scholarly journals Perbandingan Efek Analgesia antara Fentanil dan Oksikodon Intravena untuk Pengelolaan Nyeri Pascabedah Laparotomi Kolesistektomi

2021 ◽  
Vol 9 (1) ◽  
pp. 35-43
Author(s):  
Thomas Thomas ◽  
Iwan Fuadi ◽  
Iwan Abdul Rachman
Keyword(s):  
Randomized Control Trial ◽  
Patient Controlled Analgesia ◽  
Rating Score ◽  
Chi Square ◽  
Randomized Control ◽  
Numeric Rating

Nyeri pascabedah harus diatasi dengan baik menggunakan analgetik yang memiliki efek analgesia adekuat dengan efek samping minimal. Penelitian ini bertujuan mengetahui perbedaan nyeri pascabedah laparotomi kolesistekomi yang dinilai dengan numeric rating score (NRS) antara pasien yang menggunakan continuous intravenous patient controlled analgesia (IV-PCA) fentanil dan oksikodon. Penelitian dilakukan pada periode Agustus–November 2020 di RSUP dr. Hasan Sadikin Bandung. Penelitian randomized control trial (RCT) dilakukan terhadap 32 subjek status fisik ASA I–II yang terbagi menjadi dua kelompok, yaitu kelompok yang mendapat continuous IV-PCA fentanil 0,5 µg/kgBB/jam dan kelompok dengan continuous IV-PCA oksikodon 30 µg/kgBB/jam. Nyeri pascabedah dinilai dengan NRS pada jam pertama, ke-6, ke-12, dan ke-24. Analisis statistik data numerik dengan Uji Mann-Whitney, data kategorik dengan uji chi-square dan alternatif Uji Fisher’s Exact. Nilai NRS pada kelompok oksikodon lebih rendah dibanding dengan fentanil pada jam pertama hingga jam ke-24 (p=0,001). Kebutuhan rescue analgetik pada jam pertama dan ke-6 juga lebih rendah pada kelompok oksikodon (p=0,012; p=0,022, berurutan). Penelitian dengan rasio fentanil:oksikodon 1:60 ini tidak menunjukkan perbedaan efek samping kejadian mual, muntah, pusing, sakit kepala, dan pruritus antara kedua kelompok. Pemberian analgesia oksikodon intravena pada pasien pascabedah laparotomi kolesistektomi lebih baik dibanding dengan fentanil intravena.

scholarly journals Perbandingan Efektivitas Anestesi Spinal dengan Bupivacain 12,5 Mg dan Bupivacain 5 Mg yang ditambah Fentanyl 50 Mcg pada Seksio Sesarea

2021 ◽  
Vol 4 (1) ◽  
pp. 11-7
Author(s):  
Fritzky Indradata ◽  
Heri Dwi Purnomo ◽  
Muh. Husni Thamrin ◽  
Sugeng Budi Santoso ◽  
Ardana Tri Arianto ◽  
...  
Keyword(s):  
Side Effects ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Randomized Control Trial ◽  
Hyperbaric Bupivacaine ◽  
Chi Square ◽  
Double Blind ◽  
Duration Of Action ◽  
Significant Difference ◽  
Randomized Control

Latar Belakang: Anestesi spinal mempunyai efek samping berupa hipotensi dan mual muntah. Tujuan: penelitian ini adalah membandingkan efek anestesi spinal bupivacain dosis normal 12,5 mg dan bupivacain dosis rendah 5 mg dengan fentanyl 50 mg pada seksio sesarea terhadap perubahan hemodinamik, ketinggian blok, onset, durasi dan efek samping. Subjek dan Metode: Penelitian double blind randomized control trial pada 36 pasien yang memenuhi kriteria. Pasien dibagi menjadi dua kelompok, yang masing-masing terdiri 18 pasien, kelompok 1 dilakukan anestesi spinal dengan bupivacain hiperbarik 5 mg ditambah adjuvan fentanyl 50 mcg, sedangkan kelompok 2 diberikan bupivacain hiperbarik 12,5 mg. Penilaian meliputi saat mula kerja blokade sensorik, mula kerja blokade motorik, durasi, tekanan darah, laju nadi, dan saturasi oksigen, lama kerja dan efek samping. Data hasil penelitian diuji secara statistik dengan uji chi-square. Hasil: Terdapat perbedaan signifikan pada onset dan durasi blokade sensorik dan motorik, bupivacain 12,5 mg lebih baik dibandingkan bupivacain 5 mg + fentanyl 50 mcg (p<0.05). Tidak ada perbedaan signifikan pada perubahan tanda vital dan efek samping (p>0.05). Simpulan: Bupivacain 12,5 mg menghasilkan onset lebih cepat dan durasi lebih lama dibandingkan bupivacain 5 mg + fentanil 50 mcg pada anestesi spinal untuk seksio sesarea   Comparison of The Effectiveness Spinal Anesthesia with Bupivacaine 12,5 Mg and Bupivacaine 5 Mg added Fentanyl 50 Mcg in Caesarean Section Abstract Background: Spinal anesthesia has side effects such as hypotension and nausea and vomiting. Objective: The aim of this study was to compare the effects of spinal anesthesia with normal doses of 12,5 mg of bupivacaine and 5 mg of low-dose bupivacaine with fentanyl 50 mg in the cesarean section on hemodynamic changes, block height, onset, duration, and side effects. Subjects and Methods: Double-blind randomized control trial in 36 patients who met the criteria. Patients were divided into two groups, each consisting of 18 patients, group 1 underwent spinal anesthesia with 5 mg of hyperbaric bupivacaine plus 50 mcg of fentanyl adjuvant, while group 2 was given 12,5 mg of hyperbaric bupivacaine. Assessments include the initiation of sensory block action, onset of motor block action, duration, blood pressure, pulse rate, and oxygen saturation, duration of action, and side effects. The research data were statistically tested with the chi-square test. Results: There were significant differences in the onset and duration of sensory and motor blockade, bupivacaine 12,5 mg was better than bupivacaine 5 mg + fentanyl 50 mcg (p <0.05). There was no significant difference in changes in vital signs and side effects (p> 0.05). Conclusion: Bupivacaine 12,5 mg resulted in a faster onset and longer duration than bupivacaine 5 mg + fentanyl 50 mcg in spinal anesthesia for cesarean section.

scholarly journals Perbandingan Insidensi Hipotensi Saat Induksi Intravena Propofol 2 Mg/Kg Bb Pada Posisi Supine dengan Perlakuan dan Tanpa Perlakuan Elevasi Tungkai

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Beni Indra ◽  
Untung Widodo ◽  
Yunita Widyastuti
Keyword(s):  
Randomized Control Trial ◽  
Elective Surgery ◽  
P Value ◽  
Chi Square ◽  
Parametric Data ◽  
Chi Square Test ◽  
Group A ◽  
Randomized Control ◽  
American Society ◽  
Group B

Abstrak          Penggunaan Propofol untuk induksi pada general anestesi dapat menyebabkan  hipotensi akibat vasodilatasi arteri dan vena terutama vena kapasitan ditungkai. Manuver elevasi tungkai dapat mempertahankan stabilitas hemodinamik dengan meningkatkan aliran balik vena ke jantung dan mengurangi penumpukan darah di vena kapasitan tungkai. Penelitian ini dirancang dengan menggunakan cara Open Randomized Control Trial. Subyek penelitian adalah 184 sampel pasien dewasa ASA I-II yang menjalani operasi elektif dengan menggunakan general anestesi dengan induksi propofol. Kelompok sampel penelitian dibagi dalam dua kelompok masing-masing berjumlah 92 orang. Setelah prabeban cairan RL 10 cc/kgbb dan pemberian fentanyl 2 mcg/kgbb dan midazolam 0,05 mg/kgbb maka kelompok A dilakukan elevasi tungkai 45º satu menit sebelum induksi propofol dan dipertahankan sampai penelitian selesai. Sedangkan kelompok B tidak dilakukan elevasi tungkai. Data yang dikumpulkan dianalisa dengan uji t tes. Untuk data proporsi dilakukan analisa dengan tes chi-square. Dari data demografi tidak didapatkan perbedaan yang bermakna secara statistik (p>0,05) antara kedua kelompok penelitian kecuali untuk BMI (p<0,05). Insidensi hipotensi  menit pertama pasca induksi propofol pada kelompok A (elevasi tungkai) secara signifikan lebih rendah (12%) dibanding kelompok kontrol B  (27,2%) (p=0,016; p < 0,05). Pada menit ketiga pasca induksi juga didapatkan insidensi hipotensi kelompok A  (15,2%) signifikan lebih rendah dibanding kelompok B (23,9%) (p= 0,014; p < 0,05). Elevasi tungkai 45 derajat efektif dalam menurunkan insidensi hipotensi pasca induksi propofol.  Kata kunci: propofol, hipotensi, elevasi tungkai AbstractThe induction of general anaesthesia with propofol may induce of considerable degree of hypotension that has been atributed to decrease in systemic vascular resistance  caused by combination of venous and arterial vasodilatation. It will produce a shifting  of blood to venous reservoir, especially capacitance venule of legs. Leg elevation can provide hemodynamic stability by increases cardiac preload and recruits blood contained in the venous reservoir. This is Open Randomized Control Trial include 184 elective surgery patients with American Society of Anaesthesiologist (ASA) physical status I and II. Anesthesia  was induced with propofol. Patients were randomly allocated into two groups with 92 patients in each. All the patients received Ringer’s Lactate (10 ml/kg) and premedicated with fentanyl (2 mcg/kg) and midazolam (0,05 mg/kg) before induction of anesthesia. Group A was performed passive leg raising 45 degree 1 minute before injection of propofol until  the end of study and group B (control) did not receive any maneuver. Parametric data were analyzed with t-test and categorical data was done by using Chi-square test. A p value of less than 0,05 was consider significant. Demografic characteristics (age, sex, body weight and height) and  baseline haemodynamic parameters of the patients were similar in two groups (p > 0.05) except for BMI (p < 0.05) . The incidence of hypotension was significantly lower in group A (12 %, ) than group  B (27,2%) at the first minute after propofol  injection, p value = 0.016 (p < 0,05). In the third minute, incidence of hypotension was also significantly lower in group A (15,2%) than group B (23,9%), p value = 0,014 (p < 0,05). Leg elevation maneuver 45º significantly decrease incidence of hypotension after propofol induction. Keywords: Propofol, hypotension, leg elevation

scholarly journals The Effect of Dexpanthenol on the Treatment of Nipple Injuries in Breastfeeding Mothers: A Randomized Control Trial

2019 ◽  
Vol 8 (2) ◽  
pp. 80-84
Author(s):  
Kazhal Masoudin ◽  
Mahnaz Shahnazi ◽  
Mahin Kamalifard ◽  
Shakiba Pourasad Shahrak ◽  
Fariba Esmaeili
Keyword(s):  
Randomized Control Trial ◽  
Intervention Group ◽  
Invasive Technique ◽  
Chi Square ◽  
Non Invasive ◽  
Randomized Control ◽  
Double Blinded ◽  
Postpartum Mothers ◽  
And Control ◽  
Trauma Scores

Background: Considering the importance of treatment of sour nipples in breastfeeding mothers, the aim of this study was to evaluate the effect of dexpanthenol creams on the treatment of traumatic nipples. Materials and Methods: This study was a double-blinded, randomized, control trial, in which 82 postpartum mothers with nipple injuries who had attended health centers and Children’s Hospital of Sanandaj, Iran, participated. The participants were randomly divided into two groups of dexpanthenol and control. Nipple pain and trauma was measured using Storr and Champion scale. Analysis was done through chi-square and ANOVA tests using SPSS software version 13.0. P value less than 0.05 was considered significant. Results: The results of this study demonstrated that the mean score of pain and trauma in third, seventh, and fourteenth days of study in intervention group was decreased. In addition, there was significant differences in pain and trauma scores between dexpanthenol and control groups. Conclusion: Dexpanthenol is advised as an effective, simple, and non-invasive technique with no side effects for the treatment of nipple fissures and pain.

scholarly journals Efek suplementasi seng terhadap gejala yang berhubungan dengan diare akut ringan pada anak

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Esther Boas
Keyword(s):  
Incidence Rate ◽  
Acute Diarrhea ◽  
Randomized Control Trial ◽  
Fluid Transport ◽  
Age Groups ◽  
Chi Square ◽  
Cross Sectional ◽  
Significant Difference ◽  
Chi Square Test ◽  
Randomized Control

Abstract: Diarrhea is still a serious problem and is one of the factors that led to infant and young children’s deaths in developing countries, including Indonesia. Morbidity (Incidence Rate) diarrhea for all age groups in Lampung from year 2005 to 2012 are likely to rise, from 9.8 per 1000 population to 18.24 per 1000 population in 2012. It is known that zinc plays some important roles in regulation of intestinal fluid transport, maintainance of mucosal integrity, as well as improvement of immunity, gene expression, and oxidative stress. This study aimed to obtain the effect of zinc supplementation on symptoms associated with diarrhea on the seventh day of therapy in puskesmas (primary helath care) Kalianda, South Lampung. This was a randomized control trial study with a cross sectional design. Samples were children with mild acute diarrhea, divided into two groups: zinc group and without zinc group. Patients who showed no more acute diarrhea symptoms within seven days of treatment were determined as recovered. Data were presented in tabular form and analyzed by using the chi-square test. The results showed a total samples of 61 patients with acute mild diarrhea. The highest percentages were as follows: age 4 years old (19.6%), male gender (54.1%), and 2-day duration of diarrhea before admitted to Puskesmas Kalianda (44,26%). The chi-square test showed a significant difference between the two groups (P < 0.001). Conclusion: Supplementation of zinc added to oralit in children with mild acute diarrhea can significantly reduce symptoms of mild acute diarrhea on the seventh day compared to oralit monotherapy.Keywords: acute diarrhea, zinc, oralitAbstrak: Penyakit diare masih menjadi masalah yang serius dan merupakan salah satu faktor yang menyebabkan kematian bayi dan balita di negara berkembang termasuk Indonesia. Angka kesakitan (Incidence Rate) diare untuk semua kelompok usia di Provinsi Lampung dari tahun 2005-2012 cenderung meningkat, yaitu dari 9,8 per 1000 penduduk menjadi 18,24 per 1000 penduduk di tahun 2012. Seng diketahui membantu mengatur transpor cairan intestinal, menjaga integritas mukosa, meningkatkan imunitas, memperbaiki ekspresi gen dan stress oksidatif. Penelitian ini bertujuan untuk mengetahui efek pemberian suplemen seng terhadap penyembuhan dari gejala-gejala yang berhubungan dengan diare pada anak di hari ketujuh terapi di Puskesmas Kalianda, Lampung Selatan. Jenis penelitian ini ialah randomized control trial dengan desain potong lintang. Sampel penelitian ialah pasien anak dengan diare akut ringan yang dibagi menjadi dua kelompok: kelompok seng dan kelompok tanpa seng. Pasien yang menunjukkan hilangnya gejala diare akut dalam tujuh hari pengobatan dinyatakan sembuh. Data yang diperoleh dipresentasikan dalam bentuk tabel dan dianalisis dengan uji Chi-square. Hasil penelitian memperlihatkan terdapat 61 pasien anak sebagai sampel. Persentasi tertinggi diperoleh pada usia 4 tahun (19,6%), jenis kelamin laki-laki (54,1%), dan lama diare sebelum dibawa ke puskesmas ialah 2 hari (44,26%). Hasil uji Chi-square memperlihatkan terdapat perbedaan bermakna antara kedua kelompok (P < 0,001). Simpulan: Pemberian suplementasi seng dan oralit pada anak dengan diare akut dapat menurunkan gejala diare akut ringan secara bermakna pada hari ketujuh dibanding pemberian oralit tunggal.Kata kunci: diare akut, seng, oralit

scholarly journals hole-Course Application of Dexmedetomidine Combined with Ketorolac in Nonnarcotic Postoperative Analgesia for Patients with Lung Cancer Undergoing Thoracoscopic Surgery: A Randomized Control Trial

2020 ◽  
Vol 2;23 (4;2) ◽  
pp. E185-E193
Author(s):  
Qing-ping Wen
Keyword(s):  
Inflammatory Response ◽  
Immune Function ◽  
Postoperative Analgesia ◽  
Randomized Control Trial ◽  
Thoracoscopic Surgery ◽  
Patient Controlled Analgesia ◽  
Postoperative Patient ◽  
Intravenous Analgesia ◽  
Randomized Control ◽  
Rescue Drug

BACKGROUND: Opioid-based postoperative analgesia provides adequate analgesia with much adverse effects and immunosuppression. Dexmedetomidine and ketorolac have properties of opioid-sparing, antiinflammation, and immune protection. OBJECTIVES: To investigate the efficacy and safety of whole-course application of dexmedetomidine combined with ketorolac in nonnarcotic postoperative analgesia and its effect on inflammatory response and immune function in thoracoscopic surgery of lung cancer. STUDY DESIGN: Double-blind, randomized control trial. SETTING: The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China. METHODS: Sixty patients scheduled for thoracoscopic surgery were enrolled and randomly divided into 2 groups to receive a combination of intraoperative usage of dexmedetomidine and postoperative patient-controlled intravenous analgesia of dexmedetomidine 0.1 µg/kg/h and ketorolac 3 mg/kg (DEX group) or only postoperative patient-controlled intravenous analgesia of sufentanil 1.5 µg/kg and ketorolac 3 mg/kg (SUF group) for 48 hours. Vital signs, postoperative Visual Analog Scale (VAS) score, Ramsay sedation score, patient-controlled analgesia pressing times, consumption of sufentanil and rescue drug, and complications were compared between the 2 groups. The levels of inflammatory factors and immune function were also compared. RESULTS: A significant reduction in median blood pressures and heart rates within 48 hours after surgery and perioperative consumption of sufentanil were observed in the DEX group compared with the SUF group (P < 0.05). No statistically significant difference was found in VAS scores, patient-controlled analgesia pressing times, and rescue drug consumption between the 2 groups (P > 0.05). The incidence of nausea was significantly lower in the DEX group compared with the SUF group (P < 0.05). A significant decrease of interleukin (IL)-1 beta, IL-6, tumor necrosis factor (TNF)-alpha, and increased CD4+ and CD4+/CD8+ were observed in the DEX group compared with the SUF group at 24 and 48 hours after surgery (P < 0.05). There was no difference in the levels of CD8+ and natural killer cells between the 2 groups (P > 0.05). LIMITATIONS: This study was limited by its sample size. CONCLUSIONS: Whole-course application of dexmedetomidine combined with ketorolac in nonnarcotic postoperative analgesia provided adequate and safe postoperative analgesia, reduced sufentanil consumption, analgesia-related complications, alleviated inflammatory response, and immunosuppression compared with sufentanil-based analgesia in thoracoscopic surgery. KEY WORDS: Dexmedetomidine, ketorolac, sufentanil, thoracoscopic surgery, postoperative analgesic, patient-controlled analgesia, inflammatory response, immune function

scholarly journals Ginger and Lemon Aromatherapy To Relieve Nausea and Vomiting in Pregnancy

2019 ◽  
Vol 14 (1) ◽  
pp. 15
Author(s):  
Dwi Kustriyanti ◽  
Arista Adityasari Putri
Keyword(s):  
Randomized Control Trial ◽  
Well Being ◽  
Nausea And Vomiting ◽  
Wilcoxon Test ◽  
Eligibility Criteria ◽  
Chi Square ◽  
Before And After ◽  
Randomized Control ◽  
In Pregnancy

Nausea and vomiting of pregnancy (NVP) are amongst the most common complaints of women during pregnancy, up to 80% of women have experienced various degrees of it. NVP impact on the quality of life, social and general well-being. The aim of this study was to determine the effect of ginger and lemon aromatherapy on nausea and vomiting of pregnancy (NVP). This study was randomized control trial in which 90 pregnant women with nausea and vomiting before 16 age gestation who had eligibility criteria. They were randomly divided into ginger, lemon and placebo groups. Women were asked to record their nausea and vomiting for 7 days by form of PUQE-24, in first three days they were advised to adjust their diet and then received aromatherapy for four days. Data were analyzed by ANOVA, Kruskal Wallis, Chi Square and Wilcoxon test. PUQE total scores before and after intervention in the ginger, lemon and placebo groups were 7.67 ± 2.304 vs. 6.85 ± 1.575, P = 0.000; 7.16 ± 1.598 vs. 5.50 ± 1.448, P = 0.000 and 6.70 ± 1.787 vs 5.50 ± 1.803, <em>P</em> value 0.00. Ginger and lemon essential oil were equally effective in reducing pregnancy nausea and vomiting.

A randomized control trial of supplementary prenatal care: Implications for family practice

2005 ◽  
Author(s):  
Suzanne Tough ◽  
D. Johnston ◽  
J. Siever ◽  
G. Jorgenson ◽  
L. Slocombe ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Family Practice ◽  
Randomized Control Trial ◽  
Randomized Control
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