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Kadek Yogi Mahendra
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Nama

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Kadek Yogi Mahendra

NPM

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1606927734

Judul

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Efektivitas Klonidin Dosis 2 Mcg/Kg di Awal Induksi Dalam Menurunkan Angka Kejadian Emergence Delirium Pada Pasien Anak yang Menjalani Operasi Mata

Latar belakang. Emergence delirium (ED) adalah suatu kondisi yang umum terjadi, pada pasien anak-anak yang menjalani pembedahan, dimana anak menjadi sangat agitasi, memberontak, dan sulit untuk diredakan serta berpotensi membahayakan dirinya sendiri maupun orang lain, dengan insidensi di RSCM sebesar 39,7%. Etiologi, faktor resiko, dan patofisiologi diperkirakan multifaktorial. Berbagai upaya dan strategi telah diusahakan untuk mencegah kejadian tidak menyenangkan ini.

 

Metode. Penelitian uji klinik acak tersamar ganda pada anak usia 1-8 tahun yang menjalani operasi mata dengan anestesia umum di OK Kirana FKUI-RSCM pada bulan Januari-Maret 2020. Sebanyak 108 subjek didapatkan dengan metode konsekutif yang dirandomisasi menjadi dua kelompok. Kelompok klonidin (n = 54) mendapat klonidin 2 mcg/kgbb bolus IV lambat saat induksi anestesia, sedangkan kontrol (n = 54) mendapat NaCl 0,9%. Kejadian ED, waktu pulih, derajat nyeri, hipotensi dan bradikardia selama dan pascaoperasi dicatat. ED dinilai dengan Pediatric Anesthesia Emergence Delirium (PAED).

 

Hasil. Kejadian ED pada kelompok klonidin sebesar 29,6% sedangkan kontrol 31,5% (IK 95% 0,481-2,475; p=0,835). Waktu pulih kelompok klonidin memiliki nilai rerata 6 menit dibandingkan kelompok kontrol selama 5 menit (p=0,998). Nyeri sedang dirasakan pada 3,7% kelompok klonidin berbanding 0% pada kelompok kontrol. Hipotensi dialami pada 1 pasien di kelompok klonidin dan 1 pasien di kelompok kontrol, sedangkan bradikardia ditemukan pada 2 pasien di kelompok klonidin dan 3 pasien di kelompok kontrol

 

Simpulan. Pemberian klonidin 2 mcg/kgbb bolus IV lambat di awal induksi tidak lebih efektif dibanding plasebo dalam mencegah kejadian ED pada pasien anak yang menjalani operasi mata

Kata Kunci : emergence delirium, klonidin, kontrol, pasien anak, operasi mata, pembiusan umum

 


Name

:

Kadek Yogi Mahendra

NPM

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1606927734

Title

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Effectiveness Clonidine 2 Mcg/Kg during Anesthesia Induction to Reduce Emergence Delirium Rate in Pediatric Patient Underwent Eye Surgery

Background. Emergence delirium (ED) is a common condition in pediatric patient after surgery, when they become agitated, difficult to calm and could be harmful for themself or people around with incidence 39,7% in RSCM. Etiology, risk factor, and patyhophysiology are multifactorial. Some effort and strategy have been attempted to reduce this unpleasant incident

 

Method. This was a double-blind randomized clinical trial on children aged 1-8 years old underwent eye surgery under general anesthesia in OR Kirana FKUI-RSCM on January until March 2020. One hundred eight subjects were included using consecutive sampling method and randomized into two groups. Clonidine group (n=54) was given clonidine 2 mcg/kgbw slow intravenous injection during anesthesia induction while control group (n=54) was given NaCl 0,9%. Incidence of ED, recovery time, pain scale, during and postoperative hypotension and bradycardia were observed. Pediatric Anesthesia Emergence Delirium (PAED) scale was used to assess ED.

 

Result. Incidence of ED in clonidine group was 29,6% while in control group was 31,5% (IK 95% 0,481-2,475; p=0,835). Recovery time in clonidine group was 6 minutes and control group was 5 minutes (p=0,998). There was 3,7% in subject group was in moderate pain and 0% in control group. Hypotension was suffered by each 1 subject in both group and bradycardia suffered in 2 patient in clonidine group compared to 3 patients in control group

 

Conclusion. Administration of clonidine 2 mg/kg as a slow intravenous injection right after induction was not effective to prevent the incidence of ED in children underwent eye surgery"

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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"Japan has no official "poverty line," and subsequently no official statistics on poverty.In practice,the public aissistance's minimum standard of living " (below which subsistence benefits can be claimed) ia used to calculate the poverty rate or the OECD index, which is defenit as 50% of the population's median income....."
JALAREV
Artikel Jurnal  Universitas Indonesia Library
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Irwan Mahri
"Latar Belakang: Emergence delirium (ED) merupakan kondisi yang dapat terjadi saat anak pulih dari anestesi dengan cara yang tidak nyaman. ED dapat menyebabkan cedera pada anak, dan kekhawatiran pada orangtua. Berbagai intervensi dilakukan untuk menurunkan ED, namun belum ada standar khusus yang rutin dilakukan untuk mencegah ED. Deksmedetomidin dan midazolam dikatakan efektif untuk mengurangi ED. Penelitian ini bertujuan mengetahui efektivitas premedikasi deksmedetomidin intranasal dibandingkan midazolam intranasal untuk mencegah ED pada anak yang menjalani operasi mata. Metode : Penelitian ini adalah uji klinik tersamar ganda, pada pasien anak usia 1- 12 tahun dengan status fisik ASA 1 dan 2 yang menjalani operasi mata dengan anestesia umum menggunakan agen inhalasi Sevoflurane. Subjek penelitian 64 orang, didapatkan dengan consecutive sampling selama Februari-Mei 2019 yang kemudian dikelompokan menjadi kelompok deksmedetomidin dan midazolam setelah proses randomisasi. Efektivitas dinilai dari kejadian ED, waktu pulih, dan kejadian desaturasi pasca premedikasi. Analisis data menggunakan uji Chi Square dan Uji Mann-Whitney. Hasil : Kejadian ED pada kelompok deksmedetomidin sebesar 11,18% sedangkan kelompok midazolam 28,12% (p=0,109). Waktu pulih didapatkan median yang sama 6 menit, dan tidak didapatkan kejadian desaturasi di kedua kelompok. Simpulan : Pemberian premedikasi deksmedetomidin intranasal 30 menit sebelum induksi secara statistik tidak lebih efektif dibandingkan midazolam untuk mencegah kejadian ED pada anak yang menjalani operasi mata.

Background: Emergence Delirium (ED) is a condition that can occur when a child recoverds from anesthesia in a uncomfortable way. ED can cause injury to children and worries to parents. Various interventions were carried out to reduce ED, but there were no specific standards has been estabilished to prevent ED. Dexmedetomidine and midazolam are said to be effective in reducing ED. This study aims to determine the effectiveness of intranasal dexmedetomidine premedication compared to intranasal midazolam to prevent ED in children undergoing eye surgery. Method : This study is a double-blind clinical trial, in pediatric patients aged 1-12 years with physical status ASA 1 and 2 who underwent eye surgery under general anesthesia using Sevoflurane inhalation agents. There were 64 childen obtained by consecutive sampling, who underwent eye surgery in our institution during February-Mayl 2019. The subjects then grouped into dexmedetomidine group and midazolam group. Effectiveness was assessed from ED events, recovery time, and post-premedication desaturation events. Data analysis using Chi Square test and Mann-Whitney test. Result : ED incidence in the dexmedetomidin group was 11.18% while the midazolam group was 28,12% (p = 0.109). The recovery time was the same median 6 minutes, and no desaturation was found in either group. Conclusion : There are statistically no difference between the effectiveness of intranasal dexmedetomidine and midazolam premedication 30 minutes before induction to prevent ED occurrence in children undergoing eye surgery. "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
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UI - Tugas Akhir  Universitas Indonesia Library
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M. Ramdani Basri
"Berkembangnya wacana privatisasi akhir-akhir ini merupakan suatu akibat dari kondisi buruknya pelayanan, inefisiensi, ketidakmampuan pengeloaan aset negara dan tidak mampu bersaing serta semakin berkurangnya kontribusi kepada stakeholder. Situasi ini menjadi perhatian utama terhadap pokok permasalahan peneliti. Pokok permasalahan dalam penelitian ini adalah bagaimana praktik privatisasi BUMN dalam pembangunan infrastruktur di Indonesia dan daerah-daerah serta permasalahan-permasalahan apa yang mendorong serta menghambat privatisasi BUMN dalam pembiayaan pembangunan infrastruktur di Indonesia. Privatisasi memberi dampak pada kinerja perusahaan. Perusahaan yang sehat memungkinkan perseroan merekrut SDM yang berkualitas. SDM yang baik akan memberikan pelayanan yang terbaik kepada masyarakat/customer. Selain itu program-program tanggungjawab sosial perusahaan/CSR dapat dilakukan dengan baik yang juga berakibat pada masyarakat luas, sehingga dapat memberikan dampak yang luas bagi peningkatan kesejahteraan dan kelestarian lingkungan . Kinerja BUMN yang tidak sehat, defisit anggaran pemerintah dan tuntutan globalisasi menjadi pendorong utama reformasi. Sedangkan pada tahap implementasinya kendala yang terjadi seperti kapasitas pasar modal, keterbatasan pengalaman serta belum adanya kesamaan persepsi dalam hal regulasi menjadi hambatan yang berarti pencapaian tujuan reformasi ini. Peran pemerintah selaku regulator dan fasilitator serta parlemen sebagai controller yang didukung pemberdayaan masyarakat menjadi dominan bagi keberhasilan program privatisasi BUMN. Dalam penelitian ini akan dilakukan investigasi pola-pola pembangunan infrastruktur di Indonesia melalui berbagai skema kerjasama antara pemerintah dan swasta untuk kemudian disusun model yang mampu memadukan pola yang ada dan sesuai dengan kondisi karakteristik Indonesia. Metodologi penelitian yang digunakan dalam penulisan tesis ini adalah metode kualitatif dengan jenis penelitian adalah deskriptif analisis. teknik pengumpulan data berupa studi kepustakaan dan studi (kasus) banding. Analisis data yang dilakukan bersifat analisis kualitatif. Berdasarkan hasil analisis ditemukan bahwa prinsip mendasar dalam komersialisasi infrastruktur transportasi harus didasarkan pada empat landasan. Keempat landasan tersebut adalah: (i) mengarahkan tanggung jawab; (ii) menciptakan kepemilikan yang jelas; (iii) menjamin keamanan dan; kestabilan pembiayaan infrastruktur; (iv) serta mengenalkan praktek bisnis yang kokoh. Penggunaan pendekatan pasar dalam penyediaan infrastruktur. Salah satu aspek penting dalam penyertaan swasta dalam peningkatan pelayanan, penyediaan, peningkatan kualitas/kapasitas, maupun pemeliharaan infrastruktur transportasi adalah kondisi dimana terdapat pendekatan pasar. Pendekatan pasar tersebut selian berpatokan pada efektivitas, efisiensi juga peningkatan pelyanan. Dengan kata lain, bahwa terdapat mekanisme ekonomi pasar yang dapat dipelajari oleh swasta baik pelaksana maupun financier, sehingga perencanaan dan apraisal dapat dilakukan. Privatisasi yang telah dilaksanakan selama ini pada kenyataannya mengalami banyak hambatan, antara lain : (i) terbatasnya jumlah investor yang tertarik untuk menanamkan modalnya di BUMN Indonesia. (ii) tidak jelas dan tidak konsistennya peraturan yang berkaitan dengan penanaman modal, kurang transparannya pemerintah dalam membuat keputusan yang berkaitan dengan privatisasi, (iii) serta kurangnya sosialisasi kepada pihak-pihak yang terkait dengan BUMN yang akan diprivatisasi.

The emergence of privatization issues recently was a result of poor public services, inefficiency, low capacity of managing state assets and low competitiveness, and less contribution to the stakeholders. This condition had drawn the attention of the researcher towards the core issues. The core issues in this study were to what extent the privatization practice of State-Owned Enterprises in infrastructure development and Local-Owned Enterprises in the framework of Public-Private Partnership and what obstacles that impeded and hindered the involvement and participation of private sectors in funding the infrastructure development in Indonesia. Privatization provided an impact towards the company finance. Healthy finance allowed the public limited company to recruit qualified human resources. Qualified human resources would provide better services to the public. In addition, company social responsibility programs could also be well implemented which impacted to a wide public so that it could give wide impacts towards the prosperity improvement and environmental preservation. Poor performance of State-Owned Enterprises, government budget deficit, and demands of globalization had become the main driver to reform. Whereas in the implementation stage, the occurrence of such problems as capital market capacity, limited experience and diverse perceptions in terms of regulations had hindered the attainment of the reform goals. Government roles as regulator and facilitator and parliament roles as controller supported by public empowerment had become a dominant force for the success to privatization program of State-Owned Enterprises. In this study it would investigate the patterns of infrastructure development in Indonesia through various cooperation schemes between government and private sectors which would, later, design a model that integrated available format in accordance with Indonesian characteristics. The methodology of the research was qualitative method with descriptive analysis. The technique of data collection was through literature review and case study. Data analysis conducted was qualitative analysis. Based on the results of the analysis it was found that basic principles in commercialization of transportation infrastructure had to be based on four pillars. They are: (i) responsibility oriented; (ii) creation of clear ownership; (iii) security assurance and; stabilized infrastructure costs; (iv) and introducing strong business practices. The market approach was used in the provision of infrastructure. One of the important aspects of the private sector involvement in improving services, quality/capacity, as well as maintenance of transportation infrastructure was a condition where market approach present. Such approach not only focused on effectiveness and efficiency, but it also focused on service improvement. In other words, there was a market economy mechanism that could be learnt by the private sectors both by the implementers and financier, so that planning and appraisal could be conducted. Privatization that had been conducted all this time had, in fact, encountered many obstacles, amongst others: (i) limited number of investors that had an interest to invest their capital to the State-Owned Companies in Indonesia. (ii) unclear and inconsistent regulations related with investment, un-transparent government when making policies related with privatization, (iii) and lack of dissemination to the concerned parties whose company would be privatized."
Depok: Fakultas Ilmu Sosial dan Ilmu Politik Universitas Indonesia, 2008
T24602
UI - Tesis Open  Universitas Indonesia Library
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Pardede, Dimas Kusnugroho Bonardo
"Latar belakang. Emergence agitation (EA) merupakan gangguan perilaku sementara yang sering terjadi pascaanestesia inhalasi dan berpotensi membahayakan pasien. Pemberian propofol 1-3 mg/kg di akhir anestesia inhalasi mencegah EA tetapi memperpanjang waktu pindah ke ruang pulih. Penelitian ini bertujuan mengetahui efektivitas propofol dosis 0,5 mg/kg di akhir anestesia untuk menurunkan kejadian EA pasien anak yang menjalani anestesia umum inhalasi. Propofol dinilai efektif jika dapat menurunkan kejadian EA tanpa memperpanjang waktu pindah.
Metode. Penelitian uji klinik acak tersamar ganda terhadap anak usia 1-5 tahun yang menjalani anestesia umum inhalasi di RSCM pada bulan Mei – Agustus 2018. Sebanyak 108 subjek didapatkan dengan metode konsekutif yang dirandomisasi menjadi dua kelompok. Kelompok propofol (n=54) mendapat propofol 0,5 mg/kg di akhir anestesia, sedangkan kontrol (n=54) tidak mendapat propofol. Kejadian EA, waktu pindah, hipotensi, desaturasi dan mual-muntah pascaoperasi dicatat. EA dinilai dengan skala Aono dan Pediatric Anesthesia Emergence Delirium (PAED). Analisis data menggunakan uji chi-square dan t tidak berpasangan.
Hasil. Kejadian EA pada kelompok propofol sebesar 25,9% sedangkan kontrol 51,9% (RR = 0,500; IK 95% 0,298-0,840; p=0,006). Rerata waktu pindah kelompok propofol lebih lama (9,51 ± 3,93 menit) dibandingkan kontrol (7,80 ± 3,57 menit) (selisih rerata 1,71 menit; IK 95% 0,28-3,14; p=0,020). Hipotensi didapatkan pada satu pasien (1,9%) pada kelompok propofol sedangkan pada kontrol tidak ada. Mual-muntah terjadi pada lima pasien (9,3%) pada kelompok propofol dan delapan pasien (14,8%) pada kontrol. Tidak ada desaturasi pada kedua kelompok.
Simpulan. Pemberian propofol dosis 0,5 mg/kg di akhir anestesia secara statistik tidak efektif namun secara klinis efektif menurunkan kejadian EA pasien anak yang menjalani anestesia umum inhalasi.

Background. Emergence agitation (EA) is a common transient behavioral disturbance after inhalational anesthesia and may cause harm. Propofol 1-3 mg/kg administration at the end of inhalational anesthesia prevents EA but prolongs transfer time to recovery room. This study evaluated the effectivity of propofol 0,5 mg/kg at the end of anesthesia to reduce the incidence of EA in children undergoing general inhalational anesthesia. Propofol was considered effective if could reduce the incidence of EA without prolonging transfer time.
Method. This was a double-blind randomized clinical trial on children aged 1-5 years old underwent general inhalational anesthesia in Cipto Mangunkusumo Hospital. One hundred eight subjects were included using consecutive sampling method and randomized into two groups. Propofol group (n=54) was given propofol 0,5 mg/kg at the end of anesthesia while control group (n=54) was not. Incidence of EA, transfer time, postoperative hypotension, desaturation and nausea-vomiting were observed. Aono and Pediatric Anesthesia Emergence Delirium (PAED) scale were used to assess EA. Statistical tests used were chi square and unpaired t test.
Result. Incidence of EA in propofol group was 25,9% while in control group was 51,9% (RR = 0,500; 95% CI 0,298-0,840; p=0,006). Mean transfer time in propofol group was longer (9,51 ± 3,93 minute) than control group (7,80 ± 3,57 minute) (mean difference 1,71 minute; 95% CI 0,28-3,14; p=0,020). Hypotension was found in one patient (1,9%) in propofol group while in control group there was none. Nausea-vomiting was found in five patients (9,3%) in propofol group and eight patients (14,8%) in control. There was no desaturation in both groups.
Conclusion. Administration of propofol 0,5 mg/kg at the end of anesthesia statistically ineffective but clinically effective in reducing the incidence of EA in children undergoing general inhalational anesthesia."
Jakarta: Universitas Indonesia, 2018
T58605
UI - Tesis Membership  Universitas Indonesia Library
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Kusnanto Anggoro
"A new, more assertive and confident Russia is emerging from the ashes of the old Soviet Union. Given its huge oil and gas reserves, energy policy could well be instrumental in the future of Russia's foreign policy. Under a strong leadership of President Vladimir Putin, the new Russia is gaining in influence through a series of strategic moves revolving around in geopolitical assets in energy. Developments Flaming of the Russian [gas and oil] pipelines, laid down in t.he Energy Strategy 2003, are all but indicative of how the Plan served both economic and strategic considerations. Westward, the Plan may widen the wedge between the old and new member of NATO and/ or the European Union. Eastward, the Russian may succeed to grasp the olive branch of japan and the Friendship of China. As an equal partner of the West and a nearly-dominant peer of the East, Russia managed well a balance- exchangeable-relation to shift preference from one to the other and, more importantly, to drive squabble inside the crowds. A Eurasian order is about to emerge, with the Russian Federation at the centre~stage."
Depok: Program Pascasarjana Universitas Indonesia, 2008
JKWE-4-1-2008-60
Artikel Jurnal  Universitas Indonesia Library
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Seager, William
"The spectacular success of the scientific enterprise over the last four hundred years has led to the promise of an all encompassing vision of the natural world. In this elegant picture, everything we observe is based upon just a few fundamental processes and entities. The almost infinite variety and complexity of the world is thus the product of emergence. But the concept of emergence is fraught with controversy and confusion. This book ponders the question of how emergence should be understood within the scientific picture, and whether a complete vision of the world can be attained that includes consciousness."
Berlin: [, Springer], 2012
e20410735
eBooks  Universitas Indonesia Library
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Zaki Farhan
"Pendahuluan : Sevofluran memiliki waktu pulih sekitar 3 sampai 4 menit lebih cepat dibandingkan dengan isofluran dan 3 menit lebih lama dibandingkan desfluran. Sevofluran berkontribusi menyebabkan emergence agitation. Pemberian propofol 0,5 mg/kg setelah pengakhiran sevofluran diharapkan tidak lebih buruk dibandingkan kelompok kontrol dan dapat menurunkan kejadian emergence agitation pada pasien pediatrik bedah oftalmologi. Metode : Penelitian ini adalah uji acak tersamar ganda yang melibatkan 74 pasien anak usia 2-6 tahun yang menjalani operasi oftalmologi di RSUPN dr. Cipto Mangunkusumo. Pasien akan dibagi menjadi dua kelompok yaitu kelompok yang diberikan propofol 0.5 mg/kg dan kelompok kontrol yang diberikan NaCl 0,9% setelah pengakhiran sevofluran. Setelah tindakan selesai akan dicatat waktu pulih dan dilakukan observasi kejadian emergence agitation dengan menggunakan skala PAED. Hasil : Median waktu pulih pasien yang diberikan propofol 19 (10-29) menit dibandingkan kelompok kontrol 15 (9-20) menit dengan P <0,05. Kejadian emergence agitation pada kelompok propofol 10,8% dibanding kelompok kontrol 51,4% dengan P< 0,001. Kejadian efek samping hipotensi dan desaturasi 0%. Simpulan : Pemberian propofol 0,5 mg/kg setelah pengakhiran sevofluran memiliki waktu pulih yang lebih buruk dibandingkan kelompok kontrol, namun secara klinis tidak berdampak signifikan dan dapat menurunkan insiden emergence agitation.

Background: Sevoflurane has a recovery time that is approximately 3 to 4 minutes faster than isoflurane and 3 minutes longer than desflurane. Sevoflurane contributes to emergence agitation. Administration of propofol 0.5 mg/kg after discontinuation of sevoflurane is expected to be no worse than the control group and can reduce the incidence of emergence agitation in pediatric ophthalmology surgical patients. Methods: This study is a double-blind randomized trial involving 74 pediatric patients aged 2-6 years undergoing ophthalmic surgery at dr. Cipto Mangunkusumo National Central General Hospital. Patients were divided into two groups: one group received 0.5 mg/kg propofol and the control group received 0.9% NaCl after the termination of sevoflurane. After the procedure, recovery time was recorded and the incidence of emergence agitation was observed using the PAED scale. Results: The median recovery time for patients who received propofol was 19 (10- 29) minutes compared to the control group at 15 (9-20) minutes with P < 0.05. The incidence of emergence agitation in the propofol group was 10.8% compared to 51.4% in the control group with P < 0.001. The incidence of side effects such as hypotension and desaturation was 0%. Conclusion: Administration of 0.5 mg/kg propofol after the termination of sevoflurane results in a longer recovery time compared to the control group, but this is not clinically significant and can reduce the incidence of emergence agitation."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Raihanita Zahrah
"Latar belakang. Emergence Delirium (ED) merupakan stadium dari disosiasi kesadaran pasca pembiusan dengan gejala khas berupa gelisah,mengamuk,tidak dapat dibujuk dan inkoherensi. Angka kejadian ED pada anak yang menjalani pembiusan umum di RSUPN Dr. Cipto Mangunkusumo 39,7%. Saat pulih stimulus auditorik menyebabkan sinaps talamus di Lateral amigdala sehingga menimbulkan respons takut berlebihan yang merupakan salah satu faktor terjadinya ED. Kebisingan di kamar operasi yang tinggi dapat dikurangi dengan penggunaan ear plug.
Metode. Penelitian uji klinik acak tersamar ganda terhadap anak usia 1-5 tahun yang menjalani anestesia umum inhalasi di RSCM pada bulan September-Desember 2018. Sebanyak 107 subjek didapatkan dengan metode konsekutif yang dirandomisasi menjadi dua kelompok. Kelompok earplug (n=53) dilakukan pemasangan ear plug di akhir anestesia, sedangkan kontrol (n=54) tidak dilakukan pemasangan ear plug. Kejadian ED, waktu ekstubasi dicatat. ED dinilai dengan Pediatric Anesthesia Emergence Delirium (PAED). Analisis data menggunakan analisa multivariate regresi logistik dan analisa ANCOVA.
Hasil. Kejadian ED pada kelompok ear plug sebesar 16,7% sedangkan kontrol 32,1% (OR = 0,402; IK 95% 0,152-1,062; p=0,066). Rerata waktu ekstubasi kelompok ear plug vs kontrol (5,76+3,23 menit) vs (6,54+ 3,67 menit) selisih rerata 0,825(0,530-2,180); p=0,230.
Simpulan. Pemberian ear plug di akhir anestesia secara statistik tidak efektif namun secara klinis efektif menurunkan kejadian ED pasien anak yang menjalani anestesia umum inhalasi.

Background. Emergence Delirium (ED) is classified as a transient postoperative disassociation state with characteristic such as agitation, irritable, umcompromising, uncooperatative, inconsolably crying. The incidence of ED in pediatric patients who underwent general anesthesia in RSUPN Dr. Cipto Mangunkusumo was 39,7%. During emergence state, auditoric stimulation induce Thalamic synaps in Lateral amigdala which leads to over respons of fearness (one of the risk factor of ED). A high noise level in operating room can be reduced with ear plug application to the patient.
Method. A double blind randomized clinical trial towards 1-5 years old pediatrics patients who underwent inhalation general anesthesia in RSCM from September-December 2018. One hundred and seven subjects were randomized after a consecutive sampling into two groups. Earplug group (n=53) with application of ear plug at the end of surgery, while in control group (n=54) without application of ear plug. The incidence of ED and time to extubation were recorded. ED was measured using Pediatric Anesthesia Emergence Delirium (PAED). All the data was analyzed using multivariate logistic regression and ANCOVA.
Result. Incidence of ED in ear plug group was 16.7% while in control group was 32.1% (OR = 0.402; CI 95% 0.152-1.062; p=0.066). Mean value of time to extubation in ear plug vs control group (5.76+3.23 minutes) vs (6.54+ 3.67 minutes) with mean difference of 0.825(0.530-2.180); p=0.230.
Conclusion. Ear plug application at the end of anesthesia was not statistically effective. However, it was clinically effective in reducing the incidence of ED in pediatric patient underwent inhalation anesthesia.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
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