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"Pemeriksaan toksikologi forensik terdiri dari pemeriksaan kualitatif dan kuantitatif. Pemeriksaan menggunakan metode Biochip Array Technology merupakan metode baru dengan teknologi nano digunakan untuk pemeriksaan toksikologi forensik. Tujuan penelitian ini untuk mengetahui nilai diagnostik pemeriksaan morfin dan benzodiazepin menggunakan metode tersebut. Penelitian ini menggunakan desain penelitian potong lintang (Cross sectional), dengan sampel penelitian adalah seorang laki-laki atau perempuan berusia diatas 18 tahun sejumlah 20 orang yang diambil dengan cara Consecutive sampling pada bulan September 2014 di Puskesmas Johar Baru, Jakarta Pusat. Dari sampel tersebut yang diperiksa dengan GC/MS, 4 sampel terdeteksi positif morfin, dan 3 sampel terdeteksi benzodiazepin. Pemeriksaan dengan metode Biochip Array Technology, 4 sampel positif morfin, dan 6 sampel terdeteksi positif benzodiazepin. Hasil analisa uji diagnostik menunjukkan bahwa pemeriksaan morfin menggunakan metode tersebut memiliki sensitivitas sebesar 100 %, spesifisitas 100 %, nilai duga positif 100 % dan nilai duga negatif 100 %. Hasil uji diagnostik pemeriksaan benzodiazepin menggunakan metode tersebut adalah sensitivitas 100 %, spesifisitas 82,35%, nilai duga positif 50 % dan nilai duga negatif 100 %. Dapat disimpulkan bahwa metode ini sangat baik digunakan untuk pemeriksaan morfin sedangkan untuk pemeriksaan benzodiazepine kurang baik.

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Forensic toxicology examination consists of a qualitative and quantitative examination. Biochip Array Technology is a new method with nanotechnology used for Forensic toxicology examination. The aim is to know the identificcation value of Biochip Array Technology diagnostic test to forensic toxicology examination of Morphine and benzodiazepine in urine.

Cross Sectional diagnostic study was applied to those who are male or female aged over 18 years old, 20 samples were taken consecutively in Agustus 2014 from primary health centres of Johar Baru, Jakarta Pusat. From these samples using the GC/MS, 4 samples are positive morphine, 3 samples are positive benzodiazepine. From Biochip Array Technology Examination, 4 samples are positive morphine, 6 samples are positive benzodiazepine.

Diagnostic test analysis in morphine examination showed that Biochip Array Technology revealed 100 % sensitivity, 100 % specificity, 100 % positive predictive value, and 100 % negative predictive value. Diagnostic test analysis in benzodiazepine examination showed that Biochip Array Technology revealed 100 % sensitivity, 82,35 % specificity, 50 % positive predictive value and 100 % negative predictive value. It can be concluded that this method is reliable in morphine examination but only if the sample is controlled, while for benzodiazepine examination, this method is not reliable."

"Pemeriksaan toksikologi forensik terdiri dari pemeriksaan kualitatif dan kuantitatif. Pemeriksaan menggunakan metode Biochip Array Technology merupakan metode baru dengan teknologi nano digunakan untuk pemeriksaan toksikologi forensik. Tujuan penelitian ini untuk mengetahui nilai diagnostik pemeriksaan morfin dan benzodiazepin menggunakan metode tersebut. Penelitian ini menggunakan desain penelitian potong lintang (Cross sectional), dengan sampel penelitian adalah seorang laki-laki atau perempuan berusia diatas 18 tahun sejumlah 20 orang yang diambil dengan cara Consecutive sampling pada bulan September 2014 di Puskesmas Johar Baru, Jakarta Pusat. Dari sampel tersebut yang diperiksa dengan GC/MS, 4 sampel terdeteksi positif morfin, dan 3 sampel terdeteksi benzodiazepin. Pemeriksaan dengan metode Biochip Array Technology, 4 sampel positif morfin, dan 6 sampel terdeteksi positif benzodiazepin. Hasil analisa uji diagnostik menunjukkan bahwa pemeriksaan morfin menggunakan metode tersebut memiliki sensitivitas sebesar 100 %, spesifisitas 100 %, nilai duga positif 100 % dan nilai duga negatif 100 %. Hasil uji diagnostik pemeriksaan benzodiazepin menggunakan metode tersebut adalah sensitivitas 100 %, spesifisitas 82,35%, nilai duga positif 50 % dan nilai duga negatif 100 %. Dapat disimpulkan bahwa metode ini sangat baik digunakan untuk pemeriksaan morfin sedangkan untuk pemeriksaan benzodiazepine kurang baik.

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Forensic toxicology examination consists of a qualitative and quantitative examination. Biochip Array Technology is a new method with nanotechnology used for Forensic toxicology examination. The aim is to know the identificcation value of Biochip Array Technology diagnostic test to forensic toxicology examination of Morphine and benzodiazepine in urine. Cross Sectional diagnostic study was applied to those who are male or female aged over 18 years old, 20 samples were taken consecutively in Agustus 2014 from primary health centres of Johar Baru, Jakarta Pusat. From these samples using the GC/MS, 4 samples are positive morphine, 3 samples are positive benzodiazepine. From Biochip Array Technology Examination, 4 samples are positive morphine, 6 samples are positive benzodiazepine. Diagnostic test analysis in morphine examination showed that Biochip Array Technology revealed 100 % sensitivity, 100 % specificity, 100 % positive predictive value, and 100 % negative predictive value. Diagnostic test analysis in benzodiazepine examination showed that Biochip Array Technology revealed 100 % sensitivity, 82,35 % specificity, 50 % positive predictive value and 100 % negative predictive value. It can be concluded that this method is reliable in morphine examination but only if the sample is controlled, while for benzodiazepine examination, this method is not reliable."

"Latar belakang: Pemakaian heroin masih cukup tinggi di Indonesia. Tesis ini membahas tentang pengaruh penambahan natrium florida pada penyimpanan sampel darah yang mengandung heroin ( 6 monoacetylmorphine dan morfin ) di kulkas suhu 5°C - 15°.Metode: Penelitian ini merupakan penelitian analitik eksperimental dalam lingkungan yang terkontrol. Terhadap 8 subjek penelitian diambil darahnya sebanyak 9 ml yaitu yang menggunakan heroin 30 menit hingga 3 jam sebelum pengambilan darah. Kemudian 9 ml darah dibagi menjadi 3 tabung, masing- masing tabung 3 ml. Tabung pertama langsung diperiksa kadar 6 monoacetylmorphine dan morfin menggunakan Gas Choromatography Mass Spectrometry. Tabung kedua yaitu darah dengan natrium florida dan tabung ketiga darah tanpa natrium florida disimpan dikulkas suhu 5°C - 15°C selama 3 hari. Hasil: Pada pemeriksaan sampel hari pertama terhadap zat 6 monoacetylmorphine tidak ditemukan adanya zat tersebut. Karena pada kedelapan sampel , 6 monoacetylmorphinenya telah berubah menjadi morfin. Tetapi 6 monoacetylmorphine ini tetap ada hingga hari ketiga pada 50% sampel yang disimpan dengan natrium florida. Rata-rata kadar morfin hari pertama adalah 860,2 ± 669,5 ng/ml menurun pada hari ketiga menjadi 656,6 ± 425,8 ng/ml ( sampel dengan penambahan natrium florida) , 448,2 ± 270,7 ng/ml ( sampel tanpa penambahan natrium florida). Rata-rata perbedaan antara sebelum dan sesudah penyimpanan pada sampel yang ditambahkan natrium florida adalah 203,6 ± 252,4 ng/ml dengan signifikansi (p) = 0,057. Rata-rata perbedaan antara sebelum dan sesudah penyimpanan pada sampel tanpa penambahan natrium florida adalah 411,9 ± 475,2 ng/ml dengan signifikansi (p) = 0,044. Kesimpulan Dengan penambahan natrium florida dapat mencegah perubahan 6 monoacetylmorphine menjadi morfin pada 50% sampel penelitian. Pada sampel yang disimpan dengan natrium florida, tidak ada perbedaan bermakna antara kadar morfin sebelum dan sesudah penyimpanan selama 3 hari dikulkas suhu 5°C - 15°C. Pada sampel yang disimpan tanpa natrium florida , terdapat perbedaan yang bermakna antara kadar morfin sebelum dan sesudah penyimpanan selama 3 hari dikulkas suhu 5°C - 15°C.

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Background: Heroin consumption is still quite high in Indonesia. This study is to discuss the effect of adding sodium fluoride to the storage of blood samples containing heroin (6 monoacetylmorphine and morphine) in a refrigerator with a temperature of 5°C to 15°C.

Methods: This study is an experimental analysis in a controlled environment. To the 8 subject of study, 9 ml of blood was drawn who was using heroin 30 minutes to 3 hours before blood sampling. This 9 ml of blood were then saved into 3 tubes of 3 ml each. The first tube was directly examined for the levels of 6 monoacetylmorphine and morphine using Gas Choromatography-Mass Spectrometry. The second tube of blood with sodium fluoride and the third tube of blood without sodium fluoride were stored in refrigerator of 5°C to 15°C for 3 days.

Results: On the first day examinations, 6 monoacetylmorphine were not found, because all of the samples, 6 monoacetylmorphine has changed to morphine. But this 6 monoacetylmorphine remains until the third day in 50% of samples stored with sodium fluoride. Average concentration of morphine in the first day was 860.2 ± 669.5 ng/ml and decreased to 656.6 ± 425.8 ng/ml on the third day (samples with the addition of sodium fluoride), and to 448.2 ± 270.7 ng / ml (sample without the addition of sodium fluoride). The average difference between before and after storage in the samples added with sodium fluoride is 203.6 ± 252.4 ng/ml with significance of (p) = 0.057. The average difference between before and after storage in the samples without the addition of sodium fluoride was 411.9 ± 475.2 ng/ml with significance (p) = 0.044.

Conclusion The additions of sodium fluoride prevent changes of 6 monoacetylmorphine into morphine in 50% of the study sample. In samples stored with sodium fluoride, there is no significant difference between the levels of morphine before and after storage for 3 days in refrigerator with temperature of 5°C to 15°C. In the samples stored without sodium fluoride, while there is a significant difference between the levels of morphine before and after storage for 3 days in refrigerator temperature of 5°C to 15°C."

"Telah dilakukan penelitian untuk membandingkan keefektifan penambahan morfin 0.05 mg intratekal dan morfin 0.1 mg intratekal dalam hal kekerapan pruritus yang ditimbulkan oleh efek samping morfin intratekal dengan efek analgesia pasca bedah-nya tetap sama pada kasus bedah sesar dengan tehnik analgesia spinal.Disain : uji klinis acak tersamar ganda.Metode : 84 pasien yang menjalani bedah sesar dibagi 2 kelompok. Kelompok A sebanyak 42 orang mendapat 0.05 mg morfin dan kelompok B sebanyak 42 orang mendapat 0.1 mg morfin pada suntikan bupivakain 0.5% 10 mg intratekal. Selanjutnya dilakukan pemantauan nyeri menggunakan skor VAS, tekanan darah, laju nadi dan laju nafas pada jam ke 2, 4, 6, 8, 16 dan 24 pasca operasi. Selama pemantauan juga diamati kekerapan dan derajat pruritus. Penilaian pruritus dengan menggunakan skor VAS.Hasil : Pada kelompok A memberikan efek analgesia paska bedah yang tidak berbeda bermakna dengan kelompok B dalam 24 jam (p X0.05 ). Sedangkan kekerapan pruritus pada kelompok A dan kelompok B masing-masing 16.7% dan 40.5% (p<0.05). Derajat pnuitus ringan dan sedang pada kelompok A didapat 7% dan 0%. Sedangkan pada kelompok B pruritus ringan 35,7 % dan pruritus sedang 4.8 %. Dan kedua kelompok tidak ada yang mengalami pruritus berat.Kesimpulan : morfin 0.05 mg intratekal lebih efektif menurunkan kekerapan pruritus dibanding morfin 0.1 mg intratekal tetapi menghasilkan efek analgesia pasca bedah yang sama pada bedah sesar dengan analgesia spinal.

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This study compared the quality of analgesia and the incidence and degree of pruritus of 0.1 mg morphine intrathecally to 0.05 mg intrathecal morphine in patients undergoing Caesarean section.

Design: randomized and double-blinded study

Method: 84 patients who underwent Caesarean section were divided randomly into two groups. 42 patients in group A received intrathecal morphine 0.05 mg and group 13, 42 patients, received 0.1 mg morphine intrathecally in addition to a standard intrathecal dose of 10 mg bupivacaine 0.5% heavy. The quality of analgesia was assessed using Visual Analogue Score ( VAS) and the incidence and degree of pruritus were recorded during the first-24 hour postoperatively.

Result: there was no statistically significant difference in the quality of analgesia between the two groups (p > 0.05 ). The incidence of pruritus in group A and group B was 16.7% and 40.5% respectively (p<0.05 ). The degree of pruritus in group A were mild : 7% and moderate : 0% while in group B mild : 35.7% and moderate 4.8%. There was no severe pruritus in the two groups.

Conclusion : 0.05 mg intrathecal morphine significantly reduced the incidence of pruritus compared to 0A mg intrathecal morphine while there was no significant difference statistically in the quality of analgesia in the two groups."

"ABSTRAKTujuan. Penelitian ini membandingkan pemeriksaan sitologi urin dengan pemeriksaan sistoskopi konvensional untuk mendeteksi metastasis kanker serviks ke vesika urinaria.Metode. Penelitian dilakukan dengan uji diagnostik potong-lintang dengan subjek penelitian pasien kanker serviks stadium ≥IIB di RSUPN Dr. Ciptomangunkusumo dari Juli 2015 hingga Januari 2016. Nilai diagnostik pemeriksaan sitologi urin dihitung dengan luaran: sensitivitas, spesifisitas, nilai prediksi positif, nilai prediksi negatif, dan akurasi. Uji kesesuaian pemeriksaan sitologi urin dibandingkan baku emas pemeriksaan sistoskopi konvensional.Hasil. Dalam jangka waktu Juli 2015 hingga Januari 2016 didapatkan 111 kasus pasien dengan diagnosis kanker serviks stadium ≥IIB yang memiliki potensi mengalami metastasis ke vesika urinaria. Sebanyak 106 subjek diikutsertakan dalam analisis statistik. Pemeriksaan sitologi urin memiliki sensitivitas 20%, spesifisitas 89%, nilai duga positif 8,33%, nilai duga negatif 95,74%, dan akurasi 95,28%.Kesimpulan. Penelitian ini menyimpulkan bahwa pemeriksaan sitologi urin mempunyai akurasi 95,28% sehingga dapat digunakan sebagai metode penapisan untuk mendeteksi kanker serviks yang belum metastasis ke vesika urinaria dan sebagai alternatif protokol. Apabila hasil pemeriksaan sitologi urin negatif maka tidak perlu dilakukan pemeriksaan sistoskopi, tetapi apabila hasil pemeriksaan sitologi urin positif maka perlu dilakukan pemeriksaan sistoskopi.Kata kunci: kanker serviks, metastasis vesika urinaria, sitologi urin, sistoskopi, nilai diagnostik

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ABSTRACTObjective. The aim of this study is to compare the diagnostic value of urine cytology and conventional cystoscopy to diagnose bladder metastasis in cervical cancer.Methods. It is a cross sectional study with cervical cancer patients stage ≥IIB at Dr. Ciptomangunkusumo Hospital from July 2015 to January 2016 as the research subjects. The diagnostic value of urine cytology and conventional cystoscopy were calculated as sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. The gold standard was conventional cystoscopy.Result. From July 2015 to January 2016, there were 111 subjects with cervical cancer that have possibility infiltrated the bladder, and there were 106 subjects that included to statistical analysis. The urine cytology has sensitivity 20%, specificity 89%, positive predictive value 8.33%, negative predictive value 95.74%, and accuracy 95.28%.Conclusion: The urine cytology has accuracy 95.28 %, so it can be used as screening method and alternative diagnostic method to detect if there is no bladder metastasis in cervical cancer. If the result of urine cytology is negative, then there is no need to perform cystoscopy, but if the result of urine cytology is positive, then the cystoscopy should be performed.Keyword: cervical cancer, bladder metastasis, urine cytology, cystoscopy, diagnostic value"

"[ABSTRAKLatar belakang: Berdasarkan data riskesdas 2013, prevalensi batu saluran kemih di Indonesia adalah 0,6 persen. Batu saluran kemih disebabkan oleh beberapa faktor; lingkungan kerja panas dan BJ Urin. Sebagian pekerja dapur RS X Tangerang mengeluh lingkungan kerja yang panas berlebihan sehingga berkeringat dan data medical check up tahun 2014 tidak ada pemeriksaan urin sehingga gambaran status kesehatan pekerja akibat lingkungan panas tidak dapat diketahui. Penelitian ini bertujuan untuk mengetahui hubungan lingkungan kerja panas dengan kristalisasi urin pada pekerja dapur RS X Tangerang.Metode: Rancangan penelitian yang digunakan adalah kros seksional. Pengumpulan data dilakukan di RS X Tangerang dari bulan Januari sampai Maret 2015, dengan menggunakan kuesioner, wawancara, pemeriksaan tanda vital responden sebelum dan sesudah kerja, pemeriksaan urinalisa sebelum dan sesudah kerja serta pengukuran suhu lingkungan kerja dengan menggunakan alat area heat stress monitor Quest Stemp 36 dan perhitungannya berdasarkan Indeks Suhu Bola Basah. Berdasarkan metode total populasi dan setelah mempertimbangkan faktor eklusi dan inklusi didapatkan sampel sebanyak 105 orang.Hasil: Prevalensi kristal urin ditemukan sebesar 6,7% pada pemeriksaan urin sebelum kerja dan 10,5% sesudah kerja. Lingkungan kerja panas tidak mempunyai hubungan yang bermakna dengan terjadinya kristalisasi urin pada pekerja (p=0,316). BJ urin mempunyai hubungan yang bermakna dengan terjadinya kristalisasi urin (p<0,05), dimana risiko untuk terjadinya kristalisasi urin meningkat 1,8 kali sesudah kerja. Faktor risiko lain seperti umur, jenis kelamin, riwayat penyakit, Indeks Masa Tubuh, kebiasaan makan dan minum, masa kerja, lama kerja, dan jenis pekerjaan tidak terdapat hubungan yang bermakna (p>0,05).Kesimpulan: Lingkungan kerja panas dan faktor risiko lainnya tidak berhubungan dengan terjadinya kristalisasi urin pada pekerja di bagian dapur RS X Tangerang. BJ Urin responden berhubungan dengan terjadinya kristalisasi urin baik pada pemeriksaan urin sebelum dan sesudah kerja, Ini berarti sebelum kerja responden sudah dehidrasi, mungkin karena kurang minum atau paparan panas sebelumnya. Ditambah lingkungan kerja panas kepekatan urin meningkat, karenanya dianjurkan pekerja mengkonsumsi cairan minimal dua liter perhari.

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ABSTRACTBackground: According to 2013 Riskesdas data, the prevalence of urinary tract calculus in Indonesia is 0.6%. Several factors like temperature of working environment and urine specific gravity contribute to the formation of urinary tract calculus. Some of kitchen workers in the hospital X Tangerang complain about their hot working environment which caused them to sweat excessively and medical check-ups data in 2014, there was no urine examination so that an overview of health status of workers due to hot environment can‟t be obtained.This study aims to determine the relationship between hot working environment and urine crystallization on the kitchen workers of hospital X TangerangMethods: The research used a cross-sectional design. Data collection was done in Hospital X Tangerang from January to March 2015 using questionnaire, interview, and vital signs examination of the respondents before and after work, urine examination before and after work. Environment temperature was measured using area heat stress monitor Quest Stemp 36 and the calculation was done based on WBGT (Wet Bulb Globe Temperature Index). Using total population methods after considering the inclusion and exclusion factors, we acquired 105 people as samples.Result: The prevalence of urinary crystals was 6. 7% on urine samples before work and 10.5% after work. The relationship between hot working environment and the formation of crystals in the urine was not significant in the kitchen workers (p>0.316). Urine specific gravity has a significant relationship to the formation of crystals in the urine (p<0.05) in which the risk of the crystals formation increase 1,8 time after work. The other risk factors such as age, sex, hospital sheet, body mass index, eating and drinking habits, tenure, long working, and type of work showed no significant relationship (p>0.05).Conclusion: Hot working environment and the other risk factors are not related to urine crystallization in the kitchen workers of Hospital X Tangerang. Urine specific gravity is related to the formation of crystals in the urine before and after work. This means, before working respondents already dehydrated, probably due to lack of drinking or heat exposure before. Hot working environment increases urine concentration. It‟s recommended for workers to consume at least two liters of fluid perday., Background: According to 2013 Riskesdas data, the prevalence of urinary tract calculus in Indonesia is 0.6%. Several factors like temperature of working environment and urine specific gravity contribute to the formation of urinary tract calculus. Some of kitchen workers in the hospital X Tangerang complain about their hot working environment which caused them to sweat excessively and medical check-ups data in 2014, there was no urine examination so that an overview of health status of workers due to hot environment can‟t be obtained.This study aims to determine the relationship between hot working environment and urine crystallization on the kitchen workers of hospital X TangerangMethods: The research used a cross-sectional design. Data collection was done in Hospital X Tangerang from January to March 2015 using questionnaire, interview, and vital signs examination of the respondents before and after work, urine examination before and after work. Environment temperature was measured using area heat stress monitor Quest Stemp 36 and the calculation was done based on WBGT (Wet Bulb Globe Temperature Index). Using total population methods after considering the inclusion and exclusion factors, we acquired 105 people as samples.Result: The prevalence of urinary crystals was 6. 7% on urine samples before work and 10.5% after work. The relationship between hot working environment and the formation of crystals in the urine was not significant in the kitchen workers (p>0.316). Urine specific gravity has a significant relationship to the formation of crystals in the urine (p<0.05) in which the risk of the crystals formation increase 1,8 time after work. The other risk factors such as age, sex, hospital sheet, body mass index, eating and drinking habits, tenure, long working, and type of work showed no significant relationship (p>0.05).Conclusion: Hot working environment and the other risk factors are not related to urine crystallization in the kitchen workers of Hospital X Tangerang. Urine specific gravity is related to the formation of crystals in the urine before and after work. This means, before working respondents already dehydrated, probably due to lack of drinking or heat exposure before. Hot working environment increases urine concentration. It‟s recommended for workers to consume at least two liters of fluid perday.]"

"PT. Kimia Farma, Tbk, merupakan perusahaan BUMN Farmasi yang sudah lama berdiri di Indonesia, memiliki hak monopoli dalam importasi, produksi dan distribusi produk Tablet Morfin, produk ini merupakan produk yang wajib ada untuk kebutuhan pengobatan. Sangatlah penting bagi perusahaan untuk dapat mengamankan serta menganalisis rantai pasoknya, agar memiliki sistem rantai pasok yang baik. Tesis ini mempelajari dan mengevaluasi rantai pasok dan proses bisnis PT Kimia Farma, Tbk, dalam melakukan pasokan Tablet Morfin, dengan menggunakan analisis Focus Group Discussion (FDG), dan Fishbone, hasil analisis menunjukkan terjadinya ketidaksesuaian rantai pasok yang terjadi pada distributor Majapahit (Jakarta Pusat), yang memasok RS Kanker Dharmais, ketidaksesuaian berupa kekosongan produk dikarenakan beberapa akar penyebab, yaitu Lead Time yang lama, tidak adanya sistem Standard Operating Procedure (SOP) yang terintegrasi, tidak adanya sistem Teknologi Informasi terintegrasi, pengetahuan SDM mengenai regulasi kurang, dan perencanaan distribusi yang tidak tepat.

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PT. Kimia Farma Tbk, a pharmaceuticals state-owned company has established in Indonesia for many years, has a monopoly in the importation, production and distribution of Morphine tablets, this product is compulsory product for medication. It is important for companies to secure and analyze the supply chain, in order to have a good supply chain system. This thesis studied and evaluated supply chain and business process at PT Kimia Farma Tbk, in delivering Morphine Tablets to the customer, by using Focus Group Discussion (FDG), and Fishbone analysis, the results of the analysis showed the occurrence of mismatch of supply chain happens at distributor Majapahit (Jakarta Pusat), which supplies Dharmais Cancer Hospital, a mismatch in the form of zero stock because some of the root causes, some of the root causes are, Long Lead Time, lack of integrationsystem in the Standard Operating Procedure (SOP), No Integration on Information Technology systems, poor human resources knowledge on regulation, and improper distribution planning."

"Latar belakang: Nyeri pascabedah ortopedi ekstremitas bawah masih menjadi masalah yang berkaitan dengan risiko pascabedah dan lama perawatan di rumah sakit. PCA intravena morfin dan oxycodone masih belum dikaji lebih jauh sebagai analgesia pascabedah ortopedi ekstremitas bawah.Metode: Penelitian ini merupakan uji klinik acak tersamar ganda untuk menilai efektivitas PCA intravena morfin dengan oxycodone untuk analgesia pascabedah ortopedi ekstremitas bawah. Subjek penelitian berjumlah 50 orang yang didapatkan dengan consecutive sampling selama Januari-April 2019. Pasien dibagi menjadi 2 kelompok, dirandomisasi menjadi kelompok morfin dan kelompok oxycodone. Efektivitas dinilai dengan banyaknya konsumsi opioid dalam 24 jam pascabedah dan efek samping antara 2 kelompok. Penilaian derajat nyeri diam dan bergerak pada jam ke-0, 6, 12, dan 24 dengan menggunakan Visual Analogue Score (VAS) dan kepuasan pasien pada penggunaan PCA juga dinilai untuk komponen penilaian tambahan. Hasil dianalisis dengan SPSS.Hasil: Seluruh subjek penelitian menyelesaikan penelitian dan tidak didapatkan perbedaan karakteristik yang signifikan antara 2 kelompok. Banyaknya konsumsi opioid dalam 24 jam pertama pascabedah antara 2 kelompok (p 0,574) dan kejadian efek samping antara 2 kelompok tidak berbeda. Derajat nyeri istirahat dan bergerak juga tidak didapatkan hasil yang berbeda bermakna (p 0,109 ; 0,163). Kepuasan pasien pada penggunaan PCA juga tidak berbeda bermakna, namun secara umum pasien puas dengan penggunaan PCA, dan kepuasan pasien pada PCA oxycodone (76%) lebih banyak dibanding PCA morfin (52%)Simpulan: PCA intravena oxycodone tidak lebih efektif dibandingkan PCA intravena morfin untuk analgesia pascabedah ortopedi ekstremitas bawah pada penelitian ini. Pasien yang setuju dengan penggunaan PCA sebanyak 30 subjek, tidak ada perbedaan signifikan antara 2 kelompok.

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Background: Postoperative pain after lower extremity orthopedic surgery may increase morbidity after surgery and prolong the length of hospitalization. The study investigating effectiveness intravenous PCA morphine and oxycodone has not been extensively studied for managing pain after lower extremity orthopedic surgery.

Methods: This study is a double-blind randomized study clinical trial to evaluate effectiveness intravenous PCA morphine and oxycodone for post-operative analgesia after lower extremity orthopedic surgery. Total of 50 subjects were enrolled with consecutive sampling within January-April 2019. Subjects were randomly allocated into 2 groups, received intravenous PCA morphine or intravenous PCA oxycodone. Post-operative opioid consumption in 24 hours and side effects were considered the primary efficacy variable. Pain scores were measured using Visual Analogue Score (VAS) at time 0, 6, 12, and 24 after surgery. Patient satisfaction in both groups was also evaluated. Data was analyzed statistically using SPSS.

Results: All the subjects done this study. There were no differences in the characteristics of both groups. Opioid consumption between two groups no significantly different (p 0,574) and incidence of side effects between two groups were similar. Pain scores during rest and move also no significant differences (p 0,109 ; 0,163). Patient satisfaction no significant difference, but almost patient satisfied with using PCA, while group oxycodone (76%) higher than group morphine (52%).

Conclusion: Intravenous PCA oxycodone had no more effective than intravenous PCA morphine for post-operative analgesia after lower extremity orthopedic surgery in this study. Patient satisfaction was higher in group oxycodone than in group morphine."