AbstrakGabapentin dan pregabalin mempunyai efek antihiperalgesia, antialodinia, dan antinosiseptif untuk mengurangi nyeri pascaoperatif. Penelitian ini bertujuan untuk membandingkan gabapentin 600 mg (n=22) dengan pregabalin 150 mg (22) terhadap nyeri pascaoperatif modifikasi mastektomi radikal, yang dilakukan terhadap 44 wanita (18-65 tahun) status fisik American Society of Anesthesiologist (ASA) I-II secara uji acak terkontrol buta ganda dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung pada November 2011 sampai Maret 2012. Analisis statistik menggunakan Uji Mann-Whitney, uji-t, dan uji chikuadrat dengan tingkat kepercayaan 95% dan bermakna bila p<0,05. Penilaian skala nyeri menggunakan nilai numeric rating scale (NRS). Nilai NRS saat berbaring pada kelompok gabapentin 600 mg dan pregabalin 150 mg adalah sama (p>0,05). Nilai NRS saat mobilisasi pregabalin 150 mg lebih baik daripada gabapentin 600 mg pada tujuh dari sepuluh waktu pengukuran (p<0,05). Pemberian analgetik tambahan pascaoperatif antara kedua kelompok adalah sama (p>0,05). Simpulan, pregabalin 150 mg preoperatif lebih baik daripada gabapentin 600 mg dalam menurunkan nilai NRS pascaoperasi. Gabapentin 600 mg dan pregabalin 150 mg mampu menurunkan kebutuhan opioid pascaoperatif.Kata kunci: Gabapentin, kebutuhan analgetik opioid, numeric rating scale, nyeri pascaoperatif, pregabalin Comparison of Numeric Rating Scale Value and Post operative Opioid Requirement after Modified Radical Mastectomy between the Use of Pre-operative 600 mg Gabapentin and 150 mg Pregabalin Use AbstractGabapentin and pregabalin has anti hyperalgesia, anti allodynia, and anti nociceptive effects which lead to their use as additional medications to reduce post operative pain. This study compared the use of 600 mg gabapentin and 150 mg pregabalin in managing post-operative pain following modified radical mastectomy. The study was performed by conducting a double blind randomized controlled trial on 44 patients, aged 18-65 years old with American Society of Anesthesiologist (ASA) physical status I-II, who underwent modified radical mastectomy operation under general anesthesia, at Dr. Hasan Sadikin General Hospital Bandung during the period of November 2011 to March 2012. Patients were divided into two groups, 600 mg gabapentin (n=22), and 150 mg pregabalin (n=22) groups. The statistical analysis was conducted using Mann-Whitney Test, t-test, and chi-square test with 95% confidence interval. The results of the analysis would be considered significant if p<0.05. The quality of pain was assessed using the numeric rating scale. The NRS value at rest was similar in both groups (p>0.05). NRS during mobilization were significantly different in nine measurements (p<0.05). Total post-operative additional analgesia showed no significant difference in both groups (p>0.05). Therefore, oral preoperative 150 mg pregabalin is better than 600 mg gabapentin for reducing post-operative NRS. In addition, 600 mg Gabapentin and 150 mg pregabalin also reduce post-operative opioid consumption.
Introduction. Paediatric patients represent a small portion of the COVID-19 disease population. Nevertheless, the possibility of a paediatric patient requiring surgery, especially high-risk aerosol-generating surgery on the airway, while having the SARS-CoV-2 infection may potentially result in problems during the perioperative period due to concerns regarding patient, family, and staff safety. When unplanned and unrehearsed, this scenario may cause delays and efficiency issues. Our aim is to report on an 8-year-old patient with a foreign object lodged in the oesophagus with COVID-19 that required emergency surgery. Case Report. An 8-year-old female patient came to the emergency room with a history of difficulty in swallowing for 12 hours before admission, having accidentally swallowed a metal coin while playing. She did not have any recent history of disease, but her parents had noticed that, for the previous 4 days, she had had a mild fever and dry cough. Her parents and other relatives in the house had no similar complaints, and they assured us they had not been in contact with any suspected or confirmed COVID-19 patients. Our goal was to create a safe paediatric anaesthesia environment with safe working conditions for the surgical team. In this case report, we will describe our approach to patient transport, parental presence, preventions of aerosol risk, personal protection, the anaesthesia induction technique, and postoperative management. Conclusion. Safe paediatric anaesthesia, especially in a high-risk aerosol-generating procedure, during the COVID-19 era requires consideration and preparation of both the patient and healthcare provider. Multidisciplinary team work with an emphasis on a systematic and planned approach is required to improve efficiency.
Pemberian premedikasi dapat mengurangi kecemasan preoperatif dan respons tubuh pasien saat insersi jarum spinal. Premedikasi membuat intervensi spinal menjadi lebih nyaman bagi pasien, pasien kooperatif selama penyuntikan, dan mengurangi respons saat insersi jarum spinal. Tujuan penelitian ini mengetahui pengaruh premedikasi ketamin 0,3 mg/kgBB yang diberikan 3 menit sebelum dilakukan anestesi spinal terhadap respons tubuh pasien saat insersi jarum spinal dan penerimaan pasien terhadap anestesi spinal. Penelitian dilakukan periode Agustus-Desember 2020 di RSUP Dr. Hasan Sadikin Bandung. Penelitian bersifat komparatif eksperimental dengan menggunakan uji klinis acak buta ganda terhadap 46 subjek yang dibagi acak ke dalam 2 kelompok, yaitu kelompok kontrol (kelompok C, n=23) dan kelompok premedikasi ketamin (kelompok K, n=23). Pascapemberian premedikasi ketamin dinilai respons tubuh pasien saat insersi jarum spinal menggunakan prick response score dan penerimaan pasien dengan numeric rating scale. Analisis statistik untuk respons penyuntikan dan penerimaan pasien diuji dengan tes chi-square. Hasil penelitian menunjukkan respons tubuh pasien saat insersi jarum spinal berkurang (p<0,01) dan penerimaan pasien meningkat (p<0,01) pada kelompok perlakuan. Simpulan penelitian, yaitu premedikasi ketamin 0,3 mg/kgBB yang diberikan 3 menit sebelum anestesi spinal menurunkan respons tubuh pasien saat insersi jarum spinal dan meningkatkan penerimaan pasien terhadap anestesi spinal.
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