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All Journal Jurnal Anestesiologi Indonesia Jurnal Anestesi Obstetri Indonesia Jurnal Neuroanestesi Indonesia Jurnal Komplikasi Anestesi
Ratih Kumala Fajar Apsari
Departemen Anestesiologi Dan Terapi Intensif, Fakultas Kedokteran, Kesehatan Masyarakat Dan Keperawatan, Universitas Gadjah Mada, Yogyakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Penatalaksanaan Intensif Badai Thyroid pada Wanita Hamil Jufan, Akhmad Yun; Apsari, Ratih Kumala Fajar; Apriyanto
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.v7i1.7381

Abstract

Anesthesia management was conducted in a case of female 33 years old with G4P2A1, 35 weeks of pregnancy, type I respiratory failure, suggestive Thyroid Storm, CAP, anemia, and hypoalbuminemia. In emergency admission, patient was found dyspneic, agitated, measured BP is 117/60 mmHg, HR 153 x/min, RR 35 x/min, temperature 37,8oC, no wheezing or rales in physical examination. From ECG evaluation was STC 148 x/min, AF RVR. According to Burch and Wartofsky scoring, obtained score is 60, from temperature (score 5), tachycardia ≥140 (score 25), AF (score 10), agitated (score 10), and pregnancy as a precipitating factor (score10). Thyroid crisis can be diagnosed if scoring more than 45 points. The patient was intubated, and connected to mechanical ventilation, and admitted to HCU. In HCU, the patient was given supportive therapy, invasive monitoring such as CVC and parenteral nutrition. Causative therapy such as antibiotic administration, lugol, PTU, corticosteroid and propanolol were also given. During HCU admission, patient’s condition had not improved because of gravis anemia, after 3 days in HCU, patient was moved to ICU admission for 5 days, in 4th day of ICU admission, pregnancy was terminated, and in 5th day, patient was moved to maternal ward.
Anestesi pada Pembedahan Non-Obstetri dalam Kehamilan Apsari, Ratih Kumala Fajar; Uyun, Yusmein; Suryasaputra, Wahyu
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.v7i1.7392

Abstract

Non-obstetric surgery during pregnancy posts additional concerns to anesthesiologists. The chief goals are to preserve maternal safety, maintain the pregnant state and achieve the best possible fetal outcome. The choice of anesthetic technique and the election of appropriate anesthetic drugs should be guided by indication for surgery, type, and site of the surgical procedure. Anesthesiologist must consider the effects of the disease process itself and inhibit uterine contractions and avoid preterm labour and delivery. Fetal safety requires avoidance ofpotentially dangerous drugs and assurance of continuation of adequate uteroplacental perfusion. Until date, no anesthetic drug has been shown to be clearly dangerous to the human fetus. The decision on proceeding with surgery should be made by multidisciplinary team involving anesthesiologists, obstetricians, surgeons and perinatologists. This referral aims to discuss the physiological changes of pregnant patients who will undergo non-bstetric surgery and anesthesia management for non-obstetric operations of pregnant patients.
Efek Pemberian Premedikasi Deksametason Terhadap Durasi Rokuronium Dibanding Placebo pada Anestesi Umum Intubasi Adi, Danis Woro Kuncoro; Uyun, Yusmein; Apsari, Ratih Kumala Fajar
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.v7i2.7447

Abstract

Background: Dexamethasone is often used as prevention and treatment for postoperative nausea and vomiting, reducing the severity of postoperative pain and analgesic requirements. The study of dexamethasone effects on the rocuronium duration might be beneficial in patients who have contraindications to neostigmine or atropine reversal. Purpose: To evaluate the relation between rocuronium duration with dexamethasone premedication compare with placebo in patient with general anesthesia intubation procedure with rocuronium neuromuscular blocking agent in GBST RSUP Dr. Sardjito. Methods: An experimental research design, randomized clinical trial with double blind. The sample was chosen using the non-probability sampling method in a consecutive manner in 3 months. Sample was divided into two groups: group receiving dexamethasone premedication and group receiving placebo NaCl 0.9%. Time monitoring starts after the TOF shows the number 0 until it reaches TOF 0.9. Results: The study was conducted on 58 research subjects. Numeric data was analysed using independent T test and categorical data was analysed using chi square. Dexamethasone premedication was found to reduce the duration of rocuronium with the time needed to reach TOF 0.9 was 111±14.33 minutes compared with 123±14.57 minutes in the placebo group (P = 0.003). Conclusion: Dexamethasone premedication shortens the duration of rocuronium compared to the administration of placebo under intubation general anesthesia.
Manajemen Anestesi pada Seksio Sesaria Emergensi dengan Kelainan Faktor Koagulasi Uyun, Yusmein; Apsari, Ratih Kumala Fajar; Hendra, Maijoni
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.v7i3.7476

Abstract

The selection of anesthesia techniques for caesarian section is determined by various factors, namely the indication of the operation, the choice of the patient and surgeon, and the technical ability (skill) of the surgeon. Clinical evaluation of patients with coagulopathy is very important to determine the anesthetic technique. Clinical evaluation must be individualized, taking into account the risks and benefits of anesthesia techniques. The risk of spinal hematoma or epidural in patients has not been completely eliminated, but it remains a factor that must be considered individually in determining whether neuraxial anesthesia is appropriate for that patient.
Seksio Sesarea pada Wanita G3P2A0 Hamil 34 minggu dengan Preeklamsia Berat dan Perdarahan Intraserebral Spontan Apsari, Ratih Kumala Fajar; Rahardjo, Sri; Gunawan, Fanny
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.v8i1.7492

Abstract

A 32-year-old woman, G3P2A0, at 34 weeks of gestation came to Sardjito hospital emergency department with complaints of not being able to speak and right limb weakness since 8 hours before entering the hospital. Patient have hypertension since before pregnancy. CT-scan result obtain bleeding in the parietal lobes sinistra and basal nuclei with a bleeding volume 60 cc accompanied by midline shifting. Patient was diagnosed with superimposed severe preeklamsia, coma cum dekstra lateralization, and spontaneous intracerebral hemmorhage. Section cesarean and craniectomy hematoma evacuation then was performed. Postoperatively, patient was treated in the ICU and then transferred to the stroke unit.
Manajemen Anestesi pada Pasien Tricuspid Absent (Free Flow) yang Menjalani Operasi Labioplasti Fajar, Ratih Kumala; Wisudarti, Calcarina Fitriani Retno; Utomo, Wandito Gayuh
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.v9i3.8338

Abstract

Approximately 750,000-1,000,000 pediatric and adult patients with congenital heart disease undergo non-cardiac surgery. This requires anesthetic manajement that will adapt to the congenital heart disease defect, the degree of cardiopulmonary abnormalities and the type of surgical procedure planned and postoperative analgesic management. Male aged 10 months with the diagnosis as physical status ASA 3 with Absent Tricuspid Valve, Small ASD secundum, Mild PS valvar planned for labioplasty. The patient was anesthetized with GA Intubation with ETT no 3.0 cuff semiclose control breath system with analgesic fentanyl 120 mcg, induction with propofol 15 mg, Sevoflurane dial 2.5%, followed by muscle relaxant atracurium 3.5 mg. The patient was admitted to the Pediatric Intensive Care Unit postoperatively, treated for 5 days and transferred to the ward on the 6th day conscious. Pre-anesthesia assessment, stages of anesthesia procedures to postoperative monitoring of labioplasty patients with tricuspid absent require special management to reduce patient mortality and morbidity during and after surgery.ward.
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
Konsiderasi Teknik Anestesi pada Crash Ponek Fetal Distress Apsari, Ratih Kumala Fajar; Uyun, Yusmein; Adrin, Olga Elenska
Jurnal Komplikasi Anestesi Vol 9 No 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.v9i2.8342

Abstract

Neonatal and infants’ mortality rate in Indonesia is still high. Emergency case in comprehensive obstetric and neonatal emergency care is one of the causes related to high mortality rate in pregnancy and neonates. There is a thin line between true emergency which may need emergency surgery, previously known as crash-C-section and emergency that could be optimized before surgery is performed. A true emergency may need considerable anesthesia technique which could be done quickly yet also emphasizes on patient’s safety.
Manajemen Intraoperative Nausea and Vomiting (IONV) pada Pasien Seksio Sesarea dengan Anestesi Spinal Apsari, Ratih Kumala Fajar; Jufan, Akhmad Yun; Sari, Dhanty Dwita
Jurnal Komplikasi Anestesi Vol 9 No 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.v9i2.8350

Abstract

Background: Spinal anesthesia is the most commonly used anesthesia for caesarean section with it being safely, quickly and easy to administer. Current literature indicates a high incidence of intraoperative nausea and vomiting (IONV) during caesarean section under spinal anesthesia up to 80% likely to suffer from nausea and vomiting because of the pregnancy itself. This is applicable not only to the first 3 months of pregnancy but also to the last trimester due to the reduced tone of the esophagogastric junction and an increased intraabdominal pressure. During abdominal surgery under regional anesthesia, nausea may happen due to several contributing factors such as sympathetic blocks followed by parasympathetic dominance with hypotension which is the most important cause of nausea after spinal anesthesia, decreased perfusion of central nervous system, anxiety, and sudden abdominal movements during surgery
Manajemen Anestesi pada Seksio Sesarea pada Pasien COVID-19 Derajat Berat Uyun, Yusmein; Apsari, Ratih Kumala Fajar; Suharso, Pamungkas Hary
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 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.v8i3.8370

Abstract

COVID-19 infection in pregnant patients can lead to premature labor. The most common method of delivery is by caesarean section. Many aspects must be considered in carrying out anesthesia for COVID-19 patients, including physiological changes that occur due to pregnancy and the effects of COVID-19 infection which can aggravate the condition of pregnant patients. Maintaining adequate oxygenation in the blood, choosing the right anesthetic agent, considering its effect on the fetus, and mechanical ventilation management related to ARDS caused by COVID-19 infection are several things that should be concerned in anesthesia management.
Co-Authors Adi, Danis Woro Kuncoro Adrin, Olga Elenska Akhmad Yun Jufan Anasy, Naufal Apriyanto Arif Ikhwandi Atmadja, Linda Stefanie Bambang Suryono Bambang Suryono Suwondo Bambang Suryono, Bambang Calcarina Fitriani Retno Wisudarti Dede Frits Manambual Sinaga Dewi, Wahyu Jati Paramita Ekuarianto, Donny Erna Fitriana A Fadinie, Wulan Fitriati, Mariza Gunawan, Fanny Hadiwinoto, Bambang Hartono, Pinter Hendra, Maijoni Hermawan, Hendra Ikhwandi, Arif Juni Kurniawaty Muhdar Abubakar Djayanti Sari Kuncoro, Kusuma Edhi Mahmud Mahmud Negara, Adista Yugadhyaksa Gupta Nurdiansyah, Elba Nurul Ulfah Hayatunnisa Oktavian Rizki Ilahi Prayunanto A.N, Eko Rahma, Aulia Zuhria Sari, Dhanty Dwita Satrio Adi Wicaksono SATRIYAS ILYAS Shinta Shinta Sri Rahardjo Sri Rahardjo Sudadi Suharso, Pamungkas Hary Suryasaputra, Wahyu Tjahya Aryasa Untung Widodo, Untung Utomo, Wandito Gayuh Wirawan, Angga Aditya Yoga Pranata Yunita Widyastuti Yusmein Uyun