PENGARUH PEMBERIAN ASAM TRANEKSAMAT TERHADAP KADAR HEMOGLOBIN, KADAR ALBUMIN, TOTAL BLOOD LOSS, DERAJAT NYERI, DAN KEBUTUHAN TRANSFUSI DARAH PASKA OPERASI PADA PASIEN YANG MENJALANI PROSEDUR TOTAL KNEE REPLACEMENT DI RSUD DR. SOETOMO SURABAYA

Latar Belakang: Tingginya jumlah penderita osteoarthritis lutut akan membuat arthroplasty menjadi semakin sering dilakukan. Prosedur operasi Total Knee Replacement ini berisiko terjadi perdarahan yang masif. Perdarahan dapat mempengaruhi kadar albumin dan terjadinya tekanan intra kompartemen pada saraf. Penggunaan asam traneksamat merupakan salah satu cara yang dapat dilakukan untuk mengurangi perdarahan. Metode Penelitian: Penelitian dilakukan secara eksperimental menggunakan data primer pemeriskaan laboratorium yang diperoleh sebelum dan sesudah operasi pada pasien yang akan dilakukan operasi Total Knee Replacement mulai April 2017 di ruang operasi IRD RSUD Dr. Soetomo Surabaya. Hasil: Terdapat 64 pasien yang akan menjalani operasi total knee replacement. Rerata hemoglobin sebelum operasi pada kelompok asam traneksamat dan tanpa asam traneksamat sejumlah 13,06  1,46 g/dl dan 12,44  0,87 g/dl. Rerata hemoglobin setelah operasi menjadi 10,29  1,14 g/dl dan 9,16  0,97 g/dl. Pada kelompok yang mendapat asam traneksamat, 32 orang (100%) melaporkan skor VAS pasca operasi yang rendah, tidak membutuhkan transfusi darah, dan tidak membutuhkan transfusi albumin. Kelompok yang tidak mendapatkan asam traneksamat, 32 orang (100%) skor VAS pasca operasi yang sedang, 4 orang (12,5%) membutuhkan transfusi darah, dan 3 orang (9,4%) membutuhkan transfusi albumin. Kesimpulan: Hasil penelitian ini menunjukkan bahwa kelompok yang diberikan asam traneksamat memiliki kadar hemoglobin setelah operasi yang lebih tinggi dibanding kelompok yang tidak diberi asam traneksamat; tidak ada perbedaan kadar albumin setelah operasi pada kedua kelompok; pemberian asam traneksamat akan menurunkan jumlah kehilangan darah, menurunkan derajat nyeri, dan berkurangnya kebutuhan transfuse darah setelah operasi total knee replacement

Hemangioma Pedis and Tuberculoma Pedis Sinistra in Children

HISTORY: The girl 15 years old, had main complaint, there was a mass in her pedis since she got 2 years old, look red, no pain although in walk, size equal with the skin. The mass got bigger and pain in walk. The mass get bleedy after had crushed by stone, after that bleedy always happen when there was a contact, although soft touch. Patient had history contact with tuberculosis patient. INTERESTING POINTS FOR DISCUSSION: Tuberculoma is a mass that happened because infected bacil mycobacterium tuberculosis, hemangioma is a soft tissue mass that formed by vascular. hemangioma commonly happened in children about 4-10% in children’s tumor. It happened in a girl 3-5 more times than in a boy. Both of them are rare happen in the same time, especially in pedis. From this case, we can found both type in the same patient. SOLUTION AND RATIONALE: For this case of soft tissue tumor,we use open biopsy. After we found the result , the best treatment for hemangioma and tuberculoma of the pedis for this case is below knee amputation. FINAL OUTCOME: For this case, the best treatment is amputation, and after amputation, the patient never complain about pain anymore, she feel satisfied and overall her quality of life is improving

Hemangioma Pedis and Tuberculoma Pedis Sinistra in Children

HISTORY: The girl 15 years old, had main complaint, there was a mass in her pedis since she got 2 years old, look red, no pain although in walk, size equal with the skin. The mass got bigger and pain in walk. The mass get bleedy after had crushed by stone, after that bleedy always happen when there was a contact, although soft touch. Patient had history contact with tuberculosis patient. INTERESTING POINTS FOR DISCUSSION: Tuberculoma is a mass that happened because infected bacil mycobacterium tuberculosis, hemangioma is a soft tissue mass that formed by vascular. hemangioma commonly happened in children about 4-10% in children’s tumor. It happened in a girl 3-5 more times than in a boy. Both of them are rare happen in the same time, especially in pedis. From this case, we  can found both type in the same patient. SOLUTION AND RATIONALE: For this case of soft tissue tumor,we use open biopsy. After we found the result , the best treatment for hemangioma and tuberculoma of the pedis for this case is below knee amputation. FINAL OUTCOME: For this case, the best treatment is amputation, and after amputation, the patient never complain about pain anymore, she feel satisfied and overall her quality of life is improving