Pengaruh Pemberian Magnesium Sulfat Intravena Prainduksi terhadap Kebutuhan Analgetik Pasca-Simple Mastectomy

Nyeri pascabedah masih menjadi masalah dan perhatian di dunia. Pemberian analgetik preventif merupakan salah satu cara untuk mengurangi nyeri pascabedah. Beberapa obat digunakan sebagai terapi analgetik preventif antara lain opioid dan NSAID, namun obat ini mempunyai banyak efek samping. MgSO4 dapat digunakan sebagai analgetik preventif karena bersifat antagonis reseptor NMDA nonkompetitif. Tindakan operasi yang memiliki skor nyeri yang tinggi salah satunya adalah simple mastectomy dengan skor nyeri 4 sampai 8. Penelitian ini bertujuan mengetahui pengaruh MgSO4 i.v. dengan dosis bolus 50 mg/kgBB 20 menit prainduksi terhadap kebutuhan analgetik pasca-simple mastectomy. Penelitian ini merupakan penelitian analitik komparatif dengan data tidak berpasangan secara prospektif dengan uji klinis acak terkontrol buta ganda (RCT double blind) yang dilakukan terhadap 26 subjek penelitian yang menjalani simple mastectomy di RSUP Dr. Hasan Sadikin Bandung pada bulan Agustus sampai Desember 2018. Analisis statistik pada data numerik diuji dengan uji t berpasangan, sedangkan data kategorik diuji dengan uji chi-Square. Subjek dibagi menjadi kelompok M (MgSO4 20% 50 mg/kgBB) dan kelompok C (NaCl 0,9%). Hasil penelitian ini didapatkan kebutuhan opioid pascabedah pada kelompok yang diberikan MgSO4 lebih rendah dibanding dengan kelompok yang mendapatkan NaCl dengan perbedaan bermakna (p<0,05). Simpulan penelitian ini adalah MgSO4 i.v. prainduksi menurunkan kebutuhan opioid dibanding dengan kelompok kontrol pada simple mastectomy. Effect of Intravenous Magnesium Sulfate Pre-induction on Analgesics Consumption in Post-Simple MastectomyPostoperative pain is still a global problem that raises concerns all over the world. Preventive analgesics is one method to reduce postoperative pain. Several drugs are used as preventive analgesics including opioids and NSAIDs. However, these drugs have many side effects. MgSO4 can be used as alternative preventive analgesic as it is a non-competitive NMDA receptor antagonist. One of the surgical procedure that has a high pain score is simple mastectomy with a pain score of 4 to 8. The aim of this study was to determine the effect of MgSO4 i.v. with a bolus dose of 50 mg/kgBW, 20 minutes pre-induction, on the need for post-simple mastectomy analgesics. This was a comparative double blind randomized controlled trial (RCT) analytical study on prospective unpaired data from 26 study subjects who underwent simple mastectomy at Dr. Hasan Sadikin General Hospital Bandung during the period of August to December 2018. Subjects were divided into group M (MgSO4 20% 50 mg/kgBW) and group C (NaCl 0.9%). The results of this study revealed that the need for postoperative opioids in the group given MgSO4 was significantly lower compared to the group receiving NaCl (p<0.05). Therefore, MgSO4 i.v. preinduction has the ability to reduce opioid requirements in simple mastectomy when compared to NaCl.

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Randomized controlled trial of erdosteine for acute cough in children with colds

Paediatrica Indonesiana ◽

10.14238/pi51.2.2011.111-5 ◽

2011 ◽

Vol 51 (2) ◽

pp. 111

Author(s):

Yenny Yenny ◽

Roni Naning ◽

Amalia Setyati

Keyword(s):

Randomized Controlled Trial ◽

Clinical Improvement ◽

Common Cold ◽

Controlled Trial ◽

Research Subjects ◽

Acute Cough ◽

Chi Square ◽

Double Blind ◽

Randomized Controlled ◽

Significant Difference

Background T h e prevalence of the common cold in children is high, v.ith 30% of cases exhibiting an acute cough, the most common complaint by parents. Erdosteine, a recently developed cough medicine, is available for children. Erdosteine has been reported to increase mucodliary clearance, act as an antioxidant and prevent bacterial adhesion.Objective To assess the clinical improvement in acute cough in children \\lith a common cold taking erdosteine vs. a placebo.Methods We conducted a double􀀾blind, randomized, controlled trial at the Public Health Center of Gedongtengen, Yogyakarta with 140 children selected by a consecutive sampling method. Research subjects were randomized by computer program into two treatment groups, those receiving erdosteine therapy and those receiving a placebo. Both groups were monitored for 6 days. A scoring system was used to assess the improvement of acute cough symptoms and analyzed by Chi-square test.Results No significant differences in basic characteristics, cough severity, or environment were found among the 140 children with common cold in the two groups. After 6 days of treatment, no significant difference in clinical improvement of acute cough was found between the erdosteine (65 subjects improved out of 70) and placebo groups (62/70),92.5% and 88.6%, respectively (P=0.382).Conclusion Erdosteine was not more effective than the placebo for treatment of acute cough in children with common cold.

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Pengaruh Suplementasi Seng Terhadap Kejadian Pneumonia pada Penyakit Jantung Bawaan Pirau Kiri ke Kanan

Sari Pediatri ◽

10.14238/sp16.4.2014.221-8 ◽

2016 ◽

Vol 16 (4) ◽

pp. 221

Author(s):

Elvi Suryati ◽

Agus Priyatno ◽

Noor Wijayahadi

Keyword(s):

Randomized Controlled Trial ◽

Trace Element ◽

Risk Reduction ◽

Controlled Trial ◽

Chi Square ◽

Double Blind ◽

Randomized Controlled

Latar belakang. Anak dengan penyakit jantung bawaan (PJB) pirau kiri ke kanan lebih mudah menderitapneumonia. Seng merupakan trace element yang berperan dalam sistem imunitas tubuh.Tujuan. Membuktikan pengaruh suplementasi seng dalam mencegah kejadian pneumonia pada anak PJBpirau kiri ke kanan.Metode. Dilakukan double blind randomized controlled trial pada anak PJB pirau kiri ke kanan usia 12–60bulan di Poliklinik Kardiologi Anak RS dr Kariadi. Subjek penelitian dibagi 2 kelompok yang mendapatsuplementasi seng 20 mg/hari dan plasebo, pemberian selama 2 minggu, selanjutnya dipantau selama 3bulan. Data kejadian pneumonia dikumpulkan melalui wawancara saat kontrol atau melalui telepon setiap2 minggu selama 3 bulan. Pemeriksaan antropometri dan laboratorium dilakukan sebelum dan sesudahsuplementasi. Analisis statistik dilakukan dengan uji chi-square dan Mann-Whitney.Hasil. Subjek 40 anak dengan PJB pirau kiri ke kanan didapatkan kejadian pneumonia pada kelompok seng(5%) lebih rendah dibanding plasebo (30%), perbedaan ini tidak berbeda bermakna. Episode pneumonialebih rendah pada kelompok seng 1 kali dibandingkan plasebo 1-2 kali selama 3 bulan pengamatan, tidakberbeda bermakna. Terdapat peningkatan kadar seng secara bermakna pada kelompok perlakuan dari median57,55 menjadi 72,42 mcg/dL dibandingkan plasebo 42,40 menjadi 52,85 mcg/dL (p=0,002). Terdapatperbedaan bermakna selisih peningkatan kadar seng pada kelompok seng 20 mcg/dL dibanding plasebo7,25 mcg/dL (p=0,004). Didapatkan manfaat suplementasi seng terhadap pencegahan pneumonia denganrelative risk reduction (RRR) 83%.Kesimpulan. Suplementasi seng menurunkan kejadian pneumonia pada anak PJB pirau kiri ke kanan.

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Effects of an Intraoperative Intravenous Bolus Dose of Dexmedetomidine on Remifentanil-Induced Postinfusion Hyperalgesia in Patients Undergoing Thyroidectomy: A Double-Blind Randomized Controlled Trial: Erratum

Anesthesia & Analgesia ◽

10.1213/ane.0000000000005834 ◽

2022 ◽

Vol 134 (2) ◽

pp. e13-e13

Keyword(s):

Randomized Controlled Trial ◽

Bolus Dose ◽

Controlled Trial ◽

Intravenous Bolus ◽

Double Blind ◽

Intravenous Bolus Dose ◽

Randomized Controlled

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Comparison of Surgical Pleth Index–guided Analgesia with Conventional Analgesia Practices in Children

Anesthesiology ◽

10.1097/aln.0000000000000650 ◽

2015 ◽

Vol 122 (6) ◽

pp. 1280-1287 ◽

Cited By ~ 22

Author(s):

Ji Hye Park ◽

Byung Gun Lim ◽

Heezoo Kim ◽

Il Ok Lee ◽

Myoung Hoon Kong ◽

...

Keyword(s):

Postoperative Pain ◽

Pain Score ◽

Primary Outcome ◽

Controlled Trial ◽

Control Group ◽

Emergence Agitation ◽

Double Blind ◽

Randomized Controlled ◽

Fentanyl Consumption ◽

High Emergence

Abstract Background: To compare surgical pleth index (SPI)-guided analgesia with conventional analgesia by evaluating intraoperative analgesic requirements, postoperative pain, and emergence agitation in children. Methods: This study was designed as a parallel, two-arm, double-blind, randomized controlled trial. Forty-five children undergoing elective adenotonsillectomy were randomly allocated to SPI-guided group (SPI-guided analgesia group, n = 21) or control group (conventional analgesia group, n = 24). Anesthesia was maintained with sevoflurane 2 to 3 vol% in 50% nitrous oxide and oxygen to achieve state entropy between 40 and 60. Intraoperative fentanyl 0.5 μg/kg was administered for the first event persisting 3 min and subsequent events persisting 5 min. An event was defined as an SPI over 50 (SPI-guided group) or a blood pressure or heart rate 20% above the baseline (control group). The primary outcome was intraoperative fentanyl requirement. Secondary outcomes included intraoperative sevoflurane consumption, postoperative emergence agitation and pain score, and postoperative rescue analgesic requirements. Results: Intraoperative fentanyl requirement was lower in SPI-guided group than in control group (0.43 ± 0.53 vs. 1.73 ± 0.59 μg/kg; P < 0.001). Intraoperative sevoflurane consumption was similar. The proportion of patients with high emergence agitation scores (4 to 5) was greater in SPI-guided group (61.9 vs. 25.0%; P = 0.01). The postoperative pain score and rescue fentanyl consumption were higher in SPI-guided group (7 [4.5; 9] vs. 3 [2; 6.75]; P = 0.002; 0.50 ± 0.34 vs. 0.29 ± 0.30 μg/kg; P = 0.04). Conclusions: As currently constructed, SPI does not appear to be valid in children. This may be due to both differences in blood vessel distensibility and baseline increased heart rates in children versus adults.

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Perbandingan Aromaterapi Pepermin dengan Ondansetron Intravena sebagai Terapi Rescue Mual Muntah Pascaoperasi Mastektomi

Jurnal Anestesi Perioperatif ◽

10.15851/jap.v7n1.1587 ◽

2019 ◽

Vol 7 (1) ◽

pp. 25-32

Author(s):

Arna Fransisca ◽

Iwan Fuadi ◽

Dewi Yulianti Bisri

Keyword(s):

Randomized Controlled Trial ◽

Postoperative Nausea ◽

Controlled Trial ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Chi Square ◽

Double Blind ◽

Consecutive Sampling ◽

Randomized Controlled ◽

Significant Difference

Mual muntah pascaoperasi merupakan salah satu komplikasi anestesi dan operasi yang menjadi perhatian khusus karena memengaruhi kualitas pelayanan kesehatan, memperpanjang lama perawatan, dan meningkatkan angka morbiditas perioperatif. Pascaoperasi payudara berkaitan dengan angka kejadian mual muntah pascaoperasi yang tinggi. Beberapa konsensus penatalaksanaan mual muntah pascaoperasi merekomendasikan pemberian terapi nonfarmakologi dengan aromaterapi sebagai terapi rescue untuk mengatasi mual muntah pascaoperasi. Tujuan penelitian ini adalah membandingkan aromaterapi pepermin dengan ondansetron sebagai terapi rescue dalam menurunkan kejadian mual muntah pascaoperasi mastektomi. Penelitian ini merupakan penelitian eksperimental yang dilakukan secara prospektif dengan desain penelitian double blind randomized controlled trial dan consecutive sampling terhadap 32 subjek penelitian yang menjalani operasi mastektomi elektif dan memenuhi kriteria inklusi di RSUP Dr. Hasan Sadikin Bandung pada bulan Juli–September 2018. Pada penelitian ini, data ordinal diuji dengan Uji Mann Whitney dan untuk data kategorik diuji dengan uji chi-square. Hasil penelitian ini didapatkan penurunan kejadian mual muntah pascaoperasi yang signifikan pada kelompok pepermin dibanding dengan kelompok ondansetron dengan perbedaan yang bermakna (p<0,05) pada penilaian menit kedua dan menit kelima setelah perlakuan. Simpulan, aromaterapi pepermin efektif menurunkan kejadian mual muntah pascaoperasi mastektomi dan dapat digunakan sebagai alternatif terapi atau terapi tambahan untuk penatalaksanaan mual muntah pascaoperasi.Comparison of Peppermint Aromatherapy with Ondansetron Intravenous as a Rescue for Postoperative Nausea Vomiting after Mastectomy SurgeryPostoperative nausea and vomiting are among anesthesia and surgery complications that receive special considerations as it affects the quality of healthcare services, prolongs care, and increases perioperative morbidities. The incidence of postoperative nausea and vomiting is high in patients that have undergone breast surgery. The consensus for postoperative nausea and vomiting management recommends non-pharmacological treatments, one of which is through the use of aromatherapy as a rescue to resolve postoperative nausea and vomiting. This study aimed to compare the effects of peppermint aromatherapy and ondansetron as a rescue in reducing the incidence of postoperative nausea and vomiting after elective mastectomies. This was a prospective experimental double blind randomized controlled trial study with consecutive sampling on 32 research subjects underwent elective mastectomies and met the inclusion criteria in Dr. Hasan Sadikin General Hospital in July–September 2018. The ordinal data were tested using the Mann Whitney statistics test and the categorical data using the chi square test. The results show a significant decrease in nausea and vomiting incidence in the peppermint group compared to the ondansetron group with significant difference (p<0.05) in two minutes and five minutes after treatment. In conclusion, peppermint aromatherapy is effective in reducing the incidence of postoperative nausea and vomiting after mastectomies and can be used as an alternative or additional treatment in managing postoperative nausea and vomiting.

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Comparison of mean pain score using topical and oral metronidazole in post milligan morgan hemorrhoidectomy patient; A randomized controlled trial

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.5.1796 ◽

2020 ◽

Vol 36 (5) ◽

Author(s):

Syed Tatheer Abbas ◽

Ahmad Raza ◽

Ihtasham Chaudhry ◽

Tahira Hameed ◽

Nausheen Hasham ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Pain Score ◽

Controlled Trial ◽

Pain Scale ◽

Chi Square ◽

Creative Commons ◽

Randomized Controlled ◽

Significant Difference ◽

Topical Metronidazole ◽

Oral Metronidazole

Background and Objectives: Milligan Morgan Hemorrhoidectomy is one of the most commonly performed surgeries. Post-operative pain is the major cause of morbidity in post hemorrhoidectomy patients. Metronidazole has an established role in relieving post hemorrhoidectomy pain. The objective was to evaluate the pain score by using topical and oral metronidazole in post Milligan Morgan hemorrhoidectomy patients. Methods: A prospective randomized controlled trail was done in surgical departments of Akbar Niazi Teaching Hospital, Islamabad. A total of 166 consecutive patients with 3rd and 4th degree hemorrhoids were presenting in surgical OPD and who underwent Milligan Morgan hemorrhoidectomy between July 2018 and December 2018 were included in the study. Patients allocated in two groups, Group-A received topical metronidazole 10% post hemorrhoidectomy for seven days and Group-B were given oral metronidazole 400mg for 07 days. Analgesics were given on patient’s requirement. Patients post hemorrhoidectomy pain was recorded by using VSA scale at baseline (1st day) and on 7th post-operative day. Data analysis was done by using SPSS 21. Pain calculated by compared in terms of mean, standard deviation between groups and independent sample T test was used. Association between demographic details like gender and ages of the patients with pain scale on 7th day was measured and chi-square distribution was used. Results: Total 166 patients were included in this study. The mean ages of the patients were 44.07±10.62 years with minimum 20 and maximum 60 years. Out of 166 patients, female were 55 (33.1%) and male were 111 (66.9%). Results showed significantly lower pain in patients using topical metronidazole as compared to oral metronidazole (p=0.001). Association of pain with respect to ages was insignificant (p=0.202) whereas between genders inside the groups showed significant difference (p=0.028). Conclusion: These results showed that topical metronidazole significantly reduces pain in post hemorrhoidectomy patients as compared to oral metronidazole overall and even when data stratified among age, gender and type of hemorrhoids. doi: https://doi.org/10.12669/pjms.36.5.1796 How to cite this:Abbas ST, Raza A, Chaudhry I, Hameed T, Hasham N, Arshad N. Comparison of mean pain score using topical and oral metronidazole in post milligan morgan hemorrhoidectomy patient; A randomized controlled trial. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.1796 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Pengaruh Suplementasi Seng Terhadap Insidens Diare dan Tumbuh Kembang Anak pada Usia 24-33 Bulan

Sari Pediatri ◽

10.14238/sp14.3.2012.147-51 ◽

2016 ◽

Vol 14 (3) ◽

pp. 147

Author(s):

BRW. Indriasari ◽

JC. Susanto ◽

Suhartono Suhartono

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Chi Square ◽

Double Blind ◽

Randomized Controlled ◽

Scale Test

Latar belakang.Defisiensi seng sangat sering terjadi pada anak-anak di negara berkembang. Suplementasi seng dapat menurunkan insidens diare, memperbaiki defisiensi seng, serta memperbaiki pertumbuhan dan perkembangan anak. Tujuan.Membuktikan pengaruh suplementasi seng 20 mg dua kali seminggu selama 12 minggu terhadap insidens diare serta tumbuh kembang pada anak usia 24-33 bulan. Metode.Penelitian eksperimental dengan double-blind, randomized controlled trial, dilakukan di beberapa kelompok PAUD di Kelurahan Tandang, Semarang pada Desember 2010-Februari 2011. Seratus anak usia 24-33 bulan secara random dibagi menjadi 2 kelompok. Kelompok perlakuan (n=50) menerima 5 cc sirup seng elemental 20 mg dua kali seminggu dan kelompok kontrol (n=50) menerima 5 cc sirup plasebo dua kali seminggu selama 12 minggu. Kadar seng plasma diperiksa sebelum perlakuan. Pertumbuhan dinilai dengan antropometri (berat badan, tinggi badan) dan perkembangan (skor bahasa, visual motorik) menggunakan Capute scale test, diukur sebelum dan setelah perlakuan. Data morbiditas diare dan pengukuran tinggi badan dan berat badan dicatat dan diukur setiap 2 minggu, perkembangan kognitif dipantau setiap 4 minggu saat kunjungan rumah. Uji statistik dilakukan dengan Chi-square dan Mann-Whitney test.Hasil. Insidens diare pada kelompok perlakuan 34%, risiko relatif 1,32 (95% IK=0,89-1,95), sedang pada kontrol 22%. Rerata kadar seng serum pada kelompok perlakuan dan kontrol rendah (<60 mcg/dL) dengan nilai p=0,059. Rerata perubahan skor WAZ dan HAZ kelompok perlakuan sama dengan kontrol 0,11 dengan nilai p=0,098. Rerata perubahan skor WHZ kelompok perlakuan 0,19 dan kontrol 0,32 dengan nilai p=0,647. Perubahan skor bahasa kelompok perlakuan 7,72 dan kontrol 6,98 dengan nilai p=0,319 dan perubahan skor visual motorik kelompok perlakuan 6,30 dan kontrol 5,78 dengan nilai p=0,342.Kesimpulan.Suplementasi seng 20 mg dua kali seminggu selama 12 minggu tidak menurunkan insidens diare pada kelompok perlakuan. Terjadi percepatan pertumbuhan serta perubahan skor bahasa dan visualmotorik pada kelompok perlakuan tetapi dengan uji statistik tidak ada perbedaan bermakna.

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