%), sedang 52 pasien (17%), tinggi 16 pasien (5%) dan sangat tinggi 16 kasus (5%). Kejadian MACE untuk risiko sangat rendah sebanyak 4 kasus (3,96%), rendah 7 pasien (5,46%), sedang 4 pasien (7,69%), tinggi 5 pasien (31,25%) dan risiko sangat tinggi 6 kasus (37,5%).Kesimpulan : insidens mortalitas pasien pasca PCI selama perawatan 3,8% (IK 95% 2,6;5) dan MACE pasca PCI selama perawatan 8,3% (IK 95% 6,6;10). Kenaikan skor NMCRS maka akan diiringi peningkatan kejadian mortalitas dan MACE pasca PCI.

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ABSTRACTBackground : Mortality and MACE was an often complication post PCI. Capability from an expert in predict complication by doing risk stratification using risk score. New Mayo Clinic Risk Score (NMCRS) using seven variables easy to collect from medical record and had a good performance. No report about mortality and MACE studies NMCRS characteristic for post PCI patients in ICCU RSCM.Objective : To obtain mortality and MACE incidence and also NMCRS characteristic on post PCI patients in ICCU RSCM.Methods : A retrospective cohort study was conducted to evaluate 313 post PCI patients in ICCU RSCM between August 1st 2013 and August 31 2014. Patients data from medical records collect for seven variables and determined category results for each risk category.Results : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and inhospital MACE post PCI 8,3% (CI 95% 6,6-10). Patients that getting older, lower left ventricular ejection fraction, increase serum creatinine, pre-procedure cardiogenic shock, myocardial infarct and peripheral arterial disease had higher mortality and MACE post PCI. NMCRS in predict risk of mortalitas shown for very low risk 167 patient (53%), low risk 60 patient (19%), moderate risk 47 patient (15%), high risk 10 patient (3%) and very high risk 29 patient (9%). Mortality in very low risk 2 patient (1,2%), low risk no patient, moderate 2 patient (4,25%), high 1 patient (10%) and very high risk 7 patient (24,13%). NMCRS in predict MACE shown for very low risk 101 patient (32%), low risk 128 patient (41%), moderate 52 patient (17%), high 16 patient (5%) very high risk 16 patient (5%). MACE in very low risk 4 patient (3,96%), low risk 7 patient (5,46%), moderate risk 4 patient (7,69%), high risk 5 patient (31,25%) and very high risk 6 patient (37,5%).Conclusion : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and in-hospital MACE post PCI incidence 8,3% (CI 95% 6,6;10). The increase of NMCRS score was also followed with the increase of mortality and MACE post PCI.;Background : Mortality and MACE was an often complication post PCI. Capability from an expert in predict complication by doing risk stratification using risk score. New Mayo Clinic Risk Score (NMCRS) using seven variables easy to collect from medical record and had a good performance. No report about mortality and MACE studies NMCRS characteristic for post PCI patients in ICCU RSCM.Objective : To obtain mortality and MACE incidence and also NMCRS characteristic on post PCI patients in ICCU RSCM.Methods : A retrospective cohort study was conducted to evaluate 313 post PCI patients in ICCU RSCM between August 1st 2013 and August 31 2014. Patients data from medical records collect for seven variables and determined category results for each risk category.Results : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and inhospital MACE post PCI 8,3% (CI 95% 6,6-10). Patients that getting older, lower left ventricular ejection fraction, increase serum creatinine, pre-procedure cardiogenic shock, myocardial infarct and peripheral arterial disease had higher mortality and MACE post PCI. NMCRS in predict risk of mortalitas shown for very low risk 167 patient (53%), low risk 60 patient (19%), moderate risk 47 patient (15%), high risk 10 patient (3%) and very high risk 29 patient (9%). Mortality in very low risk 2 patient (1,2%), low risk no patient, moderate 2 patient (4,25%), high 1 patient (10%) and very high risk 7 patient (24,13%). NMCRS in predict MACE shown for very low risk 101 patient (32%), low risk 128 patient (41%), moderate 52 patient (17%), high 16 patient (5%) very high risk 16 patient (5%). MACE in very low risk 4 patient (3,96%), low risk 7 patient (5,46%), moderate risk 4 patient (7,69%), high risk 5 patient (31,25%) and very high risk 6 patient (37,5%).Conclusion : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and in-hospital MACE post PCI incidence 8,3% (CI 95% 6,6;10). The increase of NMCRS score was also followed with the increase of mortality and MACE post PCI., Background : Mortality and MACE was an often complication post PCI. Capability from an expert in predict complication by doing risk stratification using risk score. New Mayo Clinic Risk Score (NMCRS) using seven variables easy to collect from medical record and had a good performance. No report about mortality and MACE studies NMCRS characteristic for post PCI patients in ICCU RSCM.Objective : To obtain mortality and MACE incidence and also NMCRS characteristic on post PCI patients in ICCU RSCM.Methods : A retrospective cohort study was conducted to evaluate 313 post PCI patients in ICCU RSCM between August 1st 2013 and August 31 2014. Patients data from medical records collect for seven variables and determined category results for each risk category.Results : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and inhospital MACE post PCI 8,3% (CI 95% 6,6-10). Patients that getting older, lower left ventricular ejection fraction, increase serum creatinine, pre-procedure cardiogenic shock, myocardial infarct and peripheral arterial disease had higher mortality and MACE post PCI. NMCRS in predict risk of mortalitas shown for very low risk 167 patient (53%), low risk 60 patient (19%), moderate risk 47 patient (15%), high risk 10 patient (3%) and very high risk 29 patient (9%). Mortality in very low risk 2 patient (1,2%), low risk no patient, moderate 2 patient (4,25%), high 1 patient (10%) and very high risk 7 patient (24,13%). NMCRS in predict MACE shown for very low risk 101 patient (32%), low risk 128 patient (41%), moderate 52 patient (17%), high 16 patient (5%) very high risk 16 patient (5%). MACE in very low risk 4 patient (3,96%), low risk 7 patient (5,46%), moderate risk 4 patient (7,69%), high risk 5 patient (31,25%) and very high risk 6 patient (37,5%).Conclusion : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and in-hospital MACE post PCI incidence 8,3% (CI 95% 6,6;10). The increase of NMCRS score was also followed with the increase of mortality and MACE post PCI.]"

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Latar Belakang : Malnutrisi sering ditemukan pada pasien kanker ovarium dengan prevalensi 67% dan dapat memperburuk luaran pasien. Tujuan penelitian ini untuk mengetahui prevalensi malnutrisi dan hubungan antara malnutrisi dengan lama rawat inap dan faktor pembedahan pada pasien kanker ovarium yang menjalani prosedur tersebut di RSUPN Cipto Mangunkusumo, Jakarta.

Metode : Penelitian analitik observational dengan desain potong lintang pada 59 pasien yang menjalani pembedahan selama bulan Juli 2018-Maret 2019. Status malnutrisi dinilai dengan metode Patient-Generated Subjective Global Assessment dan faktor pembedahan yang dinilai mencakup durasi pembedahan, besar tumor, dan perdarahan selama pembedahan.

Hasil : Prevalensi malnutrisi pasien kanker ovarium 78% dengan malnutrisi sedang 42,4% dan malnutrisi berat 35,6%. Rerata lama rawat inap 8 hari dan setelah dilakukan analisis didapatkan hubungan yang bermakna antara status malnutrisi dengan lama rawat inap, besar tumor, dan perdarahan selama pembedahan.

Kesimpulan : Prevalensi malnutrisi pada pasien kanker ovarium cukup tinggi dan dapat memperpanjang lama rawat inap dan meningkatkan jumlah perdarahan saat pembedahan.

Kata kunci:

Kanker ovarium, malnutrisi, lama rawat inap, faktor pembedahan.

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Introduction : Malnutrition could be easily found in ovarian cancer with prevalence 67% and responsible for patient’s outcome worsening. The objective of this study was to identify malnutrition prevalence and correlation between malnutrition status and length of stay and surgical factors in ovarian cancer patients undergo surgery at National Hospital Cipto Mangunkusumo, Jakarta.

Method: A cross sectional study conducted with 59 patients undergo surgery during July 2018-March 2019. The nutritional status was classified as well-nourished and moderate/severe malnutrition, according to the Patient-Generated Subjective Global Assessment and surgery factors including length of surgery, size of tumor, and blood loss during surgery.

Results: The prevalence of malnutrition was 78%, being classified as moderate in 42,4% and severe in 35,6%. Median of length of stay was 8 days. After statistical analysis, malnutrition was associated with length of stay , size of tumor, and blood loss during surgery.

Conclusion: There was observed a high prevalence of malnutrition in ovarian cancer and could lengthen length of stay and increase blood loss during surgery.

Keywords:

Ovarian cancer, malnutrition, length of stay, surgical factor.

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"Penyakit kongenital atau kelainan bawaan pada anak dan neonatus merupakan urutan kelima penyebab kematian di dunia pada anak dan neonatus. Pada tahun 2015 ada sekitar 303 ribu bayi baru lahir meninggal dunia dalam waktu 4 minggu setelah kelahiran setiap tahun, di seluruh dunia karena kelainan bawaan. Polusi udara serta ketidakadekuatan nutrisi pada masa kehamilan menjadi salah satu penyebab terjadinya kelainan bawaan. Tatalaksana pada kelainan bawaan salah satunya adalah dengan prosedur pembedahan. Jenis pembedahan yang sering dilakukan pada anak adalah pembedahan gastrointestinal. Pembedahan memiliki banyak risiko, diantaranya mual muntah pasca bedah. Mual muntah pasca bedah pada anak merupakan masalah yang dapat menimbulkan kecemasan pada orang tua serta dapat mengakibatkan dehidrasi dan lamanya masa pemulihan. Terapi musik merupakan salah satu tindakan yang dapat dilakukan untuk mengatasi mual muntah pasca bedah pada anak. Terapi musik efektif dapat menurunkan mual muntah dan kebutuhsn terhadap antiemetik pada anak pasca bedah. Hasil pemberian terapi musik pada pasien anak pasca bedah berupa penurunan terhadap keluhan mual muntah dan peningkatan perasaan rileks pada anak. Oleh karena itu penanganan mual muntah pasca bedah pada anak perlu disertai dengan pemberian terapi musik sebagai terapi non farmakologis sebagai teknik distraksi dari ketidaknyaman fisik akibat mual muntah.

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Congenital disease or congenital abnormalities in children and neonates is the fifth cause of death in the world in children and neonates. In 2015 there were around 303,000 newborns died within 4 weeks of birth each year, worldwide due to congenital abnormalities. Air pollution and nutrient insufficiency during pregnancy are among the causes of congenital abnormalities. Management of congenital abnormalities is one of them is a surgical procedure. The type of surgery that is often done in children is gastrointestinal surgery. Surgery has many risks, including postoperative nausea and vomiting. Postoperative vomiting in children is a problem that can cause anxiety in the elderly and can lead to dehydration and the length of the recovery period. Music therapy is one of the actions that can be done to overcome postoperative nausea and vomiting in children. Effective music therapy can reduce vomiting nausea and the need for antiementics in postoperative children. The results of the provision of music therapy in postoperative pediatric patients in the form of a decrease in complaints of nausea vomiting and increased feelings of relaxation in children. Therefore handling postoperative vomiting in children needs to be accompanied by the provision of music therapy as non-pharmacological therapy as a distraction technique from physical discomfort due to nausea and vomiting."