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Putri Ade Meuratana
Efek elektroakupunktur pada pencegahan menggigil pasien bedah urologi dengan anestesi spinal = The effect of electro acupuncture on the prevention of shivering of urology surgery patients with spinal anesthesia.
"Menggigil selama anestesi spinal adalah salah satu komplikasi yang paling sering dihubungkan dengan penurunan suhu inti tubuh. Insiden menggigil paska anestesi cukup tinggi dan memberikan dampak perubahan fisiologis yang merugikan pada pasien sehingga perlu dicegah dan ditanggulangi secepatnya. Belum ada terapi gold standar untuk menggigil. Elektroakupunktur EA diketahui dapat mencegah menggigil dengan mempertahankan suhu inti tubuh. Penelitian ini bertujuan untuk mengetahui pengaruh elektroakupunktur pada pencegahan menggigil pasien bedah urologi dengan anestesi spinal serta mengetahui pengaruh elektroakupunktur pada rerata penurunan suhu inti pasien bedah urologi dengan anestesi spinal. Uji klinis acak tersamar tunggal dengan pembanding dilakukan terhadap 36 subjek yang akan menjalani spinal anestesi pada pasien bedah urologi dialokasikan secara acak kedalam kelompok elektroakupunktur n=18 dilakukan penusukan titik LI4, PC6, ST36, dan SP6 bilateral sampai terjadi sensasi penjaruman, diberikan elektrostimulator frekuensi 2 Hz, gelombang continues pada kelompok eletroakupunktur sham n=18 dilakukan penusukan pada plester tanpa menembus kulit kemudian dihubungkan dengan elektrostimulator yang tidak dinyalakan. Elektroakupunktur dilakukan 1 kali selama 30 menit sebelum dilakukan anestesi spinal. Penilaian objektif menggigil menggunakan skala Crossley dan Mahajan serta penilaian suhu inti tubuh melalui suhu membran timpani menggunakan termometer infra red pada menit ke 5, 15, 30 dan 60. Hasil penelitian menunjukkan terdapat perbedaan tidak bermakna angka kejadian menggigil pada kelompok elektroakupunktur dibandingkan kelompok elektroakupunktur sham p=0,22 namun secara klinis kejadian menggigil hanya ditemukan pada kelompok elektroakupunktur sham pada menit ke-60 16,7 dengan derajat menggigil 3 dan 4. Terdapat perbedaan bermakna suhu inti tubuh sebelum dan setelah dilakukan EA pada kelompok elektroakupunktur dibandingkan kelompok elektroakupunktur sham p=0,03 , menit ke-15 p=0,03 dan menit ke-60 p=0,03 setelah anestesi spinal. Terdapat perbedaan tidak bermakna suhu inti tubuh pada kelompok elektroakupunktur dibandingkan kelompok elektroakupunktur sham menit ke-5 p=0,11 dan menit ke-30 p=0,12. Kesimpulan penelitian ini penurunan suhu inti tubuh pada pasien dengan anestesi spinal dapat dicegah dengan menggunakan elektroakupunktur, namun tidak terdapat perbedaan bermakna pada kejadian menggigil.
Shivering during spinal anesthesia is one of complications which are mostly associated with the decrease of body core temperature. The shivering incidents post anesthesia is quite high and provides an adverse physiological impact to patients that need to be prevented and addressed as soon as possible. There are no gold standards for shivering. Electroacupuncture EA is known to prevent shivering by maintaining the body core temperature. The aim of this research is to learn the impact of electroacupuncture to prevent shivering on urology surgery patients with spinal anesthesia as well as to discover the impact of electro acupuncture on the average decrease of urology surgery patient rsquo;s body core temperature with spinal anesthesia. Single blinded randomized clinical trial with comparison was performed to 36 subjects that would undergo spinal anesthesia to urology surgery patients allocated randomly into electroacupuncture group n=18 by performing needling at points LI4, PC6, ST36, and SP6 bilateral until the sensation of needling occurred, electrostimulator of 2 Hz frequency was given, continues wave given while in sham n=18 electroacupuncture group was performed needling on plaster without penetrating the skin then connected to electrostimulator that was not turn on. Electroacupuncture was performed once for 30 minutes before spinal anesthesia was conducted. An objective assessment of shivering was performed by using Crossley and Mahajan scale and the assessment of body core temperature through temperature tympanic membrane was conducted by using infra red thermometer in the 5, 15, 30 and 60 minutes. The result of the research suggested that there are meaningless differences of number of shivering incidents in electro acupuncture group compared to sham p=0,22 electro acupuncture group however clinically shivering incident was only found at sham electro acupuncture group in the 60 minutes 16,7 with the degree of shivering was 3 and 4. There are meaningful differences of body core temperature before and after EA was performed to electroacupuncture group compared to sham p=0,03 electroacupuncture group in the 15 p=0,03 minutes and 60 p=0,03 minutes after spinal anesthesia. There are meaningless differences of body core temperature in electroacupuncture group compared to sham electroacupuncture group in 5 p=0,11 minutes and 30 p=0,12 minutes. The conclusion of this research is the decrease of body core temperature of patients with spinal anesthesia can be prevented by using electroacupuncture; however there are no meaningful differences on shivering incidents. "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Tugas Akhir  Universitas Indonesia Library
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Dedy Fardian
Efek premedikasi granisetron 10 µG/KGBW intravena terhadap kejadian menggigil paska anestesi spinal = Premedication effect of intravenous granisetron 10 µG/KGBW to incidence of post spinal anesthesia shivering / Dedy Fardian
"ABSTRAK
Menggigil merupakan komplikasi paska anestesi spinal dengan insidens yang cukup tinggi dan memberikan dampak perubahan fisiologis yang merugikan bagi pasien sehingga perlu dicegah dan ditanggulangi secepatnya. Tujuan dari penelitian ini adalah untuk mengetahui efek pemberian premedikasi obat golongan antagonis 5-HT3 Granisetron 10 μg/kgBB intravena terhadap kejadian menggigil paska anestesi spinal. Penelitian ini merupakan uji klinis acak tersamar ganda yang bersifat eksperimental pada 32 pasien, dengan status fisik ASA 1-2 yang menjalani operasi dengan anestesi spinal yang terbagi dua kelompok yaitu yang mendapat perlakuan (kelompok G) dan kelompok kontrol (kelompok K). Hasil penelitian didapatkan perbedaan angka kejadian menggigil yang bermakna pada kedua kelompok serta terdapat perbedaan signifikan derajat menggigil maksimal pada kedua kelompok. Kesimpulan dari penelitian ini adalah pemberian premedikasi Granisetron dengan dosis 10 μg/kgBB intravena sebelum dilakukan anestesi spinal terbukti bermakna menurunkan angka kejadian menggigil dan mengurangi derajat atau intensitas menggigil paska anestesi spinal.
ABSTRAK
Shivering is a complication of spinal anesthesia with high incidence which has adverse physiological changes to patient. It is important to prevent and treat immediately. This study aims to determine the premedication effect of intravenous Granisetron 10 μg/kgBW on the incidence of post spinal anesthesia shivering. This study was designed as double blind experimental study to 32 patients with ASA 1-2, who underwent surgery under spinal anesthesia and divided into two groups The patients were randomized and divided into two groups : Group G who received premedication before spinal puncture, Group K as a control. The result showed that incidence of shivering between two groups were statistically different and there were significant difference in maximal intensity of shivering between two groups. The conclusion of this study is intravenous Granisetron 10 μg/kgBW as premedication before spinal anesthesia has decreased the incidence and intensity of post anesthesia shivering"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
T-Pdf
UI - Tesis Membership  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
SP-pdf
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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Ferry Aditya Phan
Pengaruh terapi akupunktur terhadap uremik pruritus pada pasien hemodialisis = Effect of acupuncture treatment for uremic pruritus in hemodialysis patients
"[ABSTRAK
Uremik pruritus masih menjadi masalah dan mengurangi kualitas hidup pada pasien hemodialisis, meskipun telah banyak kemajuan dalam teknik dialisis, serta terapi yang ada belum memberikan hasil yang maksimal. Terapi akupunktur dapat dikembangkan sebagai terapi pendamping pada terapi hemodialisis untuk mengurangi gejala uremik pruritus. Penelitiasn ini merupakan penelitian akupunktur pertama di Indonesia dengan subyek pasien hemodialisis. Tiga puluh tujuh pasien hemodialisis dengan uremik pruritus dibagi dalam dua kelompok secara acak, kelompok akupunktur (n=18) mendapat terapi akupunktur pada titik tunggal LI11 Quchi, sementara kelompok kontrol (n=19) mengunakan jarum plasebo The Park Sham Device. Terapi akupunktur dilakukan saat hemodialisis, seminggu dua kali sebanyak 12 kali. Skor pruritus dinilai menggunakan kuesioner pruritus 5D sebelum terapi, setelah terapi ke-4, ke-8 dan setelah terapi ke-12, serta penilaian lanjutan 4 dan 8 minggu setelah terapi selesai. Perbedaan bermakna skor pruritus 5D antara kelompok akupunktur dan kelompok kontrol terjadi setelah akhir terapi akupunktur (7,89±0,832 vs 10,63±3,166; p=0,003) dan penilaian lanjutan 4 minggu setelah terapi selesai(8,06±1,830 vs 10,95±3,341; p=0,001). Terapi akupunktur efektif menurunkan skor uremik pruritus pada pasien hemodialisis yang menjalani dialisis seminggu dua kali.
ABSTRACT
Uremic pruritus still gives problems for hemodialysis patients especially to reducing their quality of life, although it has been many advancements in dialysis techniques, recent therapies not yet provide optimum results. Acupuncture has a role as a complement in hemodialysis therapy to alleviate the symptoms of uremic pruritus in hemodialysis patients. This study is the first acupuncture research in Indonesia with the subject of hemodialysis patients. Thirty-seven hemodialysis patients with uremic pruritus were divided randomly into two groups, the acupuncture group (n = 18) received acupuncture treatment at a single point LI11 Quchi, while the control group (n = 19) using a placebo needle The Park Sham Device. Acupuncture treatment was done simultaneously with hemodialysis therapy, twice a week for 12 times. The pruritus scores was assessed using a 5D pruritus questionnaire before treatment, after 4th, 8th, 12th acupuncture treatment and at 4 and 8 weeks follow up. Significant differences 5D pruritus scores between the acupuncture group and the control group occurred after the end of acupuncture treatment (7.89±0.832 vs 10.63±3.166; p = 0.003) and at 4 weeks follow up (8.06±1.830 vs. 10.95±3.341; p = 0.001). Acupuncture treatment is effective in lowering the score of uremic pruritus in hemodialysis patients who undergo dialysis twice a week.;Uremic pruritus still gives problems for hemodialysis patients especially to reducing their quality of life, although it has been many advancements in dialysis techniques, recent therapies not yet provide optimum results. Acupuncture has a role as a complement in hemodialysis therapy to alleviate the symptoms of uremic pruritus in hemodialysis patients. This study is the first acupuncture research in Indonesia with the subject of hemodialysis patients. Thirty-seven hemodialysis patients with uremic pruritus were divided randomly into two groups, the acupuncture group (n = 18) received acupuncture treatment at a single point LI11 Quchi, while the control group (n = 19) using a placebo needle The Park Sham Device. Acupuncture treatment was done simultaneously with hemodialysis therapy, twice a week for 12 times. The pruritus scores was assessed using a 5D pruritus questionnaire before treatment, after 4th, 8th, 12th acupuncture treatment and at 4 and 8 weeks follow up. Significant differences 5D pruritus scores between the acupuncture group and the control group occurred after the end of acupuncture treatment (7.89±0.832 vs 10.63±3.166; p = 0.003) and at 4 weeks follow up (8.06±1.830 vs. 10.95±3.341; p = 0.001). Acupuncture treatment is effective in lowering the score of uremic pruritus in hemodialysis patients who undergo dialysis twice a week., Uremic pruritus still gives problems for hemodialysis patients especially to reducing their quality of life, although it has been many advancements in dialysis techniques, recent therapies not yet provide optimum results. Acupuncture has a role as a complement in hemodialysis therapy to alleviate the symptoms of uremic pruritus in hemodialysis patients. This study is the first acupuncture research in Indonesia with the subject of hemodialysis patients. Thirty-seven hemodialysis patients with uremic pruritus were divided randomly into two groups, the acupuncture group (n = 18) received acupuncture treatment at a single point LI11 Quchi, while the control group (n = 19) using a placebo needle The Park Sham Device. Acupuncture treatment was done simultaneously with hemodialysis therapy, twice a week for 12 times. The pruritus scores was assessed using a 5D pruritus questionnaire before treatment, after 4th, 8th, 12th acupuncture treatment and at 4 and 8 weeks follow up. Significant differences 5D pruritus scores between the acupuncture group and the control group occurred after the end of acupuncture treatment (7.89±0.832 vs 10.63±3.166; p = 0.003) and at 4 weeks follow up (8.06±1.830 vs. 10.95±3.341; p = 0.001). Acupuncture treatment is effective in lowering the score of uremic pruritus in hemodialysis patients who undergo dialysis twice a week.]"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Nurul Rahmawati
Keefektifan ropivakain 15 mg hiperbarik plus M0 0,15 mg dan ruvakain 12 mg hiperbarik plus M0 0,15 mg pada anesthesia spinal bedah sesar
"Latar belakang : Penelitian ini membandingkan efek ropivakain hiperbarik 15 mg + morfin 0,15 mg dengan ropivakain hiperbarik 12 mg + morfin 0,15 mg untuk bedah sesar dengan analgesia spinal.
Metode : Dilakukan secara acak tersamar Banda. Hipotesis yang dibuat adalah Ropivakain hiperbarik 12 mg dengan morfin 0,15 mg intratekal, mempunyai mula kerja hambatan sensorik dan motorik yang sama dengan ropivakain hiperbarik 15 mg ditambah morfin 0,15 mg intratekal, namun dengan masa kerja hambatan sensorik dan motorik lebih singkat, dan dapat digunakan untuk anestesia spinal pada bedah sesar. Sebanyak 66 wanita hamil yang akan menjalani beddah sesar, ASA I -- II diberikan ropivakain hiperbarik 15 mg + morfin 0,15 mg (n=33) atau ropivakain hiperbarik 12 mg + morfin 0,15 mg (n-33) dengan teknik blok subaraknoid. Perubahan blok sensorik diukur dengan tes pinprick, dan perubahan hambatan motorik diukur dengan modifikasi skala bomage, VAS diukur 3 kali.
Basil : Tidak ada perbedaan bermakna pada data demografi kedua kelompok. Kelompok ropivakain 15 mg mempunyai penyebaran hambatan sensorik maksimal lebih tinggi (median [min-max]) : Th 4 (th 1 - 6) vs Th 5 (Th 2 -- 6), tidak ada perbedaan bermakna pada mula kerja hambatan sensorik (median [min-max]) : 3,2 mnt (2 - 5 mnt) vs 3,0 (1- 5 mnt), tidak ada perbedaan bermakna pada mula keija hambatan motorik (median [min-max]) : 3,3 mnt (1-10 mnt) vs 3 mnt (1-7 mnt), masa kerja hambatan sensorik lebih lama pada kelompok ropivakain 15 mg (median [min-max]) : 60 mnt (45 -120mnt) vs 52 mnt (30 - 103 mnt), masa kerja hambatan motorik lebih lama pada kelompok ropivakain 15 mg (median[min-max]) : 60 mnt (35-118 mnt) vs 57 mnt (32 -102 mnt), dan basil yang sama pada pengukuran VAS sebanyak 3 kali.
Simpulan : Ropivakain hiperbarik 15 mg + morfin 0,15 mg dan ropivakain hiperbarik 12 mg + mofin 0,15 mg dapat digunakan untuk analgesia spinal untuk operasi bedah sesar.
Background This study was designed to evaluate the effects of intrathecal hyperbaric ropivacaine 15 mg plus morln 0,15 mg and hyperbaric ropivacaine 12 mg plus morphine 0,15 mg in women undergoing cesarean section.
Methods : This was a prospective, randomized, doubleblinded study. We hypothesized that hyperbaric ropivacaine 12 mg plus morphin 0,15 mg has the same onset of sensory and motoric block, with longer duration of sensory and motoric block with hyperbaric ropivacaine 15 mg plus morphine 0,15 mg. Sixtysix parturients, physical status ASA I - II were given either hyperbaric ropivacaine 15 mg plus morphine 0,15 mg (n=33) or hyperbaric ropivacaine 12 mg plus morphine 0,15 mg (n=33), for cesarean section with spinal analgesia. Changing of sensory block was assessed by pinprick test and motoric block was assessed by bromage score (modification). Visual analogue score was measured three times.
Results : There were no significant differences in demographic variable between groups. Higher cephalic spread (median [range]) maximum block height to pinprick hyperbaric ropivacaine 15 mg compare hyperbaric ropivacaine 12 mg : Th 4 (th 1 - 6) vs Th 5 (Th 2 - 6), no significant difference of sensory block onset (median [range]) : 3,2 min (2 - 5 minutes) vs 3,0 (1 - 5 min), no significant difference of motoric block onset (median [range]) : 3,3 min (1-10 min) vs 3 min ( 1-7 min), longer sensoric block duration hyperbaric ropivacaine 15 mg compare to hyperbaric ropivacaine 12 mg (median [range]) : 60 min (45 -120min) vs 52 min (30 -- 103 min), longer motoric block duration in hyperbaric ropivacaine 15 mg compare hyperbaric ropivacaine 12 mg (median[range]) : 60 min (35-118 min) vs 57 min (32 - 102 min), and no significant difference in visual analogue score in three times measurements.
Conclusion : Hyperbaric ropivacaine 15 mg plus morphine 0,15 mg and hyperbaric ropivacaine 12 mg plus morphine 0,15 mg are sufficient for spinal analgesia in patients undergoing cesarean section."
Depok: Universitas Indonesia, 2005
T21413
UI - Tesis Membership  Universitas Indonesia Library
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Astria Yuliastri Permana
Perbandingan efektivitas dan efek samping penambahan klonidin 30 mcg pada kombinasi anestesi spinal bupivakain dan fentanil pada pasien seksio sesarea = Comparison of effectiveness and side effects of the addition of 30 mcg of clonidine in a combination of spinal anesthesia with bupivacaine and fentanyl in cesarean section patients
"Latar belakang. Kombinasi anestesi spinal bupivakain dan fentanil dengan penambahan klonidin dosis tinggi diketahui dapat memperpanjang durasi blok sensorik dan motorik, namun prevalensi timbulnya efek samping cukup tinggi. Dalam studi ini, kami menggunakan klonidin dosis rendah secara intratekal (30 mcg) sebagai adjuvan  bupivakain dan fentanil. 
Tujuan. Penelitian dilakukan untuk membandingkan efektifitas serta efek samping pada kombinasi anestesi spinal bupivakain fentanil dengan dan tanpa klonidin 30 mcg.
Metode. Penelitian studi potong lintang yang dilakukan pada 70 pasien seksio sesarea terbagi kedalam dua kelompok masing-masing 35 pasien yang mendapatkan kombinasi anestesi spinal dengan penambahan klonidin 30 mcg dan tanpa klonidin 30 mcg. Penelitian ini mengevaluasi kualitas blok sensorik dan motorik. Efek samping yang terjadi diamati selama 24 jam paska tindakan seksio sesarea meliputi pruritus, mual muntah, nyeri tungkai, nyeri punggung dan mata merah. 
Hasil Penelitian. Median durasi blok sensorik kelompok kombinasi anestesi bupivakain fentanil dengan klonidin 30 mcg dibandingkan tanpa klonidin 30 mcg (330 menit vs 220 menit), Median durasi blok motorik (193 menit vs 188 menit). Efek samping tertinggi adalah mual muntah terdapat pada kelompok kombinasi tanpa klonidin 30 mcg (42.85%). Perbedaan bermakna (p-value < 0.05) terdapat pada durasi blok sensorik, blok motorik dan efek samping mual muntah.
Kesimpulan. Penambahan klonidin 30 mcg pada kombinasi anestesi spinal bupivakain fentanil dapat memperpanjang durasi blok sensorik dan motorik serta meminimalisir efek samping dibandingkan dengan tanpa klonidin 30 mcg.
Background. The combination of the spinal anesthesia bupivacaine and fentanyl with the addition of high doses of clonidine are known to prolong the duration of sensory and motor blocks, but the prevalence of side effects is high. In this study, we used an intrathecally low dose of clonidine (30 mcg) as an adjuvant to bupivacaine and fentanyl.
Aim. This study was conducted to compare the effectiveness and side effects of the combination spinal anesthesia bupivacaine fentanyl with and without clonidine 30 mcg.
Method. Cross-sectional study conducted on 70 patients with cesarean section divided into two groups of 35 patients each who received a combination of spinal anesthesia with the addition of clonidine 30 mcg and without clonidine 30 mcg. This study evaluates the quality of the sensory and motor blocks. Side effects observed for 24 hours after cesarean section included pruritus, nausea, vomiting, leg pain, back pain and red eyes.
Result. Median sensory block duration in the combination group of the anesthetic bupivacaine fentanyl with clonidine 30 mcg compared without clonidine 30 mcg (330 min vs 220 min), Median motor block duration (193 min vs 188 min). The highest side effect was nausea and vomiting in the combination group without clonidine 30 mcg (42.85%). Significant differences (p-value <0.05) were found in the duration of sensory blocks, motor blocks and side effects of nausea and vomiting.
Conclusion. The addition of clonidine 30 mcg to the combination of spinal anesthesia bupivacaine fentanyl can prolong the duration of sensory and motor blocks and minimize side effects compared to 30 mcg without clonidine."
Depok: Fakultas Farmasi Universitas Indonesia, 2020
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Sidharta Kusuma Manggala
Perbandingan Crossed Leg Sitting Position dan Traditional Sitting Position terhadap keberhasilan penempatan jarum spinal pada pasien bedah urologi = Comparison of Crossed Leg Sitting Position and Traditional Sitting Position to successful insertion of spinal needle for patient undergoing urologic surgery procedure
"[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.]"
Fakultas Kedokteran Universitas Indonesia, 2015
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Robin Martilo Djajadi
Perbandingan Efektivitas Laser Akupunktur dengan Elektroakupunktur pada Titik ST40 Fenglong dalam Memperbaiki Kadar Kolesterol Total, Indeks Aterogenik, dan Berat Lemak Dinding Abdomen pada Tikus Model Diet Tinggi Lemak = Comparison of The Effectiveness of Laser Acupuncture and Electroacupuncture at The ST40 Fenglong Point for Improving Total Cholesterol Levels, Atherogenic Index, and Abdominal Wall Fat Weight in High Fat Diet Model Rats
"Pendahuluan: Peningkatan kadar kolesterol didalam plasma darah atau hiperlipidemia merupakan faktor predisposisi terjadinya aterosklerosis. Faktor risiko diet tinggi lemak amat mempengaruhi tingginya kadar kolesterol darah. Permasalahan kepatuhan dalam perubahan diet dan efek samping obat penurun kolesterol menjadi alasan perlunya terapi pilihan lain yang aman dan efektif. Penelitian menunjukkan bahwa elektroakupunktur pada titik ST40 Fenglong dapat digunakan sebagai terapi untuk memperbaiki kadar kolesterol darah. Salah satu modalitas akupunktur yang sedang berkembang adalah laser akupunktur. Tujuan penelitian ini adalah untuk mengetahui bagaimana efektivitas laser akupunktur dibandingkan dengan elektroakupunktur pada titik ST40 Fenglong dalam memperbaiki kadar kolesterol otal, indeks aterogenik, dan berat lemak dinding abdomen pada tikus model diet tinggi lemak.
Metode: Desain studi ini adalah studi eksperimental dengan randomised control group posttest only. Dua puluh empat tikus Wistar jantan, usia 10 minggu dengan berat badan 200–250 gram dibagi menjadi 4 kelompok yaitu: kelompok diet normal, kelompok diet tinggi lemak tanpa perlakuan akupunktur, kelompok diet tinggi lemak dengan elektroakupunktur dan kelompok diet tinggi lemak dengan laser akupunktur. Elektroakupunktur dan laser akupunktur dilakukan 3 kali seminggu dengan total 12 sesi. Dilakukan pengukuran kadar kolesterol total, indeks aterogenik, dan berat lemak dinding abdomen setelah 12 sesi.
Hasil: Rerata kadar kolesterol total, indeks aterogenik, dan berat lemak dinding abdomen pada kelompok tikus model diet tinggi lemak yang mendapat laser akupunktur lebih rendah dibandingkan pada kelompok tikus model diet tinggi lemak yang mendapat elektroakupunktur, namun tidak berbeda bermakna secara statistik (p > 0,05).
Kesimpulan: Laser akupunktur memiliki kecenderungan lebih baik dalam mencegah peningkatan kolesterol total, indeks aterogenik, dan peningkatan berat lemak dinding abdomen akibat konsumsi diet tinggi lemak dibandingkan dengan elektroakupunktur
Introduction: Hyperlipidemia is an increased concentration of fat in blood plasma and is a predisposing factor for atherosclerosis. Risk factor such as high-fat diet greatly affect blood cholesterol levels. The problem of adherence to diet changes and cholesterol medication side effects are reasons to look for other alternative therapies that are safe and effective. Research shows that electroacupuncture at the ST40 Fenglong point can be used as a therapy to improve blood cholesterol levels. One of the acupuncture modalities is laser acupuncture. The purpose of this study was to determine the effectiveness of laser acupuncture compared to electroacupuncture at the ST40 Fenglong point for improving total cholesterol levels, atherogenic index, and abdominal wall fat weight in high fat diet model rats.
Methods: This study was an experimental study with posttest only randomized control group. Twenty-four male Wistar rats, aged 10 weeks with a body weight of 200–250 grams were divided into 4 groups: the normal diet group, the high-fat diet without acupuncture treatment group, the high-fat diet with electroacupuncture group and the high-fat diet with laser acupuncture group. Electroacupuncture and laser acupuncture treatments were performed 3 times a week for a total of 12 sessions. Total cholesterol levels, atherogenic index, and abdominal wall fat weight were measured after 12 sessions.
Results: The mean total cholesterol levels, atherogenic index, and weight of abdominal wall fat in the high-fat diet model group which received laser acupuncture treatment was lower than that in the high-fat diet group which received electroacupuncture group, but did not significantly differ (p> 0.05).
Conclusion: Compared to electroacupuncture, laser acupuncture has a better tendency at preventing increases in total cholesterol level, atherogenic index, and abdominal wall fat weight due to high-fat diet consumption."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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Edith Anggina
Efek akupunktur tanam benang dan transcutaneous tibial nerve stimulation (TTNS) terhadap volume berkemih, nilai post void residual (PVR), qmax, dan skor kualitas hidup penderita detrusor underactivity (DU) = The effect of thread-embedding acupuncture and trancutaneous tibial nerve stimulation (TTNS) in voided volume, post void residual (PVR), qmax, and quality of life scoring changes of detrusor underactivity patients
"Detrusor underactivity DU adalah berkurangnya kekuatan dan/atau durasi kontraksi yang mengakibatkan pengosongan kandung kemih yang memanjang atau inkomplit. Sebanyak enam pasien dengan diagnosis DU diinklusikan dalam penelitian ini. Akupunktur tanam benang dilakukan dengan menggunakan polydioxanone PDO yang ditusukkan di titik akupunktur BL33 dan CV3 dengan teknik penetrating needling. Akupunktur tanam benang dilakukan sebanyak satu kali. Transcutaneous tibial nerve stimulation TTNS dilakukan sebanyak 3 kali seminggu selama 4 minggu.
Hasil penelitian menunjukkan tidak terdapat perbedaan bermakna antara rerata volume berkemih sebelum 72,00 70,48 dan setelah 158,17 139,58 akupunktur tanam benang dan TTNS, p = 0,115, namun didapatkan peningkatan dengan rerata 86,17 110,80. Tidak terdapat perbedaan bermakna antara nilai PVR sebelum 164,00 173,69 dan setelah 74,83 126,28 terapi, p = 0,151, namun didapatkan penurunan sebesar 89,17 129,07. Tidak terdapat perbedaan bermakna antara rerata Qmax sebelum 4,12 3,28 dan setelah 12,35 9,20 , p = 0,085, namun didapatkan peningkatan sebesar 8,23 9,41. Terdapat perbedaan bermakna antara skor kualitas hidup sebelum dan setelah terapi dengan p = 0,017.
Kesimpulan : akupunktur tanam benang dan TTNS dapat meningkatkan volume berkemih, menurunkan PVR, dan meningkatkan Qmax penderita DU, dan dapat memperbaiki kualitas hidup penderita DU secara signifikan.
Detrusor underactivity DU is a contraction of reduced strength and/or duration resulting in prolonged and/or incomplete bladder emptying. A total of six DU patients were included in this research. We did thread-embedding acupuncture by inserting polydioxanone PDO into BL33 and CV3 acupuncture points with penetrating needling techniques. Thread-embedding acupuncture was given once. Transcutaneous tibial nerve stimulation TTNS was given 3 times in a week during 4 weeks.
The results showed no significant differences between before and after treatment on voided volume 72,00 70,48 and 158,17 139,58, p = 0,115, but there was improvement with mean 86,17 110,80. There was no significant difference between before and after treatment on PVR 164,00 173,69 and 74,83 126,28, p = 0,151, but there was improvement with mean 89,17 129,07. There was no significant difference between before and after treatment on Qmax 4,12 3,28 and 12,35 9,20 , p = 0,085, but there was improvement with mean 8,23 9,41. There was significant difference between before and after treatment on quality of life scoring with p = 0,017.
Conclusion : thread embedding acupuncture and TTNS increase voided volume, and Qmax, decrease PVR, improve quality of life in in detrusor underactivity patients significantly "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
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