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All Journal SAINS MEDIKA : JURNAL KEDOKTERAN DAN KESEHATAN Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif Medica Arteriana (Med-Art) Journal of Anaesthesia and Pain Asian Journal of Social and Humanities Jurnal Komplikasi Anestesi
Calcarina Fitriani Retno Wisudarti
Departemen Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Gadjah Mada/RSUP Dr. Sardjito Yogyakarta
Decision Sciences, Operations Research & Management Earth & Planetary Sciences Education Environmental Science Health Professions Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Public Health

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An Ultrasonography Guidance Lumbar Epidural Anaesthesia in Patient with Difficult Landmarks Wisudarti, Calcarina Fitriani Retno; Mahmud; Mi’raj, Geza Getar
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.v10i1.8329

Abstract

Anestesi epidural banyak digunakan dalam praktik klinis. Namun, keberhasilan metode anestesi ini bergantung pada kemampuan untuk memperkirakan penempatan dengan benar dari ruang epidural untuk menusuk dan mengateterisasinya. Saat ini, metode paling umum untuk menentukan level tusukan dan arah jarum yang benar didasarkan pada landmark anatomis dan kedalaman ruang epidural penempatan dinilai dengan tes ''kehilangan resistensi''. Kompleksitas teknis dari metode tusukan epidural dapat meningkatkan risiko komplikasi neurologis, blok yang tidak berhasil, dan ketidakpuasan pasien. Panduan ultrasonografi pada blok saraf banyak digunakan dalam praktik klinis. Namun, penerapan suara ultra selama anestesi neuraksial masih terbatas karena kesulitan memvisualisasikan padat struktur yang mengelilingi ruang epidural dan tulang belakang kanal.
Gagal Spinal pada Operasi Sectio Caesarea Wisudarti, Calcarina Fitriani Retno; Uyun, Yusmein; Utomo, F uad Cipto
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.v9i3.8331

Abstract

Subarachnoid block is the most convenient and safe anesthesia to undergo cesarean section. It provides excellent anesthesia, avoids risks associated with general anesthesia and increase level of parturients' satisfaction, associated with low occurrence of intra-operative and post-operative morbidities. It's simplicity to institute, rapid onset of sensory blockage, its reliability, ease of mastering and producing optimal surgical conditions are some of the frequent reasons to choose spinal anesthesia over other techniques. Despite this significant move towards spinal anesthesia, it has a risk of failure reported in the range of 1-17%. Failed spinal anesthesia can be defined as partial or incomplete spinal block within 15-20 min after injection and requiring supplemental analgesia or conversion to general anesthesia. Failed spinal leads to maternal discomfort and it is a cumbersome event for the anesthetist. Management of failed spinal during caesarean section by repeat, sedation or conversion to general anesthesia may negatively impact maternal and fetal outcome. This may result in decreased maternal satisfaction, inadequate pain management, fetal sedation (incases of general anesthesia), suboptimal surgical anesthesia and may also pose to risks of general anesthesia on the parturient. Keywords: Caesarean Section; failed spinal anesthesia; management of failed spinal; spinal anesthesia
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.
Glasgow Coma Scale (GCS) Sebagai Prediktor Kematian dan Kualitas Hidup Pasien Cedera Otak Traumatik di RSUP Dr. Sardjito Taneo, Desy Chery Marlyn; Sudadi; Wisudarti, Calcarina Fitriani Retno
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.v9i2.8343

Abstract

Background: Glasgow Coma Scale (GCS) as one of the most important predictors and a key measure in neurological assessment after brain injury. Apart from mortality, GCS is also a predictor of quality of life that can be measured using the Extended Glasgow Outcome Scale (GOSE). GOSE is a global assessment of independent living and social reintegration that is widely used as an outcome measure in brain injury research, to analyze long-term functional outcomes. Methods: This study used a retrospective cohort observational study design that aimed to predict mortality and quality of life using the Glasgow Coma Scale. This research has been conducted at the Medical Record Installation of Dr. Sardjito Hospital Yogyakarta using data from patients whom are treated with a diagnosis of traumatic brain injury at Dr. Sardjito Hospital from January 1, 2020 to December 31, 2020 retrospectively. Quality of life was calculated using the GOSE interview questionnaire. The relationship of GCS variables to mortality and quality of life was tested by the unpaired correlative hypothesis test followed by multivariate analysis with logistic regression methods. Results: There were 174 research subjects with a mean age of 37.51 (± 14.17) years, 124 male (71,3%) and 50 female (28.7%). Subjects GCS score < 8 had a higher risk of death than those with GCS score 13-15 (p<0.001, RR=18.3). Subjects with GCS score 9-12 had a higher risk of death than those with GCS score 13-15 (p<0.001, RR=9.71). Subjects with GCS score < 8 had a higher risk of unfavourable outcome than those with GCS score 13-15 (p<0.001, RR=9.49). Subjects with GCS score 9-12 had a higher risk of unfavourable outcome than those with GCS score 13-15 (p=0.001, RR=4.93). Conclusion: GCS on admission can be a predictor of mortality and quality of life for traumatic brain injury patients
Rapid Sequence Intubation pada Pasien Hamil Ektopik dengan COVID-19 Ringan yang Menjalani Laparotomi Histerektomi Wisudarti, Calcarina Fitriani Retno; Adiyanto, Bowo; Naomi, Diah Anis
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.v8i2.8356

Abstract

Female patient aged 27 years was diagnosed with ectopic pregnancy in ampulla vateri, grade II hemorrhagic shock resolved, G2P1A0 8 weeks 5 days pregnant, mild COVID-19, underwent exploratory laparotomy and hysterectomy. The patient did not have any complaints of fever, cough, shortness of breath, and anosmia. The patient was diagnosed with mild COVID-19 because of a positive SARS-CoV-2 Qualitative PCR swab and no pneumonia. The operation was carried out in a special operation room for airborne infection patients with a HEPA filter machine installed. General anesthesia intubation using the RSI technique. No difficult airway was found in the patient. No Sellick maneuver was performed. Patient was intubated with a direct laryngoscope. The ETT position was confirmed by capnograph. After the operation, the patient was extubated deeply, then returned to the ward. There was no perioperative complication in this patient.
Manajemen Post-Dural Puncture Headache Menggunakan Teknik Blok Ganglion Sphenopalatina Wisudarti, Calcarina Fitriani Retno; Mahmud; Gupta, Adista Yugadhyaksa
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.v8i2.8358

Abstract

Post Dural Puncture Headache (PDPH) is a complication that can occur and be bothersome in patients undergoing neuraxial anesthesia. PDPH management includes conservative management such as hydration, caffeine, and oral analgesics to other invasive measures such as the Epidural Blood Patch (EBP). Sphenopalatine Ganglion Block (SPGB) is a technique to treat various kinds of headaches. The results showed that the SPGB technique improved PDPH symptoms although the data were not significant in some cases. We report a post-subarachnoid block patient who complained of PDPH symptoms. The patient's risk factor is the female gender. In this patient, an SPGB procedure was performed. Symptoms of PDPH were relieved after 17 days post-subarachnoid block procedure.
Korelasi Kadar Prokalsitonin dengan Angka Leukosit pada Pasien Sepsis Bakterial di Ruang Rawat Intensif RSUP Dr. Sardjito Yogyakarta Utami, Vengky; Wisudarti, Calcarina Fitriani Retno; Jufan, Akhmad Yun
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.v8i2.8361

Abstract

Background: The Surviving Sepsis Campaign recommends using procalcitonin to help diagnose acute systemic infections, infection resolution, escalation, and discontinue antibiotic therapy on sepsis patients. Unfortunately, procalcitonin testing is very expensive and not yet available in all hospitals. Alternative biological markers are needed besides procalcitonin. The component of differentiated leukocyte count is known to be correlated with procalcitonin. Methods: This is a cross-sectional retrospective study and includes all bacterial sepsis patients that have been treated in the Dr. Sardjito General Hospital ICU between 1 January - 31 December 2019. Data of 436 laboratory examinations have been collected from 104 patients’ medical records, then processed with SPSS version 26 to look for correlations between procalcitonin with each component of leukocyte count value, followed by regression analysis between procalcitonin and leukocyte count values. Results: We found very strong positive correlation (R2 = 0.823, p <0.05) in multivariate analysis between procalcitonin levels and differential leucocyte count. There was moderate positive correlation in bivariate correlation between procalcitonin and leucocytes (r = 0.279, p <0.05) and absolute monocytes (r = 0.254, p> 0.05). There was also very weak positive correlation between procalcitonin and absolute neutrophils (r = 0.239, p <0.05), percentage neutrophils (r = 0.078, p <0.05), absolute eosinophils (r = 0.148, p<0.05), percentage eosinophils (r = 0.104, p<0.05), absolute basophils (r = 0.029, p>0.05), percentage basophils (r = 0.011, p> 0.05), absolute lymphocytes (r = 0.121, p>0.05), lymphocyte percentage (r = 0.074, p> 0.05), monocyte percentage (r = 0.208, p>0.05), absolute immature granulocytes (r = 0.064, p <0.05) , and percentage immature granulocytes (r = 0.029, p> 0.05). Conclusion: There was a strong positive correlation between procalcitonin levels and leukocyte count in bacterial sepsis patients treated in Dr. Sardjito General Hospital, Yogyakarta intensive care unit
Perbandingan Efektivitas Kombinasi Gabapentin-Ondansetron dengan Dexamethasone-Ondansetron sebagai Profilaksis Postoperative Nausea-Vomiting (PONV) pada Operasi Laparoskopi Ridha, Ihsanur; Wisudarti, Calcarina Fitriani Retno; 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.v8i2.8364

Abstract

Background: Post Operative Nausea and Vomiting (PONV) is a complication that most often occurs in patients undergoing surgery under general anesthesia, with an incidence rate of 40-90%. The existing combination drug guidelines to prevent PONV have not been effective in significantly reducing the incidence of PONV. There are several research results that suggest that the GabapentinOndansetron combination is effective in reducing the incidence of PONV. Objective: This study aims to compare the effectiveness of the combination of Gabapentin-Ondansetron with Dexamethasone-Ondansetron as a prophylactic of Post Operative Nausea and Vomiting (PONV) in laparoscopic surgery. Methods: This study is a double-blind Randomized Controlled Trial/RCT involving 78 patients who underwent a laparoscopic procedure. Subjects were divided into two groups A and B. Group A was given a combination of Gabapentin 600 mg and Ondansetron 0.1 mg/kgBW. Group B was given a combination of Dexamethasone 10 mg and Ondansetron 0.1 mg/kgBW. Both groups assessed the incidence of PONV using VNRS for nausea and assessed the presence or absence of vomiting. Results: At 15 and 30 minutes postoperatively, Gabapentin-Ondansetron was better than Dexamethasone-Ondansetron as a prophylactic of nausea (p <0.05) in laparoscopic surgery. At 60, 90, and 24 hours postoperatively, the drug combination of the two groups was as good as nausea prophylaxis (p >0.05) for laparoscopic surgery. Both of these drug combinations had the same effect as vomiting prophylaxis (p >0.05) after laparoscopic surgery. Conclusion: Gabapentin-Ondansetron combination is more effective thanDexamethasone-Ondansetron combination as a prophylactic of Post OperativeNausea and Vomiting (PONV) in laparoscopic surgery
Diagnosis dan Tatalaksana Sepsis Maternal Jufan, Akhmad Yun; Wisudarti, Calcarina Fitriani Retno; Atmanagara, Dikho
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.v8i2.8366

Abstract

Maternal sepsis is a common and potentially preventable cause of direct maternal death globally. A barrier to further progress has been the lack of consensus on the definition of maternal sepsis. Recognition and treatment of maternal sepsis are often delayed due to the physiological adaptations of pregnancy and vague or absent signs and symptoms during its initial presentation. Over the past decade, our understanding of sepsis has evolved and maternal early warning systems have been developed to help providers promptly identify and stratify parturients who are at risk. In addition, new consensus definitions and care bundles have recently been published by the World Health Organization and the Surviving Sepsis Campaign to facilitate earlier recognition and timely management of sepsis. Standardizing the criteria for maternal sepsis optimizes clinical findings. It may facilitate the evaluation of the role of different clinical parameters and biomarkers in the diagnosis, earlier recognition, and management of maternal infection and sepsis. Further work is required to develop an international consensus on the criteria for diagnosing maternal sepsis and any associated organ dysfunction.
Optimalisasi Keselamatan Pasien di Post-Anesthesia Care Unit Widodo, Untung; Wisudarti, Calcarina Fitriani Retno; Krispratama, Avian
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.v8i3.8367

Abstract

Post-Anesthesia Care Unit (PACU) is a place for monitoring patients who have undergone the anesthesia process, both regional and general. The recovery period begins immediately after the patient leaves the operating table. Complications can occur at any time, including when transferring a patient from the operating room to the recovery room. The patient must be closely monitored and monitored. Several post-anesthesia complications include consciousness disorder, a decrease of peripheral resistance and cardiac output due to residual anesthesia, and hypovolemia due to inadequate fluid replacement during surgery or continued postoperative bleeding. Hypertension may occur due to increased activity of sympathoadrenal and severe pain.
Co-Authors Agustina, Ayu Yesi Akhmad Yun Jufan Akhsaniati, Novi Dwi Andriani, Ika Jati Setya Anggraini, Diana Anindita, Triatma Anisa Fadhila Farid Atmanagara, Dikho Bambang Suryono, Bambang Baskoro, Windu Adi Bayu, Timor Krisna Bhirowo Yudo Pratomo Bowo Adiyanto Daniswara Dian Ayu Listiarini Djayanti Sari Ferdiansyah, David Gupta, Adista Yugadhyaksa Helen Yudi Irianto, Helen Yudi Ikhsan, Isroful Jufan, Ahmad Yun Juni Kurniawaty Muhdar Abubakar Djayanti Sari Krisdiyantoro, Nova Krisna Bayu, Timor Krispratama, Avian Kuncoro, Kusuma Edhi Kusumasari, Nur Hesti Loho, Irvan Revaldi Mahardieni, Karlina Maryani, Nova Meta Restu Synthana Mi’raj, Geza Getar Mochammad Imron Awalludin Mustikawati, Siti Rakhmah Naomi, Diah Anis Nasution, Rusdi Anwar Negara, Adista Yugadhyaksa Gupta Nova Maryani Nova Maryani Nugraha, Achmad Fauzani Nur, Muhammad Ikhwan Palupi, Isnafianing Pasmawati, Desti Pradana, Gilar Rizki Aji Prasamya, Erlangga Pratomo, Bhirowo Yudho Rahman, Farhan Ali Rakhmatjati, Pradana Bayu Ratih Kumala Fajar Apsari Ridha, Ihsanur Sadiyanto, Dewang Sari, Ayu Rosema Setiandari, Kristina Siti Helmyati Sri Rahardjo Sudadi Taneo, Desy Chery Marlyn Trijayanti, Christiana Untung Widodo Untung Widodo, Untung Utami, Vengky Utomo, F uad Cipto Utomo, Wandito Gayuh wandito, Gayuh Utomo Wibowo, Catur Prasetyo Yuliani, Irma Yunita Widyastuti Yusmein Yusmein Uyun Zulfakhri, Zulfakhri