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"[Latar Belakang: Posisi pasien selama tindakan anestesia spinal menentukan keberhasilan penempatan jarum spinal. Traditional sitting position (TSP) merupakan posisi standar untuk anestesia spinal, namun angka keberhasilannya masih cukup rendah. Crossed leg sitting position (CLSP) merupakan salah satu posisi alternatif dalam anestesia spinal yang memiliki kelebihan berupa derajat fleksi lumbal yang lebih besar. Penelitian ini bertujuan untuk membandingkan CLSP dan TSP terhadap keberhasilan penempatan jarum spinal pada pasien bedah urologi. Metode: Penelitian ini adalah uji klinik acak tidak tersamar terhadap pasien yang menjalani anestesia spinal untuk prosedur urologi pada bulan Maret-April 2015 di RSUPN dr. Cipto Mangunkusumo. Setelah mendapatkan persetujuan izin etik dari Komite Etik Penelitian Kesehatan FKUI-RSCM, sebanyak 138 subjek dialokasikan ke dalam dua kelompok posisi penusukan jarum spinal yaitu kelompok CLSP dan TSP. Proporsi keberhasilan penempatan jarum spinal di rongga subarakhnoid, kemudahan perabaan landmark, dan jumlah needle-bone contact pada kedua kelompok kemudian dinilai.Hasil: Enam subjek masuk kriteria pengeluaran berupa kegagalan penempatan jarum spinal setelah lebih dari sembilan kali percobaan. Tersisa 132 subjek, 67 subjek pada kelompok CLSP dan 65 subjek pada kelompok TSP, yang berhasil menyelesaikan penelitian. Keberhasilan penempatan jarum spinal secara one shot pada kelompok CLSP dan TSP tidak berbeda bermakna (64.2% vs 53.8%, p=0.227). Kemudahan perabaan landmark pada kelompok CLSP berbeda bermakna dengan TSP (94% vs 75%, p=0.003). Jumlah needle-bone contact pada kedua kelompok tidak berbeda bermakna (p=0.337). Simpulan: Keberhasilan penempatan jarum spinal pada kelompok CLSP tidak berbeda bermakna dibandingkan dengan keberhasilan penempatan jarum spinal pada kelompok TSP pada pasien bedah urologi.;Background: Patient position during spinal anesthesia plays a major role in determining the success of spinal needle insertion to subarachnoid space. Traditional sitting position (TSP) is a standard position for spinal anesthesia, but the success rate for spinal anesthesia in TSP is still quite low. Crossed leg sitting position (CLSP) is one of the alternative positions in spinal anesthesia, which can increase the degree of lumbar flexion. This study aimed to compare CLSP and TSP to the successful insertion of spinal needle in urologic surgery patients.Methods: This study was a non-blinded randomized controlled trial in patients undergoing spinal anesthesia for urologic procedures between March-April 2015 in RSUPN dr. Cipto Mangunkusumo. After obtaining approval from FKUI-RSCM Ethical Committee, 138 subjects were allocated into two groups, CLSP group and TSP group. The proportion of successful spinal needle insertion to the subarachnoid space, ease of landmark palpation, and the number of needle-bone contact in both groups were then analyzed and assessed.Result: Six subjects met dropout criteria, which was failure of obtaining successful spinal needle insertion after nine consecutive redirections. The remaining 132 subjects, 67 subjects in the CLSP group and 65 subjects in TSP group, successfully completed the study. The proportion of successful spinal needle insertion in a one-time shot, was not significantly different between CLSP and TSP group (64.2% vs. 53.8%, p = 0227). Ease of landmark palpation in CLSP group was significantly different with TSP group (94% vs. 75%, p = 0.003). The number of needle-bone contact in both groups was not significantly different (p = 0337).Conclusion: The proportion of successful spinal needle insertion in CLSP group was not significantly different compared to TSP group for urologic surgery patients.;Background: Patient position during spinal anesthesia plays a major role in determining the success of spinal needle insertion to subarachnoid space. Traditional sitting position (TSP) is a standard position for spinal anesthesia, but the success rate for spinal anesthesia in TSP is still quite low. Crossed leg sitting position (CLSP) is one of the alternative positions in spinal anesthesia, which can increase the degree of lumbar flexion. This study aimed to compare CLSP and TSP to the successful insertion of spinal needle in urologic surgery patients.Methods: This study was a non-blinded randomized controlled trial in patients undergoing spinal anesthesia for urologic procedures between March-April 2015 in RSUPN dr. Cipto Mangunkusumo. After obtaining approval from FKUI-RSCM Ethical Committee, 138 subjects were allocated into two groups, CLSP group and TSP group. The proportion of successful spinal needle insertion to the subarachnoid space, ease of landmark palpation, and the number of needle-bone contact in both groups were then analyzed and assessed.Result: Six subjects met dropout criteria, which was failure of obtaining successful spinal needle insertion after nine consecutive redirections. The remaining 132 subjects, 67 subjects in the CLSP group and 65 subjects in TSP group, successfully completed the study. The proportion of successful spinal needle insertion in a one-time shot, was not significantly different between CLSP and TSP group (64.2% vs. 53.8%, p = 0227). Ease of landmark palpation in CLSP group was significantly different with TSP group (94% vs. 75%, p = 0.003). The number of needle-bone contact in both groups was not significantly different (p = 0337).Conclusion: The proportion of successful spinal needle insertion in CLSP group was not significantly different compared to TSP group for urologic surgery patients., Background: Patient position during spinal anesthesia plays a major role in determining the success of spinal needle insertion to subarachnoid space. Traditional sitting position (TSP) is a standard position for spinal anesthesia, but the success rate for spinal anesthesia in TSP is still quite low. Crossed leg sitting position (CLSP) is one of the alternative positions in spinal anesthesia, which can increase the degree of lumbar flexion. This study aimed to compare CLSP and TSP to the successful insertion of spinal needle in urologic surgery patients.Methods: This study was a non-blinded randomized controlled trial in patients undergoing spinal anesthesia for urologic procedures between March-April 2015 in RSUPN dr. Cipto Mangunkusumo. After obtaining approval from FKUI-RSCM Ethical Committee, 138 subjects were allocated into two groups, CLSP group and TSP group. The proportion of successful spinal needle insertion to the subarachnoid space, ease of landmark palpation, and the number of needle-bone contact in both groups were then analyzed and assessed.Result: Six subjects met dropout criteria, which was failure of obtaining successful spinal needle insertion after nine consecutive redirections. The remaining 132 subjects, 67 subjects in the CLSP group and 65 subjects in TSP group, successfully completed the study. The proportion of successful spinal needle insertion in a one-time shot, was not significantly different between CLSP and TSP group (64.2% vs. 53.8%, p = 0227). Ease of landmark palpation in CLSP group was significantly different with TSP group (94% vs. 75%, p = 0.003). The number of needle-bone contact in both groups was not significantly different (p = 0337).Conclusion: The proportion of successful spinal needle insertion in CLSP group was not significantly different compared to TSP group for urologic surgery patients.]"

"Insersi jarum spinal dapat menimbulkan nyeri sehingga perlu dilakukan teknik stimulasi kompres dingin guna menurunkan intensitas nyeri yang dialami. Penelitian ini bertujuan untuk mengidentifikasi efektivitas kompres dingin dalam menurunkan intensitas nyeri insersi jarum spinal pada prosedur spinal anestesi. Desain yang digunakan adalah quasy experimental dengan pendekatan post test only design non equivalent control group. Sampel terdiri dari 72 pasien dewasa yang terbagi atas 36 orang kelompok intervensi dan 36 orang kelompok kontrol. Analisis data untuk mengetahui perbedaan rerata kelompok perlakuan (kompres dingin) dan kelompok kontrol (standar prosedur) dengan intensitas nyeri dan menganalisis hubungan variabel jenis kelamin dan pengalaman nyeri insersi spinal dengan intensitas nyeri menggunakan uji Mann Whitney. Analisis data untuk mengetahui hubungan variabel usia, ukuran jarum spinal dan kecemasan dilakukan uji Kruskal Wallis. Hasil analisis menunjukkan terdapat perbedaan bermakna antara kelompok perlakuan (kompres dingin) dan kelompok kontrol (standar prosedur) dan hubungan bermakna antara variabel kecemasan dengan intensitas nyeri (p<0,05). Hasil analisis menunjukkan tidak terdapat hubungan bermakna pada variabel usia, jenis kelamin, pengalaman nyeri insersi dan ukuran jarum spinal (p>0,05). Dapat disimpulkan kompres dingin merupakan intervensi yang terbukti efektif untuk menurunkan intensitas nyeri insersi jarum spinal pada prosedur spinal anestesi.

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Spinal needle insertion may cause pain hence cold compress stimulation technique to reduce the intensity of the pain is required. This study aims to identify the effectiveness of cold compress in reducing the intensity of spinal needle insertion pain in spinal anesthesia procedures. The design used was quasy experimental with post test only design non equivalent control group approach. The sample consisted of 72 adult patients divided into 36 intervention groups and 36 control groups.

Data analysis is to obtain the difference average of treatment group (cold compress) and control group (standard procedure) with pain intensity and analyze the connection of gender and spinal insertion pain variables and the intensity of pain using Mann Whitney test. Data analysis to obtain the correlation of age, spinal needle size and anxiety variables was conducted using Kruskal Wallis test.

Analysis results show that there are significant differences between treatment group (cold compress) and control group (standard procedure) and significant relationship between anxiety variables with pain intensity (p <0.05). The results show no significant association in age, sex, insertion pain experience and spinal needle size (p> 0.05). It can be concluded that cold compress is an effective intervention to decrease the intensity of spinal needle insertion pain in spinal anesthesia procedure."

"Latar belakang: Anestesia obstetrik termasuk anestesia yang memiliki risiko tinggi dalam praktik anestesia. Perubahan fisiologi ibu selama kehamilan dan keberadaan janin merupakan tantangan yang unik untuk anestesia obstetrik. Baik kehamilan normal maupun obesitas, sama-sama mengalami perubahan anatomi dan fisiologi yang signifikan dan pengaruh anestesi yang hampir sama. Belum ada penelitian sebelumnya yang membandingkan tingkat keberhasilan insersi jarum spinal dalam posisi duduk bersila antara ibu hamil obes maupun ibu hamil bukan obes yang menjalani seksio sesarea. Penelitian ini dilakukan di RSCM dan RSU Tangerang antara bulan Juli sampai Agustus 2016. Tujuan: Penelitian ini bertujuan untuk membandingkan tingkat keberhasilan insersi jarum spinal pada posisi duduk bersila antara ibu hamil obes dan ibu hamil bukan obes yang menjalani seksio sesarea. Metode: Penelitian ini merupakan open label study yaitu uji klinis terbuka dimana perlakuan sama-sama diketahui oleh subjek maupun pelaku anestesia. Ibu hamil yang menjalani seksio sesarea dibagi menjadi dua kelompok yaitu obes O dan bukan obes NO . Pada keduanya dilakukan insersi jarum spinal dalam posisi duduk bersila. Pada penelitian ini dilakukan penilaian tingkat keberhasilan insersi jarum spinal, persentase keberhasilan insersi jarum spinal, banyaknya kontak jarum spinal dengan tulang, dan kekerapan tusukan pembuluh darah. Hasil: Dari136 subjek penelitian, tidak ada yang termasuk kriteria penolakan dan pengeluaran. Keberhasilan insersi jarum spinal pada kelompok NO adalah 47 subjek 69,12 dan pada kelompok O 45 subjek 66,18. Secara statistik tidak berbeda bermakna antara kelompok NO dan kelompok O pada tingkat keberhasilan insersi jarum spinal p=0,714, jumlah kontak jarum spinal dengan tulang p=0,591, dan kekerapan tertusuknya pembuluh darah pada waktu insersi jarum spinal p=0,282. Simpulan: Tingkat keberhasilan insersi jarum spinal yang dilakukan dalam posisi duduk bersila pada ibu hamil bukan obes tidak lebih baik jika dibandingkan pada ibu hamil obes.

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Background: Obstetric anesthesia is high risk in practice. The physiological changes during pregnancy and fetal wellbeing are unique challenges posed for obstetric anesthesia. Significant changes in anatomy and physiology along with anesthesia considerations are similar in normal and obese pregnancy. Up to this day, there are no studies comparing successful spinal needle insertion rate in cross legged sitting position between obese and non obese parturient undergoing caesarean section. This study was done in RSCM and RSU Tangerang between July August 2016.

Aim: This study aims to compare successful rate of spinal needle insertion in cross legged sitting position between obese and non obese parturient undergoing caesarean section.

Method: This was an open label study, which was an open clinical trial where treatment was known by subjects and anesthesiologist. Parturient undergoing caesarean section were categorized into two groups, which were obese O and non obese NO. Both of the groups had spinal needle insertion in cross legged sitting position. In this study, the variables assessed were the rate of successful spinal needle insertion, the percentage of successful spinal needle insertion, the frequency of spinal needle contact with bone, and the frequency of vein puncture.

Result: All 136 subjects were included in the analysis. The rate of successful spinal needle insertion in the NO group was 47 subjects 69.12 and 45 subjects in the O group 66.18. This result was not statistically significant p 0.714, along with the frequency of spinal needle contact with bone p 0.591 , and the frequency of vein puncture during spinal needle insertion p 0.282.

Conclusion: The rate of successful spinal needle insertion in cross legged sitting position on non obese parturient was not better than on obese parturient.Key Words Spinal needle insertion, cross legged sitting position, obese and non obese parturient, bone contact, vein puncture."