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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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Manajemen Anestesi pada Seksio Sesaria dengan Hipotiroid Kurniawaty, Juni; Adiyanto, Bowo; Joni, Rendy Pranda
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.v7i3.7474

Abstract

Thyroid disease is a disorder that affects the thyroid gland. Thyroid hormones regulate metabolism and affect nearly every organ in the body. The management of anesthesia on the hypothyroid is crucial and consist of preoperative, intraoperative, and postoperative management. We reported a 36-year-old female patient with multigravida and hypothyroid on therapy, which would performed sectio caesarea. Patient had hypothyroid and consumed levothyroxine since a year earlier. Spinal regional anesthesia with low doses was administered and sedation was neither prescribed before nor during surgery to maintain hemodinamic stability. A pregnant women with hypothyroidism need special management of anesthesia. Hypothyroid patients are very sensitive to anesthetic drugs so that preoperative sedation should be avoided. During intraoperation, surveillance of haemodynamics must be strict because hypothyroidism can trigger refractory hypotension. Sedation drugs should not use both in preoperative and intraoperative period.
Perawatan Pascaanestesi pada Resipien Transplantasi Ginjal Kurniawaty, Juni
Jurnal Komplikasi Anestesi Vol 8 No 1 (2021): Volume 8 Number 1 (2021)
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.v8i1.7489

Abstract

Renal transplantation is a principal therapy for end stage renal disease. Renal transplantation can decrease mortality and improve recipient quality of life substantially. However, immunosuppressant therapy and comorbid disease in those patients make perioperative management challenging. A good urine output is a usual sign of good allograft function. Postoperatively, recipient should have a slight positive fuid balance and higher blood pressures to maintenance adequate posttransplanted organ perfusion. Fluid replacement should consider urine output, insensible water loss dan volume status of the recipient. Goal of the management is to reduce fuid replacement gradually while maintain hemodynamic stability
Anestesi Inhalasi dengan Teknik Low Fresh Gas Flow Pratomo, Bhirowo Yudo; Kurniawaty, Juni; Kusuma, Danur Adi
Jurnal Komplikasi Anestesi Vol 10 No 2 (2022)
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.v10i2.8292

Abstract

Any technique that employs a fresh gas flow that is less than the alveolarventilation can be classified as low-flow anesthesia. The complexities involvedin the calculation of uptake of anesthetic agents during the closed-circuitanesthesia made this technique less popular. However, the awareness of thedangers of operating theatre pollution with trace amounts of the anestheticagents and the prohibitively high cost of the new inhalational agents, havehelped in the rediscovery of low-flow anesthesia.
Manajemen Extracorporeal Membrane Oxygenation (ECMO) pada Pasien COVID-19 Derajat Kritis Synthana, Meta Restu; Kurniawaty, Juni; Wisudarti, Calcarina Fitriani Retno
Jurnal Komplikasi Anestesi Vol 10 No 2 (2022)
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.v10i2.8304

Abstract

We reported 42 years old male patient with weight 84 kg, height 167 cm, and BMI of 30.1 kg/m2 with a diagnosis of severe COVID-19 and ARDS. The patient was previously known to have comorbids of type 2 DM, stage 1 hypertension, cardiac arrhythmias, and grade 1 obesity. On the 7th day of care, the patient clinically and radiologically worsened and we decided to intubate and support with mechanical ventilation. An ECMO indication was assessed, the patient was indicated to have ECMO, so that ECMO was installed immediately after the patient was intubated. ECMO was successfully running 7 hours after the patient was intubated. During hospitalized the patient also received renal replacement therapy, hemadsorption therapy, and plasma exchange. The patient deceased on 31st day of ECMO.
Manajemen Anestesi Pasien dengan Low Ejection Fraction yang Menjalani Operasi Tumor Ovarium Pratomo, Bhirowo Yudo; Kurniawaty, Juni; Sari, Dhanty Dwita
Jurnal Komplikasi Anestesi Vol 10 No 2 (2022)
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.v10i2.8305

Abstract

Anesthetic management of patients with dilated cardiomyopathy (DCM) is a challenge to the anesthesiologist, due to poor left systolic function, ventricular enlargement, risk of malignant arrhythmias and sudden cardiac death. Therefore, preoperative assessment and appropriate anesthetic management are important in patients with DCM. Patients with a low EF <35% may be at risk for life-threatening irregular heart rhythms. Any arrhythmia in these patients requires immediate treatment because otherwise it can lead to sudden cardiac arrest and sudden death. In summary, the optimal anesthetic management of patients with dilated cardiomy- opathy requires good preoperative assessment, close perioperative monitoring, suitable anesthetic, optimization fluid management, and stable hemodynamic status.
Manajemen Anestesi pada Pasien Hamil G1P0 UK 26 Minggu Yangmenjalani Craniotomy Removal Tumor Fossa Posterior Sudadi; Kurniawaty, Juni; Utomo, F uad Cipto
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
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.v10i1.8322

Abstract

Brain tumor during pregnancy are very rare and presents several challenges to the neurosurgeons, obstetricians and anaesthesiologist in not only establishing the diagnosis, but also in the perioperative management as it requires a careful plan to balance both maternal and fetal well-being. We report the anaesthetic management of a 26-week pregnant patient with brain tumor meningioma. As the patient was 26 weeks pregnant with sign and symptoms of raised intracranial pressure (ICP) with progressive neurological deficits, not manageable with drugs, elective craniotomy was planned for decompression of the brain tumor. We held a multidisciplinary meeting before the operation and made a detailed plan for how to proceed. During the operation, our team ensured intensive monitoring, provided adequate oxygen and achieved hemodynamic stability. Anaesthetic drugs like fentanyl, rocuronium, propofol and sevoflurane were carefully chosen in order to ensure the safety of both the mother and fetus. Under the careful and successful anaesthetic management, the patient underwent the surgery smoothly neither the mother nor baby experienced pre- or post-operative complications. Neurosurgeries in pregnancy are sparse, and careful planning with cross-disciplinary specialist was need in advanced of the operation. Moreover, when dealing with such surgeries, we should consider the safety of both the mother and fetus, which challenging but important.
Hubungan Kadar Awal D-Dimer Terhadap Mortalitas pada Pasien COVID-19 Di RSUP Dr. Sardjito Alqustar, Adam; Kurniawaty, Juni; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
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.v10i1.8325

Abstract

In severe COVID-19 infection, the immune response can be exaggerated andcause a systemic cytokine storm that triggers systemic inflammatory responsesyndrome (SIRS). Excessive systemic inflammatory response can lead to systemicendothelial injury (endotheliopathy) and a hypercoagulable state that increasesthe risk of systemic macrothrombosis and microthrombosis. D-dimers arereleased when plasmin, a fibrinolytic enzyme, breaks down fibrin and is areflection of the endovascular thrombosis process. Assessment of circulating Ddimer concentrations is a sensitive test for diagnosing thrombotic status(including pulmonary embolism and DIC) and predicting mortality event inpatient contracted with COVID- 19
Validasi National Early Warning Score 2 (News2) Dewasa untuk Memprediksi Mortalitas Pasien COVID-19 di RSUP. Sardjito Yogyakarta Sofwan, Fachruddin; Kurniawaty, Juni; Adiyanto, Bowo
Jurnal Komplikasi Anestesi Vol 9 No 3 (2021)
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.v9i3.8335

Abstract

Latar belakang: Skoring untuk menilai risiko klinis dan mortalitas pasien dengan Coronavirus Disease 2019 (COVID-19) masih jarang dilakukan. Angka mortalitas yang tinggi pada pasien COVID-19 memerlukan intervensi segera dari tindakan penanganan COVID-19. Untuk memberikan intervensi yang sesuai dibutuhkan skor risiko klinis agar penanganan yang diberikan lebih tepat. National Early Warning Score 2 (NEWS2) dapat digunakan sebagai dasar logis untuk memprediksi mortalitas pasien di rumah sakit melalui observasi tanda-tanda vital. Tujuan: Untuk melakukan validasi terhadap NEWS2 dewasa dalam memprediksi angka mortalitas pasien COVID-19 di RSUP Sardjito Yogyakarta. Metode: Penelitian ini menggunakan rancangan penelitian observasional kohort retrospektif. Sampel pada penelitian ini adalah semua kasus konfirmasi COVID-19 yang dirawat di RSUP Dr. Sardjito Yogyakarta serta memenuhi kriteria inklusi dan eksklusi yang diambil dari 1 Maret 2020 sampai dengan 31 Oktober 2020. Hasil: Total sampel yang digunakan pada penelitian ini adalah 302 pasien dengan jumlah pasien yang meninggal dunia sebanyak 87 orang. Penilaian validasi total NEWS2 dalam memprediksi mortalitas pasien COVID-19 menggunakan tes diskriminasi dengan kurva ROC menunjukkan 0,824 CI 95% (0,762-0,886) dimana hasil ini termasuk dalam diskriminasi yang baik. Dari penilaian kalibrasi menggunakan Hosmer and Lemeshow test didapatkan nilai p=0,094 (>0,05) yang berarti total NEWS2 memiliki reliabilitas yang baik. Simpulanꓽ NEWS2 dapat digunakan dalam penilaian risiko klinis pasien dengan COVID-19 karena memiliki tes diskriminasi dan kalibrasi yang baik.
Manajemen Operasi Pasien Obstetri pada Operasi Non-Obstetri Kurniawaty, Juni; Fajar, Ratih Kumala; Hermawan, Hendra
Jurnal Komplikasi Anestesi Vol 9 No 3 (2021)
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.v9i3.8339

Abstract

Background: Breast cancer is the most common malignancy in women, but it rarely occurs as a comorbidity in pregnant women. Although it is rare, its occurrence is currently increasing worldwide. This trend is also occurring in Indonesia, where more than 80% of non-pregnant women are diagnosed with latestage breast cancer. Method: We report the female patient Mrs. A is 33 years old, diagnosed with G3P2A0, 21 weeks of gestation with Ca mammae and will be planning a Modified Radical Mastectomy (MRM). The patient had never received chemotherapy or other treatment. We report female patient Mrs. The age of 33 years diagnosed G3P2A0, 21 weeks gestation with Ca mammary and will be planning a Modified Radical Mastectomy (MRM). The patient has never received any medication or other treatment. The patient has had an MRM procedure on June 29, 2021, with GA LMA anesthesia with attention to the physiology of the mother and fetus. Things that need to be considered are preoperative consultation with related sections (obstetrics and surgical oncology), provision of aspiration prophylaxis, drug selection, monitoring of maternal and fetal vital signs, providing adequate analgesia . Discussion: The action taken on the patient is a radical modification of mastectomy, with an surgical and anesthetic technique approach that is expected to reduce the effect on the fetus in intraoperatively. Conclusion: Anesthesiologists understand that pregnancy alters maternal anatomy and physiology to support fetal growth, but does not prevent the mother from developing pathologies that may require operative correction. The decision to operate should be postponed if possible, to avoid risks to the mother and fetus
Perbandingan Efektivitas Anestesi Spinal Menggunakan Levobupivakain Isobarik 0,5% 7,5 Mg Dibandingkan Levobupivakain Isobarik 0,5% 10 Mg pada Pasien Kanker Serviks yang Menjalani Brakiterapi Intrakaviter di RSUP Dr. Sardjito Rani, Hajar Rafika; Pratomo, Bhirowo Yudo; Kurniawaty, Juni
Jurnal Komplikasi Anestesi Vol 8 No 2 (2021): Volume 8 Number 2 (2021)
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.v8i2.8359

Abstract

Background: Levobupivacaine is an S-enantiomer of bupivacaine, has a similar effect but less cardiotoxic than bupivacaine. The aim of this study was to evaluate the effectiveness of 7,5 mg levobupivacaine compared with 10 mg levobupivacaine in terms of sensory block, motor, recovery, and the incidence of hypotension in intracavitary brachytherapy. Methods: A prospective, randomized, single-blinded study with inclusion criteria: ASA I-II, 140-165 cm of height, 18-65 years, BMI <30 kg/m2. One hundred fifteen samples were randomized and divided into 2 groups: 0,5% isobaric levobupivacaine 7,5 mg and 10 mg. Results: In both groups, there were no significant differences for sensory block height reaching T10 and the incidence of hypotension (p> 0.05), there were significant differences for the onset, the duration of sensory block, bromage score, and recovery time (p <0.005). The 7,5 mg levobupivacaine group and 10 mg levobupivacaine group had 18±16 minutes and 15±20 minutes for sensory blockonset (p=0,009) in which it was not clinically significant. The 7,5 mg levobupivacaine group and 10 mg levobupivacaine group had 128±26 minutes and 152±39 minutes for sensory block duration (p=0,005), both groups sensory block duration was sufficient for brachytherapy (97±39 minutes). The 7,5 mg levobupivacaine group and 10 mg levobupivacaine group had 107±28 minutes dan 148±24 minutes for recovery (p=0,000). Both groups had no hypotension. Clinically, intracavitary brachytherapy worked well with sensory block heights <T10 and bromage scores <2. Conclusion: Spinal anesthesia with levobupivacaine 7.5 mg group was as effective as10 mg levobupivacaine group for cervical cancer patients who underwent intracavitary brachytherapy.
Co-Authors . Supomo Akhmad Yun Jufan Alqustar, Adam Ancilla, Cornelia Anindita, Mohammad Pradhana Baskoro, Ronggo 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 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 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 Sudadi Utomo, F uad Cipto Wardhana, Ardyan Wibowo, Erry Alamsyah Asjhuri yudihart, Subhan Yunita Widyastuti Yusmein Uyun