Cesarean section is generally performed on pregnant women and the prevalence is continuously increasing every years. This study was aimed to determine the profile of the occurence of hypotension in patients of sectio caesarea with spinal anesthesia using bupivacaine at Prof. Dr. R. D. Kandou Manado. This was a descriptive retrospective study. Data were obtained from the emergency operation room at Prof. Dr. R. D. Kandou Manado from November through December 2015. The results showed that there were 15 cases of cesarean section with spinal anesthesia using bupivacaine. According to age group, there was 1 patient (6.66%) in age group <20 years; 11 patients (73.33%) in age group 20-35 years; and 3 patients (20%) in age group >35 years. After spinal anaesthesia using bupivacaine, the highest percentage of decrease in systolic blood pressure was 18.18%, meanwhile of diastolic blood pressure was 11.11%. Conclusion: The decreases in systolic blood pressure and diastolic blood pressure after spinal anesthesia using bupivacaine were within normal limits.Keywords: spinal anesthetic, bupivacaine, hypotension Abstrak: Sectio caesarea (SC) merupakan operasi yang umum dan luas dilakukan pada wanita hamil dan prevalensi meningkat setiap tahun. Penelitian ini bertujuan untuk mengetahui profil kejadian hipotensi pada pasien SC yang diberikan anestesi spinal dengan bupivakain di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif retrospektif. Data penelitian diambil dari ruang operasi darurat periode November 2015 sampai Desember 2015. Hasil penelitian mendapatkan 15 kasus bedah SC dengan menggunakan teknik anestesi spinal. Berdasarkan golongan usia, ditemukan kelompok usia <20 tahun sebanyak 1 pasien (6,66%); usia 20-35 tahun sebanyak 11 pasien (73,33%); dan usia >35 tahun sebanyak 3 pasien (20%). Persentase penurunan tekan darah sistolik yang paling tinggi sesudah dilakukan anestesi spinal ialah sebesar 18,18% sedangkan untuk tekanan darah diastolik paling tinggi mencapai 11,11%. Simpulan: Penurunan tekan darah sistolik dan tekanan darah diastolik sesudah dilakukan anestesi spinal masih berada dalam batas normal.Kata kunci: anestesi spinal, bupivakain, hipotensi

Traumatic brain injuries are still the leading cause of death and disability, and require care on Intensive Care Unit (ICU). A traumatic brain injury caused by mechanical mass from outside the body, leads to impaired cognitive and psychosocial function that can occur temporarily or permanently, and can cause loss of consciousness. This study aims to determine the profile of the patients with moderate and severe traumatic brain injuries treated in ICU and HCU, using retrospective descriptive study conducted in September to November 2016 in the Medical Record department of Prof. Dr. R.D. Kandou, Manado. The sample size was determined by non-probability sampling method, a purposive sampling. Samples are ICU and HCU patients with the diagnosis of moderate to severe traumatic brain injury, who meet the inclusion criteria in the medical record of the data period September 2015 to August 2016. From the obtained sample of 40 patients, males dominate the gender category with 33 cases (83%). SIRS complications found in 23 cases (57.5%). Most patients are treated within 1–7 days, which also become the most patients who died within their length of stay. Patients who dies account for a total of 25 patients (62.5%) and most died after > 48 hours (72%) of treatment; out of the 25 deceased patients, 18 among them (45%) died from severe traumatic brain injury. Conclusion: The mortality rate is highest on severe head injury; most patients died after > 48 hours in the ICU and the HCU.Keywords: moderate traumatic brain injury, severe traumatic brain injury Abstrak: Cedera kepala masih merupakan penyebab utama kematian dan kecacatan, dan memerlukan perawatan Intensive Care Unit (ICU). Cedera kepala disebabkan oleh massa mekanik dari luar tubuh yang mengakibatkan gangguan fungsi kognitif dan psikososial, dapat terjadi sementara atau permanen, dan dapat menyebabkan penurunan kesadaran. Penelitian ini bertujuan untuk mengetahui profil pasien cedera kepala sedang dan berat yang dirawat pada ICU dan HCU, menggunakan metode penelitian deskriptif retrospektif yang dilakukan pada September sampai dengan November 2016 di Instalasi Rekam Medik RSUP Prof. Dr. R.D. Kandou, Manado. Besar sampel ditentukan dengan metode non probability sampling yaitu purposive sampling. Sampel penelitian adalah pasien ICU dan HCU dengan diagnosa cedera kepala sedang dan berat yang memenuhi kriteria inklusi pada data Rekam Medik periode September 2015 sampai dengan Agustus 2016. Hasil penelitian didapatkan jumlah sampel 40 pasien, dengan jenis kelamin terbanyak laki-laki 33 orang (83%). Komplikasi SIRS ditemui pada 23 kasus (57,5%). Paling banyak pasien dirawat pada 1–7 hari dan pasien yang meninggal dunia terbanyak pada lama rawat 1–7 hari. Pasien meninggal dunia berjumlah 25 orang (62,5%) dan terbanyak meninggal dunia setelah > 48 jam (72%); dari 25 orang yang meninggal dunia pasien dengan cedera kepala berat sebanyak 18 orang (45%). Simpulan: Angka mortalitas tertinggi ada pada cedera kepala berat, dan pasien meninggal dunia paling banyak setelah > 48 jam di ICU dan HCU. Kata kunci: cedera kepala sedang, cedera kepala berat

No abstract

No abstract

The aim of this study is to find out the neuroprotective mechanism of lidocaine in epidural haematoma (EDH) in moderate brain injury. The effects are measured by the level of interleukin-6 (IL-6) and phospholipase A2 (PLA2). This study is done in forty epidural haematoma patients with moderate brain injury. The objects are divided into two groups, group A with NaCl 0.9% infusion only (control) and group B with NaCl 0.9% infusion combined with lidocaine 1 mg/kg/hr. The blood samples were taken right before induction and two hours after infusion. The result shows that the level of IL-6 and PLA2 is significantly low in group B (p<0.005) with Mann Whitney and Dependent t test. The decreasing level of IL-6 and PLA2 is related with the dose of lidocaine. The inhibition mechanism of IL-6 and PLA2 secretion by lidocaine is considered as a responsible factor in inflammation and brain cells damage. Summary • Infusion of lidocaine 1 mg/kg/hr will decrease the level of IL-6 in moderate brain injury • Infusion of lidocaine 1 mg/kg/hr will decrease the level of PLA2 in moderate brain injury J o u rn al of A n e s th es ia & C li n ic a l Resea rc h