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"Latar belakang: Proses pembedahan seperti kraniotomi mengakibatkan inflamasi, dimulai sejak awal insisi dan berdampak pada kejadian nyeri pascabedah yang memengaruhi lama rawat pasien. Lidokain intravena intraoperatif memiliki efek analgesik dan antiinflamasi yang terbukti efektif sebagai terapi ajuvan dalam manajemen nyeri pasca pembedahan abdominal. Penelitian ini bertujuan untuk mengevaluasi efek pemberian lidokain intravena kontinyu intraoperatif pada kraniotomi, terhadap nyeri pascabedah, kadar TNF-alfa, dan lama rawat.Metode: Randomized controlled trial ini menggunakan pengambilan sampel secara consecutive sampling. Sebanyak 50 subjek penelitian dengan tumor otak yang menjalani kraniotomi. Kelompok intervensi diberikan bolus intravena lidokain 2% dosis 1,5 mg/kgBB saat induksi, dilanjutkan rumatan 2 mg/kgBB/jam. Kelompok kontrol dengan pemberian NaCl 0,9% dengan volume sama. Luaran penelitian adalah skala nyeri pascabedah berdasarkan nilai NPS, kadar TNF-alfa dan lama rawat.Hasil: Skor nyeri sesuai nilai NPS pada 1 jam pascabedah, 6 jam pascabedah, dan 24 jam pascabedah antara kelompok intervensi dengan kontrol (p < 0,001). Terdapat perbedaan bermakna antar dua kelompok mengenai selisih kadar TNF-alfa prainduksi dengan 1 jam pascabedah (p = 0,001). Sedangkan selisih kadar TNF-alfa prainduksi dengan 24 jam antar dua kelompok tidak menunjukkan perbedaan signifikan (p = 0,334). Luaran lama rawat tidak berbeda bermakna.Simpulan: Pemberian lidokain intravena kontinyu intraoperatif dibandingkan plasebo pada kraniotomi berpengaruh terhadap nyeri pascabedah dan kadar TNF-alfa, namun tidak berpengaruh pada lama rawat.

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Background: Surgery such as craniotomy causes inflammation which affects the incidence of postoperative pain and then affect hospitalization duration. Lidocaine has analgesic and anti-inflammatory effects which effective as an adjuvant in the management of postoperative pain in abdominal surgery. This study aims are to investigate the effects of the intraoperative continuous intravenous lidocaine during craniotomy on postoperative pain, TNF-α levels, and hospitalization duration.

Methods: This randomized controlled trial uses consecutive sampling method. A total of 50 subjects with brain tumors underwent craniotomy. The therapy group was given lidocaine 2% intravenous bolus 1.5 mg/kg at induction followed by maintenance at 2 mg/kg/hour, the control group was given NaCl 0.9% with the same volume. The outcomes assessed were postoperative pain, TNF-α levels, and hospitalization duration.

Results: There was a significant difference in NPS 1-hour postoperative, 6-hour postoperative NPS, and 24-hour postoperative NPS scores between the treatment group and the control group (p < 0.001). There was a significant difference between pre-induction TNF-α levels and 1 hour postoperatively (p = 0.001) however pre-induction TNF-α levels with 24 hours was not significantly different (p = 0.334). There was no significant difference in hospitalization duration between those groups.

Conclusions: Intraoperative continuous intravenous lidocaine administration compared to placebo at craniotomy had an effect on postoperative pain and TNF-α levels but had no effect on hospitalization duration."

"Latar Belakang : Sectio Caesar merupakan tindakan persalinan yang dilakukan dengan cara memutuskan jaringan kontuinitas atau persambungan dengan insisi untuk mengeluarkan bayi. Luka insisi operasi meninggalkan reseptor nyeri. Penulisan karya ilmiah ini bertujuan untuk melaporkan asuhan keperawatan maternitas pada pasien post sectio caesarea yang mengalami nyeri dan pengaruh penerapan hand food massage dan relaksasi otot progresif untuk menurunkan tingkat nyeri. Pembahasan : Pasien dengan status paritas P1A0 post sectio caesarea hari pertama mengeluh nyeri area luka post operasi (skala nyeri 8/10 ). Pasien mengatakan adanya penurunan tingkat nyeri (skala 8-2) setelah dilakukan latihan hand foot massage dan relaksasi otot progresif selama 5 hari berturut-turut dengan waktu latihan 1x 40 menit setiap harinya disertai konsumsi analgetik pada 2 jam sebelum intervensi tersebut. Kesimpulan : Nyeri post sectio caesarea adalah perasaan tidak menyenangkan yang diakibatkan karena luka sayatan dari insisi pembedahan caesarea. Perpaduan hand food massage dan relaksasi otot progresif dapat diterapkan sebagai terapi non farmakologi dalam menurunkan tingkat nyeri pasien post sectio caesarea yang mengalami nyeri.

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Background: Caesarean section is a delivery procedure that is carried out by breaking tissue continuity with an incision to remove the baby. The surgical incision leaves pain receptors. The aim of writing this scientific work is to report maternity nursing care for post caesarean section patients who experience pain and the effect of applying hand food massage and progressive muscle relaxation to reduce pain levels. Discussion: Patients with parity status P1A0 post caesarean section on the first day complained of pain in the post-operative wound area (pain scale 8/10). The patients stated that there was a decrease in the level of pain (scale 8-2) after doing hand foot massage and progressive muscle relaxation exercises for 5 consecutive days with 1 x 40 minute training time per day accompanied by taking analgesics 2 hours before the intervention. Conclusion: Post caesarean section pain is an unpleasant feeling caused by the incision of the caesarean section. The combination of hand food massage and progressive muscle relaxation can be applied as a non-pharmacological therapy to reduce the pain level of post-cesarean section patients who experience pain."

"Latar Belakang: Refleks okulokardiak dengan manifestasi bradikardia, aritmia hinggaasistol masih sangat potensial terjadi pada operasi strabismus. Operasi dalam anestesiumum saja belum dapat mencegah kejadian tersebut. Tujuan: Penelitian ini bertujuanuntuk mengetahui apakah injeksi ropivakain 0,75% subtenon dengan kombinasi anestesiumum menunjukkan hasil yang lebih baik dalam menurunkan angka kejadian refleksokulokardiak dan nyeri pasca operasi. Metode: Uji klinis acak terkontrol tersamar gandadilakukan pada 15 subjek usia 7-60 tahun yang menjalani reseksi rektus medial/lateraldan status fisik sesuai American Society of Anesthesiologists adalah ASA I-II.Randomisasi membagi subjek menjadi dua kelompok yaitu ropivakain dan plasebo.Perubahan laju nadi dan kejadian refleks okulokardiak diukur saat insisi konjungtiva,traksi dan reseksi otot. Nyeri pasca operasi dinilai pada jam ke-1,2,4 dan 6 dengan VisualAnalog Score (VAS). Hasil: Penelitian ini menunjukkan rerata laju nadi pada kelompokintervensi pasca induksi, insisi konjungtiva, traksi dan reseksi otot adalah 70.4, 66.8, 65.4,dan 65.4 secara berurutan, sedangkan plasebo 78, 74.5, 68.8, dan 74.8 kali per menit.Insidens kejadian refleks okulokardiak pada kelompok intervensi adalah 28.5%sedangkan plasebo 50% (p>0.05). Median skor nyeri kelompok intervensi lebih rendahpada jam pertama pasca operasi. Kesimpulan: Walaupun tidak bermakna secara statistik,namun secara klinis, dengan power penelitian 75%, kombinasi anestesi umum dan injeksisubtenon memberi hasil yang lebih baik.

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Background: Squint surgery is associated with oculocardiac reflex with bradycardia,

arrhythmia and even asystole case. Surgery in general anesthesia alone could not prevent

this reflex. Objective: The aim of this study was to investigate the effects of a sub-

Tenon’s block combined with general anesthesia on oculocardiac reflex and

postoperative pain. Method: This double blind randomized controlled trial included 15

patients aged 7-60 years scheduled for medial/lateral rectus resection and American

Society of Anesthesiologists status were ASA I-II. Patients were randomly allocated to

receive either sub-Tenon ropivacaine 0,75% or placebo prior to surgery. Changes in heart

rate and incidence of oculocardiac reflex were measured during several stages. Result:

The mean heart rate measured at post induction, conjunctival incision, muscle traction

and resection in ropivacaine group were 70.4, 66.8, 65.4, and 65.4 bpm, respectively and

in placebo group were 78, 74.5, 68.8, and 74.8 bpm. Incidence of oculocardiac reflex in

ropivacaine and placebo group were 28,5% and 50% respectively (p>0.05). Median pain

scores were lower in ropivacaine group at the first hour postoperative. Conclusion: We

conclude that eventhough statistically there was no difference between two groups (power

75%), clinically, combination of ropivacaine 0,75% sub-Tenon block with general

anesthesia showed lower incidence of oculocardiac reflex and lower pain score at the first

hour after surgery."

"[ABSTRAKLaki-laki dewasa merupakan kelompok narapidana terbanyak yang tinggal di Lapas dan Rutan. Selama menjalani masa hukuman, narapidana laki-laki dewasa yang telah menikah tidak dapat memenuhi kebutuhan seksualnya karena di Lapas dan Rutan tidak disediakan akomodasi untuk pemenuhan kebutuhan tersebut. Seksual merupakan kebutuhan dasar bagi manusia. Tidak adekuatnya pemenuhan kebutuhan dasar termasuk ketidakefektifan pola seksual dapat menyebabkan ansietas. Penelitian ini bertujuan untuk mengetahui pengaruh Relaksasi Otot Progresif dan Terapi Logo terhadap ansietas narapidana akibat ketidakefektifan pola seksual. Desain penelitian quasi eksperimental pre-post test with control group. Sampel penelitian 56 orang narapidana yang mengalami ketidakefektifan pola seksual sedang atau berat, 28 narapidana kelompok yang mendapatkan Relaksasi Otot Progresif dan 28 narapidana yang mendapatkan Relaksasi Otot Progresif dan Terapi Logo. Hasil penelitian ditemukan penurunan ansietas akibat ketidakefektifan pola seksual kelompok narapidana yang mendapatkan Relaksasi Otot Progresif dan Terapi Logo lebih besar dibandingkan kelompok narapidana yang hanya mendapatkan Relaksasi Otot Progresif saja (p value < 0,05). Relaksasi Otot Progresif dan Terapi Logo direkomendasikan sebagai terapi keperawatan lanjutan dalam mengatasi masalah psikososial pada narapidana.

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ABSTRACTMen are the largest population in prison. During the period of imprisonment, married-men cannot fulfill their sexual need because of unavailable facilities. Sexuality is a human basic need. The inadequate fulfillment of basic needs will cause anxiety. This study aims to obtain the effect of progressive muscle relaxation and Logo therapy on prisoners? anxiety as the result of ineffective sexual pattern.This study used pre and post-test quasi experimental research design with control group. The samples of this study were 56 prisoners consisted of 28 progressive muscle relaxation prisoners and 28 progressive muscle relaxation and Logo therapy prisoners. The result of this study shows ineffective sexual pattern of prisoners decreased. Based on that analysis result, it can be concluded that prisoners who get progressive muscle relaxation and Logo therapy is bigger than prisoners that only get progressive muscle relaxation (p value < 0,05). Progressive muscle relaxation and Logo therapy are recommended for advanced nursing treatment dealing with prisoner anxiety related to ineffective sexual pattern, Men are the largest population in prison. During the period of imprisonment, married-men cannot fulfill their sexual need because of unavailable facilities. Sexuality is a human basic need. The inadequate fulfillment of basic needs will cause anxiety. This study aims to obtain the effect of progressive muscle relaxation and Logo therapy on prisoners’ anxiety as the result of ineffective sexual pattern.This study used pre and post-test quasi experimental research design with control group. The samples of this study were 56 prisoners consisted of 28 progressive muscle relaxation prisoners and 28 progressive muscle relaxation and Logo therapy prisoners. The result of this study shows ineffective sexual pattern of prisoners decreased. Based on that analysis result, it can be concluded that prisoners who get progressive muscle relaxation and Logo therapy is bigger than prisoners that only get progressive muscle relaxation (p value < 0,05). Progressive muscle relaxation and Logo therapy are recommended for advanced nursing treatment dealing with prisoner anxiety related to ineffective sexual pattern]"

"ABSTRAKNyeri pascabedah jantung menjadi masalah bagi pasien, sehingga perlu intervensi dengan terapi farmakologi dan non farmakologi seperti terapi komplementer keperawatan. Terapi komplementer dari beberapa penelitian sebelumnya yang dilakukan perawat merupakan terapi tunggal dan kombinasi dua terapi. Bentuk kombinasi tiga terapi seperti pijat, hipnosis, dan musik (Formula PHISIK) bekerja saling menguatkan dalam menurunkan nyeri. Tujuan penelitian ini mengidentifikasi pengaruh pemberian formula PHISIK terhadap intensitas nyeri pascabedah jantung di RS PJNHK Jakarta. Desain penelitian ini yaitu quasi eksperiment design dengan non equivalent control group design. Sampel dalam penelitian ini adalah 36 pasien pascabedah jantung. Pemberian formula PHISIK menurunkan intensitas nyeri secara signifikan melalui selisih skala nyeri, denyut jantung, frekuensi pernafasan, dan tekanan darah pra dengan pascaperlakuan (p value < 0,05). Formula PHISIK berpengaruh secara signifikan dalam menurunkan skala nyeri, denyut jantung, frekuensi pernafasan, dan tekanan darah pada pasien pascabedah jantung. Formula PHISIK dapat digunakan sebagai bagian dari intervensi keperawatan dalam upaya menurunkan nyeri pascabedah jantung.

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ABSTRACTPost-cardiac surgery pain has become a problem for patients. Therefore, it needs intervention either use pharmacological or non-pharmacological therapies. Complementary therapies from several previous studies by nurses are focused on a single or two combined therapy. No study found to combine more than two. A combination of three therapies such as massage, hypnosis, and music (PHISIK formula) each other may reduce pain.The objective to identify the effect of PHISIK formula to pain intensity of patient with post-cardiac surgery pain at national cardiac center hospital Harapan Kita Jakarta. This study used a quasi-experimental design with non-equivalent control group design. The sample in this study were 36 post-cardiac surgery patients. PHISIK formula significantly reduce pain intensity as showed in the difference of pre post-treatment on pain scale, heart rate, respiratory rate, and blood pressure (p value < 0,05). PHISIK formula is found significant reduce pain scale, heart rate, respiratory rate, and blood pressure on post-cardiac surgery. PHISIK formula can be used as part of a nursing intervention in reducing post-cardiac surgery pain."

"Gangguan tidur mempengaruhi kualitas hidup anak yang mendapatkan kemoterapi. Penelitian bertujuan untuk mengidentifikasi pengaruh relaksasi otot progresif terhadap kualitas tidur dan efek samping kemoterapi pada anak dengan kanker. Desain penelitian randomized clinical trial dengan metode single blind, 30 anak secara random dialokasikan pada kelompok kontrol dan kelompok intervensi. Kelompok intervensi mendapat relaksasi otot progresif 2x sehari, pagi dan malam hari, 15 menit setiap sesi selama 7 hari. Kelompok kontrol mendapat tindakan keperawatan rutin. Hasil penelitian menyimpulkan tidak ada perbedaan yang bermakna pada kedua kelompok terhadap fatigue, nyeri, dan mual muntah, namun bermakna pada kualitas tidur dimana terdapat penurunan skor kualitas tidur. Terapi relaksasi terutama relaksasi otot progresif dapat menjadi salah satu tindakan keperawatan untuk meningkatkan kualitas tidur dan mengurangi efek samping kemoterapi pada anak dengan kanker.

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Sleep disturbances affects quality of life in children receiving chemotherapy. The aim of this study to identify the effect of progressive muscle relaxation for the sleep quality and side effects of chemotherapy in children with cancer. In this study randomized clinical trial with single blind method applied, 30 children were allocated randomly to the control group and intervention group. The intervention group received progressive muscle relaxation twice a day, in the morning and evening, 15 minutes each session for 7 days. Control group received routine nursing care. The study concluded there was no significant difference in the two groups on fatigue, pain, and nausea, vomiting, however progressive muscle relaxation significant on the quality of sleep in which there is a decrease in sleep quality scores. Relaxation therapy particularly progressive muscle relaxation may be one of the nursing care to improve sleep quality and reduce the side effects of chemotherapy in children with cancer."

"Hipertensi merupakan penyakit yang dapat menyebabkan kematian secara diam-diam (silent killer) karena tidak disadari oleh penderitanya. Hipertensi juga menjadi masalah kesehatan yang paling banyak dialami lansia. Pengendalian hipertensi pada lansia diharapkan dapat mengurangi komplikasi akibat hipertensi. Oleh karena itu penulis mengembangkan program pengendalian hipertensi pada lansia melalui Program MERONA. Tujuannya memberikan bukti evidence based practice dalam mengendalikan hipertensi dengan melibatkan 10 keluarga dan 60 lansia di komunitas yang dipilih menggunakan cluster random sampling. Program ini merupakan integrasi manajemen diri hipertensi dan terapi relaksasi yaitu terapi musik, relaksasi otot progresif dan relaksasi nafas dalam. Metode yang digunakan yaitu one group pre test and post test design yang dilaksanakan selama 12 minggu dengan pemantauan oleh penulis, keluarga dan support group melalui pendekatan asuhan keperawatan keluarga dan komunitas. Evaluasi terhadap perilaku lansia dan kemandirian keluarga dilakukan menggunakan kuesioner pada akhir minggu ke 12. Pengukuran tekanan darah dilakukan pada minggu ke 4, 8 dan 12. Hasil intervensi program MERONA yaitu terjadi peningkatan perilaku lansia (pengetahuan, sikap, psikomotor) dan tingkat kemandirian keluarga dalam perawatan hipertensi, adanya penurunan rerata tekanan darah sistolik dan diastolik pada lansia. Hasil penerapan program MERONA diharapakan dapat diaplikasikan dalam pelayanan kesehatan komunitas.

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Hypertension is a disease that can cause death silently (silent killer) because the sufferer is not aware of it. Hypertension is also the most common health problem experienced by the elderly. Controlling hypertension in the elderly is expected to reduce complications due to hypertension. Therefore, the authors developed a hypertension control program in the elderly through the MERONA Program. The aim is to provide evidence based practice in controlling hypertension by involving 10 families and 60 elderly people in the community selected using cluster random sampling. This program is an integration of hypertension self-management and relaxation therapy, namely music therapy, progressive muscle relaxation and deep breathing relaxation. The method used is one group pre test and post test design which was carried out for 12 weeks with monitoring by the author, family and support group through family and community nursing care approaches. Evaluation of the behavior of the elderly and family independence was carried out using a questionnaire at the end of week 12. Blood pressure measurements were carried out at weeks 4, 8 and 12. The results of the MERONA program intervention were an increase in elderly behavior (knowledge, attitude, psychomotor) and the level of family independence in hypertension treatment, a decrease in the average systolic and diastolic blood pressure in the elderly. The results of implementing the MERONA program are expected to be applied in community health services.

Keywords: hypertension, elderly, program merona."

"Hipertensi merupakan faktor utama penyebab kematian lansia secara global. Berbagai upaya telah dilakukan namun belum optimal. Kondisi tersebut mendorong para ilmuwan untuk mengembangkan terapi non farmakologis guna melengkapi terapi farmakologis salah satunya dengan relaksasi otot progresif dan terapi musik. Tujuan penelitian ini adalah untuk mengetahui pengaruh RESIK terhadap tekanan darah pada lansia dengan hipertensi di Kota Depok. Penelitian ini menggunakan desain quasi eksperiment dengan pendekatan pre-post test with control group. Seratus lansia dengan hipertensi dibagi menjadi dua kelompok menggunakan stratified random sampling dan purposive sampling. Setelah dilakukan 11 sesi terapi RESIK dalam 6 hari, analisis t-test menunjukkan adanya penurunan tekanan darah sebesar 29,2 mmHg pada tekanan darah sistolik dan 16,2 mmHg pada tekanan darah diastolik. Kesimpulannya, RESIK dapat menurunkan tekanan darah sistolik (p value = 0,000; α = 0,05) namun tidak signifikan menurunkan tekanan darah diastolik (p value = 0.167; α = 0,05). Terapi ini disarankan untuk diterapkan sesuai dengan prosedur dan dilakukan secara rutin untuk mendapatkan pengaruh yang maksimal.

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Hypertension is a major factor causes the death of older people globally. Various efforts have been made but are not optimal. These conditions encouraged scientists to develop nonpharmacological therapies to complement pharmacological therapy, one of them was progressive muscle relaxation and music therapy. The purpose of this study was to determine the influence of RESIK toward blood pressure in older people with hypertension in Depok. This study used quasi experimental design with pre-post test with control group approach. One hundred older people with hypertension divided into two groups using stratified random sampling and purposive sampling. After 11 RESIK therapy sessions in 6 days, t-test analysis showed the decrease of blood pressure in 29.2 mmHg at systolic blood pressure and in 16.2 mmHg at diastolic blood pressure. In conclusion, RESIK could decrease systolic blood pressure (P value = 0,000; α = 0,05) but it could not significantly decrease diastolic blood pressure (P value = 0.167; α = 0,05). This therapy was recommended to be applied in accordance with the procedure and done regularly to get the maximum influence."