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"Sevofluran adalah obat anestetik inhalasi yang relatif baru, tetapi harganya lebih mahal daripada halotan. Apakah dengan mengurangi aliran gas kurang lebih duapertiga dari yang biasa dipakai di RSUPN CM yang berarti penghematan obat anestetik inhalasi sebesar 66% dan tanpa obat intravena, sevofluran dapat dipakai sebagai teknik anestesia yang lebih murah dan lebih baik. Tujuan penelitian ini membandingkan biaya - keefektifan sevofluran-N20-02 (0,6L/0,3L) untuk induksi dan pemeliharaan anestesia dengan anestesia propofoi-N20-02 (2L/1L)-halotan Penelitian ini melibatkan 17 pasien laki-laki dan 37 pasien perempuan, usia 15-65 (28,57±15,60 tahun), berat badan 26-70 (50±10,56 kg), tinggi badan 145-180 (160±6,70 sm), ASA I, yang menjalani tindakan bedah umum, ortopedik atau ginekologik ringan, tanpa obat premedikasi, lama tindakan antara 30-120 (50,28±5,46 menit) dan tanpa obat pelumpuh otot. Pasien dibagi dalam dua kelompok secara proposif. Kelompok S ( n = 27 ) diberi anestesia dengan gas N20/02 (0,6L/0,3L)-sevofluran, kelompok H ( n = 27) diberi anestesia dengan prcpofol iv-N20/02 (2L/1L)-halotan. Dicatat waktu induksi ( hilangnya refleks bulu mata dan perintah verbal ), waktu pulih ( pertama kali membuka mata, mengikuti perintah verbal, orientasi personal, waktu dan tempat ), efek samping selama prosedur, serta jumlah total pemakaian obat anestetik. Selama tindakan dilakukan pemantauan terhadap tekanan darah, laju nadi, laju nafas, saturasi oksigen dan konsentrasi tidal akhir C02. Waktu induksi lebih singkat dengan propofol. Hilangnya perintah verbal : 7,33±2,60 detik, hilangnya refleks bulu mata : 1 0,26±2, 70 detik. Untuk sevofluran hilangnya perintah verbal : 27,26±3,25 detik, hilangnya refleks bulu mata : 29,85±3,03 detik. Waktu pulih sevofluran lebih singkat daripada halotan. Untuk membuka mata : 4,15±0,66 menit, mengikuti perintah verbal : 4, 78± 1, 12 menit, melakukan orientasi personal, tern pat dan waktu : 6,63±1,04 menit. Sedangkan waktu pulih halotan untuk membuka mata : 23,48±4,57 menit, mengikuti perintah verbal : 26,70±6,91 menit, melakukan orientasi personal, tempat dan waktu : 33,70±10,75 menit. Kekerapan efek samping lebih tinggi pada kelompok H daripada kelompok S. Biaya anestesia per pasien ternyata lebih rendah dengan teknik sevofluran (Rp 1{)1,452,-) dat;pada teknik propofol-halotan (Rp 181.201,37,-).

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Sevoflurane is a relative new anaesthetic inhalation agent which is more expensive than halothane. It is a question whether sevoflurane can be used as a better and cheaper anaesthesia technique by reducing two-third of fresh gas flow, which means that it will also cut the cost of anaesthetic drug to 66% and without iv drug. The purpose of this study is to compare the cost-effectiveness between sevoflurane-N20-02 (0,6L/0,3L) for induction and maintenance of anaesthesia with anaesthesia propofol-N20-02 (2L/1L )halothane. This study involved 17 male patients and 37 female patients between 15-65 ( 28,57±15,60 ) years old of age, 26-70 ( 50±10,56 ) Kg of body weight, 145-180 ( 160±6,70 ) CM of height, physical status ( ASA ) I whom underwent general surgery, orthopaedic surgery and mild gynaecology surgery without premedication, the action took between 30-120 ( 50,28±5,46) minutes oftime and without muscle relaxant. The patients were divided into two groups in a proposif way. Group S (n=27) was given anaesthesia with N20-02 (0,6L/0,3L)-sevoflurane, group H (n=27) was given anaesthesia with propoflol-N20-02 (2LIIL)-halothane. We recorded time of induction (the disappearance of eye lashes reflex and verbal response ), time of recovery ( first time patients open their eyes, following verbal order, personal orientation, time and place ), side effect during the procedure and the total dose of the anaesthetic drug. During the action, we monitored the blood pressure, heart rate, respiration rate, 02 saturation and EtC02. Induction time of propofol is much shorter. The disappearance of verbal response is 7,33±2,60 seconds, eye lashes reflex is 10,26±2,70 seconds. For sevoflurane the dissapearance ofverbal rensponse is 27,26±3,25 seconds, eye lashes reflex is 29,85±3,03 seconds. The recovery time of sevoflurane is quicker than halothane. For eyes opening, the time taken is 4,15±0,66 minutes, following verbal order is 4,78±1,12 minutes, having personal, time and place orientation is 6,63±1,04 minutes. With halothane eyes opening took 23,48±4,57 minutes, following verbal order is 26,70±6,91 minutes, having personal, time and place orientation is 33,70±10,75 minutes. Side effects appeared more on the group H than group S. The cost of anaesthesia with sevoflurane for each patient is less ( 161.459 IDR) than with propofol-halothane ( 181.201,37 IDR )."

"Latar belakang dan tujuan: Anastasia subarahnoid adalah salah satu tindakan anestesia regional yang sexing dilakukan untuk bedah sesar. Bupivakain hiperbarik 0,5% adalah obat anestetik lokal yang lazim dipakai untuk tehnik pembiusan tersebut. Posisi tubuh dan gaya gravitasi memiliki efek dan mempengaruhi penyebaran dari obat yang bersifat hiperbarik. Penelitian ini dilakukan untuk mengetahui pengaruh posisi tubuh saat penyuntikan obat bupivakain hiperbarik 0,5% terhadap efek hipotensi yang ditimbulkan.Metode : Penelitian dilakukan terhadap 90 wanita hamil berstatus ASA I-II usia 17-50 tahun yang menjalani bedah sesar, dibagi secara arak menjadi 2 kelompok duduk dan lateral dekubitus kiri. Setelah dilakukan penyuntikan obat, setelah 2 menit pasien dikembalikan ke posisi terlentang miring kiri 15 derajat, dan dilakukan co loading kristaloid 10 mllkgBB selama 10 menit Dilakukan pencatatan tekanan darah selama operasi setiap 2 menit selama 20 menit pertama clan selanjutnya tiap 5 menit. Ketinggian hambatan sensorik clan ketinggian maksimal hambatan, jumlah total efedrin dan cairan kristaloid yang diberikan selama operasi juga dicatat. Data hasil penelitian diolah dengan menggunakan uji t, uji Mann Whitneydan uji Chi kuadrat.Hasil : Kekerapan hipotensi antara kelompok posisi duduk dan lateral dekubitus kiri tidak berbeda secara statistik meskipun lebih banyak terjadi pada kelompok lateral dekubitus kiri (67%) dibandingkan posisi duduk (51%). Posisi duduk mengalami hipotensi lebih lambat, derajat hipotensinya lebih rendah dan pemakaian efedrin yang lebih sedikit.Kesimpulan: Posisi tubuh saat penyuntikan that bupivakain hiperbarik 0,5% pada anestesia subarahnoid mempengaruhi derajat hipotensi yang terjadi pada kasus bedah sesar.

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Backgrounds and objectives . Spinal anesthesia is one of the regional anesthesia technique frequently performed for cesarean section. Hyperbaric bupivacaine 0.5% is the most frequent local anesthetic used for this technique. Spread of the hyperbaric local anesthetics is affected by the position of the patient and gravity. In the present study we evaluated the effect of maternal posture whether sitting position during the induction of spinal anesthesia using 05% hyperbaric bupivacaine would induce less hypotension as compared with the left lateral position.

Methods. Ninety pregnant women underwent cesarean delivery were randomly assigned to receive a spinal injection consisting of 12.5 mg 0.5% hyperbaric bupivacaine in either sitting or left lateral position. After 2 minutes, patients were turned to a 15 degrees left lateral position and intravenous infusion of 10 mllkgbodyweigh t of crystalloids was started for 10 minutes along with the induction of spinal anesthesia. Intraoperative blood pressure were recorded , in this study hypotension is defined as a decrease in systolic blood pressure less than 100 mmHg or 20% below baseline values. The height of sensory block was measured, time to T6 spread of the sensory block and the highest level of sensory blockade were noted. Total given of ephedrine and crystalloids rntraopertive were also noted. Statistical evaluation was performed using t?test, Mann Whitney test and Chi square as appropriate.

Result : The incidence of hypotension was not significantly different between sitting and left lateral position but more often in lateral position (51% vs 67%). Sitting position group has longer interval of the first hypotension (p=0.008),less severe of hypotension (p=0.042), less ephedrine supplementation (p=0.014), and longer interval for reaching the T6 dermatome blockade (p <0,0001).

Conclusion: Maternal posture during induction of spinal anesthesia using 0.5% hyperbaric bupivacaine has influence to severity of hypotension for cesarean section."

"Menggigil pasca anesthesia merupakan komplikasi yang potensial bagi pasien pasca bedah yang dapat mengakibatkan Iiipoksemia karena peningkatan konsumsi oksigen jaringan dan peningkatan kadar C02 dalam darah. Hal ini berbahaya tenriama bagi pasien dengan riwayat penyakit jantung iskemi atau pasien-pasien dengan fungsi cadangan ventilasi yang terbatas. Teiah banyak upaya pencegahan maupun penanggulangan dilakukan untuk mengatasi menggigil pasca anestesia, obat yang lazim digunakan adalah petidin. Penelitian terbaru juga menunjukkan bahwa ketamin juga efektif untuk mencegah menggigil pasca anestesia.Penelitian ini bertujuan membuktikan apakah ketamin lebih efektif dibandingkan petidin untuk mencegah menggigil pasca anestesia inhalasi N20/02/isofluran, Penelitian ini bersifat uji klinis tersamar ganda yang membandingkan keefektifan ketamin intravena 0,5 mg/kb BB dengan petidin 0.35 mg/kg BB. Penelitian dilakukan di Instalasi Bedah Pusat RSCM dengan jumlah sampel 40, laki-laki dan perempuan, usia 16-65 tahun, status fisik ASA I-II. Kriteria penolakan adalah mempunyai riwayat alergi terhadap petidin dan ketamin, memiliki riwayat kejang, hipertensi dan penyakit jantung koroner, jika suhu tubuh sebelum induksi >38 °C atau <36°C dan bila pasien mengkonsumsi obat inhibitor monoamine oksidase. Kriteria pengeluaran jika operasi berlangsung >180 menit atau kurang dari 30 menit, mendapatkan darah atau komponen darah, memerlukan perawatan di ruang rawat intesif pasca pembedahan., mengalami komplikasi selamaanestesia seperti syok atau henti jantung dan bila intra operatif pasien mendapatkan obat klonidin, prostigmin, petidin dan ondansetron."

"[ABSTRAKLatar Belakang. Manajemen jalan nafas merupakan salah satu tahap yang paling penting dalam bidang anestesiologi. Salah satu jenis Alat bantu jalan nafas yang telah dipergunakan secara luas adalah Laringeal Mask Airway (LMA/Sungkup Laring). Pada pemasangan sungkup laring tanpa menggunakan pelumpuh otot membutuhkan kedalaman anestesi yang cukup, Tes klinis yang mudah, akurat dan aplikatif diperlukan untuk menghindari terjadinya komplikasi. Penelitian ini bertujuan untuk membandingkan trapezius squeezing test dan jaw thrust sebagai indikator kedalaman anestesi pada pemasangan sungkup laring dengan propofol sebagai agen induksiMetode. Sebanyak 128 pasien di randomisasi ke dalam 2 kelompok yaitu jaw thrust dan trapezius squeezing test. Seluruh pasien mendapatkan premedikasi dengan midazolam 0.05 mg/kgBB dan Fentanyl 1 mcg/kgBB. Induksi menggunakan propofol titrasi. Manuver jaw thrust dan trapezius squeezing test dilakukan setiap 15 detik. Saat respon motorik hilang dilakukan pemasangan sungkup laring. Dicatat keberhasilan pemasangan, dosis propofol, tekanan darah, laju jantung, dan insiden apneu.Hasil. Keberhasilan pada kelompok jaw thrust 93.8%, sedangkan trapezius squeezing test yang 90.6%. Penggunaan rerata propofol pada kelompok jaw thrust yaitu sebesar 120.34 mg, sedangkan pada kelompok trapezius squeezing test yaitu sebesar 111,86 mg. Insiden apneu yang pada kelompok jaw thrust terjadi pada 10 (15.6%) pasien, sedangkan pada kelompok trapezius squeezing test sebesar 11 (17.2%) pasien. Tidak terdapat perubahan hemodinamik yang berarti pada kelompok jaw thrust sedangkan sedangkan pada kelompok trapezius squeezing test terdapat perubahan hemodinamik yang berarti di menit ke 3 dan ke 4Kesimpulan. Trapezius squeezing test tidak lebih baik daripada jaw thrust sebagai indikator klinis dalam menilai kedalaman anestesia pada insersi sungkup laring.

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ABSTRACTBackground. Airway management is one of the most important phase in anesthesiology. One of airway device that have been used generally is Laryngeal Mask Airway (LMA). Laryngeal mask insertion without muscle relaxant requires a level of depth anesthesia. An easy, accurate, an applicable clinical indicator were required to avoid complication. This study was determine the comparison trapezius squeezing test and jaw thrust as indicator of depth of anesthesia in laryngeal mask insertion with propofol as induction agent.Methods. 128 patient have been randomize in to 2 group that are jaw thrust and trapezius squeezing test. All patients were received premedication with midazolam 0.05 mg/kg and fentanyl 1 μg/kg. Induction were done by propofol titration. Jaw thrust and trapezius squeezing test maneuver were done in every 15 second. When motoric respond negative the laryngeal mask were inserted. The successful of laryngeal mask insertion was recorded, propofol consumption, blood pressure, heart rate, and incidence of apnea were also documented.Result. Laryngeal mask successfully inserted in 93.8% patients in jaw thrust group, and 90.6% in trapezius squeezing test group. Mean of propofol consumption in jaw thrust group is 120.34 mgs, and in trapezius squeezing test is 11.86 mgs. Incident of apnea in jaw thrust group happened in 10 patients (15.6%), and in trapezius squeezing test group happened in 11 patient (17.2%). Hemodynamic in jaw thrust group relatively stable but in trapezius squeezing test there is significant hemodynamic changing in minute third and fourth.Conclusion. Trapezius squeezing test is not better than jaw thrust as clinical indicators of depth of anesthesia for laryngeal mask insertion.;Background. Airway management is one of the most important phase in anesthesiology. One of airway device that have been used generally is Laryngeal Mask Airway (LMA). Laryngeal mask insertion without muscle relaxant requires a level of depth anesthesia. An easy, accurate, an applicable clinical indicator were required to avoid complication. This study was determine the comparison trapezius squeezing test and jaw thrust as indicator of depth of anesthesia in laryngeal mask insertion with propofol as induction agent.Methods. 128 patient have been randomize in to 2 group that are jaw thrust and trapezius squeezing test. All patients were received premedication with midazolam 0.05 mg/kg and fentanyl 1 μg/kg. Induction were done by propofol titration. Jaw thrust and trapezius squeezing test maneuver were done in every 15 second. When motoric respond negative the laryngeal mask were inserted. The successful of laryngeal mask insertion was recorded, propofol consumption, blood pressure, heart rate, and incidence of apnea were also documented.Result. Laryngeal mask successfully inserted in 93.8% patients in jaw thrust group, and 90.6% in trapezius squeezing test group. Mean of propofol consumption in jaw thrust group is 120.34 mgs, and in trapezius squeezing test is 11.86 mgs. Incident of apnea in jaw thrust group happened in 10 patients (15.6%), and in trapezius squeezing test group happened in 11 patient (17.2%). Hemodynamic in jaw thrust group relatively stable but in trapezius squeezing test there is significant hemodynamic changing in minute third and fourth.Conclusion. Trapezius squeezing test is not better than jaw thrust as clinical indicators of depth of anesthesia for laryngeal mask insertion., Background. Airway management is one of the most important phase in anesthesiology. One of airway device that have been used generally is Laryngeal Mask Airway (LMA). Laryngeal mask insertion without muscle relaxant requires a level of depth anesthesia. An easy, accurate, an applicable clinical indicator were required to avoid complication. This study was determine the comparison trapezius squeezing test and jaw thrust as indicator of depth of anesthesia in laryngeal mask insertion with propofol as induction agent.Methods. 128 patient have been randomize in to 2 group that are jaw thrust and trapezius squeezing test. All patients were received premedication with midazolam 0.05 mg/kg and fentanyl 1 μg/kg. Induction were done by propofol titration. Jaw thrust and trapezius squeezing test maneuver were done in every 15 second. When motoric respond negative the laryngeal mask were inserted. The successful of laryngeal mask insertion was recorded, propofol consumption, blood pressure, heart rate, and incidence of apnea were also documented.Result. Laryngeal mask successfully inserted in 93.8% patients in jaw thrust group, and 90.6% in trapezius squeezing test group. Mean of propofol consumption in jaw thrust group is 120.34 mgs, and in trapezius squeezing test is 11.86 mgs. Incident of apnea in jaw thrust group happened in 10 patients (15.6%), and in trapezius squeezing test group happened in 11 patient (17.2%). Hemodynamic in jaw thrust group relatively stable but in trapezius squeezing test there is significant hemodynamic changing in minute third and fourth.Conclusion. Trapezius squeezing test is not better than jaw thrust as clinical indicators of depth of anesthesia for laryngeal mask insertion.]"

"Latar belakang : Telah dilakukan penelitian untuk waktu optimal pemberian fentanil 2 .tg/kg BB dengan tujuan menekan respon kardiovaskuler akibat laringoskopi dan intubasi dengan membandingkan waktu pemberian fentanil 5 dan 7 menit sebelum dilakukan tindakan laringoskopi dan intubasi.Metode:Tiga puluh enam pasien ASA 1 dan ASA 2 dibagi dalam dua kelompok secara acak masing-masing tediri dari delapan belas pasien. Kelompok pertama diberikan fentanil dosis 2 µglkg BB waktu 5 menit sebelum laringoskopi dan intubasi, sedangkan kelompok kedua diberikan dosis yang sama dengan waktu 7 menit sebelum laringoskopi dan intubasi , data tekanan darah sistolik , diastolik, tekanan arteri rata-rata dan laju jantung dari kedua kelompok dibandingkan sampai 5 menit setelah intubasi.Hasil : Secara statistik tidak terdapat perbedaan bermakna antara kedua kelompok yang dibandingkan (p>0.05) dalam hal tekanan darah sistolik, tekanan darah diastolik, tekanan arteri rata-rata dan laju jantung akibat laringoskopi dan intubasi.Kesimpulan : Waktu optimal untuk injeksi fentanil 21tg kg BB-' untuk dapat menekan respon hemodinamik akibat laringoskopi dan intubasi adalah 5 dan 7 menit sebelum tindakan tersebut dilakukan.

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Background :This study was designed to examine the optimal time of injection of 2 gg/kg fentanyl to Attenuate circulatory responses due to laringoscopy and tracheal intubation that compared between 5 minute and 7 minute before laringoscopy and tacheal intubation.

Method : Thirty six patients ASA 1 and ASA 2 were randomly in two groups which each group eighteen patients. The patients in group 1 received fentanyl 2 pg/kg 5 minute and group 2 received the same dose 7 minute before laringoscopy and tracheal intubation.

Result : The result of this study were no statistical significant values both of groups in systolic, diastolic, mean arterial pressure and heart rate due to laringoscopy and intubation

Conclusion : The effective time to administer fentanyl 2pg kg _I to protect circulatory response to laringoscopy and tracheal intubation are 5 minute and 7 minute before intubation."

"Berbagai studi dan penelitian telah dilakukan di berbagai negara untuk mengetahui pengetahuan pasien terhadap anestesia namun tidak ada instrumen kuesioner yang baku untuk menilai pengetahuan pasien tentang anestesia, dan hal ini belum pernah dilakukan di Indonesia khususnya di RSUPN Cipto Mangunkusumo. Kuesioner pengetahuan yang valid dan reliabel diharapkan menjadi standar untuk menilai pengetahuan masyarakat terhadap anestesia, dan dapat menjadi dasar bagi penelitian selanjutnya.Metode: Kuesioner pengetahuan anestesia sebelumnya telah melalui tahapan pretest oleh ahli dan uji pilot, hasil kuesioner uji pilot disempurnakan sehingga dianggap layak diujicobakan. Penelitian dilakukan pada bulan Januri 2014 sampai dengan Maret 2014 terhadap subyek secara consecutive sampling yang akan menjalani pembiusan dan diperiksa di klinik preoperatif RSUPN Cipto Mangunkusumo Jakarta. Teknik uji validitas menggunakan validitas konstruk dengan koefisien korelasi minimal 0,3 dapat dianggap valid dan uji reliabilitas menggunakan teknik konsistensi internal dengan nilai cronbach α minimal 0,4 dianggap reliabel.Hasil: Penelitian ini diikuti oleh 95 subyek dengan 1 subyek dikeluarkan dari penelitian karena tidak mengisi kuesioner secara lengkap. Kuesioner pengetahuan terdiri dari 20 pertanyaan, 8 pertanyaan diantaranya dinilai tidak valid dan reliabel yang dapat disebabkan oleh pertanyaan dan jawaban kuesioner yang tidak dapat dimengerti oleh subyek, pembahasan terlalu dalam dan penggunaan istilah medis yang tidak familiar. Beberapa jawaban pertanyaan memiliki kesamaan yang dapat membingungkan subyek, serta terdapat inkonsistensi jawaban yang diberikan oleh subyek. Tingkat penghasilan dan pendidikan subyek yang rendah serta pengalaman dan informasi yang kurang, sangat mempengaruhi pengetahuan subyek terhadap anestesia, tercermin dari rendahnya rerata tingkat pengetahuan subyek sebesar + 31,6%.Kesimpulan: Kuesioner penilaian pengetahuan tentang anestesia pada pasien di klinik preoperatif RSUPN Cipto Mangunkusumo tidak dapat dijadikan sebagai suatu standar instrumen yang baku oleh karena dinilai tidak valid dan reliabel.

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Various studies and researches have been conducted abroad to determine the patient?s anesthesia knowledge, although no standard questionnaires exist. Research on anesthesia?s knowledge questionnaires have never been done specifically in Cipto Mangunkusumo hospital. A valid and reliable questionnaire is aimed to be a standard instrument assessing the community?s knowledge on anesthesia, and as a foundation for future researches.Methods: The anesthesia knowledge questionnaires has been evaluated through a pre-test phase done by experts and pilot test, the results was then revised until it is acceptable and can be tested. Researches was conducted on January 2014 until March 2014 on subjects by consecutive sampling who are going to undergo anesthesia and evaluated at the preoperative clinic Cipto Mangunkusumo Hospital Jakarta. Validity test techniques using construct validity with the minimal correlation coefficient 0.3 is valid. Reliability tests using internal consistency techniques with minimal cronbach alpha value 0.4 is reliable.Results: Research was participated by 95 subjects with 1 subject excluded from the research because of not filling in the questionnaire completely. The knowledge questionnaire included 20 questions, whereas 8 questions was marked to be invalid and unreliable that may be caused by questions and answers were not fully understood by the subjects, the contents was too spesific, usage of medical terms that aren?t familiar. Some of the given answers have similarities that may confuse the subject, and also inconsistency from the subject?s answers. Low level of salary and education with lacking of experience and information from the subjects, has significant influence on the subjects knowledge on anesthesia which is reflected by the low average level of the subject`s knowledge which is + 31.6%.Conclusions: Anesthesia knowledge questionnaires on patients at preoperative clinic Cipto Mangunkusumo hospital is invalid and unreliable therefore fail to be a standard instrument."

"Latar belakang : Hipotensi merupakan salah satu komplikasi akibat anestesia subarakhnoid pada seksio sesarea yang berpotensi membahayakan ibu dan janin. Kejadian hipotensi pada seksio sesarea dengan dosis bupivakain 8 - 12,5 mg berkisar antara 25 - 60%. Mengkombinasikan anestetika lokal dosis rendah dengan opioid lipofilik dan modifikasi posisi saat injeksi subarakhnoid mungkin dapat lebih menurunkan kejadian hipotensi. Tujuan penelitian ini adalah mengetahui efektivitas posisi Oxford dalam menurunkan kejadian hipotensi dibanding posisi lateral dengan regimen bupivakain 7,5 mg ditambah fentanil 25 mcg. Metode : Setelah lolos kaji etik dan mendapatkan persetujuan klinik 180 pasien yang akan menjalani seksio sesarea elektif dirandomisasi blok ke dalam kelompok posisi Oxford atau posisi lateral. Semua pasien mendapatkan dosis intratekal bupivakain 0,5% hiperbarik 7,5 mg ditambah fentanil 25 mcg. Coloading kristaloid diberikan 10 ml/ kgBB. Efedrin intravena diberikan sesuai standar. Kondisi hemodinamik dan profil blok sensorimotor dicatat. Penggunaan efedrin, efek samping dan nilai APGAR juga didokumentasikan. Hasil : Terdapat perbedaan yang secara statistik tidak bermakna pada kejadian hipotensi diantara kedua kelompok (p=0,121). Total jumlah penggunaan efedrin intravena diantara kedua kelompok berbeda dan dapat diperbandingkan. Profil blok sensorimotor diantara kedua kelompok dapat diperbandingkan. Kesimpulan : Modifikasi posisi Oxford pada anestesia subarakhnoid dengan dosis bupivakain 7,5 mg ditambah fentanil 25 mcg tidak memberikan hasil yang bermakna dalam menurunkan kejadian hipotensi.

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Background : Hypotension was one of the complications of subarachnoid anesthesia in caesarean section that potentially detrimental to the mother and baby. The insidens of hypotension in caesarean section with bupivacaine 8 - 12,5 mg were between 25 and 60%. Combining low dose of local anesthetics with lipofilic opioid and modification of position during subarachnoid injection might be more in lowering the hypotension insidens. The study was conducted to prove the effectiveness of Oxford position in lowering the hypotension insidens with regimen 7,5 mg bupivacaine added with 25 mcg fentanyl.

Methods : After ethical clearance and receive informed consent 180 elective caesarean section patient were randomized into Oxford group or lateral group. All the patient were receive the same dose of intrathecal 7,5 mg 0,5% hyperbaric bupivacaine added with 25 mcg fentanyl. Coloading of 10 ml/ kgBW with cristaloid was given. Intravenous ephedrine was given according to a standard. Hemodynamic changes and sensorimotor block profile were documented. Epedhrine consumption, side effect and APGAR score were also documented.

Result : There is a difference that statistically not significant in hypotension insidens between two groups (p=0,121). The total intravenous ephedrine consumption between two groups was different and comparable. The profile of sensorimotor block between two groups could be compared.

Conclusion : Modification of Oxford position in subarachnoid anesthesia with 7,5 mg bupivacaine added with 25 mcg fentanyl was not more effective in lowering insidens of hypotension."

"Tujuan: Membandingkan keefektifan klonidin dan meperidin dalam mencegah menggigil pasta anestesia umum.Metode: Uji KIinik Acak Tersamar Ganda. Penelitian dilakukan di Instalasi Bedah Pusat RSCM pada bulan Maret sampai Mei 2006, dengan jumlah sampel 61 ()rang dan dikeluarkan 5 sampel, sehingga tersisa 56 sampel yang menjalani operasi berencana dan anestesia umum. Pasien dibagi secara acak kedalam 2 kelompok; 28 pasien mendapatkan klonidin 1,54g/kgBB sebagai premedikasi dan 28 pasien Iainnya mendapatkan meperidin 0,35mg ketika isofluran dihentikan. Dilakukan pencatatan pasta operasi kejadian menggigil pada kedua perlakuan, dilakukan juga pencatatan terhadap efek samping pada kedua kelompok perlakuan. Analisa statistik untuk melihat perbedaan kekerapan antara kedua perlakuan dilakukan uji Chi Square.Hasil: Tidak terdapat perbedaan yang bermakna secara statistik antara kedua kelompok perlakuan dalam haI kekerapan kejadian menggigil.

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Objective: To compare the effectiveness of Clonidin and Meperidin in preventing the post-anesthesia shivering.

Methods: Double-blinded, randomized clinical trial. The study was conducted at Cipto Mangunkusumo Hospital Central Surgery Room from March until May 2006 to 61 adult patients who went to elective surgery and were planned to be under general anesthesia, 5 of them were excluded The rest were divided randomly into two groups; 28 patients were given 1,5 pg/kg BW Clonidin intravenously as premedication and the other 28 patients were given 0,35 mg/kg BW Meperidin intravenously when Isoflurane was stop. The incidence of post-anesthesia shivering and adverse-effect on both groups were recorded. Chi Square method was performed to identify the frequency difference between the two groups.

Result: There were no significant statistical differences' between the two groups in a matter of frequency of shivering."

"Latar Belakang : Tingkat kepuasan pasien merupakan salah satu indikator kualitas pelayanan anestesia, baik rawat inap maupun rawat jalan. Bedah rawat jalan menawarkan banyak kelebihan dibandingkan rawat inap, sehingga berkembang sangat pesat di Indonesia khususnya di RSUPN Cipto Mangunkusumo Jakarta dan sebagian besar jenis anestesia pada bedah rawat jalan adalah anestesia umum. Perkembangan ini harus diimbangi dengan peningkatan kualitas pelayanan anestesia. Oleh karena itu perlu dilakukan penilaian terhadap tingkat kepuasan pasien dan faktor-faktor yang memengaruhinya. Tingkat kepuasan pasien dapat memberikan feedback untuk meningkatkan kualitas pelayanan anestesia pada instalasi bedah rawat jalan. Tujuan : Mengetahui tingkat kepuasan pasien yang menjalani anestesia umum pada instalasi bedah rawat jalan di RSUPN Cipto Mangunkusumo dan faktor yang memengaruhinya. Metode : Penelitian ini adalah penelitian potong lintang. Dilakukan penilaian tingkat kepuasan pada 76 pasien dengan menggunakan kuesioner yang telah divalidasi. Kriteria penerimaan adalah usia 18-65 tahun yang menjalani pembiusan umum pada instalasi bedah rawat jalan di RSUPN Cipto Mangunkusumo Jakarta, dapat berbahasa Indonesia, membaca dan menulis, bersedia berpartisipasi dan menandatangani surat persetujuan penelitian, pulang dihari yang sama setelah pembedahan atau dirawat kurang dari 24 jam. Hasil kuesioner akan diolah menggunakan perangkat lunak SPSS dengan uji univariat dan bivariat. Hasil : Uji univariat menunjukkan tingkat kepuasan pasien terhadap anestesia umum rata-rata diatas 70 %. Sedangkan dari uji bivariat, faktor yang berpengaruh terhadap tingkat kepuasan pasien adalah usia, jenis kelamin dan pekerjaan. Kesimpulan : Pasien merasa puas terhadap pelayanan anestesia umum pada instalasi bedah rawat jalan di RSUPN Cipto Mangunkusumo Jakarta. Karakteristik pasien yang memengaruhi tingkat kepuasan pasien adalah usia, jenis kelamin dan pekerjaan.

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Background : Patient satisfaction has been one of quality indicators in anesthesia services whether it is inpatient or outpatient. Ambulatory surgery offers more advantages compares to inpatient services, thus it developed nicely in Indonesia especially in RSUPN Cipto Mangunkusumo Jakarta where most patients undergone general anesthesia. This development is yet to be offset by improvement in anesthesia quality services. Thus, it is needed to assess patient satisfaction and factors. Patient satisfaction can give feedback to improve quality of anesthesia services in ambulatory surgery.

Purpose : The purpose of this study was to know patient satisfaction toward general anesthesia and influencing factors in ambulatory surgery RSUPN Cipto Mangunkusumo Jakarta.

Methods : This is a cross sectional study. Patient satisfaction was assessed in 76 patients using validated questionnaire. The inclusion criteria were age 18-65 undergoing general anesthesia in Ambulatory Surgery, Bahasa speaking, able to read and write, and agreed to participate in this study by signing research consent and discharged on the same day or hospitalized less than 24 hours after surgery. Result was processed using SPSS with univariate and bivariate test.

Results: Univariate test showed patient satisfaction toward general anesthesia was above 70%. While Bivariate test indicated factors influencing patient satisfaction were age, gender and occupation.

Conclusion : Patients were satisfied with general anesthesia services in Ambulatory Surgery RSUPN Cipto Mangunkusumo Jakarta. Patient characteristics influencing patient satisfaction were age, gender and occupation."