scholarly journals Pengaruh Premedikasi Midazolam 0,04 mg/kgBB sebelum Anestesi Spinal terhadap Respons Tubuh Saat Insersi Jarum Spinal dan Kepuasan

2020 ◽  
Vol 8 (2) ◽  
pp. 82-90
Author(s):  
Anna Christanti ◽  
Ezra Oktaliansah ◽  
Indriasari Indriasari

Conscious sedation pada pasien yang dilakukan tindakan anestesi spinal membuat pasien menjadi lebih nyaman, kooperatif selama penyuntikan, dan mengurangi respons tubuh saat insersi jarum spinal. Midazolam memiliki efek ansiolitik, sedatif-hipnotik, amnesia, melemaskan otot, dan mengurangi mual-muntah akibat pembedahan. Tujuan penelitian ini mengetahui pengaruh premedikasi midazolam 0,04 mg/kgBB yang diberikan 30 menit sebelum dilakukan anestesi spinal terhadap respons tubuh pasien saat insersi jarum spinal dan kepuasan pasien terhadap anestesi spinal. Penelitian dilakukan periode September–Desember 2019 di RSUP Dr. Hasan Sadikin Bandung. Penelitian bersifat prospektif eksperimental menggunakan uji klinis acak buta ganda terhadap 46 subjek yang dibagi acak ke dalam 2 kelompok, yaitu kelompok kontrol (kelompok K, n=23) dan kelompok premedikasi midazolam (kelompok M, n=23). Pasca- pemberian premedikasi midazolam dinilai respons tubuh pasien saat insersi jarum spinal menggunakan prick response score dan kepuasan pasien dengan numeric rating scale. Analisis statistik untuk respons penyuntikan dan kepuasan pasien diuji dengan uji chi-square. Hasil penelitian menunjukkan respons tubuh pasien saat insersi jarum spinal berkurang (p<0,01) dan kepuasan pasien meningkat (p<0,01) pada kelompok premedikasi midazolam. Simpulan, premedikasi midazolam 0,04 mg/kgBB yang diberikan 30 menit sebelum anestesi spinal menurunkan respons tubuh pasien saat insersi jarum spinal dan meningkatkan kepuasan pasien terhadap anestesi spinal

2019 ◽  
Vol 2 (2) ◽  
pp. 71-76
Author(s):  
Yuni Tri Yustianti ◽  
Pusparini Pusparini

LATAR BELAKANG Dekade terakhir menunjukkan neck pain pada remaja semakin meningkat, bersamaan dengan meningkatnya penggunaan gawai (gadget). Seiring perkembangan zaman, gawai menjadi kebutuhan dan gaya hidup masyarakat luas. Pelajar menjadi pasar terbesar dalam penggunaan gawai sehubungan dengan kebutuhan belajar yang memerlukan akses Internet. Salah satu faktor penyebab neck pain pada pengguna gawai adalah intensitas penggunaan gawai yang mempengaruhi lamanya posisi fleksi pada otot leher. Tujuan penelitian ini adalah untuk mengetahui hubungan intensitas pemakaian gawai dengan neck pain pada usia 15-20 tahun. METODE Penelitian ini merupakan studi observasional dengan desain cross sectional yang mengikutsertakan 164 pelajar SMAN 28 Jakarta dan Fakultas Hukum Universitas Trisakti. Data dikumpulkan dengan cara pengisian kuesioner yang meliputi usia, jenis kelamin, intensitas pemakaian gawai dan keluhan neck pain. Penilaian neck pain menggunakan NRS (Numeric Rating Scale). Analisis data dilakukan dengan uji Chi-square dengan tingkat kemaknaan p<0.05. HASIL Subjek perempuan berjumlah 121 orang (73.8%). Paparan gawai dengan intensitas >56 jam/minggu dijumpai pada 109 subjek (66.5%). Keluhan neck pain dijumpai pada 138 subjek (84.1%). Uji Chi-square menunjukkan terdapat hubungan yang bermakna antara intensitas penggunaan gawai dengan neck pain pada usia 15-20 tahun dengan nilai p=0.004. KESIMPULAN Terdapat hubungan yang bermakna antara intensitas penggunaan gawai dengan neck pain pada usia 15-20 tahun.    


2019 ◽  
Vol 12 (2) ◽  
pp. 47
Author(s):  
Yoga Tri Wijayanti ◽  
Sumiyati Sumiyati ◽  
Prasetyowati Prasetyowati

<p><strong>Latar belakang:</strong> Nyeri persalinan merupakan  kombinasi nyeri fisik akibat kontraksi miometrium disertai regangan segmen bawah rahim yang menyatu dengan kondisi psikologis ibu selama persalinan. Nyeri persalinan yang tidak diatasi menyebabkan partus lama dan asfiksia pada janin. <strong>Tujuan:</strong> Tujuan penelitian untuk mengetahui faktor yang berhubungan dengan nyeri persalinan. <strong></strong></p><p><strong>Metode:</strong> Rancangan penelitian menggunakan studi <em>cross sectional</em><em>. </em>Sampel berjumlah 32 responden dan diambil dengan teknik<em> </em><em>purposive sampling. </em>Variabel independen meliputi kecemasan, usia dan paritas, sedangkan variabel dependen nyeri persalinan. Pengumpulan data menggunakan alat kuesioner, <em>Zung Self-Rating Anxiety Scales </em>(ZSAC) untuk mengukur kecemasan dan lembar observasi <em>Numeric Rating Scale</em> (NRS)  (skala 0-10) untuk nyeri persalinan. Analisis bivariat menggunakan uji <em>chi square</em>.  <strong></strong></p><p><strong>Hasil:</strong> Hasil penelitian menunjukkan terdapat 43,75% ibu bersalin merasakan kecemasan menghadapi persalinan. Studi memperoleh hasil ada hubungan kecemasan dengan nyeri persalinan kala I (<em>p</em> = 0,017; POR 7,5 CI 95%: 1,3-43,7). <strong></strong></p><p><strong>Simpulan</strong>: Kecemasan pada ibu bersalin meningkatkan persepsi nyeri persalinan kala I. Perlu upaya penurunan  atau menghilangkan kecemasan pada ibu bersalin dengan diberikan dukungan  oleh keluarga atau Bidan dan pemahaman cara merespon nyeri.</p><p><strong><em>Background:</em></strong><em> Labor pain is a combination of physical pain due to myometrial contraction accompanied by a stretch of the lower uterine segment that integrates with the psychological condition of the mother during labor. Untreated labor pain causes prolonged labor and asphyxia in the fetus. </em><strong><em>Purpose</em></strong><strong><em>:</em></strong><em> The purpose of this study was to determine factors associated with labor pain. </em><strong><em></em></strong></p><p><strong><em>Method</em></strong><strong><em>s</em></strong><strong><em>:</em></strong><em> The study design used a cross-sectional study. The sample consisted of 32 respondents and was taken by purposive sampling technique. The independent variables include anxiety, age, and parity, while the dependent variable is labor pain. Data collection using a questionnaire tool, Zung Self-Rating Anxiety Scales (ZSAC) to measure anxiety and observation sheet Numeric Rating Scale (NRS) (scale 0-10) for labor pain. Bivariate analysis using the chi-square test. </em><strong><em></em></strong></p><p><strong><em>Results:</em></strong><em> The results showed that 43.75% of mothers felt anxiety facing labor. The study found an association of anxiety with first stage labor pain (p = 0.017</em><em>; CI 95%: 1,3-43,7</em><em>). </em><strong><em></em></strong></p><p><strong><em>Conclusion:</em></strong><em> Anxiety in labor increases the perception of labor pain in the first stage. It is necessary to reduce or eliminate anxiety in labor by giving support from the family or midwife and understanding how to respond to pain.</em></p>


2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 144-144
Author(s):  
Vishal Navnitray Ranpura ◽  
Lynne Wood ◽  
Stephanie Heller ◽  
Linda Self ◽  
Sekwon Jang

144 Background: Medstar Washington Cancer Institute (MWCI) has participated in Quality Oncology Practice Initiative (QOPI) since 2008. Adherence to pain assessment and intensity documentation was high, but lower in plan of care for moderate/severe pain documentation (69%, compared to QOPI aggregate of 79%) during the fall 2011 round. One potential explanation for the discrepancy was lack of communication between the nursing staff assessing the pain and the physician treating pain. We hypothesized that the use of pain card can improve the communication between nurses and doctors, as well as prompt physicians to document the plan of care for moderate/severe pain. Methods: MWCI created a team of physicians, nurses, quality resources, and administrative staff in December 2011. We abstracted up to 10 patients charts per oncologist for those patientswho reported moderate to severe pain (pain score of more than 3 of 10 on numeric rating scale) each quarter during 2012.We used data for quarter 1 and 2 as a baseline. We implemented the use of pain card by nurses to report pain for these patients to the physician in quarter 3 and 4. Chi square test was used to compare documentation rate in the first two quarters and last two quarters. Results: The total number of charts evaluated, pain documentation as well as confidence intervals for each quarter are shown in the table. Our results show significant improvement in pain documentation by physician in last two quarters compared to first two quarters ( p = 0.0007). Conclusions: Our study demonstrates pain card improved communication between nurse and physician resulting improved documentation of pain by physician. [Table: see text]


2018 ◽  
Vol 09 (02) ◽  
pp. 208-213 ◽  
Author(s):  
Jayantee Kalita ◽  
Kamlesh Kumar Sonkar ◽  
Usha Kant Misra ◽  
Sanjeev K. Bhoi

ABSTRACT Introduction: Obesity may be associated with more severe and disabling low backache (LBA) due to alteration in biomechanics, but there are no such studies from developing countries. Aims: We report the frequency of metabolic syndrome (MS) in chronic LBA (CLBA) and its association with severity and disability of CLBA. Subjects and Methods: Consecutive patients with CLBA attending to the neurology service from October 2015 to February 2016 were included in the study. Clinical and demographic parameters were recorded. Routine biochemical test was done. The severity of pain was assessed by a 0–10 Numeric Rating Scale (NRS) and disability by Oswestry Disability Index (ODI) version 2. Comparison of variables was done by Chi-square or independent t-test and correlation by Karl Pearson or Spearman's rank correlation test. Results: Seventy-none (39.3%) patients had MS as per the International Diabetic Federation (IDF) criteria and 68 (33.8%) as per the National Cholesterol Education Program Adult Treatment Panel III criteria. Abdominal obesity was the most common (171 [85.1%]) feature of MS. The patients with MS had longer duration of sitting work and did less frequently exercise. The NRS score (6.95 ± 1.06 vs. 6.65 ± 0.95; P = 0.04) and ODI score (54.91 ± 8.42 vs. 51.89 ± 8.54; P = 0.01) were higher in CLBA patients with MS compared to those without MS. Conclusion: About 40% patients with CLBA have metabolic syndrome, and they have more severe pain and disability.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20700-e20700
Author(s):  
Sekwon Jang ◽  
Vishal Navnitray Ranpura ◽  
Lynne Wood ◽  
Heller Stephanie ◽  
Linda Self

e20700 Background: MWCI has participated in Quality Oncology Practice Initiative (QOPI) since 2008. Adherence to pain assessment and intensity documentation was high, but lower in plan of care for moderate/severe pain documentation (69%, compared to QOPI aggregate of 79%) during the Fall 2011 round. One potential explanation for the discrepancy was lack of communication between the nursing staff assessing the pain and the physician treating pain. We hypothesized that the use of pain card can improve the communication between nurses and doctors, as well as prompt physicians to document the plan of care for moderate/severe pain. Methods: MWCI created a team of physicians, nurses, quality resources and administrative staff in December 2011. We abstracted up to 10 patients charts per oncologist for those patientswho reported moderate to severe pain (pain score of more than 3 of 10 on numeric rating scale) each quarter during 2012.We used data for quarter 1 and 2 as a baseline. We implemented the use of pain card by nurses to report pain for these patients to the physician in quarter 3 and 4. Chi square test was used to compare documentation rate in the first two quarters and last two quarters. Results: The total number of charts evaluated, pain documentation as well as confidence intervals for each quarter are shown in the Table. Our results show significant improvement in pain documentation by physician in last two quarters compared to first two quarters (p =0.0007). Conclusions: Our study demonstrates pain card improved communication between nurse and physician resulting improved documentation of pain by physician. [Table: see text]


2020 ◽  
Vol 6 (2) ◽  
pp. 164-170
Author(s):  
Dewi Nurlaela Sari ◽  
Aay Rumhaeni

ABSTRAK Sectio caesarea merupakan tindakan alternatif dalam proses persalinan untuk menyelamatkan ibu dan janin. Ibu Bersalin dengan operasi sectio caesarea dilakukan pembedahan pada dinding abdomen dan dinding rahim. Dampak yang paling sering muncul dirasakan oleh postpartum dengan post operasi sectio caesarea adalah  nyeri. Nyeri akan berdampak pada bounding attachment terganggu, mobilisasi terbatas, Activity Daily Living (ADL) terganggu serta berpengaruh  terhadap Inisiasi Menyusui Dini (IMD). Asuhan yang diberikan terbatas pada terapi farmakologi dibandingkan  non farmakologi. Foot massage adalah salah satu terapi non farmakologi yang dapat membantu menutup gerbang di posterior horns dari sumsum tulang belakang dan memblokir bagian dari nyeri ke sistem saraf pusat. Tujuan penelitian ini untuk mengetahui pengaruh foot massage terhadap skala nyeri pada klien post operasi sectio caesarea di RS AMC. Penelitian ini merupakan penelitian pre eksperimen dengan pendekatan one group pre test post test design. Jumlah sampel yang digunakan berjumlah 27 orang dengan menggunakan teknik purposive sampling. Instrumen yang digunakan adalah Numeric Rating Scale (NRS) dan prosedur kerja foot massage. Responden dilakukan foot massage selama 20 menit selama 2 hari. Data di analisis dengan menggunakan uji wilcoxon. Hasil penelitian menunjukkan lebih dari setengah klien post operasi sectio caesarea berada di skala nyeri 6 sebelum dilakukan foot massage dan hampir setengah memiliki skala nyeri 3 sesudah dilakukan foot massage dan didapatkan nilai p value = 0.000, sehingga disimpulkan ada pengaruh foot massage terhadap skala nyeri pada klien post operasi sectio caesarea. Diharapkan rumah sakit dapat menjadikan foot massage sebagai salah satu alternatif manajemen non farmakologi dalam penanganan nyeri.   Kata kunci: Foot Massage; Post Partum; Nyeri; Sectio Caesarea      


2019 ◽  
Vol 8 (2) ◽  
pp. 152
Author(s):  
Adi Antoni ◽  
Yanna Wari Harahap

Abstrak   Latar belakang: Diabetes mellitus (DM) merupakan penyakit kronik dan menjadi masalah global. Salah satu komplikasi yang ditimbulkan dari DM adalah luka kaki diabetic. Langkah awal dalam perawatan luka kaki diabetic adalah mencuci luka. Tujuan penelitian ini adalah mengetahui keefektifan dari rebusan daun jambu biji sebagai cairan pencuci luka terhadap tingkat malodor pada luka kaki diabetic. Metode: Desain penelitian yang digunakan adalah quasy experiment dengan rancangan one group pretests-posttest only. Teknik sampling yang digunakan adalah consecutive sampling dengan jumlah sampel 16 orang. Kriteria sampel yang digunakan adalah klien luka kaki diabetic, tingkat malodor 1-10 dengan NRS. Alat ukur yang digunakan adalah Numeric Rating Scale (NRS). Analisa data yang digunakan dalam penelitian ini menggunakan uji paired t test. Hasil: tingkat malodor sebelum intervensi pencucuan luka menggunakan rebusan daun jambu biji rata-rata sebesar 4.40 dan sesudah intervensi sebesart 2.44 dengan p value < 0.001. Selisih tingkat malodor antara sebelum dan sesudah intervensi sebesar 1.96. Hasil penelitian ini menunjukkan bahwa daun jambu dapat digunakan sebagai cairan pencuci luka dalam mengatasi tingkat malodor pada luka kaki diabetik. Kesimpulan : daun jambu biji dapat digunakan sebagai cairan pencuci luka pada luka kaki diabetic. Perawat diharapkan dapat memanfaatkan daun jambu biji sebagai salah satu alternatif dalam pencucian luka kronik khususnya luka kaki diabetik.   Kata kunci: Daun Jambu Biji, Tingkat Malodor, Luka Kaki Diabetik   Abstract   Background: Diabetes mellitus (DM) is a chronic disease and a global problem. One of the complications that arise from DM is diabetic foot ulcer. The first step in treating diabetic foot ulcer is washing the wound. The purpose of this study was to determine the effectiveness of guava leaf decoction as a washing fluid for malodor levels in diabetic foot ulcer. Method: The research design used was quasy experiment with one group pretests-posttest only design. The sampling technique used was consecutive sampling with a sample of 16 people. Sample criteria used were diabetic foot ulcer clients, malodor level 1-10 with NRS. The measuring instrument used is the Numeric Rating Scale (NRS). Analysis of the data used in this study used paired t test. Results: the level of malodor before intervening in wound washing using guava leaf decoctions on average was 4.40 and after the intervention was 2.44 with p value <0.001. The difference in the level of malodor between before and after the intervention was 1.96. The results of this study indicate that guava leaves can be used as a washing fluid in dealing with malodor levels in diabetic foot ulcer. Conclusion: Guava leaves can be used as a washing fluid for diabetic foot wounds. Nurses are expected to be able to use guava leaves as an alternative in washing chronic wounds, especially diabetic foot injuries.   Key words: Guava Leaf, Malodor Level, Diabetic foot ulcer.


Author(s):  
Bahaa R. Youssef ◽  
Andreas Söhnel ◽  
Alexander Welk ◽  
Mohamed H. Abudrya ◽  
Mohamed Baider ◽  
...  

Abstract Objective To compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth. Materials and methods In this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes. Results Patients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations. Conclusion This study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed. Clinical relevance ILA could be considered as an effective alternative for routine dental treatment. Trial registration NCT04563351


Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 566
Author(s):  
Masato Ise ◽  
Eiji Nakata ◽  
Yoshimi Katayama ◽  
Masanori Hamada ◽  
Toshiyuki Kunisada ◽  
...  

Psychological distress is common in patients with soft tissue and bone tumors. We first investigated its frequency and the associated risk factors in patients with pre-operative bone and soft tissue tumors. Participants included 298 patients with bone and soft tissue tumors who underwent surgery in our institution between 2015 and 2020. Psychological distress was evaluated by the Distress and Impact Thermometer (DIT) that consists of two types of questions (questions about the severity of the patient’s distress (DIT-D) and its impact (DIT-I)). We used a cut-off point of 4 on the DIT-D and 3 on the DIT-I for screening patients with psychological distress. We therefore investigated: (1) the prevalence of psychological distress as assessed with DIT or distress thermometer (DT), which can be decided by DIT-D ≥ 4, (2) what are the risk factors for the prevalence of psychological distress, and (3) what is the number of patients who consulted a psychiatrist for psychological distress in patients with pre-operative bone and soft tissue tumors. With DIT and DT, we identified 64 patients (21%) and 95 patients (32%), respectively, with psychological distress. Multivariate logistic regression revealed that older age, sex (female), malignancy (malignant or intermediate tumor), a lower Barthel Index, and higher numeric rating scale were risk factors for psychological distress. Two patients (3%) consulted a psychiatrist after surgery. In conclusion, careful attention to psychological distress is needed, especially for female patients, older patients, and those with malignant soft or bone tissue tumors who have more than moderate pain.


2021 ◽  
pp. 030089162199043
Author(s):  
Silvia Gonella ◽  
Dino S. Di Massimo ◽  
Marinella Mistrangelo ◽  
Gianmauro Numico ◽  
Paola Berchialla ◽  
...  

Introduction: Chemotherapy-induced nausea, vomiting, and retching (CINVR) remains a common side effect of treatment. Most previous studies have focused on vomiting control; nausea and retching have been less explored. This study aimed at describing the incidence, severity, and impact on daily life (IDL) of CINVR in the acute (0–24 hours), delayed (>24–120 hours), and overall (0–120 hours) postchemotherapy periods and beyond 120 hours (until next chemotherapy administration); and the pharmacologic and nonpharmacologic strategies adopted by patients to relieve symptoms. Methods: This was a single-center, cross-sectional study of 60 patients undergoing chemotherapy. Participants reported the frequency, severity, and IDL of CINVR from the day of chemotherapy administration up to 120 hours thereafter and nausea and vomiting that occurred beyond 120 hours, as well as pharmacologic and nonpharmacologic remedies used. Results: Forty-seven (78.3%, 95% confidence interval [CI] 66.4–86.9), 37 (61.7%, 95% CI 49.0–72.9), and 35 (58.3%, 95% CI 45.7–69.9) patients reported no nausea (Numeric Rating Scale ⩽1), vomiting, or retching in the acute, delayed, and overall periods, respectively. Nausea was more frequent, more severe, and had a greater IDL than did vomiting and retching across the overall observation period; beyond 120 hours, 11 (18.3%, 95% CI 10.6–29.9) patients reported nausea and none reported vomiting, with a median IDL of 1/10 (interquartile range: 0.75–5.00; 95% CI 0–7.6). Metoclopramide (n = 57 administrations), dexamethasone (n = 28), eating small servings of food (n = 13), and aloe (n = 11) were the most commonly used rescue therapies. Conclusions: Future studies should set hard outcomes, such as the absence of any symptoms, as a primary end point, and these should be assessed across and beyond the 120-hour period.


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