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All Journal Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif Folia Medica Indonesiana Indonesian Journal of Tropical and Infectious Disease Majalah Kesehatan FKUB Health Notions Bali Journal of Anesthesiology Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Journal of Health Sciences Jurnal Respirasi (JR) PREPOTIF : Jurnal Kesehatan Masyarakat Indonesian Journal of Anesthesiology and Reanimation (IJAR) Jurnal Layanan Masyarakat (Journal of Public Service) Jurnal Syntax Transformation Indian Journal of Forensic Medicine & Toxicology Jurnal Neuroanestesi Indonesia Jurnal Widya Medika

Utariani, Arie

Departemen Anestesiologi Dan Reanimasi, Fakultas Kedokteran, Universitas Airlangga/RSUD Dr. Soetomo, Surabaya, Indonesia

Author-ID : 2386867

Humanities Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Earth & Planetary Sciences Education Environmental Science Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Hubungan Antara Tingkat Stres dan Kadar Kortisol Saliva dan Faktor Penyebab Stres Residen Anestesiologi dan Terapi Intensif pada Era Pandemi Covid-19 Andre Kurniawan; Arie Utariani; Hamzah; Nalini
Jurnal Syntax Transformation Vol 2 No 02 (2021): Jurnal Syntax Transformation
Publisher : CV. Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jst.v2i2.229

Pandemi COVID-19 berdampak pada proses pendidikan residen anestesi yang merupakan salah satu garda depan pelayanan medis. Situasi seperti ini akan menambah stres dan beban mental yang berpotensi menurunkan imunitas tubuh dan kualitas pelayanan. Kortisol saliva merupakan biomarker stres yang reliabel dalam mengukur tingkat stres karena bersirkulasi akut dalam tubuh. Penelitian ini bertujuan menganalisis hubungan antara kadar kortisol saliva dengan tingkat stres residen anestesiologi dan terapi intensif di era pandemi COVID-19 yang diukur menggunakan perceived stress scale (PSS-10). Metode penelitian adalah observasional analitik dilakukan pada 40 residen anestesiologi usia 28-39 tahun dan dalam masa putaran stase ruang isolasi khusus (RIK) dan ruang resusitasi (RES) yang menangani pasien terpapar COVID-19 di RSUD Dr. Soetomo Surabaya pada bulan Agustus-September 2020. Hasil perhitungan statistik dengan Uji Spearman, hubungan antara PSS-10 dan kadar kortisol, tingkat stres ringan (25% vs 67,5%) dan stres sedang (75% vs 37,5%) secara statistik bermakna (p=0,005; r=0,388) Simpulan: Tingkat stres residen anestesiologi berdasarkan PSS-10 berkorelasi linear terhadap kadar kortisol saliva di era pandemi COVID-19. Faktor stres paling dominan yakni perasaan kesal akibat sesuatu terjadi secara mendadak dan gugup jika terjadi hal diluar kendali. PSS-10 layak dipertimbangkan sebagai modalitas alat ukur dalam menilai tingkat stres residen anestesi di era pandemi COVID-19.

Adherence Level Of Medical Personnel In Implementing 2019 Postoperative Pain Management Guidelines Nasrulloh Nasrulloh; Hamzah Hamzah; Arie Utariani; Dedi Susila
Jurnal Ilmiah Kesehatan Vol 14 No 02 (2021): Jurnal Ilmiah Kesehatan (Journal of Health Sciences)
Publisher : Universitas Nahdlatul Ulama Surabaya

Introduction: Inadequate pain management may increase the risk of complications and postoperative chronic pain. Postoperative Pain Management Guidelines of The Anesthesiology and Reanimation Department, Faculty of Medicine Universitas Airlangga/ Dr. Soetomo Hospital Surabaya were arranged in 2019. Purposes: This study aim is to analyze the medical personnel’s adherence in implementing postoperative pain management guidelines. Methods: This is descriptive observational study with retrospective design. Total sampling was carried out on the medical records of patients who underwent elective surgery and received postoperative acute pain management during March-May 2020. Results: A total of 349 patients, most of the pain intensity was moderate (62.8%). The medical personnel adherence with postoperative pain management guidelines was 88.0%. The overall use of multimodal analgesia was 61.0%. Adherence to guidelines on pain category was mostly good adherence: 99.1% in mild pain, 82.6% in moderate pain, and 81.2% in severe pain. The use of multimodal analgesia was found in 12.3% mild pain; 83.6% moderate pain, and 100% severe pain patients. Conclusion: Most of the medical personnel have adhered to the postoperative pain management guideline, and widely-used multimodal analgesia. Systematic evaluation of guidelines implementation, patient satisfaction, and outcomes are needed.

The The Length Of Stay In Patients Undergoing Diagnostic MRI And CT-Scan With Intravenous Anesthesia At Outpatient Clinic Dr. Soetomo General Hospital: An Overview Virda Maharani; Arie Utariani; Lucky Andriyanto; Bambang Harjono
Jurnal Ilmiah Kesehatan Vol 14 No 02 (2021): Jurnal Ilmiah Kesehatan (Journal of Health Sciences)
Publisher : Universitas Nahdlatul Ulama Surabaya

Background: Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) Scans might be challenging for children or patients with anxiety or claustrophobia. The use of general anesthesia aims to increase the success rate, but inadequate management can result in longer length of stay. Purpose: To analyze patients' length of stay on MRI and CT-scan with intravenous anesthesia. Methods: A descriptive observational study. The datas were collected retrospectively from the medical records in General Diagnostic Center. Total of 721 patients who underwent MRI or CT Scan procedures with intravenous anesthesia during 2017-2018. The data obtained were patients' age, sex, the type of procedure, physical status, comorbid, type of anesthesia drug, diagnostic procedure duration, length of observation in the Post Anesthesia Care Unit (PACU), and overall length of stay. Results: All MRI procedures used midazolam-propofol combination, and only one CT scan procedure used this combination, while the other used only propofol. Patients undergoing MRI had length of stay with a mean duration of 6,6,3±1,26 hours, compared to CT scans with 5,20 ±1,38 hours, due to the more prolonged procedure and observation duration in the PACU. Conclusion: Patients undergoing MRI had a longer length of stay than the ones doing CT scans.

Risk Factors for Mortality in Children with Hospital-Acquired Pneumonia in Dr. Soetomo General Hospital Surabaya Diska Hanifah Nurhayati; Retno Asih Setyoningrum; Arie Utariani; Ira Dharmawati
Jurnal Respirasi Vol. 7 No. 2 (2021): May 2021
Publisher : Faculty of Medicine Universitas Airlangga

Introduction: Hospital-Acquired Pneumonia (HAP) is a nosocomial pneumonia that brings negative impacts, such as prolonged hospital stay and increased cost. Previous studies often discussed about the risk factors of HAP mortality in adult patients rather than in children. This study aimed to analyze the risk factors of mortality in children with HAP.Methods: This was a retrospective observational analytic study using cross sectional method with total sampling. A total of 73 children were enrolled in this study, consisted of inpatients at Pediatric Inpatient Room Dr. Soetomo General Hospital Surabaya who met the inclusion and exclusion criteria. Independent variables were gender, age, onset of HAP, length of stay (LOS), comorbidities, birth weight, type of breastfeeding, the use of mechanical ventilation (MV), and response to therapy. Dependent variable was mortality. The data were collected from medical records, which later were analyzed by bivariate and multivariate analysis.Results: The mortality of children with HAP was 23.3%. Bivariate analysis showed that age (p = 0.009), the use of MV (p = 0.029), and response to therapy (p = 0.036) were proven to affect mortality in children with HAP in Dr. Soetomo General Hospital Surabaya. In addition, the use of MV was the significant risk factor (p = 0.023) given by the multivariate analysis. Gender, onset of HAP, LOS, comorbidities, and type of breastfeeding were not proven to be the risk factors for mortality.Conclusion:Mortality in children with HAP in Dr. Soetomo General Hospital Surabaya was significantly affected by children’s age, the use of MV, and response to therapy. This information might be used as early signs and treatment strategies for children with HAP which lead to the decrease of hospital mortality.

Efektivitas Body Surface Area dibanding Predicted Body Weight dalam Menentukan Volume Semenit untuk Mencapai Target PaCO2 pada Operasi Tumor Otak Nanang Nurofik; Prananda Surya Airlangga; Bambang Pujo Semedi; Arie Utariani; Elizeus Hanindito; Hamzah Hamzah
Jurnal Neuroanestesi Indonesia Vol 8, No 1 (2019)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Latar Belakang dan Tujuan: Manajemen neuroanestesi pada operasi tumor otak bertujuan untuk mencegah terjadinya cedera otak sekunder dan memberikan lapangan operasi yang baik. Hal ini dapat dicapai melalui brain relaxation therapy. Penelitian ini bertujuan menganalisis efektifitas Body Surface Area (BSA) dan Predicted Body Weigh (PBW) untuk menentukan volume semenit dalam mencapai target PaCO2 pada pasien yange menjalani operasi tumor otak.Subjek dan Metode: Penelitian analitik observasional dengan desain cross-sectional melibatkan 31 pasien yang menjalani operasi tumor otak di RSUD Dr Soetomo Surabaya. Pasien yang memenuhi kriteria, dilakukan pengukuran tinggi badan dan berat badan, kemudian dibagi dalam 2 kelompok BSA dan PBW. Kelompok BSA mendapat volume semenit 4xBSA (laki-laki) dan 3.5xBSA (perempuan). Kelompok PBW mendapat volume semenit 100mL/kgBB. Tiga puluh menit setelah pengaturan ventilasi mekanik, dilakukan pemeriksaan analisa gas darah untuk menilai PaCO2.Hasil: Penentuan volume semenit menggunakan BSA menghasilkan volume yang lebih besar dibanding PBW pada pasien normal hingga obesitas.Penggunaan BSA dibanding PBW secara signifikan memiliki PaCO2 lebih rendah (33.55±3.43: 39.29±3.32 mmHg) dengan nilai p=0.0001. Simpulan: Penggunaan BSA dalam menentukan volume semenit efektif dalam mencapai target PaCO2 pada pasien yang menjalani operasi tumor otak. Effectiveness of Body Surface Area over Predicted Body Weightto determine Minute Volume to achieve PaCO2 Target in Brain Tumor SurgeryBackground and Objective: Neuroanesthesia management in brain tumor surgery aims to prevent secondary brain injury and provide a good operating field. This goal can be achieved by brain relaxation therapy .This study aims to analyze the effectiveness of Body Surface Area (BSA ) and Predicted Body Weigh (PBW) in determining minute volume to achieve PaCO2 target in brain tumor surgery patient.Subject and Methods: This was an observational analytic study with a cross-sectional approach. Thirty patient with brain tumor surgery were enrolled in this study. Patient who met the inclusions criteria was measured for height and weight then divided into two groups of BSA and PBW. The BSA group gets a minute volume 4xBSA for men and 3.5xBSA for women. The PBW group received minute volume 100mL / kg. Thirty minutes after adjusting mechanical ventilation, a blood gas analysis was examined to measure PaCO2 value.Results: Minute volume which is predicted by BSA had a greater volume than PBW in normal to obese patient. Body surface area is statistically significant compared to PBW in reducing PaCO2 average (33.55±3.43: 39.29±3.32 mmHg) with p value = 0.0001.Conclusion: Body surface areaas more effective to determine minute volume compare to PBW to achievePaCO2 target in brain tumor surgery patient.

Effectiveness of Ketoprofen Suppositoria as Preemptive Analgesia for Postoperative Pain in Patients Undergoing Elective Surgery with General Anesthesia Lupi Lestari; Elizeus Hanindito; Arie Utariani
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 1 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, reduced risk deep vein thrombosis, fast recovery, and reduced cost of care. Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period, has the potential to be more effective than a similar analgesic treatment initiated after surgery. As a part of multimodal analgesia, the use of NSAIDs should always be considered for acute postoperative pain management. NSAIDs can be used preoperatively as a part of the preemptive regimen and for postoperative pain control to increase the efficacy of opioids and reduce its side effects. Material and Method: This research was experimental research with a case-control design of the study. The samples separated into two groups, the first group got ketoprofen suppository before the induction, and the second group didn't get the ketoprofen suppository The intensity of pain measured with the Numeric Rating Scale (NRS) or Wong-Baker Faces Pain Scale was the variable studied at different postoperative times (30 min, 60 min, 120 min, 2-6 hours, 6-12 hours). The total amount of rescue analgesics (fentanyl) and side effects were other variables of this study. Result and Discussion: The result is ketoprofen suppository as preemptive analgesia administrations can reduce postoperative pain. Numeric Rating Scale was significantly lower in the ketoprofen group compared to the control group (p < 0,05) at 30 min, 60 min, 230 min, 2-6 hours, 6-12 hours. The number of postoperative analgesics needed in the recovery room was significant differences among both groups (p < 0,05). Conclusion: Preemptive analgesia in patients who underwent an operation with general anesthesia with ketoprofen suppository was effectively in blocking noxious stimuli and central sensitization, with subsequent prevention of acute postoperative pain.

Profile Hemodynamics (Blood Pressure And Heart Rate) Changes in The Use of Adrenaline in Cesarean Section With Spinal Anesthesia at Dr Soetomo Surabaya Hospital Ainur Rahmah; Arie Utariani; Achmad Basori
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 1 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: spinal anesthesia block is one of anesthesia technique that aims to block motor nerves resulting in paresis or anesthesia and paralysis or loss of muscle function in myotomes that are the same level as blocked dermatomes. Caesarean section is one of the surgical actions that are often performed mainly in birth cases. Besides that, the mechanism of the effects of giving birth to the operation of type B autonomic caesarean section autonomic nerve pronglion nerve which results in a decrease in the resistance of peripheral veins and peripheral vasodilatation which results in an imbalance in hemodynamics especially in blood pressure and heart rate and cause of hypotension. Vasopressor, fluid therapy, vasoconstrictor are given to reduce the toxicity of local anesthesia and to overcome hypotension. Objective: To determine hemodynamic changes (blood pressure and pulse) in spinal anesthesia block surgery patients with caesarean section at Dr Soetomo Hospital. Material and Method: This research is descriptive with a retrospective from January - March 2018, the sample taken with total sampling from secondary data from the central medical record at RSUD Dr. Soetomo. Results and Discussion: 68 samples were obtained from inclusion and exclusion criteria there was a change in blood pressure and pulse in patients with caesarean section with spinal anesthesia block with the addition of vasoconstrictors. There was a decrease in average systolic pressure 13.25, diastole 18.25 and pulse 4.5 and in no increase. There was a decrease in average systolic pressure 11.9286, diastole 13.8929 and pulse 5.6429 and no addition of p> 0.05 the two are not significantly different. Conclusion: addition of adrenaline to spinal anesthesia in caesarean section patients was not cause significant hemodynamic (blood pressure and heart rate) changes.

Screening Protocol of Propofol Infusion Syndrome Muzaiwirin Muzaiwirin; Arie Utariani
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 2 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: Propofol is often used as sedation for a long time in the ICU. The use is at risk of Propofol Infusion Syndrome (PRIS) which is characterized by arrhythmias or decreased heart function, metabolic acidosis, rhabdomyolysis, and acute renal failure. Literature Review: The pathophysiology of PRIS is due to a disturbance in cell metabolism which inhibits the transport of Free Fatty Acid (FFA) into cells and inhibits the mitochondrial respiration chain. The management of PRIS is supportive of every symptom that arises so that screening is needed as a treatment to reduce high mortality rates. Screening using creatine phosphokinase (CPK) and lactate is supporting data as an initial introduction for symptoms of PRIS. Conclusion: PRIS can occur if continuous administration of propofol > 4 mg / kg / hour. CPK levels> 5000 IU / L become a benchmark to stop propofol before the onset symptoms of PRIS. Implementation of screening protocol is very helpful for clinicians to reduce mortality in ICU due to the use of propofol.

Effectivity Comparison of Ketamine and Morphine as Post-Operative Analgesic in Spinal Surgery Nenden Suliadiana Fajarini; Nancy Margarita Rehatta; Arie Utariani
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 2 (2019): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: Patients who undergo spinal procedure, experience the post-operative pain as the major problem. From the Visual Analog Scale (VAS), patients scale their pain around 8. An inadequate pain management could fasten the healing process and reduce patient life quality. Opioid group as the gold standard still inflicts several problems, such as respiratory depression. Moreover, the combination NSAID and opioid which used to suppress the side effect, still burden the healthcare cost. In a research of analgesic, through the discovery of N-Methyl D Aspartate receptor, researchers found an explanation of the ketamine effect in relieve chronic and intense pain which safer and cheaper. Method and Material: This research using single blind randomized control trial. Comparing 0.25mg/kg ketamine IV followed by ketamine 0,1mg/kg/h for the intervention group and 0.02mg/kg/h of morphine for the control group to manage the first 24 hours pain sensation. If patient VAS was more than 4, patient would get additional 0.5mg/kg ketamine (intervention group) and 25Î¼g fentanyl (control group). Result and Discussion: From 17 patients each groups, the VAS values were better in control group rather than on intervention group. Low dose ketamine can't be compared with morphine to manage post spinal procedure pain. There were no hemodynamic changes, respiratory rate depression, loss of consciousness and hallucination, nystagmus, vomiting and hyper salivation. Even though 11.8% of the subject were nausea. The morphine group tends to experience hemodynamic changes and loss of consciousness in the first 12 hours but still within normal range. In the control group, 47.1 % patients were having nausea in the first hour, but only 17.6% of them who actually vomited. Conclusion: The analgesic effect of morphine is higher than ketamine, but the amount effect of ketamine is lower than morphine so that ketamine is more effective and safer given in the room.

Laparotomy Exploration In Pediatric With Severe Thrombocytopenia: A Report Rudy Vitraludyono; Arie Utariani
Indonesian Journal of Anesthesiology and Reanimation Vol. 3 No. 1 (2021): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: Perioperative bleeding in patients was a serious problem in the exploration of laparotomy, especially in severe thrombocytopenia patients. In addition, spontaneous bleeding often occurs in patients who have a platelet count of less than 10 to 20.109 cells. L-1 blood. When surgery must be performed on a patient with platelet counts < 50.109 cells L-1, platelet concentrate was urgently needed to be transfused during induction of anesthesia. Benefits and risks of transfusion before surgery had to be done on a per-patient basis. The available data was very limited in informing perioperative management of patients with thrombocytopenia. However, there have been previous reports of surgery cases in 66-year-old patients with a history of immune thrombocytopenia (ITP) and diagnosed with acute appendicitis related to disseminated intravascular coagulation (DIC), showing excellent postoperative hemostasis. Another one, a seven-year-old boy who has a severe refractory case of ITP with very low platelet counts was referred to urgent splenectomy performed without increase platelet counts before, and then the patient underwent plasma exchange (PE) after surgery. Those reports aimed to present 2 cases of laparotomy exploration in pediatric patients with severe thrombocytopenia. Case Report: The first laparotomy exploration was conducted on an 11-year-old boy who suffered acute perforated appendicitis. The patient obtained general anesthesia with intubation. The second laparotomy exploration was conducted on a 1-month-old baby boy with a weight of 3400 grams who suffered bowel low-level obstruction suspect Hirschsprung disease. The patient also obtained general anesthesia with intubation. Discussion The general anesthesia with oral intubation was successfully afforded to both patients for the laparotomy exploration with the preoperative condition under severe thrombocytopenia with receiving platelet transfusion therapy before surgery. Complications of spontaneous bleeding at the time of intubation were not found, no bleeding-difficult-intubation during surgery, and no symptoms of spontaneous bleeding were found. Postoperatively, platelet levels gradually improved. Conclusion: Exploration of laparotomy in patients with severe thrombocytopenia can be carried out with the support of platelet transfusion and providing general anesthesia with oral intubation to patients.

Co-Authors Abdul Kadir Munsy Achmad Basori, Achmad Agustina Salinding Ainur Rahmah Akhyar Nur Uhud Alivery Raihanda Armando Andre Kurniawan Anna Erliana Oetarman Anna Surgean Veterini Ardiansyah Arina Setyaningtyas Bambang Harjono Belindo Wirabuana Budi Prasetyo Christopher Ryalino Christrijogo Soemartono Waloejo Cindy Aprilia Eka Prasanty Dedi Susila Dharmawati, Ira Diska Hanifah Nurhayati Dwi Rachmawati Edward Kusuma Eka Prasetiyawan Elizeus Hanindito Hamzah Hamzah Hamzah Hamzah Hamzah Hamzah Hanif Hanif Hardiono Hardiono Herdiani Sulistyo Putri Imam Susilo Inge Andriani Jusak Nugraha Kapuangan, Christopher Khildan Miftahul Firdaus Kun Arifi Abbas Lucky Andriyanto Lupi Lestari M Yusuf Gunawan Mahendra Dwi Aditya Lopulalan Mahendratama Purnama Adhi Maulana Hanif Ibrahim Maulydia, Maulydia Meilissa Eka Susanti Muh Kemal Putra Muzaiwirin Muzaiwirin Nalini Nanang Nurofik Nasrulloh Nasrulloh Nenden Suliadiana Fajarini Neurinda Permata Kusumastuti Ninik Asmaningsih Soemyarso Notopuro, Paulus Budiono Nugroho Setia Budi Nurofik, Nanang Perdhana, Fajar Prananda Surya Airlangga Pratama Ananda Puspita, Eka Ari Puspita, Eka Ari Putu Kurniyanta R. Muhammad Aviv Pasa Rafida Anshori Rehatta, Nancy Margarita Retno Asih Setyoningrum Robby Dwestu Nugroho Rudi Iskandar Suryadani Rudy Vitraludyono Samuel Hananiel Rory Sandi Ardiya Rasitullah Santoso, Kohar Hari Santoso, Kohar Hari Santoso Hari SATRIYAS ILYAS Semedi, Bambang Pujo Semedi, Bambang Pujo Setiawan, Philia Soni Sulistiawan Soni Sunarso Sulistiawan Sudarmanto, Aisya Azzahra Sulistiawan, Soni Sunarso Teguh Sylvaranto Teuku Aswin Husain Virda Maharani

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