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All Journal Jurnal Anestesiologi Indonesia Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Anestesi Perioperatif The Indonesian Journal of Public Health Indonesian Journal of Anesthesiology and Reanimation (IJAR) Jurnal Anestesi Obstetri Indonesia Jurnal Kesehatan Tambusai Solo Journal of Anesthesi, Pain and Critical Care Journal of Anesthesiology and Clinical Research Majalah Anestesia & Critical Care (MACC) Jurnal Komplikasi Anestesi
Juni Kurniawaty Muhdar Abubakar Djayanti Sari
Departemen Anestesiologi Dan Terapi Intensif, Fakultas Kedokteran, Kesehatan Masyarakat Dan Keperawatan, Universitas Gadjah Mada, Yogyakarta|Universitas Gadjah Mada
Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Penanganan Perioperatif Pasien dengan Atrial Septal Defect Kurniawaty, Juni; Baskoro, Ronggo
Jurnal Komplikasi Anestesi Vol 3 No 2 (2016): Volume 3 Number 2 (2016)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v3i2.7240

Abstract

Atrial septal defect (ASD) adalah bentuk penyakit jantung kongenital yang paling sering didapatkan pada pasien dewasa muda setelah kelainan katup aorta bikuspid dan prolaps katup mitral. Komorbid yang paling sering didapatkan pada defek kongenital pada usia dewasa muda adalah hipertensi pulmonal, aritmia, infeksi respirasi dan penyakit kardiovaskular lainnya. Terapi optimal ASD masih kontroversial. Secara sederhana, operasi direkomendasikan pada pasien usia pertengahan dan usia tua dengan shunting kiri kekanan yang bermakna.Dilaporkan pasien perempuan usia 39 tahun dengan atrial septal defect dengan hipertensi pulmonal berat yang dilakukan operasi ASD closure dan Tricuspid Valve Repair (TVr). Persiapan preoperasi mencakup anamnesa, pemeriksaan fi sik dan pemeriksaan penunjang. Pemeriksaan penunjang preoperasi mencakup pemeriksaan kateterisasi dengan hasil reaktif terhadap test oksigen. Perubahan patologi utama adalahpeningkatan resistensi vaskuler paru dan tekanan vaskuler paru, sekunder terhadap peningkatan aliran darah dari shunt kiri ke kanan. Masalah yang dihadapi pasien perioperasi pasien ini adalah hipertensi pulmonal, dengan tekanan arteri pulmonal 2/3 tekanan darah arteri. Pasien dirawat di ICU selama 3 hari dan kemudian dipindahkan ke bangsal.
Anestesi pada Pasien Anak dengan Penyakit Jantung Kongenital Asianotik (PDA, ASD, VSD) Setiandari, Kristina; Kurniawaty, Juni; Pratomo, Bhirowo Yudo
Jurnal Komplikasi Anestesi Vol 4 No 1 (2016): Volume 4 Number 1 (2016)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v4i1.7269

Abstract

Penyakit jantung kongenital merupakan kelainan kongenital pada anak yang banyak dijumpai. Mortalitas akan meningkat pada pasien yang berusia < 6 bulan, status emergensi, lesi jantung yang kompleks dan pasien yang menjalani prosedur pembedahan mayor. Penyakit jantung kongenital yang banyak dijumpai dalampraktek sehari-hari di antaranya adalah yang digolongkan pada penyakit jantung asianotik dengan kelainan anatomi berupa atrial septal defect (ASD), ventricular septal defect (VSD) dan patent ductus arteriosus (PDA). Anestesi pada pasien anak dengan PDA, ASD dan VSD memerlukan pemahaman yang baik mengenai anatomi dan patofiologi defek yang terjadi sehingga perencanaan manajemen anestesi dapat mengoptimalkan kondisi pasien serta mengurangi mortalitas maupun komplikasi yang terkait dengan anestesi.
Manajemen Anestesi pada Operasi Revaskularisasi Miokardium yudihart, Subhan; Pratomo, Bhirowo Yudo; Kurniawaty, Juni
Jurnal Komplikasi Anestesi Vol 4 No 3 (2017): Volume 4 Number 3 (2017)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v4i3.7308

Abstract

Pada tahun 1997 di Amerika, setidaknya > 70.000 prosedur operasi jantung dilakukan tiap tahunnya, dan lebih dari 60.000 diantaranya adalah operasi coronary artery bypass grafting (CABG). Pembiusan pada operasi jantung merupakan suatu hal yang menarik sekaligus menantang bagi seorang ahli anestesi. Salah satu prinsip dasar dalam tindakan anestesi bedah revaskularisasi jantung adalah menjaga keseimbangan dua faktor penting, yakni menjaga pasokan suplai oksigen, dan menurunkan kebutuhan / demand oksigen. Persiapan pembiusan pada operasi jantung harus dilakukan dengan matang, mulai dari persiapan premedikasi, pilihan obat yang harus diberikan atau dihentikan, persiapan monitor baik invasif maupun non invasif. Induksi dilakukan dengan pengawasan monitor dan gejolak hemodinamik yang signifikan sebisa mungkin dihindari dengan pemilihan obat dan penyesuaian terhadap pasien. Setelah teranestesi, pasien yang mengalami prosedur opersi revaskularisasi koroner konvensional harus mengalami proses shunting aliran darah dengan alat cardiopulmonary bypass (CPB) yang bertujuan agar aliran darah dari seluruh tubuh tidak melewati aliran jantung paru. Menjelang operasi selesai, penyapihan CPB perlu dilakukan agar mendapatkan hasil postoperasi yang baik. Beberapa teknik dikembangkan untuk mengurangi lama waktu rawat operasi jantung koroner, yakni teknik fastrack dan offpump coronary artery bypass (OPCAB).
Manajemen Preoperatif pada Protokol Enhanced Recovery After Surgery (Eras) Anindita, Mohammad Pradhana; Kurniawaty, Juni; Sudadi
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i2.7327

Abstract

Surgery and trauma stimulate metabolic, hormonal, haematological, immunological complex response and activate sympathetic nerve systems. Generally, stress response induced by surgery may causes dangerous impacts. Enhanced Recovery After Surgery (ERAS) is multimodal and multidisciplinary perioperative management approach designed for minimizing stress response, patient complication, length of hospital stay, and enhancing patient recovery. ERAS protocol or pathway includes preoperative, intraoperative, and postoperative management. ERAS preoperative management is started at preadmission phase. Preadmission management includes patient and family education and counseling, alcohol and smoking cessation, nutritional screening, patient’s health condition optimizing and coexist disease medication optimizing. Preoperative management includes carbohydrate treatment, fasting protocol, preoperative antibiotic prophylaxis, preoperative thromboembolic prophylaxis, and prophylaxis against nausea and vomit.
Manajemen Peripartum pada Pasien Sindrom Eisenmenger Kurniawaty, Juni
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i3.7339

Abstract

Eisenmenger’s syndrome is the most severe form of pulmonary hypertension associated with congenital heart defects. Maternal mortality rates in female patients with Eisenmenger syndrome are still very high (30-50%). The main causes of death are hypovolemia, thromboembolism and preeclampsia. Pregnancy should be avoided in women with Eisenmenger syndrome because of high maternal mortality and a poor prognosis for babies. Epidural has been proven to be preferred for the delivery of labor and cesarean section in pregnant women with Eisenmenger syndrome. A 30-year-old woman with a 32-week pregnancy was diagnosed with Eisenmenger’s syndrome. She was diagnosed with congenital heart disease during antenatal care, she was never diagnosed with congenital heart disease before. Blood pressure examination was obtained 110/75 mmHg, heart rate 82 times per minute, respiratory rate 18-20 times / minute, with oxygen saturation 80-84% using nasal cannula 3 liters / minute. An L4-5 epidural catheter was placed with a catheter tip in L1. Intermittent Epidural Labor Analgesia (ELA) uses ropivacaine 0.0625% + fentanyl 0.125 mcg 5 cc, which is adjusted to the delivery process. During stable hemodynamic delivery with VAS 0. The main goal of handling Eisenmenger’s patients is to minimize pulmonary vascular resistance (PVR), and decrease systemic vascular resistance (SVR) and reduce catecholamine release. To maintain a balance between epidural effects on SVR and PVR, we use a combination of low concentrations of ropivacaine and opioids.
Manajemen Perioperatif pada Pasien dengan Sindrom Brugada Kurniawaty, Juni; Widyastuti, Yunita; Ridha, Ihsanur
Jurnal Komplikasi Anestesi Vol 6 No 3 (2019): Volume 6 Number 3 (2019)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v6i3.7360

Abstract

Background: Brugada syndrome is a congenital disease characterized by Right Bundle Branch Block(RBBB) with an increase in the ST segment in the right precordial sadapans and is associated with suddendeath and lethal arrhythmias. Brugada syndrome is reported to be responsible for 4% of all sudden deaths and 20% of sudden deaths in those who do not suffer from structural heart disease and is the sadapaning cause of death in subjects under the age of 40 years. We reported a 40 years-old man with diagnosis of SO Filled Eye OD and was planned to underwent an OD Evacuation SO. There was Brugada ECG type 2 in this patient without any history and clinical symptoms of Brugada. Anesthesia was carried out with GA LMA Supreme No. 4 and induction of anesthesia with Sevoflurane inhalation agents. Monitoring during operations with 5 sadapan ECGs, NIBP, SpO2 and IOC. Patient’s hemodynamics during surgery was managed to be stable without any turmoil that can cause arrhythmias and VT VF. After the operation, monitoring in the recovery room was carried out for 4 hours and after being stabilized returned to the ward.
Monitoring Hemodinamik Non Invasif Perioperatif Kurniawaty, Juni; Pratomo, Bhirowo Yudo; Khoeri, Fatkhur Roofi
Jurnal Komplikasi Anestesi Vol 7 No 1 (2019): Volume 7 Number 1 (2019)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i1.7377

Abstract

In perioperative medicine, hemodynamic management aims at an optimization of perfusion pressure and oxygen delivery in order to maintain or restore adequate cellular metabolism. To optimize cardiopulmonary function, hemodynamic management triggers the administration of fluids and vasoactive agents according to predefined target values of hemodynamic variables. Besides basic hemodynamic variables (blood pressure and heart rate), include advanced hemodynamic variables such as pressure- or volume-based cardiac preload variables, dynamic cardiac preload variables, and blood flow variables (stroke volume, cardiac output). A variety of invasive, less-invasive, and non-invasive hemodynamic monitoring technologies are nowadays available to assess hemodynamic variables in the operating room or the intensive care unit.
Manajemen Anestesi pada Seksio Sesar Pasien G5P4A0 dengan Severe Pulmonal Stenosis Uyun, Yusmein; Kurniawaty, Juni; Daniswara
Jurnal Komplikasi Anestesi Vol 7 No 1 (2019): Volume 7 Number 1 (2019)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i1.7378

Abstract

Pada pasien ini terdapat PS severe dan TR moderate yang menunjukan bahwa PS severe sudah cukup lama, tetapi tidak ada manifestasi klinisdari pasien, hanya ditemukan bising jantung saat dilakukan auskultasi dan tidak ada limitasi aktifitas pasien. Target hemodinamik pada pembiusan pasien dengan PS dan TR hampir sama, sehingga target tersebut digunakan untuk membius pasien seperti pada kasus ini yaitu dengan menjaga preload tinggi, heart rate tinggi, kontraktilitas normal, SVR normal, dan PVR normal rendah. Pemilihan pembiusan dari beberapa literatur menyebutkan bahwa dapat dilakukan dengan anestesi umum maupun regional dengan targettarget hemodinamik seperti diatas. Persiapan obatobatan untuk menjaga target hemodinamik juga harus ada sebelum operasi, bisa juga diberikan profilaksis seperti pada suatu case report yang sudah disebutkan diatas untuk menjaga SVR tetap normal.
Hubungan Antara Neutrophyl-Lymphocyte Ratio dan Kadar Prokalsitonin Plasma pada Pasien Sepsis yang Dirawat di Ruang Intensif RSUP Dr Sardjito Wibowo, Erry Alamsyah Asjhuri; Kurniawaty, Juni; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7446

Abstract

Background: The immune response of leukocytes to physiological stresses such as tissue damage, severe trauma, major surgery and sepsis is characterized by increased neutrophil levels and decreased lymphocyte levels. In pathological conditions due to severe infection or systemic inflammation, the NLR will increase, so that NLR can be used for clinical evaluation in patients with systemic inflammation. This study aims to determine whether there is a correlation between alteration of Neutrophyl-lymphocyte ratio and plasma procalcitonin as a parameter of infection severity in sepsis patients treated in intensive care RSUP Dr Sardjito. Methods: Prospective observational correlation study. The study was conducted in Intensive care RSUP Dr. Sardjito Yogyakarta for 5 months (starting June 2019). Subject: 29 patients of sepsis admitted to intensive care RSUP dr. Sardjito on June-October 2019. Results: Positive correlations between Neutrophil-lymphocyte ratio and plasma procalcitonin on day 0, day 1 and day 3 of observations, r=0,220 (very weak), r=0,389 (moderate), and 0,065 (very weak). Positive significant correlation was found on day 1 of observation. Meanwhile, on analysis between Neutrophillymphocyte ratio and plasma procalcitonin, Positive correlations were obtained on day 0-1, day 1-3 and day 0-3 of observations, r = 0.159 (very weak), r = 0,450 (moderate) and 0,235 (very weak). The significant positive correlation (p<0.05) was found in alterations between day 1-3. Conclusion: There were no strong correlations between Neutrophyl-lymphocyte ratio and plasma procalcitonin in sepsis patients treated at ICU RSUP Dr Sardjito on day 1 of observation.><0.05) was found in alterations between day 1-3. Conclusion: There were no strong correlations between Neutrophyl-lymphocyte ratio and plasma procalcitonin in sepsis patients treated at ICU RSUP Dr Sardjito on day 1 of observation.
Manajemen Perioperatif Pasien Insulinoma dengan Komorbid Epilepsi Adiyanto, Bowo; Kurniawaty, Juni; Pambudi, Estu Agung
Jurnal Komplikasi Anestesi Vol 7 No 3 (2020): Volume 7 Number 3 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i3.7473

Abstract

Insulinoma is a rare benign functional neuroendocrine in pancreas. Inappropriate secretion of insulin in patient with insulinoma results in hypoglycaemic episode with clinical symptoms. Meanwhile, epilepsy is a manifestation of brain disorder with a variety of clinical symptoms, cause by the release of electrical charges from brain neuron. We reported a 50 years old man with insulinoma which was planned for laparoscopic tumor resection. Patient also have epilepsy as a comorbid. The choice of anesthesia technique is intubation general anesthesia. Hypoglycemia is the main problem that can happen in preoperative and intraoperative period, so blood glucose was monitored every 30 minutes. Anesthesia consideration in this patient was avoiding hypoglycemia in preoperative and intraoperative period and avoiding proconvulsan anesthetic agent because the patient also have epilepsy as comorbid.
Co-Authors . Supomo Akhmad Yun Jufan Alqustar, Adam Ancilla, Cornelia Anindita, Mohammad Pradhana Baskoro, Ronggo BHIMO PRIAMBODO Bhirowo Yudo Pratomo Bowo Adiyanto Budi Yuli Setianto Calcarina Fitriani Retno Wisudarti Cindy Elfira Boom Cornelia Ancilla Daniswara Dewi, Baiq Dessy Resmana Djayanti Sari Fadinie, Wulan Fatmi Eka Putri Gentong, Metia Gledis Gilang Hartiah Haroen Herdono Poernomo Hermawan, Hendra Joni, Rendy Pranda Khoeri, Fatkhur Roofi Kurniaji Kurniaji Kusuma, Danur Adi Kusumandaru , Novierta Prima Meta Restu Synthana Muhammad Mufti Sofyanoor Muhdar Abubakar Novita Intan Arovah Nurdiansyah, Elba Oktavian Rizki Ilahi Pambudi, Estu Agung Parna, Dian Raseka Prandani, Muhammad Yogi R W, Calcarina Fitriani Rani, Hajar Rafika Ratih Kumala Fajar Apsari Rayhandika Ridha, Ihsanur Rifdhani Fakhrudin Nur Rifdhani Fakhrudin Nur Sadewo, Yuri Sari, Dhanty Dwita SATRIYAS ILYAS Setiandari, Kristina Sofwan, Fachruddin Stanie, Shianita Sudadi Utomo, F uad Cipto Wardhana, Ardyan Wardhana, Ardyan Prima Wibowo, Erry Alamsyah Asjhuri yudihart, Subhan Yunita Widyastuti Yusmein Uyun