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All Journal Jurnal Anestesiologi Indonesia Bali Journal of Anesthesiology The New Ropanasuri Journal of Surgery
Zahra, Raihanita
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology 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. 
Survival Rate of Critically Ill Coronavirus Disease 2019 Patients on Tracheostomy in Indonesia Ramdhani, Aris; Aditianingsih, Dita; Zahra, Raihanita; Putra, Muhammad A; Soeharto, Wuryantoro; Kwa, Melvin D.B.
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. During COVID-19 global pandemic, tracheostomy is often performed on critically ill COVID-19 patients. There is no available data on the survival rate of critically ill COVID-19 patients on tracheostomy in Indonesia. This study aimed to find the survival rate of critically ill COVID-19 patients on tracheostomy in Indonesia. Methods. A descriptive survival analysis study enrolled critically ill COVID-19 patients in RSUI who underwent a tracheostomy procedure. Baseline data, including clinical characteristics and laboratory findings before tracheostomy, were recorded. Survival analysis was conducted using the Kaplan-Meier plot. Results. Forty-two subjects were enrolled in the study: 25 males (59.5%) and 17 females (40.5%). The median age was 57 (26 – 72) years. Subjects with diabetes mellitus or hypertension were 78.6% and 78.6% with BMI >25 kg/m2. The mean duration of intubation was 16.24 ±7.62 days, the median duration of tracheostomy before the outcome was 8 (0 – 53) days. There were 9.5% of subjects survived and were discharged. The median survival time was 8 (0 – 53). In the first 15 days after tracheostomy procedures, those who were deceased were 75% of the subjects. Conclusion. In this study, the survival rate of critically ill COVID-19 patients on tracheostomy remains low. Another study to evaluate the cause of the low survival rate of critically ill patients with COVID-19 on tracheostomy is required.
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): Jurnal Anestesiologi Indonesia (Issue in Progress)
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.
Co-Authors Dita Aditianingsih Fadhila, Fulki Ferdiana, Komang Ayu Kapuangan, Christopher Kwa, Melvin D.B. Perdana, Aries Putra, Muhammad A Rahendra, Rahendra Ramdhani, Aris Ramlan, Andi Ade Wijaya Soeharto, Wuryantoro