BACKGROUND Finger method is a new simple technique of nasogastric tube (NGT) insertion for intubated patients which only requires the practitioner’s own fingers. This study was aimed to compare the feasibility of finger method and the standard reverse Sellick maneuver in NGT insertion for intubated patients. METHODS This was a single-blinded, randomized clinical trial that included 210 patients aged 18–65 years old who were intubated under general anesthesia and needed NGT insertion. Initially, subjects were randomly allocated by the third party into two groups: subjects who had NGT insertion with finger method and those with reverse Sellick maneuver. Success rate of NGT insertion at the first attempt, duration of the procedure, and complication rate of blood spots were all recorded. Chi-square test and Mann–Whitney analysis were used to analyze the data. RESULTS Success rate of NGT insertion at the first attempt in finger method group was higher in comparison with reverse Sellick maneuver group (81.6% versus 60%, respectively, p = 0.002). Likewise, the median of NGT insertion duration was longer in finger group compared to reverse Sellick maneuver group (13 sec versus 12 sec, respectively, p < 0.001) but it was not clinically significant. Moreover, the complication rate of blood spots found during the procedure was lower in subjects with finger method than with reverse Sellick maneuver (10.7% versus 28%, respectively, p = 0.003). CONCLUSIONS Using finger method was more feasible than reverse Sellick maneuvers in NGT insertion.

Pain management in post transperitoneal laparoscopic nephrectomy is a key to early recovery. Different types of regional anesthesia techniques have been applied for managing post-operative pain. However, the results are still not satisfactory. This study aims to compare effectiveness of ultrasound-guided bilateral Quadratus Lumborum (QL) block with continuous epidural analgesia in improving post transperitoneal laparoscopic nephrectomy analgesia and motoric mobility. This is a randomized controlled trial that included 26 healthy living kidney donor patients. All subjects were randomized to receive preoperatively bilateral QL block (n=13) or continuous epidural analgesia (n=13). Subjects in QL group received 20 mL of bupivacaine 0.25% bilaterally and subjects in epidural group received continuous bupivacaine 0.125% infusion 6 mL/hour. Numerical rating scale (NRS), Bromage score, and duration of urinary catheterization were recorded. The results presented no significant differences in NRS scores at rest and movement, and Bromage score between QL block group and epidural block group in at 2,6,12,24 hours after surgery. The QL block group received significantly lower total dose of bupivacaine (p<0.001) and duration of urinary catheterization was significantly shorter (p=0.001) compared to epidural group. This study found that QL block produced similar postoperative NRS and Bromage score with fewer dose of bupivacaine and shorter duration of urinary catheterization compared with continuous epidural analgesia within 24 hours.

Latar Belakang. Teknik multimodal analgesia dengan menggunakan dua atau lebih obat analgesik yang berkerja pada dua atau lebih jalur nyeri yang berbeda merupakan rekomendasi teknik manajemen nyeri akut pasca seksio sesarea. Teknik yang paling sering dipakai adalah dengan menggunakan analgesik intravena diikuti dengan penggunaan analgesik oral. Penelitian ini bertujuan membandingkan efektifitas analgesik oral controlled release oksikodon 10 mg dan parasetamol 1000 mg dengan tramadol 50 mg dan parasetamol 1000 mg untuk mengatasi nyeri pascaseksio sesarea dalam 24 jam pertama. Metode. Penelitian ini menggunakan metode uji klinis prospektif acak tersamar ganda pada 58 pasien yang menjalani operasi seksio sesarea dengan anestesi spinal. Pasien dibagi menjadi dua kelompok sama besar untuk penanganan nyeri pascabedah. Kelompok oksikodon sebanyak 29 orang diberikan oksikodon controlled release 10 mg oral setiap 12 jam dan parasetamol 1000 mg oral setiap 8 jam sedangkan kelompok tramadol sebanyak 29 orang diberikan terapi tramadol 50 mg oral tiap 6 jam dan parasetamol 1000 mg oral tiap 8 jam. Penilaian nyeri pascabedah menggunakan Numerical Rating Scale (NRS) dalam posisi duduk, istirahat, menarik napas, dan interval waktu yang berbeda yaitu jam ke-1, 6, 12, 18, dan 24 pascapemberian obat pertama. Data yang terkumpul dianalisa lebih lanjut dengan secara statistik. Hasil. Oksikodon controlled release 10 mg dan parasetamol 1000 mg lebih efektif dibandingkan tramadol 50 mg dan parasetamol 1000 mg dalam mengatasi nyeri pascaseksio sesarea dengan NRS kelompok oksikodon lebih rendah secara signifikan dibandingkan kelompok tramadol pada tiap posisi pengukuran (P < 0,001). Kesimpulan. Oksikodon 10 mg CR oral ditambah dengan parasetamol 1000 mg lebih efektif untuk mengatasi nyeri pascaseksio sesarea dibandingkan dengan tramadol 50 mg oral ditambah dengan parasetamol 1000 mg.