Acute pain is the most common early complication after total knee arthroplasty causing delayed mobilization and increased demands of morphine, leading to higher operative cost. Several studies have assessed the effectiveness, side-effects, and ease of use of various analgesics. Preemptive analgesia with combined celecoxib and pregabalin has been reported to yield positive outcomes. In this randomized, double-blind controlled clinical trial, 30 subjects underwent surgery for total knee arthroplasty using 15-20mg bupivacaine 5% epidural anesthesia. All subjects were divided into three groups. Group 1 was given celecoxib 400mg and pregabalin 150mg 1 hour before the operation, Group 2 was given celecoxib 200mg and pregabalin 75mg twice daily starting from 3 days before the operation, and Group 3 was given a placebo. The outcome was measured with Visual Analog Scale, knee range of motion, and postoperative mobilization. There was a significant difference in postoperative morphine usage between the groups that were administered with preemptive analgesia and the placebo group, but no significant difference was found between Group 1 and Group 2 that were given preemptive analgesia at different doses. ROM and postoperative mobilization were not significantly different among the three groups. Two patients in the first group, one patient in the second group, and one patient in the third group developed nausea. Preemptive analgesia is proven to reduce postoperative usage of morphine independent of the dosage. We recommend the use of combined celecoxib and pregabalin as preemptive analgesia after the total knee arthroplasty procedure. This trial is registered with NCT03523832 (ClinicalTrials.gov).

Traffic related death and trauma are major health problems in developing countries. Traffic accident needs multidisciplinary approach. Data regarding the profile of traumatic patients due to traffic accidents are still limited especially in Indonesia. This study was aimed to obtain the profile of traumatic patients due to traffic accidents admitted to the emergency unit of Surgery Department, Prof. Dr. R. D. Kandou Hospital Manado, from 1st January to 31st December 2017. This was a descriptive retrospective study using medical record data of the patients. Samples were all traumatic patients due to traffic accidents admitted to the emergency unit of Surgical Department. The results showed that of 173 patients the majority were as follows: adults 121 patients (69.9%), males 123 patients (71.1%), drivers 113 patients (65.3%), bikers 138 patients (88.5%), without using safety equipment 93 patients (59.6%), negative alcohol 141 patients (81.5%), head trauma 91 patients (52.6%), and outpatients as many as 130 patients (75.1%).Keywords: trauma, traffic accident Abstrak: Trauma dan kematian akibat kecelakaan lalu lintas (KLL) merupakan masalah kesehatan masyarakat yang utama di negara berkembang. Kecelakaan lalu lintas memerlukan penanganan dengan pendekatan multidisipliner. Data tentang profil pasien trauma akibat KLL terbilang masih sedikit khususnya di Indonesia. Penelitian ini bertujuan untuk mengetahui profil pasien trauma akibat KLL yang dirawat di Instalasi Rawat Darurat Bedah RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari s/d 31 Desember 2017. Jenis penelitian ialah deskriptif retrospektif menggunkan data rekam medik pasien. Sampel penelitian ialah semua pasien trauma akibat KLL yang dirawat di Instalasi Rawat Darurat Bedah RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian menunjukkan bahwa dari 173 pasien KLL, didapatkan yang terbanyak ialah pasien usia dewasa 121 orang (69,9%), jenis kelamin laki-laki 123 orang (71,1%), pengendara 113 orang (65,3%), pengguna motor 138 orang (88,5%), tidak memakai alat pengaman 93 orang (59,6%), negatif alkohol 141 orang (81,5%), trauma kepala 91 orang (52,6%), dan rawat jalan 130 orang (75,1%).Kata kunci: trauma, kecelakaan lalu lintas

Abstrak: Infeksi pada tulang dan sendi masih merupakan kasus yang menantang. Kondisi ini memberikan banyak penyulit baik kepada dokter maupun pasien. Meski terapi antibiotika dilaporkan memberikan hasil yang memuaskan pada banyak kasus infeksi, tidak demikian pada kasus infeksi tulang dan sendi. Hal ini berhubungan dengan struktur anatomi dan fisiologi dari tulang. Diperlukan sebuah strategi tata laksana yang baik untuk mencapai hasil yang optimal. Prinsip dasar yang utama dalam mencapai pengobatan yang optimal ialah penegakan diagnosis awal yang tepat, termasuk di dalamnya proses investigasi pemeriksaan mikrobiologi dan patologi. Diperlukan pengertian dasar serta pengenalan kembali anatomi, fisiologi, patofisiologi, dan tata laksana terkini tentang osteomielitis untuk mencapai tatalaksana yang optimal.Kata kunci: diagnosis dan tata laksana osteomielitisAbstract: Infection in bone and joint is still a challenging case. It gives a lot of problems and frustration to the physician and patient. The successful antibiotic therapy in most infectious diseases is abortive to achieve in bone and joint infections because the different characteristic in anatomy and physiology of these structures. Therefore, treatment strategy, including non operative and operative techniques is required to deal with such conditions. The basic principle to achieve a successful management of osteomyelitis in general is correct initial diagnosis including investigation for microbiological and pathological examinations to allow the proper and long term lasting therapy of antibiotic. For that reason, it is required to have the basic understanding in dealing with this issue, obvious and updated. It is commited to review the pathophysiology, the diagnosis, and the management of osteomyelitis in order to presents basic facilities in dealing with osteomyelitis.Keywords: osteomyelitis diagnosis and management

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