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"[Tujuan. Tujuan pertama yaitu mengetahui kemudahan pemasangan Laryngeal Mask Airway(LMA) dengan teknik baku disertai penekanan lidah. Tujuan kedua yaitu mengetahui perbandingan kemudahan pemasangan LMA antara teknik baku disertai penekanan lidah dan teknik baku. Latar Belakang. Laryngeal Mask Airway merupakan alat bantu jalan nafas untuk mengatasi kesulitan jalan nafas. Teknik terbaru pemasangan Laryngeal Mask Airway berdasarkan penelitian Roodneshin dkk yang dipublikasikan pada Tanaffos 2011 yaitu teknik baku disertai penekanan lidah memberikan angkakeberhasilan pemasangan 100%(tingkat keberhasilan paling tinggi pada penelitian LMA). Pemasangan LMA diharapkan mulus dan berhasil dalam pemasangan pertama tanpa menimbulkan trauma tetapi dalam prakteknya, pemasangan LMA bisa lebih dari satu kali. Penelitian ini dilakukan di RSUPN-Cipto Mangunkusumo sebagai penelitian perbandingan pertama dari penelitianRoodneshin dkk dengan beberapa penyesuaian. Metode. Penelitian ini dilakukan pada 80 pasien dewasa yang menjalani operasielektif dengan anestesia umum menggunakan Laryngeal Mask Airway. Secara random, 40 pasien mengalami pemasangan LMA dengan teknik baku disertai penekanan lidah dan 40 pasien mengalami pemasangan LMA dengan teknik baku. Upaya pemasangan dan kemudahan pemasangan LMA dicatat dan dinilai. Pemasangan mudah bila kurang atau sama dengan 2 kali pemasangan LMA. Komplikasi pemasangan LMA berupa noda darah, nyeri menelan dan nyeri tenggorokan dicatat dan dinilai. Analisa statistik dilakukan dengan uji Chi-square dan Fisher Exact. Batas kemaknaan yang digunakan untuk semua uji adalah p<0,05. Hasil. Perbandingan proporsi keberhasilan upaya pemasangan pertama kali antara kelompok teknik baku disertai penekanan lidah dan teknik baku adalah 87,5% dibandingkan 65%. Perbandingan proporsi keberhasilan upaya pemasangan maksimal dua kali antara kelompok teknik baku disertai penekanan lidah dan teknik baku adalah 100% dibandingkan 97,5%. Secara statistik, perbandingan upaya pemasangan, kemudahan, komplikasi nyeri menelan, komplikasi nyeri tenggorokan antara teknik baku disertai penekanan lidah dan teknik baku, tidak berbeda bermakna.Kesimpulan. Pemasangan Laryngeal Mask Airway dengan teknik baku disertai penekanan lidah tidak lebih mudah dibandingkan teknik baku(100% dibandingkan 97,5%). Kekerapan komplikasi yang berbeda bermakna berupa noda darah (0% pada teknik baku disertai penekanan lidah dibandingkan 6,2% pada teknik baku).......Purpose, The objective of this study is to know easiness of inserting Laryngeal Mask Airway(LMA) with the classic approached combined with tongue supression technique. Secondly, the study is to compare the success rate between classic approached combined with tongue supression technique and classic approached technique. Background, Laryngeal Mask Airway is a device to overcome the difficulty of the airway management. Novel technique of Laryngeal Mask Airway insertion based on Roodneshin et aI research, publicised in Tanaffos 2011 was the classic approached combined with tongue supression technique resulted in 100% succes rate of insertion(highest success rate based on LMA research or study). LMA insertion is expected to be smooth and successful in the first attempt without inflicting trauma but in daily practice, insertion LMA can be more than once. This research is done at Cipto Mangunkusumo Hosptal, as the first comparison of research Roodneshin et al with some adjustments. Methods, The study was done at 80 adult patients who underwent elective surgery with general anesthesia. A total of 80 adult patients was scheduled for elective operation with general anesthesia using Laryngeal Mask Airway. In random, 40patients undergoing LMA insertion with classic approached combined with tongue supression technique and 40 patients undergoing LMA insertion with classic approached technique. The effort and success rate of LMA insertion was noted and evaluated. The easiness is if the insertion is attempted maximally twice. Complications of LMA insertion such as blood stains, sore throat, dysphagia was noted and evaluated. Statistical analysis conducted by test Chi-square and Fischer Exact. P<0,05 was considered significant. Result, Comparison proportion first attempt of Laryngeal Mask Airway insertion between classic approached combined with tongue supression technique and classic approached technique was 87,5% compared with 65%. The proportion maximally twice attempt of Laryngeal Mask Airway insertion between classic approached combined with tongue supression technique and classic approached technique was 100% compared with 97,5%. Statistically, comparison attempt, success rate, dysphagia, sore throat between classic approached combined with tongue supression technique and classic approached technique, not significantly different Conclusion, Laryngeal Mask Airway insertion with classic approached combined with tongue supression technique no more easy compared with classicapproached technique(100% compared with 97,5%). Complication which statistically significant different was blood stains(0% with classic approached combined with tongue supression technique compared with 6,2% classic approached technique).......Purpose, The objective of this study is to know easiness of inserting Laryngeal Mask Airway(LMA) with the classic approached combined with tongue supression technique. Secondly, the study is to compare the success rate between classicapproached combined with tongue supression technique and classic approached technique. Background, Laryngeal Mask Airway is a device to overcome the difficulty of the airway management. Novel technique of Laryngeal Mask Airway insertion based on Roodneshin et aI research, publicised in Tanaffos 2011 was the classic approached combined with tongue supression technique resulted in 100% succes rate of insertion(highest success rate based on LMA research or study). LMA insertion is expected to be smooth and successful in the first attempt without inflicting trauma but in daily practice, insertion LMA can be more than once. This research is done at Cipto Mangunkusumo Hosptal, as the first comparison of research Roodneshin et al with some adjustments. Methods, The study was done at 80 adult patients who underwent elective surgery with general anesthesia. A total of 80 adult patients was scheduled for elective operation with general anesthesia using Laryngeal Mask Airway. In random, 40patients undergoing LMA insertion with classic approached combined with tongue supression technique and 40 patients undergoing LMA insertion with classic approached technique. The effort and success rate of LMA insertion was noted and evaluated. The easiness is if the insertion is attempted maximally twice. Complications of LMA insertion such as blood stains, sore throat, dysphagia was noted and evaluated. Statistical analysis conducted by test Chi-square and Fischer Exact. P<0,05 was considered significant. Result, Comparison proportion first attempt of Laryngeal Mask Airway insertionbetween classic approached combined with tongue supression technique and classic approached technique was 87,5% compared with 65%. The proportion maximally twice attempt of Laryngeal Mask Airway insertion between classic approached combined with tongue supression technique and classic approached technique was 100% compared with 97,5%. Statistically, comparison attempt,success rate, dysphagia, sore throat between classic approached combined with tongue supression technique and classic approached technique, not significantly different Conclusion, Laryngeal Mask Airway insertion with classic approached combined with tongue supression technique no more easy compared with classicapproached technique(100% compared with 97,5%). Complication which statistically significant different was blood stains(0% with classic approached combined with tongue supression technique compared with 6,2% classic approached technique)., Purpose, The objective of this study is to know easiness of inserting LaryngealMask Airway(LMA) with the classic approached combined with tongue supressiontechnique. Secondly, the study is to compare the success rate between classicapproached combined with tongue supression technique and classic approachedtechnique.Background, Laryngeal Mask Airway is a device to overcome the difficulty of theairway management. Novel technique of Laryngeal Mask Airway insertion basedon Roodneshin et aI research, publicised in Tanaffos 2011 was the classicapproached combined with tongue supression technique resulted in 100% succesrate of insertion(highest success rate based on LMA research or study). LMAinsertion is expected to be smooth and successful in the first attempt withoutinflicting trauma but in daily practice, insertion LMA can be more than once. Thisresearch is done at Cipto Mangunkusumo Hosptal, as the first comparison ofresearch Roodneshin et al with some adjustments.Methods, The study was done at 80 adult patients who underwent elective surgerywith general anesthesia. A total of 80 adult patients was scheduled for electiveoperation with general anesthesia using Laryngeal Mask Airway. In random, 40patients undergoing LMA insertion with classic approached combined withtongue supression technique and 40 patients undergoing LMA insertion withclassic approached technique. The effort and success rate of LMA insertion wasnoted and evaluated. The easiness is if the insertion is attempted maximally twice.Complications of LMA insertion such as blood stains, sore throat, dysphagia wasnoted and evaluated. Statistical analysis conducted by test Chi-square andFischer Exact. P<0,05 was considered significant.Result, Comparison proportion first attempt of Laryngeal Mask Airway insertionbetween classic approached combined with tongue supression technique andclassic approached technique was 87,5% compared with 65%. The proportionmaximally twice attempt of Laryngeal Mask Airway insertion between classicapproached combined with tongue supression technique and classic approachedtechnique was 100% compared with 97,5%. Statistically, comparison attempt,success rate, dysphagia, sore throat between classic approached combined withtongue supression technique and classic approached technique, not significantlydifferent Conclusion, Laryngeal Mask Airway insertion with classic approached combinedwith tongue supression technique no more easy compared with classicapproached technique(100% compared with 97,5%). Complication whichstatistically significant different was blood stains(0% with classic approachedcombined with tongue supression technique compared with 6,2% classicapproached technique).]"

"Latar BeJakang: Laryngeal Mask Airway (LMA) telah diterima secara umum sebagai alat jalan napas. Pada praktik klinis, insersi LMA pada percobaan pertama dengan waktu sesingkat mungkin merupakan kondisi yang diharapkan sehingga efek samping agen anestesi minimal tanpa menimbulkan komplikasi demi keselamatan pasien. Dosis kecil atrakurium sebelum induksi dipilih untuk operasi dengan durasi singkat, agar tidak menunda pemulihan akibat pelumpuh otot namun perlu diperhatikan efek samping gejala kelemahan. Penelitian ini bertujuan mengetahui pengaruh pemberian atrakurium sebelum induksi dosis 75 dan 150 rncglkgBB terhadap keberhasilan percobaan pertama dan waktu insersi sehingga dapat menjadi standar dosis atrakurium untuk insersi LMA. Metode: Penelitian uji klinis acak tersamar ganda ini mengelompokkan 150 pasien dewasa yang mendapat layanan anestesia di ruang operasi RSCM rnenjadi 2 kelompok. Setelah koinduksi midazolam dan fentanyl, pasien kelompok eksperimen diberikan atrakurium dosis 75 mcglkgBB, sedangkan kontrol 150 mcglkgBB. Setelah 1 menit, diamati gejala keJernahan, yaitu ptosis, diplopia, dan sesak napas sebelurn induksi propofol. Insersi LMA dilakukan setelah pasien tidak respon terhadap jaw thrust setelah 90 detik pemberian propofol. Diambil data keberhasilan percobaan pertama dan waktu insersi, selain itu dicatat nilai rasio TOF sebelurn insersi, respon hernodinamik, dan komplikasi pascainsersi. Hasil: Keberhasilan insersi pertama kedua kelornpok tidak berbeda signifikan, yaitu 90,7% pada kelompok eksperimen dibandingkan 93,3% kontrol (p=0,547). Begitu pula waktu insersi 36,05±16,98 detik dan 33,75±13,55 detik untuk dosis 75 dan 150 mcglkgBB berurutan (p=0,359). Kornplikasi insersi pada kelompok ekspersimen 90,7% dan 93,3% kelompok kontrol. Gejala kelemahan ditemukan harnpir 2 kali lipat di kelompok kontrol dengan nilai rasio TOF yang juga lebih rendah. Respon hemodinamik setelah insersi LMA mirip di kedua kelompok. Simpulan: Penggunaan atrakurium dosis 75 mcglkgBB sama baiknya dibandingkan 150 mcglkgBB dalam memudahkan insersi LMA. ......Background: In clinical practice, success on first attempt of LMA insertion with the shortest times is aimed to achieve minimal adverse eventfrom. Small dose of atracurium given beJore induction is chosen Jor brieJ duration procedure therefore has minimal or no effect to recovery from neuromuscular blocking agent, but the consequences of partial paralysis before induction should be a concern. This study aims to compare the success onfirst attempt and insertion time oJLMA between 75 and 150 mcglkgBWatracurium, given beJore propofol induction in search for standard dose of atracurium to ease LMA insertion. Methotl: This double-blind randomized clinical trial divided 150 adult patients who received anesthesia procedllre in Cipto Mangunkusumo General Hospital operating theatres into two groups. After coinduction with midazolam and Jentanyl, patients in the study group received 75 mcglkgBWalracurium, meanwhilefor the control group was 150 mcglkgB W After 1 minute all the samples were evaluated for paralysis symptoms of ptosis, diplopia and shortness oj breath before propofol induction. LMA insertion then attempted after no response to jaw thrust manuever evaluated after 90 seconds from propoJol injection. Success on first attempt and time of insertion were the main outcomes evaluated, beside TOF ratio, hemodynamic responses and complications. Result: Success on first attempt rate was not significally worse, which was 90.7% for experiment group compare to 93.3% in .control (p=0,547). Insertion time was 36.05±I6,98 and 33,75±i3,55 second Jor respective group (p=0.359). Postinsertion complication in experiment group were higher but the paralysis symptoms were lower. Conclusion: Low dose oJ 75 mcglkgBW atracurium is equal compared to 150 mcglkgBW 10 ease LMA insertion."