AbstrakKepentingan dari conus medularis bagi dokter spesialis anestesi adalah saat dilakukan tindakan anestesi spinal yang memiliki risiko terjadi trauma medula spinalis yang serius. Conus medularis dapat diidentifikasi melalui hasil pencitraan magnetic resonance imaging (MRI). Penelitian yang dilakukan sekarang bertujuan untuk mengetahui distribusi letak ujung conus medularis pada orang Indonesia secara observasional deskriptif dengan menggunakan hasil pencitraan magnetic resonance imaging (MRI) lumbosakral. Penelitian dilakukan melalui pemeriksaan terhadap letak ujung conus medularis secara retrospektif pada 135 hasil pencitraan MRI pasien usia 18-65 tahun dari bulan Januari 2013 hingga Maret 2014 di Departemen Radiologi Rumah Sakit Dr. Hasan Sadikin Bandung. Dari penelitian ini didapatkan letak ujung conus medularis paling banyak berada setinggi sepertiga tengah L1, dengan rentang mulai dari setinggi sepertiga tengah T12 hingga sepertiga bawah L2. Berdasarkan parameter jenis kelamin didapatkan distribusi letak conus medularis pada perempuan cenderung lebih kaudal dibandingkan dengan laki-laki. Kata kunci: Conus medularis, magnetic resonance imaging, orang Indonesia Determination of Conus Medullaris Position within the Vertebra using Magnetic Resonance Imaging in Dr. Hasan Sadikin General Hospital Bandung for Spinal Anesthesia Purpose AbstractThe position of conus medullaris is important to be identified by anesthesiologists during spinal anesthesia to avoid serious spinal cord trauma risk. Conus medullaris can be accurately identified through magnetic resonance imaging (MRI) images. The aim of this study was to determine the distribution of conus medullaris in Indonesians through a descriptive observation using magnetic resonance imaging (MRI) images of lumbosacral. The locations of conus medullaris were observed retrospectively on 135 MRI images scanned, aged 18-65 years, during the period of January 2013 to March 2014 at the Departement of Radiology, Dr. Hasan Sadikin General Hospital Bandung. From this study, it was revealed that the conus medullaris are mostly located at the middle third of L1, ranging from the middle third of T12 to the lower third of L2. With gender as a parameter, it was shown that the distribution of conus medullaris in women tends to be more caudal than in men.
AbstrakGabapentin mempunyai efek antihiperalgesia, antialodinia, dan antinosiseptif. Penelitian ini bertujuan untuk menilai efek gabapentin 600 mg dan 1.200 mg per oral preoperatif terhadap nilai visual analogue scale (VAS) dan pengurangan kebutuhan petidin pascaoperatif. Penelitian dilakukan secara uji acak terkontrol buta ganda terhadap 38 orang pasien di Rumah Sakit Dr. Hasan Sadikin Bandung pada MeiSeptember 2010. Pasien dibagi menjadi dua kelompok yaitu kelompok gabapentin 600 mg dan gabapentin 1.200 mg. Penilaian skala nyeri dilakukan dengan menggunakan nilai VAS. Data hasil penelitian dianalisis menggunakan Uji Mann-Whitney dengan tingkat kepercayaan 95% dan dianggap bermakna bila nilai p<0,05. Hasil penelitian didapatkan nilai VAS saat diam dan saat mobilisasi berbeda bermakna (p<0,05). Kelompok gabapentin 1.200 mg lebih sedikit diberikan analgetik petidin tambahan (10,5% vs 15,8%), tetapi perbedaan tersebut tidak bermakna (p=0,631). Simpulan penelitian ini adalah gabapentin 1.200 mg per oral preoperatif lebih baik bila dibandingkan dengan 600 mg dalam mengurangi nilai VAS pascaoperatif pada operasi modifikasi radikal mastektomi, namun tidak mengurangi kebutuhan petidin. AbstractGabapentin is a GABA analog which has the effect of anti hyperalgesia, anti allodynia, and anti nociceptive. This research was conducted in order to assess the effect of 600mg and 1,200 mg gabapentin given preoperatively to assess visual analogue scale (VAS) score and reduction of pethidine requirement. The study was done by conducting a double blind randomized controlled trial on 38 patients, aged 18-65 years, with ASA physical status I-II. Patients were divided into two groups: 600 mg gabapentin and 1,200 mg gabapentin group. The quality of pain was assessed using VAS score. The results were statistically analyzed using Mann-Whitney Test with 95% confidence interval and considered significant if p value <0.05. From the results, the VAS values obtained at rest and during mobilization were significantly different (p<0.05). The 1,200 mg gabapentin group received less additional pethidine (10.5% vs 15.8%), although no significant difference was shown (p=0.631). The conclusion of this study is that administration of 1,200 mg gabapentin per oral pre operatively is better when compared to 600 mg in reducing post operative visual analog scale score in modified radical mastectomy. However, it do not reduce the need for analgesic significantly.
AbstrakNyeri tenggorok pascaoperasi atau post operative sore throat (POST) terjadi karena iritasi dan inflamasi lokal di daerah faring, laring, dan trakea akibat trauma pemasangan pipa endotrakeal. Penelitian ini bertujuan mengetahui efek tablet hisap Strepsils ® untuk mengurangi POST pada pasien yang dilakukan anestesi umum dengan intubasi pipa endotrakeal. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan Oktober-November 2013, terhadap 66 pasien status fisik American Society of Anesthesiologist (ASA) I-II secara prospektif single blind randomized controlled trial. Pasien dibagi menjadi dua kelompok, yaitu kelompok I, sebanyak 33 orang mendapatkan Strepsils ® dan kelompok II, sebanyak 33 orang mendapatkan plasebo. Pasien diminta untuk mengulum permen sebelum induksi. Data dianalisis dengan uji-t, uji chikuadrat, dan Uji Mann-Whitney. Keluhan POST lebih banyak terjadi pada kelompok II dibandingkan dengan kelompok I. Secara statistik pada T0 didapatkan hasil perbedaan yang bermakna (p<0,05). Pada kelompok II, POST dengan skor 1 sebesar 14 (42%) kasus, dibandingkan dengan kelompok I sebesar 3 (9%) kasus dan tidak ada skor 2. Pada T2 didapatkan hasil perbedaan bermakna (p<0,05), POST sebesar 11 (33%) pada kelompok II, sedangkan kelompok I didapatkan 2(6%) kasus. Pada T4 didapatkan perbedaan tidak bermakna (p>0,05), POST pada kelompok II sebesar 3 (9%) kasus, sedangkan kelompok I skor 1 sebesar 1 (3%) kasus. Simpulan, pemberian Strepsils ® praoperasi dengan anestesi umum mengurangi kejadian dan derajat POST. Strepsils® as Pre-operative Lozenge to Attenuate Post-endotracheal Tube Intubation Related Sore Throat AbstractPost-operative sore throat (POST) is caused by local inflammation and irritation at pharynx and larynx due to traumatic endotracheal tube installation. Sixty six patients, ASA I-II, who underwent elective surgery under general anesthesia and installation of endotracheal tube were enrolled in this single blind randomized controlled trial. Patients were randomly allocated into two groups of 33 subjects: receiving Lozenge and receiving placebo. Designated as Group I (Strepsils® group) and Group II (Placebo group). Patients were asked to suck the candy slowly in the mouth before the induction of anesthesia. Data were analyzed with t-test, Chi-square test and Mann-Whitney test using SPSS ver. 13 program for Windows. The results were POST 9.1% and 42.4% at T0, 6.1% and 33.3% at T2 for Strepsils® and Placebo groups, respectively, which were statistically significant (p<0.05). In T4 and T24, non-significant differences were found (p>0.05).In conclusion, dissolving Strepsils® slowly in the mouth before induction of anesthesia pre-operatively reduces POST following general anesthesia.
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