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All Journal Jurnal Anestesiologi Indonesia Bali Journal of Anesthesiology Majalah Anestesia dan Critical Care Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia
Perdana, Aries
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health Other

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The effectivity of ear plug utilization on emergence delirium incidence in pediatric patient undergoing general inhalated anesthesia Perdana, Aries; Kapuangan, Christopher; Zahra, Raihanita
Bali Journal of Anesthesiology Vol 3, No 2 (2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (198.556 KB) | DOI: 10.15562/bjoa.v3i2.159

Abstract

Background. Emergence Delirium (ED) also known as emergence agitation, is a postoperative condition characterized by aberrant cognitive and psychomotor behaviors such as agitation, irritable, uncompromising, uncooperative, inconsolably crying following general anesthesia. The incidence of ED in pediatric patients in Dr. Cipto Mangunkusumo hospital was 39,7%. During emergence state, auditory stimulation induces thalamic synapse in lateral amygdala which leads to over response of fear (one of the risk factor of ED). A high noise level in operating room can be reduced with ear plug application to the patient. Design and Method. A double blind randomized clinical trial towards 1-5 years old pediatrics who underwent inhalation general anesthesia in Dr. Cipto Mangunkusumo hospital from September-December 2018. One hundred and seven subjects were randomized after a consecutive sampling into two groups. Earplug group (n=53) with application of ear plug at the end of surgery, while in control group (n=54) without application of ear plug. The incidence of ED and time to extubation were recorded. ED was measured using Pediatric Anesthesia Emergence Delirium (PAED) scale. All the data was analyzed using multivariate logistic regression and ANCOVA. Result. Incidence of ED in ear plug group was 16.7% while in control group was 32.1% (OR = 0.402; CI 95% 0.152-1.062; p=0.066). Mean value of time to extubation in ear plug vs control group (5.76+3.23 minutes) vs (6.54+ 3.67 minutes) with mean difference of 0.825(0.530-2.180); p=0.230. Conclusion. Ear plug application at the end of anesthesia was not statistically effective. However, it was clinically effective in reducing the incidence of ED in pediatric patient underwent inhalation anesthesia. 
Construct Validity and Reliability of The Amsterdam Preoperative Anxiety and Information Scale (APAIS) Indonesian Version Perdana, Aries; Firdaus, Muhammad Fikry; Kapuangan, Christopher; , Khamelia
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
Publisher : Perdatin Pusat

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Preoperative anxiety has a significant effect on anesthesia and surgery. Currently there is no specific instrument for measuring preoperative anxiety in Indonesian population. APAIS have been used worldwidely to measure preoperative anxiety. APAIS instrument has been used widely to measure preoperative anxiety. The purpose of this study was to obtain the validity and reliability of APAIS instrument in Indonesia. This cross-sectional study enrolled 102 patients in Cipto Mangunkusumo Hospital who underwent elective surgery to answer the Indonesian APAIS one day before operation. The translation utilized backward and upward approach. Following ethic approval, the subjects filled the APAIS instrument one day before the surgery. Construction validity was measured by factor analytic method. The internal consistency was evaluated by Cronbach?s alpha. A total 102 patient (42 men and 60 women) enrolled in this study. Factor analysis showed anxiety scale and similar information in comparison to the original instrument. High reliability Cronbach?s alpha anxiety and need for information scale Indonesian APAIS respectively 0,825 and 0,863. The APAIS scales were independent of sex, previous surgery, type of operation or type of anesthesia. Indonesian APAIS proved to be reliable and valid instrument to measure preoperative anxiety in Indonesian population.
Colorado Pediatric Airway Score (COPUR) as a Predictor of Intubation Difficulty in Children Aged 1-8 Years Kapuangan, Christopher; Perdana, Aries; Fadhila, Fulki; Ramlan, Andi Ade Wijaya; Zahra, Raihanita; Ferdiana, Komang Ayu; Rahendra, Rahendra
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 2 (2025): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.70707

Abstract

Background: Airway management is critical in pediatric anesthesia, as failure can lead to severe complications, including cardiac arrest. Anticipating and preparing for difficult intubation is essential, particularly in children with unique anatomical and physiological characteristics. The Colorado Pediatric Airway Score (COPUR) is a predictive tool for assessing intubation difficulty in pediatric patients.Objective: This study evaluates the validity of COPUR in predicting difficult intubation in children.Methods: A cross-sectional diagnostic study was conducted on 121 pediatric patients (aged 1–8 years) undergoing general anesthesia at Cipto Mangunkusumo Hospital. COPUR assesses jaw structure, mouth opening, prior intubation history, uvula visibility, neck movement, and additional modifying factors (macroglossia, obesity, mucopolysaccharidosis, and protruding teeth). A COPUR score >7 was used to predict difficult intubation, while intubation difficulty was defined by an Intubation Difficulty Score (IDS) >5.Results: A COPUR score ≥8 predicted difficult intubation in 15.7% of patients, whereas actual difficult intubation occurred in 9.92%. A COPUR threshold of ≥7 provided optimal sensitivity (83.3%) and specificity (61.47%), outperforming the original cutoff of 8 (50% sensitivity, 87% specificity). The score demonstrated good discriminative ability (AUC-ROC: 0.770, 95% CI: 0.685–0.842) and suitable calibration (Hosmer-Lemeshow test, p = 0.584).Conclusion: The COPUR score is a valid tool for predicting difficult intubation in pediatric patients aged 1–8 years, demonstrating fairly good discrimination and calibration values.
Prediktor Kesulitan Intubasi: Perbandingan Antara Rasio Tinggi Badan Terhadap Jarak Tiromental, Skor Mallampati Dan Jarak Tiromental Firdaus, Riyadh; Perdana, Aries; Effendi, Rinal
Majalah Kedokteran Indonesia Vol 73 No 1 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.1-2023-813

Abstract

Introduction: The Mallampati score and thyromental distance (TMD) are frequently used to identify challenging laryngoscopies, but their reliability in predicting difficulty is uncertain. This study aims to assess the effectiveness of using the ratio of height to thyromental distance (RHTMD) in predicting difficult visualization of the larynx (DVL) when compared to the Mallampati score and TMD.Method: To achieve this goal, 277 patients who received general anesthesia during elective surgery were evaluated using the Mallampati score, TMD, and RHTMD. The Cormack and Lehane (CL) classification was used to grade the laryngeal view, with CL grade 3 and 4 indicating difficult visualization. The study then determined and compared the area under the curve (AUC), sensitivity, and specificity for each airway predictor.Results: The AUC of RHTMD (85.5%) was better than TMD (82.7%) and significantly better than the Mallampati score (61.4%).Conclusion: RHTMD is more accurate in predicting difficult laryngoscopy than both the Mallampati score and TMD.
Co-Authors , Khamelia Fadhila, Fulki Ferdiana, Komang Ayu Firdaus, Muhammad Fikry Firdaus, Riyadh Kapuangan, Christopher Rahendra, Rahendra Ramlan, Andi Ade Wijaya Rinal Effendi Zahra, Raihanita