1,720,990 research outputs found
Perbandingan Skala Nyeri Akibat Penyuntikan Propofol yang di dahului dengan Injeksi Lidokain dan Ketamin pada General Anestesi
No full textBackground: Provision of ketamine with a dose of 10 mg before injection of
propofol reduced pain due to injection of propofol. The optimal dose of lidocaine
is thought to prevent pain due to injection of propofol. The aim of this study was
to assess the comparison of the scale of pain due to injection of propofol which
was preceded by injection of lidocaine and ketamine in general anesthesia.
Method: Experimental analytical study with a double blind randomized control
trial design with a sample of 50 elective surgical patients. Patients were divided
into two groups, namely treatment (n = 25) given lidocaine and controls (n = 32)
given ketamine. Pain scores were asked again every 5 second interval and the
highest pain scale was recorded as research data. If the patient says no, the pain
scale is 0. The measuring instrument used in the study uses VAS. Data were
analyzed using SPSS.
Results: In this study it was found that in the ketamine treatment group that did
not feel pain in the ketamine group as many as 13 people (52%), who felt mild
pain as many as 8 people (32%), who felt moderate pain as much as 3 people
(12%) and who feel severe pain as much as 1 person (4%). In addition, 19 people
(76%) did not feel the lidocaine treatment group, 8 people felt mild pain (20%), 1
person felt moderate pain (4%) and 0 people who felt severe pain. The degree of
pain in the absence lidocaine group was found to have severe degree of pain,
whereas in the ketamim group there were still samples that experienced severe
degree of pain after injection of propofol. Based on the difference test conducted
by the Mann-Whiteny test it was found that there was no difference in the degree
of pain due to injection of propofol which was preceded by injection of lidocaine
and ketamine.
Conclusion: There was no difference in the degree of pain due to injection of
propofol which was preceded by injection of lidocaine and ketamine.85 HalamanTesis Magiste
Perbandingan Efek Analgesia Deksketoprofen Trometamol dengan Ketorolak sebagai Preventif Analgesia pada Anestesi Umum
No full textBackground and Objective: Postoperative pain is one of the most important problems that follows the surgery process, which leads to the need of potent analgesic drugs during the postoperative period. NSAIDS are prominent as analgesics because they can decrease the need of opioids and the rate of inflammatory mediators but do not cause sedation The purpose of this research is to compare the analgesic effects of Dexketoprofen trometamol and Ketorolac as preventive analgesics during general anaesthesia.
Method: After obtaining permission from the FK USU ethics committee, 64 samples of research were collected, men and women who were in the inclusive criteria and underwent elective surgeries at COT RSUP HAM MEDAN under general anaestesia. Samples were divided into 2 groups randomly, each with 32 subjects. Thirty minutes before the first cut, Group A was given Dexketoprofen trometamol 50 mg/iv dan Group B was given Ketorolac 30 mg, and general anesthesia procedures were continued.VAS data was observed in the postoperative period of both groups, by asking the patients to show their pain intensity on the VAS assessment card. The result was assessed from 0 (no pain) to 10 (terrible pain) from the first 8 hours till the sixth 8 hours.
Result: VAS results that were obtained after the administration of analgesics showed significant differences in both groups. The result of the research repeatedly using the T-test showed p=0.004, p=0.001, p=0.000, p=0.005, p=0.013, p=0.003.
Conclusion: The results of the research shows that there is a significant difference between both groups statistically Patients who were administered Dexketoprofen trometamol showed a lower VAS score, onset of action being faster compared to Ketorolac dan both drugs can be used as preventive analgesia.Latar Bolakang dan TuJuan: Nyeri paska bedah merupakan salah satu
masalah penting yang menyertai proses operasi, sehingga analgesia yang
kuat sangat dibutuhkan pada periode paska bedah. Obat-obat AINS
sudah popular sebagai analgesia kerena obat ini dapat menurunkan
kebutuhan analgetik opioid dan kadar mediator inflamatori pada daerah
trauma tetapi tidak menyebabkan sedasi. Penelitian ini ditujukan untuk
membandingkan efek analgesia Deksketoprofen trometamol dengan
Ketorolak sebagai prevenUf analgesia pada anestesi umum.
t€tode: Setelah merdapat persetujuan dari komite etik FK USU,
dikumpulkan sebenyak 64 sampel penelitian, laki-laki dan perempuan
yang masuk kriteria inklusi dan menjalani operasi elektif di IBP RSUP
HAM Medan dengan tindakan general anesEsi. Sampel dibagi menjadi
dua kelompok secara randomisasi masing-masing 32 subjek. Tiga puluh
menit sebelum sayatan pertama Kelompok A diberikan Deksketoprofen
tromatamol 50 mgflV den kelornpok B diberikan Ketorolek 30 mg
kemudian dilanjutkan prosedur tetap general anestesi. Paska
pembedahan kedua kelompok diobseNasi data VAS, dengan cara
menanyakan kapada pasien dan meminta untuk menunjukkan intensitas
nyeri pada kartu penilaian VAS. Hasilnya dinilai 0 (tidak nyeri) sampai 10
(nyeri sangat hebat) mulai I jam I sampai I jam Vl .
Hasil: Didapatkan nilai VAS sesudah pemberian analgetik ada perbedaan
bermakne diantara kedua kelompok. Hasil penelitien secara berlurut-turut
dengan uji t-test didapati p=0.004 , p=0.0O1, p=0.0N, p=0.005, p=0-013,
p=0.N3.
Keeimpulan: Dari hasil penelitian ada pertedaan bermakna diantara
kedua kelompok secara statistik. Pasien yang diberikan Deksketoprofen
trometamol mendapatkan nilai VAS yang lebih kecil, wakfu kefja lebih
cepat dibandingkan Ketorolak dan kedua obat dapat dipakai sebagai
preventif analgesia76 HalamanTesis Magiste
Perbandingan Level Sedasi Premedikasi Midazolam Dosis 0,05, 0,08 dan 0,1 MG/KGBB Intravena pada Anestesi Umum Menggunakan Bispectral Index
No full textPendahuluan : Midazolam merupakan golongan yang larut dalam air, bila
diberikan secara intravena pada orang dewasa dengan dosis 1 – 2 mg efektif untuk
premedikasi, sedasi saat anestesi regional dan prosedur singkat.
Tujuan penelitian : • Untuk mengetahui perbandingan level sedasi premedikasi
midazolam dosis 0,05 mg/kgBB, 0,08 mg/kgBB dan 0,1 mg/kgBB
Metode : Uji coba terkontrol secara acak dan double-blind. Penelitian ini dilakukan
di Rumah Sakit Umum Haji Adam Malik Medan dari bulan Februari 2019. Populasi
penelitian adalah seluruh pasien yang menjalani tindakan anestesi di RSUP. H.
Adam Malik. Dalam penelitian yang dilakukan pada 66 sampel yang dibagi menjadi
3 kelompok, kelompok A mendapat midazolam intravena 0,05 mg/kg serta
kelompok B mendapat midazolam intravena 0,08 mg/kgBB dan kelompok C
mendapat midazolam intravena 0,1 mg/kgBB. Uji kenormalan data numerik
digunakan uji Kolmogorv - Smirnov, sedangkan untuk data kategorik digunakan
uji chi-square.
Hasil : Berdasarkan penelitian ini, pada jenis obat A diperoleh nilai mean pada
pengamatan T0 sebesar 95 dan pada pengamatan T7 diperoleh rerata 75.05 artinya
mengalami penurunan sebesar 19.95. dari hasil uji statistik diperoleh nilai p (0.000)
< 0.05. Pada jenis obat B diperoleh nilai mean pada pengamatan T0 sebesar 95.77
dan pada pengamatan T7 diperoleh rerata 53.59 artinya mengalami penurunan
sebesar 42.18. dari hasil uji statistic diperoleh nilai p (0.000) < 0.05. Sedangkan
pada jenis obat C diperoleh nilai mean pada pengamatan T0 sebesar 96.09 dan pada
pengamatan T7 diperoleh rerata 51.00 artinya mengalami penurunan sebesar 45.09.
dari hasil uji statistic diperoleh nilai p (0.000) < 0.05.
Kesimpulan : Dosis midazolam 0,05mg/KgBB memberikan efek sedasi yang lebih
baik dan dapat menjaga kedalaman sedasi dengan nilai BIS diantara 60 – 80
dibandingkan dengan dosis 0,08 mg/KgBB dan 0,1 mg/KgBB yang menyebabkan
kedalaman sedasi masuk kedalam level anestesi umum dengan nilai BIS < 60.Introduction: Midazolam is a water-soluble group, when administered
intravenously to adults at a dose of 1-2 mg effective for premedication, sedation
during regional anesthesia and short procedures.
Objective: To determine the ratio of midazolam premedication sedation levels to
0.05 mg / kg body weight, 0.08 mg / kg body weight and 0.1 mg / kg body weight
Method: A randomized and double-blind controlled trial. This study was conducted
at Haji Adam Malik General Hospital in Medan from February 2019. The study
population was all patients who undergo anesthesia in Haji Adam Malik General
Hospital. In the study conducted on 66 samples divided into 3 groups, group A
received intravenous midazolam 0.05 mg / kg, group B received intravenous
midazolam 0.08 mg / kgBB and group C received intravenous midazolam 0.1 mg /
kgBB. Numerical data normality test was used Kolmogorv - Smirnov test, and
analysis bivariat is used chi-square test.
Results: Based on this study, the type of drug A obtained by the mean value of T0
was 95 and in observation of T7 it was obtained that the mean was 75.05 which
means a decrease of 19.95. from the results of statistical tests obtained p value
(0.000) <0.05. In the type of drug B, the mean value of the observation T0 was
95.77 and the T7 observation was 53.59, which meant a decrease of 42.18. From
the results of the statistical test obtained p value (0.000) <0.05. Whereas in the type
of drug C, the mean value at T0 observation is 96.09 and in observation of T7 it is
obtained that the average of 51.00 means that it has decreased by 45.09. From the
results of the statistical test obtained p value (0.000) <0.05.
Conclusion: 0.05mg / KgBW midazolam provides a better sedation effect and
maintaining the sedation level with BIS value between 60-80 compared to 0.08 mg
/ KgBW and 0.1 mg / KgBW which bring the sedation level into general anesthesia.
with BIS value <60.80 HalamanTesis Magiste
Perbandingan Skala Nyeri Akibat Penyuntikan Propofol yang Didahului dengan Injeksi Lidokain dan Ketamin pada General Anestesi
No full textLatar Belakang : Pemberian ketamin dengan dosis 10 mg sebelum injeksi
propofol menurunkan nyeri akibat penyuntikan propofol. Dosis optimal dari
lidokain diduga dapat mencegah nyeri akibat injeksi propofol. Tujuan dari
penelitian ini adalah Untuk menilai perbandingan skala nyeri akibat penyuntikan
propofol yang didahului dengan injeksi lidokain dan ketamin pada general
anestesi.
Metode : Penelitian analitik eksperimental dengan desain penelitian double blind
randomized control trial dengan jumlah sampel 50 pasien pembedahan elektif.
Pasien dibagi dalam dua kelompok yaitu perlakuan (n=25) diberikan lidokain dan
kontrol (n=32) diberikan ketamin. Skor nyeri ditanyakan lagi setiap interval 5
detik dan skala nyeri tertinggi dicatat sebagai data penelitian. Jika pasien
mengatakan tidak, maka skala nyeri adalah 0. Alat ukur yang digunakan pada
penelitian menggunakan VAS. Data dianalisis dengan menggunakan SPSS.
Hasil : Pada penelitian ini didapatkan bahwa pada kelompok perlakuan ketamin
yang tidak merasakan nyeri pada kelompok ketamin sebanyak 13 orang (52%),
yang merasakan nyeri ringan sebanyak 8 orang (32%), yang merasakan nyeri
sedang sebanyak 3 orang (12%) dan yang merasakan nyeri berat sebanyak 1 orang
(4%). Selain itu, kelompok perlakuan lidokain yang tidak merasakan sebanyak 19
orang (76%), yang merasakan nyeri ringan sebanyak 8 orang (20%), yang
merasakan nyeri sedang sebanyak 1 orang (4%) dan yang merasakan nyeri berat
sebanyak 0 orang. Derajat nyeri pada kelompok lidokain tidak ada yang
ditemukan mengalami nyeri derajat berat, sedangkan pada kelompok ketamim
masih ditemukan sampel yang mengalami nyeri derajat berat setelah penyuntikan
propofol. Berdasarkan uji perbedaan yang dilakukan dengan uji Mann-Whiteny
didapatkan bahwa tidak terdapat perbedaan derajat nyeri akibat penyuntikan
propofol yang didahului dengan injeksi lidokain dan ketamin.
Kesimpulan : Tidak terdapat perbedaan derajat nyeri akibat penyuntikan propofol
yang didahului dengan injeksi lidokain dan ketamin.Background: Provision of ketamine with a dose of 10 mg before injection of
propofol reduced pain due to injection of propofol. The optimal dose of lidocaine
is thought to prevent pain due to injection of propofol. The aim of this study was
to assess the comparison of the scale of pain due to injection of propofol which
was preceded by injection of lidocaine and ketamine in general anesthesia.
Method: Experimental analytical study with a double blind randomized control
trial design with a sample of 50 elective surgical patients. Patients were divided
into two groups, namely treatment (n = 25) given lidocaine and controls (n = 32)
given ketamine. Pain scores were asked again every 5 second interval and the
highest pain scale was recorded as research data. If the patient says no, the pain
scale is 0. The measuring instrument used in the study uses VAS. Data were
analyzed using SPSS.
Results: In this study it was found that in the ketamine treatment group that did
not feel pain in the ketamine group as many as 13 people (52%), who felt mild
pain as many as 8 people (32%), who felt moderate pain as much as 3 people
(12%) and who feel severe pain as much as 1 person (4%). In addition, 19 people
(76%) did not feel the lidocaine treatment group, 8 people felt mild pain (20%), 1
person felt moderate pain (4%) and 0 people who felt severe pain. The degree of
pain in the absence lidocaine group was found to have severe degree of pain,
whereas in the ketamim group there were still samples that experienced severe
degree of pain after injection of propofol. Based on the difference test conducted
by the Mann-Whiteny test it was found that there was no difference in the degree
of pain due to injection of propofol which was preceded by injection of lidocaine
and ketamine.
Conclusion: There was no difference in the degree of pain due to injection of
propofol which was preceded by injection of lidocaine and ketamine.85 HalamanTesis Magiste
Rasio C Reaktive Protein / Albumin Sebagai Prediktor Mortalitas pada Pasien Sepsis di ICU RSUP. H. Adam Malik Medan dan Dihubungkan dengan Skor SOFA
No full textLatar Belakang : Sepsis merupakan penyebab utama mortalitas di ICU. Memperkirakan mortalitas pasien dari ruang perawatan ICU sangat penting. Kegagalan organ merupakan salah satu penyebab tingginya angka mortalitas pasien ICU. Di perlukan suatu biomarker yang dapat memprediksi mortalitas tersebut yang mampu merefleksikan konsep inflamasi dari sepsis. Maka penelitian ini di tujukan untuk melihat rasio CRP/Albumin yang di hubungkan dengan skor SOFA untuk memprediksi mortalitas pasien sepsis.
Metode : Penelitian ini mengambil sample darah pasien yang dirawat di ICU sebanyak 58 pasien. Sample diperiksa untuk CRP dan Albumin hari 1 dan 3, sekaligus di hitung skor SOFA hari 1 dan 3 dan rasio CRP/Albumin hari 1 dan 3. Penelitian dilaksanakan setelah mendapat ethical approval dan informed consent. Hasil dan Pembahasan : 30 orang laki-laki (51,7%) dan 28 orang wanita (48,3%) dengan usia termuda 16 tahun dan tertua 65 tahun. Rasio CRP/Albumin hari 1 tidak mempunyai hubungan yang signifikan dengan skor SOFA hari 1. (P>0,05) dan rasio CRP/Albumin hari 3 mempunyai hubungan yang signifikan dengan skor SOFA hari 3.(P<0,05)
Simpulan dan saran: Rasio CRP/ Albumin dan skor SOFA dapat memprediksi mortalitas pasien sepsis. Perlu dilakukan penelitian lebih lanjut untuk melihat rasio CRP/Albumin dan skor SOFA sebagai prediktor mortalitas pasien sepsis.Background: Sepsis is a major cause of mortality in the ICU. Therefore, estimating patient mortality from ICU treatment rooms is very important. Organ failure is one of the causes of high mortality rates for ICU patients. Accordingly we need a biomarker that can predict the mortality in which way it can reflect the concept of inflammation from sepsis. Based on that reason, this study is aimed at looking at the CRP / Albumin ratio associated with the SOFA score to predict mortality in septic patients.
Methods: This study took the blood samples of 58 patients who were being treated at the ICU. Samples were checked for CRP and Albumin on day 1 and 3. At the same time, the SOFA scores and CRP / Albumin ratios were also calculated on day 1 and 3. Finally, the study was conducted after obtaining ethical approval and informed consent. Result And Discussion: 30 men (51,7%) and 28 women (48,3%) with the youngest was 16 years old and the oldest was 65 years old. The CRP / Albumin ratio for day 1 did not have a significant relationship with day 1 of the SOFA scores (P>0.05) and The CRP / Albumin ratio for day 3 have a significant relationship with day 3 of the SOFA scores (P<0.05)
Conclusion and Suggestion: The CRP / Albumin ratio and SOFA score can predict the mortality of septic patients. Further research is needed to see the CRP / Albumin ratio and SOFA score as a mortality predictor for septic patients.126 HalamanTesis Magiste
Analisis Profil Kultur Darah Dan Faktor – Faktor Yang Berhubungan Dengan Pola Kuman Di Icu Rsup Ham
No full textIntroduction: Bloodstream infection is an infectious disease characterized by the presence of live bacterial or fungal microorganisms in the bloodstream, as evidenced by positive blood cultures. These pathogens have an important role in infection, especially in the ICU. Although infection is not the most common cause of mortality in ICU care, infection is confirmed to be associated with increased hospitalization and high treatment costs.
Objective: This study aims to determine the profile of blood culture, the factors that have a bearing on the results, and the description of antibiotic resistance in patients at RSUP HAM
Method: This study is a study using secondary data from patients in ICU HAM RSUP in 2019 - 2020 conducted by blood culture.
Results: This study included data from 52 patients who were recorded between 2019 – 2020 and underwent blood culture. There are 50% women and men each with an average age of 54,69 years. Based on the acquisition of a positive blood culture in terms of the day of admission, found 33 people (61.4%) positive patients after passing 48 hours. The highest morphology was Gram negative rods, 52.8% with the most species, Klebsiella pneumoniae ESBL positive, and found Carbapenemase-producing bacteria (5.5%). The most common Gram-positive bacterium is Staphylococcus aureus (15%), and half is suspected MRSA.
Conclusion: Most types of bacteria found in ICU HAM patients in RSUP HAM are Gram-negative rod bacteria, with the time it was found above 48 hours after entering the hospital. The picture of antibiotic resistance is in line with the bacteria found with the property of drug resistance. Preventive measures are needed to prevent patients from the possibility of transmitting these microorganismsPendahuluan: Infeksi aliran darah adalah penyakit infeksi yang ditandai dengan adanya mikroorganisme bakteri atau jamur hidup dalam aliran darah, yang dibuktikan dengan kultur darah positif. Patogen – patogen ini memiliki peran penting dalam infeksi terutama di ICU. Meskipun infeksi bukan merupakan penyebab tunggal tersering pada mortalitas pasien dalam rawatan ICU, namun infeksi dipastikan berhubungan dengan meningkatnya masa rawatan dan biaya rawatan yang tinggi.
Tujuan: Penelitian ini bertujuan untuk mengetahui profil kultur darah, faktor – faktor yang berhubungan dengan hasil, serta gambaran resistensi antibiotikan apda pasien RSUP HAM.
Metode: Penelitian ini merupakan penelitian menggunakan data sekunder dari pasien di ICU RSUP HAM pada tahun 2019 – 2020 yang dilakukan kultur darah.
Hasil: Penelitian ini meliputi data dari 52 orang pasien yang terekam antara tahun 2019 – 2020 dan menjalani proses kultur darah. Terdapat masing – masing 50% perempuan dan laki - laki dengan rata – rata usia 54,69 tahun. Berdasarkan perolehan kultur darah yang positif ditinjau dari hari masuk rawatan, didapatkan 33 orang (61,4%) pasien positif setelah melewati 48 jam. Morfologi terbanyak adalah batang Gram negatif yaitu 52,8% dengan spesies terbanyak yaitu Klebsiella pneumoniae ESBL positif, dan dijumpai bakteri penghasil Carbapenemase (5,5%). Bakteri Gram positif terbanyak dijumpai adalah Staphylococcus aureus (15%), dan setengahnya merupakan terduga MRSA.
Kesimpulan: Jenis bakteri terbanyak ditemukan pada pasien rawatan ICU RSUP HAM dalah bakteri batang Gram negatif, dengan waktu ditemukannya di atas 48 jam setelah masuk RS. Gambaran resistensi antibiotika sejalan dengan dengan bakteri – bakteri yang ditemukan dengan properti resistensi obat. Langkah preventif dibutuhkan untuk menghindarkan pasien dari kemungkinan transmisi mikroorganisme tersebut.65 HalamanTesis Magiste
Perbandingan Keberhasilan Obat Kumur Ketamin dan Aspirin dalam Mencegah Nyeri Tenggorok dan Suara Serak Akibat Intubasi Endotrakeal
No full textBackground. Post Operative Sore Throat (POST) and hoarseness are common complications of general anaesthesia with endotracheal intubation that affects patient satisfaction. Various non-pharmacological and pharmacological methods have been used to prevent these complications, but some have it own advantages and disadvantages. We compared the efficacy of ketamine gargle with aspirin gargle for prevention of POST and hoarseness after using endotracheal tube.
Methods. We studied 84 patients 18 – 60 years old, ASA I or II, Mallampati Class I or II with endotracheal intubation supine position with the periode surgery 60 – 240 minutes. In double blind randomized, divided into two equalgroups. First group received 40 mg ketamine gargle in 30 ml normal saline and 300 mg aspirin gargle in 20 ml normal saline. Patients were asked to gargle during 30 seconds before induction of anesthesia. Premedication using midazolam 0,05 mg/kgBB and fentanyl 2 ug/kg. Tracheal intubation was facilitated by rocuronium 1 mg/kgBB. Anesthesia was maintained with N2O : O2 = 2:2 and isofluran 1%. Evaluation of POST and hoarseness were done at 0, 2, 24 hours postoperative with Visual Analogue Score.
Results. At the end of study 84 completed the study. The withdrawal 8 patients. Incident sorethroat after endotracheal intubation ketamine group of found sorethroat 38,1%, no sorethroat 61,9%. In the aspirin group found sorethroat 45,2%, no sorethroat 54,8% with a value of P> 0,05 is not significantly different then the incidence of sorethroat in the two groups. Incidence of hoarseness after endotracheal intubation ketamine group found 11,9%, no hoarseness 88,1%. In the aspirin group found hoarseness 21,4%, no hoarseness 78,6% with a value of P> 0,05 is not significantly different then the incidence of hoarseness in the two groups. Ketamine group found no sorethroat and no hoarseness 59,5%, sorethroat and hoarseness 28,6%, not 2,4% sorethroat and hoarseness, sorethroat and hoarseness 9,5%. In the aspirin group found no sorethroat and no hoarseness 50%, sorethroat and hoarseness 28,6,%, not 4,8% sorethroat and hoarseness, sorethroat and hoarseness 6,3% of the value of P>0,05 is not significantly different comparison sorethroat and hoarseness between two groups.
Conclusions. There are no outcome differences between ketamine and aspirin in reducing pain in throat and hoarseness after endotracheal intubation.
Keywords. Intubation endotracheal, ketamine gargle, aspirin gargle, post operative sorethroat, hoarseness.94 HalamanTesis Magiste
Perbandingan Keberhasilan Obat Kumur Ketamin dan Aspirin dalam Mencegah Nyeri Tenggorok dan Suara Serak Akibat Intubasi Endotrakeal
No full textBackground. Post Operative Sore Throat (POST) and hoarseness are common complications of general anaesthesia with endotracheal intubation that affects patient satisfaction. Various non-pharmacological and pharmacological methods have been used to prevent these complications, but some have it own advantages and disadvantages. We compared the efficacy of ketamine gargle with aspirin gargle for prevention of POST and hoarseness after using endotracheal tube.
Methods. We studied 84 patients 18 – 60 years old, ASA I or II, Mallampati Class I or II with endotracheal intubation supine position with the periode surgery 60 – 240 minutes. In double blind randomized, divided into two equalgroups. First group received 40 mg ketamine gargle in 30 ml normal saline and 300 mg aspirin gargle in 20 ml normal saline. Patients were asked to gargle during 30 seconds before induction of anesthesia. Premedication using midazolam 0,05 mg/kgBB and fentanyl 2 ug/kg. Tracheal intubation was facilitated by rocuronium 1 mg/kgBB. Anesthesia was maintained with N2O : O2 = 2:2 and isofluran 1%. Evaluation of POST and hoarseness were done at 0, 2, 24 hours postoperative with Visual Analogue Score.
Results. At the end of study 84 completed the study. The withdrawal 8 patients. Incident sorethroat after endotracheal intubation ketamine group of found sorethroat 38,1%, no sorethroat 61,9%. In the aspirin group found sorethroat 45,2%, no sorethroat 54,8% with a value of P> 0,05 is not significantly different then the incidence of sorethroat in the two groups. Incidence of hoarseness after endotracheal intubation ketamine group found 11,9%, no hoarseness 88,1%. In the aspirin group found hoarseness 21,4%, no hoarseness 78,6% with a value of P> 0,05 is not significantly different then the incidence of hoarseness in the two groups. Ketamine group found no sorethroat and no hoarseness 59,5%, sorethroat and hoarseness 28,6%, not 2,4% sorethroat and hoarseness, sorethroat and hoarseness 9,5%. In the aspirin group found no sorethroat and no hoarseness 50%, sorethroat and hoarseness 28,6,%, not 4,8% sorethroat and hoarseness, sorethroat and hoarseness 6,3% of the value of P>0,05 is not significantly different comparison sorethroat and hoarseness between two groups.
Conclusions. There are no outcome differences between ketamine and aspirin in reducing pain in throat and hoarseness after endotracheal intubation.
Keywords. Intubation endotracheal, ketamine gargle, aspirin gargle, post operative sorethroat, hoarseness.94 HalamanTesis Magiste
Perbandingan Skala Nyeri Akibat Penyuntikan Propofol yang Didahului dengan Injeksi Lidokain dan Ketamin pada General Anestesi
No full textLatar Belakang : Pemberian ketamin dengan dosis 10 mg sebelum injeksi
propofol menurunkan nyeri akibat penyuntikan propofol. Dosis optimal dari
lidokain diduga dapat mencegah nyeri akibat injeksi propofol. Tujuan dari
penelitian ini adalah Untuk menilai perbandingan skala nyeri akibat penyuntikan
propofol yang didahului dengan injeksi lidokain dan ketamin pada general
anestesi.
Metode : Penelitian analitik eksperimental dengan desain penelitian double blind
randomized control trial dengan jumlah sampel 50 pasien pembedahan elektif.
Pasien dibagi dalam dua kelompok yaitu perlakuan (n=25) diberikan lidokain dan
kontrol (n=32) diberikan ketamin. Skor nyeri ditanyakan lagi setiap interval 5
detik dan skala nyeri tertinggi dicatat sebagai data penelitian. Jika pasien
mengatakan tidak, maka skala nyeri adalah 0. Alat ukur yang digunakan pada
penelitian menggunakan VAS. Data dianalisis dengan menggunakan SPSS.
Hasil : Pada penelitian ini didapatkan bahwa pada kelompok perlakuan ketamin
yang tidak merasakan nyeri pada kelompok ketamin sebanyak 13 orang (52%),
yang merasakan nyeri ringan sebanyak 8 orang (32%), yang merasakan nyeri
sedang sebanyak 3 orang (12%) dan yang merasakan nyeri berat sebanyak 1 orang
(4%). Selain itu, kelompok perlakuan lidokain yang tidak merasakan sebanyak 19
orang (76%), yang merasakan nyeri ringan sebanyak 8 orang (20%), yang
merasakan nyeri sedang sebanyak 1 orang (4%) dan yang merasakan nyeri berat
sebanyak 0 orang. Derajat nyeri pada kelompok lidokain tidak ada yang
ditemukan mengalami nyeri derajat berat, sedangkan pada kelompok ketamim
masih ditemukan sampel yang mengalami nyeri derajat berat setelah penyuntikan
propofol. Berdasarkan uji perbedaan yang dilakukan dengan uji Mann-Whiteny
didapatkan bahwa tidak terdapat perbedaan derajat nyeri akibat penyuntikan
propofol yang didahului dengan injeksi lidokain dan ketamin.
Kesimpulan : Tidak terdapat perbedaan derajat nyeri akibat penyuntikan propofol
yang didahului dengan injeksi lidokain dan ketamin.Background: Provision of ketamine with a dose of 10 mg before injection of
propofol reduced pain due to injection of propofol. The optimal dose of lidocaine
is thought to prevent pain due to injection of propofol. The aim of this study was
to assess the comparison of the scale of pain due to injection of propofol which
was preceded by injection of lidocaine and ketamine in general anesthesia.
Method: Experimental analytical study with a double blind randomized control
trial design with a sample of 50 elective surgical patients. Patients were divided
into two groups, namely treatment (n = 25) given lidocaine and controls (n = 32)
given ketamine. Pain scores were asked again every 5 second interval and the
highest pain scale was recorded as research data. If the patient says no, the pain
scale is 0. The measuring instrument used in the study uses VAS. Data were
analyzed using SPSS.
Results: In this study it was found that in the ketamine treatment group that did
not feel pain in the ketamine group as many as 13 people (52%), who felt mild
pain as many as 8 people (32%), who felt moderate pain as much as 3 people
(12%) and who feel severe pain as much as 1 person (4%). In addition, 19 people
(76%) did not feel the lidocaine treatment group, 8 people felt mild pain (20%), 1
person felt moderate pain (4%) and 0 people who felt severe pain. The degree of
pain in the absence lidocaine group was found to have severe degree of pain,
whereas in the ketamim group there were still samples that experienced severe
degree of pain after injection of propofol. Based on the difference test conducted
by the Mann-Whiteny test it was found that there was no difference in the degree
of pain due to injection of propofol which was preceded by injection of lidocaine
and ketamine.
Conclusion: There was no difference in the degree of pain due to injection of
propofol which was preceded by injection of lidocaine and ketamine.85 HalamanTesis Magiste
Perbandingan Efektifitas dan Efek Samping Ketamin Dosis 0,2 mg/kg dengan Morfin Dosis 0,1 mg/kg Bolus Intravena untuk Penanganan Nyeri Akut Pasien Trauma Extremitas di Instalasi Gawat Darurat Rumah Sakit Haji Adam Malik Medan
No full textBackground and Purpose: Pain is the main cause of the patient came to the hospital. The right analgesia will cause the patient free of pain since early admission to the hospital. Ketamine and Morphine is a potent analgesic for acute pain management. The study compared reduction in pain scale after administration of ketamine bolus dose of 0.2 mg / kg morphine dose of 0.1 mg / kg for the treatment of moderate-severe acute pain.
Methods: After the approval of research ethics committees in health FK USU and Hospital Haji Adam Malik conducted research on 36 samples. After randomization of samples were divided into two treatment groups: group A was given ketamine intravenous bolus of 0.2 mg / kg and group B is given a bolus intravenous morphine 0.1 mg / kg. Pain assessment performed before treatment and every 15 minutes up to 120 minutes after treatment with NRS pain assessment scale.
Results: Based on the reduction in NRS score differences seem significant reduction in NRS score on almost all observations. From T1 to T4 observation seems lower average decline occurred in the ketamine group, but after observation T6 to T8 mean the decline occurred in the group of morphine.
In general, the average value of the incidence of sedation and nausea-vomiting in both groups can be stated that there are no significant side effects from the study arms.
Conclusion: The group ketamine intravenous bolus of 0.2 mg / kg intravenous bolus of morphine 0.1 mg / kg was statistically no difference in decreasing the mean value of the NRS, but clinically bolus intravenous ketamine leave impairment NRS faster than an intravenous bolus of morphine 0 , 1 mg / kg.Latar Belakang dan Tujuan : Nyeri merupakan penyebab utama pasien datang ke rumah sakit. Pemberian analgetik yang tepat akan menyebabkan pasien terbebas dari rasa sakit sejak awal masuk ke rumah sakit. Ketamin dan Morfin merupakan analgetik yang poten untuk penanganan nyeri akut. Penelitian ini membandingkan penurunan skala nyeri setelah pemberian bolus ketamin dosis 0,2 mg/kg dengan morfin dosis 0,1 mg/kg untuk penanganan nyeri akut sedang berat.
Metode: Setelah mendapat persetujuan dari komite etik penelitian bidang kesehatan FK USU dan Rumah Sakit Haji Adam Malik Medan dilakukan penelitian pada 36 sampel. Setelah randomisasi sampel dibagi menjadi 2 kelompok perlakuan yaitu kelompok A diberikan bolus ketamin intravena 0,2 mg/kg dan kelompok B diberikan bolus morfin intravena 0,1 mg/kg. Dilakukan penilaian nyeri sebelum perlakuan dan setiap 15 menit hingga 120 menit setelah perlakuan dengan penilaian skala nyeri NRS.
Hasil : Berdasarkan nilai penurunan skor NRS tampak perbedaan penurunan skor NRS yang signifikan pada hampir semua pengamatan. Dari pengamatan T1 sampai T4 rerata penurunan tampak lebih rendah terjadi pada kelompok ketamin, namun setelah pengamatan T6 sampai T8 rerata penurunan terjadi pada kelompok morfin.
Secara umum rerata nilai insiden sedasi dan mual-muntah di kedua kelompok dapat dinyatakan bahwa tidak ada efek samping yang bermakna dari kedua kelompok penelitian.
Kesimpulan : Kelompok bolus intravena ketamin 0,2 mg/kg dan bolus intravena morfin 0,1 mg/kg secara statistik tidak menunjukkan perbedaan dalam menurunkan rerata nilai NRS, namun secara klinis bolus intravena ketamin memberikan penurunan nilai NRS lebih cepat dibandingkan bolus intravena morfin 0,1 mg/kg.113 HalamanTesis Magiste
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