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Mohamad Rachadian Ramadan
Uji klinis perbandingan suntikan pada jari dengan beberapa kombinasi semprit dan jarum terhadap rasa nyeri = A trial comparing pain during local injection in fingers using different syringe-needle combination
Depok: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Tugas Akhir  Universitas Indonesia Library
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Prasasta Adhistana
Perangkat injeksi gaya dan tekanan : Sebuah studi perbandingan antara spuit dan jarum suntik yang digunakan untuk penyuntikan larutan tumescent pada anestesi lokal untuk operasi tangan dan jari = Injection kit force and pressure : A comparison of the syringes and needles in local anesthesia tumescent injection technique in hand and digits surgery
"LATAR BELAKANG : Manajemen cidera dan penyakit pada tangan membutuhkan intervensi bedah dan non-bedah yang baik dan teliti untuk mencapai restorasi anatomi dan fungsional yang optimal. Saat ini penggunaan tourniquet kimia dengan epinephrin mulai mengantikan touniquet udara untuk operasi tangan sadar penuh menggunakan infiltrasi lokal ke tempat pembedahan sebagai metode dari pembiusan lokal. Berbagai jenis spuit dan jarum dapat digunakan untuk infiltrasi bius lokal. Untuk mengeluarkan larutan dari spuit ke jaringan membutuhkan gaya yang spesisfik. Ada 2 jenis gaya yg digunakan untuk mengeluarkan larutan dari spuit: (1) untuk gerakan awal dari piston (PBF: plunger-stopper break loose force), (2) gaya untuk mempertahankan laju piston (DGF: dynamic gliding force). Kedua gaya tersebut dipengaruhi oleh diameter spuit dan jarum, dan juga viskositas larutan. Tujuan dari studi ini untuk memberikan kombinasi yang terbaik antara spuit dan jarum suntik yang membutuhkan tenaga yang minimal untuk mengeluarkan larutan dari spuit.
METODE : Untuk menjelaskan aspek fisik dan mekanik mengenai gaya yang dibutuhkan untuk infiltrasi bius lokal pada kombinasi spuit dan jarum, kami mengunakan spuit 1cc, 3cc, 5cc, 10cc dan 20cc serta jarum suntik asli dari kemasan, jarum 27-Gauge, jarum spinal 27-Gauge, dan jarum 30-Gauge. Setiap kombinasi spuit dan jarum dilakukan sebanyak 3 kali. Kami telah melakukan total 60 tes pada kombinasi spuit dan jarum. Tes dilakukan dengan menggunakan mesin Instron 5940 dengan kecepatan 100mm/menit.
HASIL : Nilai PBF terdendah didapatkan pada kombinasi spuit 1cc dengan jarum 27-Gauge; nilai PBF tertinggi didapatkan pada kombinasi spuit 10cc dengan jarum 30-Gauge. Nilai DGF terendah didapatkan pada kombinbasi spuit 1cc dengan jarum pada kemasannya; nilai DGF tertinggi didapatkan pada kombinasi spuit 20cc dengan jarum 27-Gauge needle. Kombinasi spuit 20cc dengan jarum 27-Gauge membutukan gaya sebesar 25,33 N untuk PBF dan 113,367 N buat DGF. Gaya ini 33x lebih tinggi untuk PBF dan 324x lebih tinggi untuk DGF pada spuit 1cc. Ketika kita menggunakan spuit 3cc dengan jarum27-Gauge, makan akan membutuhkan gaya 5,8x lebih inggi pada PBF dan 24,8x lebih tinggi pada DGF. Pada spuit 5ccdenga kombinasi jarum 27-Gauge, perlu gaya 2,4 kali lebih tinggi pada PBF dan 5,8 kali lebih tinggi pada DGF. Untuk jarum suntik 10cc, maka akan membutuhkan gaya 5,8 lebih tinggi di PBF dan 2,6 lebih tinggi pada DGF.
SIMPULAN : Kombinasi terbaik dari spuit dan jarum suntik untuk memasukan larutan bius lokal adalah yang membutuhkan PBF dan DGF yang rendah yang terdapat pada spuit 1cc dan jarum yang berada pada kemasannya. Hal lain yang harus dipertimbangkan adalah kekuatan individual tangan dokter bedah untuk memenuhi beban fisiologis dan ergonomis bersama dengan gaya yang rendah untuk menjalankan operasi.
BACKGROUNDS : Management of hand injury or disease needs meticulous surgical intervention as well as tender loving non-surgical intervention to reach optimal goals which are anatomical restoration and good functional outcome. The application of chemical tourniquet using epinephrine has begun to replace the use of pneumatic tourniquet. Wide-awake hand surgery uses local infiltration to the surgical site as the method of anesthesia. Different types of syringe can be used to administer the tumescent solution. Injection of the tumescent solution in the syringe requires a specific force to eject the solution into the tissue. There are two types of power used in syringe: (1) for initial movement of the syringe?s piston which is known as plunger-stopper break loose force (PBF) and (2) the power to maintain the sustaining or the forward motion of the piston which is known as dynamic gliding force (DGF). Both of these forces are affected by the diameter of the needle and syringe, and also the viscosity of the tumescent solution as well. The purpose of this studyis to data for describing the best combination of syringe and needle which requires the least force.
METHODS : To elaborate the physical and mechanical aspect regarding the power and force in the combination of needle and syringe used for local anesthesia injection, we use 1cc, 3cc, 5cc, 10cc and 20cc syringe with original needle from packaging, 27-Gauge needle, 27-Gauge spinal needle, and 30-Gauge needle. We have performed 60 test of syringe and needle combination. Each combination was tested in triplet data using Instron 5940 Series testing systems, in 100mm/minute velocity.
RESULT : The lowest PBF value was performed by the combination of 1cc syringe and 27-Gauge Needle; and the highest PBF value was achieved by the combination of 10cc syringe and 30-Gauge Needle.The lowest DGF value was measured in the combination of 1cc syringe and original needle. And the highest DGF value was performed by the combination of 20cc syringe and 27-Gauge needle. The 20cc syringe needs 25.33 Newton for PBF and 113.367 Newton for DGF. These forces are 33 times higher for PBF and 324 times higher for DGF, if we use the 1 cc syringe. When we choose 3cc syringe and 27-Gauge needle, it will need 5,8 times higher in PBF and 24,8 times higher in DGF. Another option of syringe is 5cc syringe, that will need 2,4 times higher in PBF and 5.8 times higher in DGF. For 10cc syringe, it will need 5.8 higher in PBF and 2.6 higher in DGF.
CONCLUSIONS : The best combination of syringe and needle that required the least force (PBF and DGF) for hand and digit surgery are 1 cc syringe and original needle. Another thing to be considered is the individual power of the Surgeon?s hand to meet the physiologic and ergonomic burden along with the initial and maintenance force needed through the operations."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Bassett, Kathy B.
Local anesthesia for dental professionals
New Jersey: Pearson, 2015
617.867 6 BAS k
Buku Teks SO  Universitas Indonesia Library
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Niluh Archi Sri Ramandari
Perbandingan efektivitas injeksi subkonjungtiva bevacizumab dosis 5 mg dengan dosis 2.5 mg dalam menurunkan area neovaskularisasi kornea = Comparison of the effectiveness between 5 mg and 2.5 mg subconjunctival injection of bevacizumab in reducing corneal neovascularization.
"Penelitian ini bertujuan menilai dan membandingkan efektivitas injeksi subkonjungtiva bevacizumab dosis 5 mg dengan dosis 2.5 mg dalam menurunkan area neovaskularisasi kornea. Sampel adalah dua puluh empat pasien dengan neovaskularisasi kornea oleh karena berbagai etiologi. Pemeriksaan pada sampel dilakukan sebelum, satu minggu setelah injeksi dan empat minggu setelah injeksi yang meliputi penilaian area neovaskularisasi kornea dengan menggunakan image J analysis, pemeriksaan tajam penglihatan tanpa dan dengan koreksi, derajat kekeruhan kornea serta kadar vascular endothelial growth factor (VEGF) air mata. Pada satu minggu dan empat minggu paska injeksi perubahan area neovaskularisasi kornea pada dosis 5 mg (5.21% dan 5.37%) lebih besar dibandingkan dosis 2.5 mg (3.77% dan 4.13%). Hasil yang serupa juga didapatkan pada etiologi non-infeksi dan area neovaskularisasi kornea yang melibatkan lebih dari dua kuadran kornea. Pada keluaran sekunder yaitu tajam penglihatan, derajat kekeruhan kornea dan kadar VEGF air mata di kedua dosis cenderung stabil jika dibandingkan sebelum dan sesudah injeksi. Injeksi subkonjungtiva bevacizumab dosis 5 mg menurunkan area neovaskularisasi kornea lebih banyak dibandingkan dosis 2.5 mg terutama pada etiologi non-infeksi dan keterlibatan kuadran kornea yang meliputi lebih dari dua kuadran.
This study aim to assess and compare the effectiveness of subconjunctival bevacizumab injection 5 mg with 2.5 mg in decreasing the area of corneal neovascularization. Samples consist of twenty-four patients with corneal neovascularization due to various etiologies. The examinations were taken at each visit before injection, 1 week after injection and 4 weeks after injection . Changes in neovascularization evaluated by using image J analysis, visual acuity, density of corneal haziness and level of vascular endothelial growth factor (VEGF) in tears were documented every visit. At 1 week and 4 weeks after injection, changes of neovascularization were higher in 5 mg (5.21% and 5.37%) compare to 2.5 mg (3.77% and 4.13%). The same results were also found in non-infection patient and patient involving more than two quadrants cornea. All of the secondary outcomes showed a stable result before and after injection between the two injections dose. Subconjunctival bevacizumab injection 5 mg is more effective in decreasing corneal neovascularization compare to 2.5 mg especially in non-infection patient and patient involving more than two quadrants cornea. "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Tugas Akhir  Universitas Indonesia Library
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Marpaung, Madeline F.N.
Prediksi kesulitan penempatan jarum spinal berdasarkan gambaran radiologis dan penanda anatomis pada pasien bedah urologi = Predicting the difficulty of spinal needle insertion using radiological characteristics of the lumbar vertebrae and spinal bony landmarks in urologic patients
"[ABSTRAK
Latar belakang. Penyuntikan berulang pada prosedur anestesia spinal berkaitan dengan tingginya angka komplikasi dan ketidaknyamanan pasien. Sistem prediksi praoperatif yang akurat terhadap kemungkinan kesulitan penempatan jarum spinal dapat membantu mengurangi insiden penyuntikan berulang sehingga mengurangi risiko komplikasi terhadap pasien. Penelitian ini bertujuan untuk mengetahui ketepatan prediksi kesulitan penempatan jarum spinal berdasarkan gambaran radiologis dan penanda anatomis pada pasien bedah urologi.
Metode. Penelitian ini bersifat observasional analitik terhadap pasien bedah urologi yang menjalani anestesia spinal di Rumah Sakit Cipto Mangunkusumo pada bulan April sampai Mei 2015. Sebanyak 109 subyek diambil dengan metode consecutive sampling. Data pasien (usia, jenis kelamin, indeks massa tubuh, status fisik, gambaran radiologis vertebrae lumbal, dan kualitas penanda anatomis tulang belakang), jumlah penusukan kulit dan redireksi jarum spinal, serta angka kesulitan penempatan jarum spinal dicatat. Kesulitan penempatan jarum spinal ditentukan berdasarkan jumlah penusukan kulit dan redireksi jarum spinal. Variabel yang signifikan ditentukan melalui uji Pearson?s Chi-square dan uji Fisher, kemudian analisis multivariat dengan metode regresi logistik digunakan untuk melihat hubungan antara kesulitan penempatan jarum spinal dengan variabel-variabel yang signifikan.
Hasil. Faktor usia memiliki hubungan yang bermakna hanya pada analisis bivariat (p=0,028). Kualitas penanda anatomis dan gambaran radiologis vertebrae lumbal memiliki nilai prediksi terhadap kesulitan penempatan jarum spinal (p=0,000 dan p=0,006). Hasil uji kalibrasi menunjukkan kualitas prediksi yang baik. Dari uji diskriminasi didapatkan AUC sebesar 0,84 (IK 95% 0,751-0,929).
Simpulan. Kualitas penanda anatomis dan gambaran radiologis vertebrae lumbal mampu memprediksi kesulitan penempatan jarum spinal dengan tepat pada pasien bedah urologi. ABSTRACT Background. Multiple attempts at spinal puncture have been related to many complications and patient discomfort. Accurate preoperative prediction of spinal needle insertion difficulty would reduce the incidence of multiple puncture and minimize the complications consequently. This study was designed to determine the accuracy of lumbar vertebrae radiological characteristics and spinal bony landmark quality in predicting the difficulty of spinal needle insertion in patients undergoing urologic procedure.
Methods. This was an analytic observational study in urologic patients scheduled for spinal anesthesia at Cipto Mangunkusumo hospital between April and May 2015. A total of 109 subjects were included in the study by consecutive sampling. Patient data (age, sex, body mass index, physical status, radiological characteristics of the lumbar vertebrae, and quality of spinal bony landmark), number of skin puncture and needle redirection, and the prevalence of spinal needle insertion difficulty were recorded. The first skin puncture success and number of needle redirection were used to assess the difficulty. Significant variables were first determined by Pearson?s Chi-square and Fisher test, and then multivariate analysis using logistic regression method tested the association of the skin puncture success and number of needle redirection with the significant variables.
Results. Age was significant only in bivariate analysis (p=0,028). The quality of spinal bony landmark and the radiological characteristics of the lumbar vertebrae had predictive value on spinal needle insertion difficulty (p=0,000 and p=0,006 respectively). Calibration test showed that the prediction quality was good. The discrimination test resluted in AUC of 0,84 (CI 95% 0,751 to 0,929).
Conclusion. The quality of spinal bony landmark and the radiological characteristics of the lumbar vertebrae were accurate in predicting the difficulty of spinal needle insertion in patients undergoing urologic procedure. ;Background. Multiple attempts at spinal puncture have been related to many complications and patient discomfort. Accurate preoperative prediction of spinal needle insertion difficulty would reduce the incidence of multiple puncture and minimize the complications consequently. This study was designed to determine the accuracy of lumbar vertebrae radiological characteristics and spinal bony landmark quality in predicting the difficulty of spinal needle insertion in patients undergoing urologic procedure.
Methods. This was an analytic observational study in urologic patients scheduled for spinal anesthesia at Cipto Mangunkusumo hospital between April and May 2015. A total of 109 subjects were included in the study by consecutive sampling. Patient data (age, sex, body mass index, physical status, radiological characteristics of the lumbar vertebrae, and quality of spinal bony landmark), number of skin puncture and needle redirection, and the prevalence of spinal needle insertion difficulty were recorded. The first skin puncture success and number of needle redirection were used to assess the difficulty. Significant variables were first determined by Pearson?s Chi-square and Fisher test, and then multivariate analysis using logistic regression method tested the association of the skin puncture success and number of needle redirection with the significant variables.
Results. Age was significant only in bivariate analysis (p=0,028). The quality of spinal bony landmark and the radiological characteristics of the lumbar vertebrae had predictive value on spinal needle insertion difficulty (p=0,000 and p=0,006 respectively). Calibration test showed that the prediction quality was good. The discrimination test resluted in AUC of 0,84 (CI 95% 0,751 to 0,929).
Conclusion. The quality of spinal bony landmark and the radiological characteristics of the lumbar vertebrae were accurate in predicting the difficulty of spinal needle insertion in patients undergoing urologic procedure. , Background. Multiple attempts at spinal puncture have been related to many complications and patient discomfort. Accurate preoperative prediction of spinal needle insertion difficulty would reduce the incidence of multiple puncture and minimize the complications consequently. This study was designed to determine the accuracy of lumbar vertebrae radiological characteristics and spinal bony landmark quality in predicting the difficulty of spinal needle insertion in patients undergoing urologic procedure.
Methods. This was an analytic observational study in urologic patients scheduled for spinal anesthesia at Cipto Mangunkusumo hospital between April and May 2015. A total of 109 subjects were included in the study by consecutive sampling. Patient data (age, sex, body mass index, physical status, radiological characteristics of the lumbar vertebrae, and quality of spinal bony landmark), number of skin puncture and needle redirection, and the prevalence of spinal needle insertion difficulty were recorded. The first skin puncture success and number of needle redirection were used to assess the difficulty. Significant variables were first determined by Pearson’s Chi-square and Fisher test, and then multivariate analysis using logistic regression method tested the association of the skin puncture success and number of needle redirection with the significant variables.
Results. Age was significant only in bivariate analysis (p=0,028). The quality of spinal bony landmark and the radiological characteristics of the lumbar vertebrae had predictive value on spinal needle insertion difficulty (p=0,000 and p=0,006 respectively). Calibration test showed that the prediction quality was good. The discrimination test resluted in AUC of 0,84 (CI 95% 0,751 to 0,929).
Conclusion. The quality of spinal bony landmark and the radiological characteristics of the lumbar vertebrae were accurate in predicting the difficulty of spinal needle insertion in patients undergoing urologic procedure. ]"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Raymond
Kombinasi anestesi umum dan spinal dibandingkan anestesi umum terhadap kebutuhan opioid dan kestabilan MAP pada bedah laparoskopi abdomen = Combined general and spinal anesthesia vs. general anesthesia: impact on opioid requirements and MAP stability in laparoscopic abdominal surgery
"Latar Belakang: Tindakan pembedahan dengan invasi minimal seperti laparoskopi abdomen seringkali menjadi modalitas terpilih dengan perkembangan teknologi. Selama pembedahan, digunakan teknik anestesi umum pada pasien. Teknik anestesi yang ideal adalah teknik yang dapat menjaga kestabilan kardiovaskular dan respirasi, mengurangi kejadial mual muntah pascabedah, serta dapat mengurangi derajat nyeri pascabedah. Namun, prosedur laparoskopi menyebabkan perubahan fisiologis akibat kondisi pneumoperitoneum yang disebabkan oleh insuflasi gas karbon dioksida selama pembedahan, yang merupakan sebuah tantangan tambahan dalam pemberian anestesi yang ideal. Maka, penelitian ini bertujuan untuk membandingkan efektivitas penggunaan kombinasi anestesi umum dan spinal dengan anestesi umum saja dalam pembedahan laparoskopi abdomen.
Metode: Penelitian ini merupakan uji klinik acak terkendali tanpa penyamaran pada pasien laparoskopi abdomen di Rumah Sakit Cipto Mangunkusumo. Pemberian anestesi umum menggunakan lidokain, fentanyl, propofol, dan rocuronium. Pemberian anestesi spinal menggunakan bupivakain 10 mg. Luaran yang dinilai berupa kebutuhan opioid intraoperatif, kestabilan MAP, nyeri pascabedah, dan kejadian post-operative nausea and vomiting (PONV).
Hasil: Kombinasi anestesi umum dan spinal menyebabkan penurunan kebutuhan opioid fentanyl intraoperatif (p<0.001), kestabilan MAP yang lebih baik (p<0.009), dan penurunan nyeri pascabedah secara signifikan dibandingkan kelompok anestesi umum. Tidak terdapat perbedaan signifikan dari tingkat kejadian PONV. Simpulan: Kelompok anestesi umum dan spinal menunjukan penurunan kebutuhan opioid intraoperatif dan MAP yang lebih stabil pada tindakan laparaskopi dibandingkan dengan kelompok anestesi umum.
Background: Minimally invasive surgical procedures such as laparoscopic abdominal surgery have often become the preferred modality with technological advancements. During surgery, general anesthesia techniques are employed in patients. The ideal anesthesia technique is one that can maintain cardiovascular and respiratory stability, reduce postoperative nausea and vomiting, and alleviate postoperative pain. However, laparoscopic procedures induce physiological changes due to pneumoperitoneum conditions caused by the insufflation of carbon dioxide gas during surgery, posing an additional challenge in achieving ideal anesthesia. Therefore, this study aims to compare the effectiveness of using a combination of general and spinal anesthesia with general anesthesia alone in laparoscopic abdominal surgery.
Methods: This research is a controlled randomized clinical trial without masking on patients undergoing laparoscopic abdominal surgery at Cipto Mangunkusumo Hospital. General anesthesia is administered using lidocaine, fentanyl, propofol, and rocuronium, while spinal anesthesia is administered using bupivacaine. The assessed outcomes include intraoperative opioid requirements, MAP stability, postoperative pain, and the incidence of postoperative nausea and vomiting (PONV).
Results: The combination of general and spinal anesthesia resulted in a significant reduction in intraoperative fentanyl opioid requirements (p<0.001), better MAP stability (p<0.009), and a significant decrease in postoperative pain compared to the general anesthesia group. There was no significant difference in the incidence of PONV .
Conclusion: The combination of general and spinal anesthesia group showed decreased intraoperative opioid requirements and more stable in mean arterial pressure (MAP) during laparoscopic procedures compared to general anesthesia group."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tugas Akhir  Universitas Indonesia Library
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Dita Aditianingsih
Perbandingan kekerapan dan derajat hipotensi antara anestesia sobarahnoid posisi duduk dengan posisi lateral dekubitus kiri pada kasus bedah sesar
"Latar belakang dan tujuan: Anastasia subarahnoid adalah salah satu tindakan anestesia regional yang sexing dilakukan untuk bedah sesar. Bupivakain hiperbarik 0,5% adalah obat anestetik lokal yang lazim dipakai untuk tehnik pembiusan tersebut. Posisi tubuh dan gaya gravitasi memiliki efek dan mempengaruhi penyebaran dari obat yang bersifat hiperbarik. Penelitian ini dilakukan untuk mengetahui pengaruh posisi tubuh saat penyuntikan obat bupivakain hiperbarik 0,5% terhadap efek hipotensi yang ditimbulkan.
Metode : Penelitian dilakukan terhadap 90 wanita hamil berstatus ASA I-II usia 17-50 tahun yang menjalani bedah sesar, dibagi secara arak menjadi 2 kelompok duduk dan lateral dekubitus kiri. Setelah dilakukan penyuntikan obat, setelah 2 menit pasien dikembalikan ke posisi terlentang miring kiri 15 derajat, dan dilakukan co loading kristaloid 10 mllkgBB selama 10 menit Dilakukan pencatatan tekanan darah selama operasi setiap 2 menit selama 20 menit pertama clan selanjutnya tiap 5 menit. Ketinggian hambatan sensorik clan ketinggian maksimal hambatan, jumlah total efedrin dan cairan kristaloid yang diberikan selama operasi juga dicatat. Data hasil penelitian diolah dengan menggunakan uji t, uji Mann Whitneydan uji Chi kuadrat.
Hasil : Kekerapan hipotensi antara kelompok posisi duduk dan lateral dekubitus kiri tidak berbeda secara statistik meskipun lebih banyak terjadi pada kelompok lateral dekubitus kiri (67%) dibandingkan posisi duduk (51%). Posisi duduk mengalami hipotensi lebih lambat, derajat hipotensinya lebih rendah dan pemakaian efedrin yang lebih sedikit.
Kesimpulan: Posisi tubuh saat penyuntikan that bupivakain hiperbarik 0,5% pada anestesia subarahnoid mempengaruhi derajat hipotensi yang terjadi pada kasus bedah sesar.
Backgrounds and objectives . Spinal anesthesia is one of the regional anesthesia technique frequently performed for cesarean section. Hyperbaric bupivacaine 0.5% is the most frequent local anesthetic used for this technique. Spread of the hyperbaric local anesthetics is affected by the position of the patient and gravity. In the present study we evaluated the effect of maternal posture whether sitting position during the induction of spinal anesthesia using 05% hyperbaric bupivacaine would induce less hypotension as compared with the left lateral position.
Methods. Ninety pregnant women underwent cesarean delivery were randomly assigned to receive a spinal injection consisting of 12.5 mg 0.5% hyperbaric bupivacaine in either sitting or left lateral position. After 2 minutes, patients were turned to a 15 degrees left lateral position and intravenous infusion of 10 mllkgbodyweigh t of crystalloids was started for 10 minutes along with the induction of spinal anesthesia. Intraoperative blood pressure were recorded , in this study hypotension is defined as a decrease in systolic blood pressure less than 100 mmHg or 20% below baseline values. The height of sensory block was measured, time to T6 spread of the sensory block and the highest level of sensory blockade were noted. Total given of ephedrine and crystalloids rntraopertive were also noted. Statistical evaluation was performed using t?test, Mann Whitney test and Chi square as appropriate.
Result : The incidence of hypotension was not significantly different between sitting and left lateral position but more often in lateral position (51% vs 67%). Sitting position group has longer interval of the first hypotension (p=0.008),less severe of hypotension (p=0.042), less ephedrine supplementation (p=0.014), and longer interval for reaching the T6 dermatome blockade (p <0,0001).
Conclusion: Maternal posture during induction of spinal anesthesia using 0.5% hyperbaric bupivacaine has influence to severity of hypotension for cesarean section."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2006
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UI - Tesis Membership  Universitas Indonesia Library
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Dyah Yarlitasari
Perbandingan pengaruh penggunaan pelincir jeli lidokain 2% dengan salin 0,9% terhadap keberhasilan pemasangan LM proseal dan kekerapan "sore throat" pasca anestesi inhalasi dengan N20/O2/enfluran
"Tujuan : Mengetahui besarnya kegunaan dan keberhasilan pemasangan LMP yang menggunakan pelincir jeli lidokain 2% dibandingkan dengan yang dibasahi salin 0,9% pada anestesi umum inhalasi dengan N20 : 02 = 70% : 30%. Disain : Uji klinik tersamar ganda. Pasien : 56 pasien yang menjalankan operasi berencana dengan anestesi umum inhalasi dan tidak ada indikasi kontra penggunaan LMP di InstaIasi Bedah Pusat RSCM pada bulan Oktober sampai dengan Desember tahun 2005, usia 18-60 tahun, ASA 1/1I, berat badan sesuai ukuran LMP no 3 atau 4. Pasien dibagi menjadi 2 kelompok, masing masing 26 pasien, kelompok 1 dilakukan pemasangan LMP dengan pelincir salin 0,9% dan kelompok II dilakukan pemasangan LMP dengan pelincir ieli lidokain 2%. Apabila LMP terinsersi dilakukan OGT. Selama pemasangan LMP tersebut dilakukan pengamatan dan pengukuran tekanan sungkup LMP setiap 30 menit sarnpai operasi selesai. Analisa statistik dilakukan dengan uji t untuk data numerik, uji x kuadrat untuk data nominal dan koreksi yaitu bila nilai ekspektasi kurang dari 5 dengan tingkat signifikan p<0,05.
Hasil : Angka keberhasilan pemasangan LMP dengan menggunakan pelincir lidokain sama dengan menggunakan pelincir salin (92,3 %><84,6 %) p>0,05. Sehingga pada uji statistik perbedaan tersebut tidak signifikan (p>0,05). Komplikasi "sore throat" yang timbal selama pemasangan LMP dengan pelincir lidokain dan salin pada 5 menit pasca ekstubasi di ruang pulih adalah sama yaitu "sore throat" ringan 3,8 % pada pelincir salin dan 7,7 % "sore throat" sedang pada pelincir lidokain, namun dari uji statistik perbedaan ini tidak signifikan (p>0,05). Begitu juga "sore throat" yang terjadi 24 jam pasca bedah pada pemasangan LMP dengan salin terdapat 3,8 % "sore throat" sedang dan pada lidokain 7,7 % "sore throat" ringan secara uji statistik perbedaan ini tidak signifikan (p>0,05).
Kesimpulan : Secara uji statistik keberhasilan pemasangan sungkup LMP pada kelompok salin dan lidokain tidak berbeda secara signifikan. Begitu pula dengan kekerapan "sore throat" dan derajat "sore throat" antara kelompok salin dan lidokain tidak berbeda secara signifikan.
OBJECTIVE : To compare the successfully of attempt LMP with correlation between lubricant lidocain 2 % or saline 0,9 % and incidence of post operative sore throat after general anesthesia inhalation with N20/02/Enflurance facilitated by LMP with lubricant lidocain 2 % or saline 0,9%.
STUDY DESIGN : Double blind randomized clinical trial. PATIENT : 56 patient, 18 to 60 years old, underwent elective surgery in IBP RSUPN -- CM, ASA I 1 II malampatie score 1, area of surgery not in the head and neck, in supine position with OGT placement. Patients were allocated into two groups. 26 patients in group I with saline lubricant, and 26 patients in group II with lidocaine lubricant. After the operation patients was recorded about successfully attempt of LMP and complaint of sore throat in the recovery room, and 24 hours after anesthesia. Statistics analysis with T-test for continues data, x2 test and Fischer's exact test for categorical data. Spearman correlations test with significant value P <0,05 and confidence interval 95%.
RESULTS : The incidence of successfully attempt LMP with lidocaine equivalent with saline (92,3% >< 84,6%) P >0,05, The incidence of mild sore throat at the recovery room 3,8% with saline and 7,7% moderate sore throat with lidocaine (P >0,05). The incidence of sore throat at 24 hours after surgery were 3,8% moderate sore throat with saline and 7,7% mild sore throat with lidocaine (P > 0,05).
CONCLUSION : The successfully attempt of LMP in the saline group not signifikan compare to lidocain group. Morbidity of sore throat not significant between saline group compare to lidocaine group and intensity of sore throat between saline group not significant compare to lidocaine group."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2006
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Dian Citra Resmi
Kondisi intubasi 60 detik setelah pemberian rokuronium: Perbandingan induksi kombinasi profol-efedrin profol
"Tujuan : Mengetahui kondisi intubasi 60 delik setelah peinberian rokuronium 0,6 mg/kg berat badan dengan menggunakan teknik induksi kombinasi propofol-efedrin 10 mg intravena dan teknik induksi propolbl intravena.
Desain: Prospektif, data dikumpulkan pada salah pusat penelilian dengan uji acak tersamar ganda.
Metode: 42 pasien dengan status fisik ASA 1 atau 2 yang akan dilakukan pembedahan berencana dengan anestesia uimnl dan intubasi endotrakea disertakan dalaah penelitiaa ini. Pasien dibagi dalam dua kelompok, kelompok I diberikan kombinasi propofol 2,5 mg/kg berat badan-efedrin 10 mg intravena (kelompok efedrin) dan kelompok II diberikan propofol 2,5 mg/kg berat badan intravena (kelompok salin). Premedikasi dengan midazolam 0,05 mg/kg berat badan dan fentanyl 1 pg/kg berat badan diberikau 3 merit sebeluin induksi. Setelah pemberian obat induksi, diberikan rokuronium 0,6 mg/kg berat badan. Kondisi intubasi dinilai bcrdasarkan kritcria Krieg dan peman[auan neuromuskular dengan nicnggunakan Train-of-four pada otot adductor pollicir.
Hasil: Kelompok efedrin didapatkan kondisi intubasi yang sangat baik 85,7% dan baik 14,3%. Kelompok satin didapatkan kondisi intubasi yang sangat balk 75% dan baik 25%.
Kesimpulan . Kondisi intubasi 60 delik selclah pemberian rokuronium 0,6 mg/kg berat badan dengan inenggunakan teknik induksi kombinasi propofol-efedrin 10 ing intravena saina baiknya dengan teknik induksi propofol intravena.
Objective : The aim of this study was to evaluate intubating conditions 60 second after rocuronium 0,6 mg/kg body weight administration using induction technique propofol-ephedrine 10 mg intravenous in combination and induction technique propofol intravenous.
Design : Prospective, randomiked controlled trial study.
Methods : 42 patients with physical status ASA 1 or 2 who were scheduled for elective surgery requiring general anaesthesia and tracheal intubation. Patients were randomly assigned to receive either propofol 2,5 ing/kg body weight-ephedrine 10 mg intravenous in combination (ephedrine group) or propofol 2,5 mg/kg body weight intravenous (saline group). Premedication drugs were midazolam 0,05 mg/kg body weight and fenlanyl l }mg/kg body weight, 3 minute prior to induction. Alter induction drugs were administered. then rocuronium 0,6 inglkg body weight was given. Criteria of Krieg was used to evaluate when intubating conditions and neuromuscular function which was assessed by using Train-of dour monitoring at the adductor pollicis.
Results : In the ephedrine group the intubating conditions were excellent 85,7% and good 14,3%. In the saline group the intubating condition were excellent 75% and good 25%.
Conclusion : intubating conditions 60 second after rocuronium 0,6 mg/kg body weight administration using induction technique propofol-ephedrin 10 mg intravenous in combination as good as induction technique propofol intravenous."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2005
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Hadi Prakoso Wreksoatmodjo
Perbandingan teknik anestesia parabulbar dan anestesia retrobulbar pada pembedahan katarak
Fakultas Kedokteran Universitas Indonesia, 1989
T58506
UI - Tesis Membership  Universitas Indonesia Library
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