AbstrakDeksametason merupakan kortikosteroid yang memiliki efek anti-inflamasi paling kuat. Penelitian ini bertujuan membandingkan deksametason 10 mg dengan deksametason 15 mg intravena prabedah terhadap nyeri pascabedah dan kebutuhan analgetik opioid. Penelitian ini merupakan uji acak terkontrol buta ganda pada 60 wanita dengan status fisik American Society of Anesthesiologist (ASA) I-II yang menjalani pembedahan radikal mastektomi termodifikasi dalam anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung periode Desember 2013-April 2014. Pasien dibagi menjadi dua kelompok, yaitu 30 orang menerima deksametason 10 mg dan 30 orang menerima deksametason 15 mg yang diberikan 30 menit prabedah. Penilaian skala nyeri menggunakan nilai numeric rating scale (NRS) pada saat istirahat dan mobilisasi, pada jam ke-1, 2, 4, 12, dan 24 pascabedah. Pemberian analgetik tambahan opioid dilakukan bila nilai NRS>3. Analisis statistika data hasil penelitian menggunakan uji-t, chi-kuadrat, dan Mann-Whitney. Hasil penelitian menunjukan nilai NRS saat istirahat pada kelompok deksametason 10 mg dengan deksametason 15 mg tidak berbeda bermakna (p>0,05), sementara nilai NRS saat mobilisasi pada kelompok deksametason 10 mg lebih tinggi dibanding dengan kelompok deksametason 15 mg (p<0,05). Pemberian analgetik tambahan pascabedah tidak terdapat perbedaan secara bermakna antara kedua kelompok (p>0,05). Simpulan penelitian ini adalah pemberian deksametason 15 mg dapat diberikan karena mempunyai efek analgesia yang lebih baik. Kata kunci: Deksametason, numeric rating scale, nyeri pascabedah Comparison between 10 mg and 15 mg of Intravenous Dexamethasone as Analgesia Adjunct on Post Operative Pain in Patients Undergo Modified Radical Mastectomy AbstractDexamethasone is a glucocorticoid with the strongest anti-inflammatory property. The aim of this study was to compare the effect of 10 mg and 15 mg of intravenous dexamethasone on post operative pain and opioid analgetic need. This was a randomized double-blind study involving 60 females with physical status ASA I-II whom underwent modified radical mastectomy under general anesthesia at Dr. Hasan Sadikin General Hospital during December 2013-April 2014. Patients were divided into 2 groups where 30 patients received 10 mg dexamethasone and 30 patients received 15 mg dexamethasone 30 minutes prior to surgery. Pain assessment was performed using numeric rating scare (NRS) at rest and during activity, documented on the 1 st , 2 nd , 4 th , 12 th and 24 th hour post operative. Additional analgesia was given if NRS >3. Data were analyzed statistically using Student's t test, chi-square and Mann Whitney U test. Result showed that the difference between NRS at rest for 10 mg and 15 mg dexamethasone (p>0.05) was not significant, while the difference in NRS during activity at all time measurements were statistically significant (p<0.05). There was no statistical significant difference in additional opioid administered between the two groups (p>0.05). This study concludes that 15 mg dexamethasone has a be...

The Journal of Health and Medical Sciences is an Open Access publication. It may be read, copied, and distributed free of charge according to the conditions of the Creative Commons Attribution 4.0 International license.

Penggunaan fentanil pada anestesi umum memiliki pengaruh terhadap pemulihan pascaoperasi dan penurunan hemodinamik saat induksi. Metode anestesi umum menggunakan analgetik nonopioid diharapkan meningkatkan kualitas pemulihan pascaoperasi. Pemberian ketamin dosis subanestesi memberi efek analgetik dengan efek samping minimal serta perubahan tekanan darah dan nadi lebih stabil. Tujuan penelitian ini membandingkan efek fentanil dengan ketamin terhadap kualitas pemulihan serta perubahan tekanan darah dan nadi saat induksi. Penelitian ini merupakan uji klinis tersamar ganda pada 30 pasien yang menjalani operasi odontektomi dengan anestesi umum di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung dari Januari-Maret 2020. Pasien dibagi menjadi 2 kelompok, yaitu kelompok ketamin, diinduksi menggunakan ketamin 0,5 mg/kgBB dan kelompok fentanil, diinduksi menggunakan fentanil 1,5 mcg/kgBB. Data dianalisis dengan uji-t tidak berpasangan, Uji Mann Whitney, dan Uji Kolmogorov-smirnov dengan nilai p<0,05 dianggap bermakna. Terdapat penurunan tekanan darah dan nadi yang signifikan (p<0,05) di menit ke-1, 3, dan 5 pada grup fentanil. Penilaian QoR-40 pada kelompok ketamin memiliki angka lebih tinggi (181,07±5,32) dibanding dengan kelompok fentanil (176,60±2,59) secara bermakna (p<0,05). Simpulan, skor pemulihan pascaanestesi umum dengan ketamin lebih tinggi dibanding dengan fentanil pada operasi odontektomi yang dinilai dengan QoR-40 dan ketamin dengan dosis subanestesi saat induksi menunjukkan hemodinamik yang lebih stabil dibanding dengan induksi menggunakan fentanil.

Background: Myasthenia Gravis and Guillain-Barré syndrome are two of the most common autoimmune diseases affecting the peripheral nervous system in the world. Both of the diseases manifested as progressive muscle weakness, areflexia, and inspiratory muscle weakness which leads to mechanical ventilation support. Therapeutic Plasma Exchange is the first line of treatment according to the American Society for Apheresis (AFSA), which is a relatively safe and often performed procedure In the Intensive Care Unit (ICU), including in Hasan Sadikin Hospital Bandung (RSHS). Purpose: The goal of this study is to obtain the background characteristics of MG and GBS patients and to obtain the outcome of TPE in these patients. Methods: The study was a descriptive study performed on 30 MG and GBS patients who received TPE in the Intensive care unit, RSHS from January 2017 to December 2020. Data for the study was obtained retrospectively from the patient medical record. Results: The result showed that the most common side effect during TPE was electrolyte imbalance. There was no reported morbidity and mortality in MG patients, in contrast to two mortality cases in GBS patients. Length of stay in the intensive care unit was influenced by several factors including age, comorbidities, the severity of MG, and morbidities that occurred during the hospital stay. Conclusion: Outcome of MG and GBS patients with TPE procedure is good in relation with low TPE-unrelated morbidity and mortality.

Coronary artery bypass graft (CABG) surgery is a surgical therapy for coronary artery disease (CAD) patients who cannot be solely treated using pharmacological therapy. Patients undergoing CABG surgery require careful postoperative monitoring in the intensive care unit (ICU). This leads to the need for careful selection of patients due to the limited number of ICU beds available. A prolonged stay in ICU could delay surgery for other patients. This retrospective study analyzed how preoperative factors such as age, gender, and preoperative left ventricular ejection fraction (LVEF) may influence patient's length of stay (LOS) in the ICU. For this study, subjects were patients undergoing isolated CABG in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, during the period of January 2019- December 2020 who were selected using the simple random sampling method. The subjects were categorized into  <65 years old and ≥65 years old age groups;  man and woman gender; preoperative LVEF of <40% and ≥40%; and prolonged ICU LOS (>96 hours) and non-prolonged ICU LOS (<96 hours). Deceased patients in the ICU were excluded.  Results of the bivariate and multivariate analyses showed that age was the only factor (p-value of 0.017) that increased the risk of prolonged ICU LOS (OR of 3.34) after CABG surgery that was statistically significant. This study concluded that patient of old age (>65 years old) is at a higher risk of having prolonged ICU LOS after CABG; thus, a careful scheduling of patients for CABG surgery by age is important to prevent prolonged ICU LOS after CABG.