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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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Opioid-Sparring and Multimodal Analgesia as Parts of Enhanced Recovery After Surgery (ERAS) Applied In The Ksatria Airlangga Floating Hospital Pratama Ananda; Bambang Pujo Semedi; Christrijogo Sumartono Waloejo; 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: Enhanced Recovery After Surgery (ERAS) protocol is a perioperative multimodal service program designed to achieve a faster surgical recovery period and a better outcome, the key in reducing morbidity in surgery is by reducing the "surgical injury” and reducing the body's stress response caused by the surgery. The success of the ERAS protocol depends on the interpretation and collaboration of the multidisciplinary team, therefore though the protocol is carried out in a hospital that has sufficient facilities and resources, the obstacle in the implementation of ERAS can still happen. The implementation of ERAS protocol in the non-permanent hospital service facility becomes a challenge in itself. Case Reports: From the two case reports of the implementation of ERAS protocol in the Ksatria Airlangga Floating Hospital (RST-KA) it is obtained that the key success of the anesthesia in ERAS protocol above lies on the administration of opioid-sparring therapy where it will reduce the use of opioid. Although there are many obstacles obtained in the RST-KA, the use of ERAS protocol can be conducted by making effective use of opioid-sparring combined with the administration of multimodal analgesia. Conclusion: Therefore, it can be concluded that the ERAS protocol can be applied in the social service concept in the non-permanent health facility.

Successful Anesthetic Management from Separation Surgery of Pygopagus Conjoined Twin; Lesson-Learning With A Teleanesthesia Mahendratama Purnama Adhi; Arie Utariani; Lucky Andriyanto
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 1 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: The management of conjoined twins requires multidisciplinary teamwork. The complex problems in conjoined twin separation surgery are challenging for anesthesiologists without experience in the management of conjoined twins. Objective: To describe anesthetic management and utilization of teleanesthesia in conjoined twin separation surgery. Case Report: Sixty days-old pygopagus type conjoined twins, with a total body weight of 7030 grams. Both babies looked healthy, moved actively, found no respiratory function disorders, were hemodynamically stable and had no congenital abnormalities. The sacral region's computerized tomography scan (CT-scan) reveals conjoined twins with skin unification and subcutaneous in the perianal region and no internal-vertebral-spinal fusion. Two anesthesia teams performed the management of anesthesia. After confirming there was no cross-circulation with the atropine test, we alternately induced anesthesia by inhalation technique while maintaining spontaneous breathing. Anesthesia was maintained with sevoflurane 2.0-3.0 vol%, in a mixture of oxygen and air with a flow of 4 L/min using Jackson Reese. Circulating volume, hemodynamic stability, and normothermia were maintained intraoperatively. The separation surgery lasted 20 minutes, and the total surgical time for each baby was two hours. Awake extubation was performed immediately after the surgery was complete. Both babies underwent postoperative care at the PICU and were discharged on day 11. During the pre-operative for surgery, the local team conducted telemedicine consultations with the pediatric anesthesia team at Dr. Soetomo hospital and performed intra-anesthesia telementoring. Conclusion: Careful preparation and pre-operative evaluation, proper intra-anesthesia maintenance and monitoring, as well as good communication and teamwork, are keys to successful anesthesia management in conjoined twin separation surgery. Consultation and assistance from an experienced team during surgery using teleanesthesia are significantly beneficial to the anesthesiologist without experience in conjoined twin separation surgery.

Pediatric Shock Profile in The Pediatric Intensive Care Unit (PICU) of Dr. Soetomo General Academic Hospital Rafida Anshori; Arina Setyaningtyas; Arie Utariani; Neurinda Permata Kusumastuti
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 1 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I12023.11-17

Introduction: Shock is a life-threatening condition caused by circulatory failure which increases morbidity and mortality rate. According to the western literature, about 2% of children are admitted to hospitals worldwide due to shock. Objective: This study aimed to describe the pediatric shock profile of patients in the Pediatric Intensive Care Unit (PICU) of Dr. Soetomo General Academic Hospital between 1 January to 1 December 2019. Methods: A total of 60 patients were selected as the participants using a descriptive method. Data collection was carried out by recording the exact time the participants first entered the PICU. Furthermore, data were collected based on gender, age, physical and laboratory examination, diagnosis of shock, patients' outcomes, as well as PRISM III score. Results: The results of this study that the males and children are 51.7% and 53.3%, respectively. At an infant age, the distribution of the highest average pulse and breathing frequency was 135 and 32.2, respectively. The highest average body temperature at the age of adolescents was 37.19°C. Furthermore, the patients' diagnoses were dominated by distributive shock with the highest PRISM III score â‰¥8 and deaths recorded of 76.6%, 60%, and 61.7%, respectively. The diagnosis results showed that distributive shock leads to the highest mortality with a PRISM III score of 51.7% and 53.3%. Conclusion: Distributive shock contributes to the patient's diagnoses and mortality rate with the highest score of PRISM III being â‰¥8. From this conclusion, the PICU needs to be more responsive to detect distributive shock in children.

The Difference in Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Lactate Levels Between Sepsis and Septic Shock Patients Who Died in The ICU Dwi Rachmawati; Arie Utariani; Paulus Budiono Notopuro; Bambang Pujo Semedi
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 2 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I22023.64-71

Introduction: Sepsis and septic shock are organ dysfunctions caused by the dysregulation of the body's response to infection and are the most common causes of death. Objective: This study aims to describe the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and lactate levels in patients with sepsis and septic shock who died in the Intensive Care Unit (ICU). Methods: An observational retrospective study was conducted by examining the medical record data of sepsis and sepsis shock patients who were hospitalized in the ICU of Dr. Soetomo General Academic Hospital Surabaya from January to December 2019. Results: The study sample was 28 patients: 16 with sepsis and 12 with septic shock. Fifteen patients (53.6%) were women. The patients' mean age was 53.18 ± 13.61 years, and most patients (8 patients, 28.6%) belonged to the late adult age group (36-45 years). The most common comorbidities were diabetes mellitus and hypertension (30.8%). The highest incidence of infection in both groups occurred in the lungs (42.9%). Most of the patients had high SOFA scores, in the moderate (7-9) to severe (â‰¥ 10) category (39.3%). Almost all patients (82.1%) were treated for less than one week. The hematological examination within the first 24 hours showed a leukocyte value of 16,995 (Leukocytosis) and a platelet value of 279,500 (Normal). The NLR of septic shock patients (31.38±55.61) was higher than the NLR of sepsis patients (23.75±22.87). The PLR of septic shock patients (534.02±1000.67) was lower than the PLR of patients (802.93±1509.89). Lastly, the lactate levels in septic shock patients (3.84±1.99) were higher than in sepsis patients (1.97±1.06). Conclusion: There were no significant differences in the NLR and PLR values "‹"‹between sepsis and septic shock patients, but there were significant differences in their initial lactate levels.

PAIN TREATMENT SERVICE AND BASIC MANAGEMENT PAIN TRAINING FOR COMMONS AND MEDICAL PERSONNEL IN SURABAYA Arie Utariani; Soni Sulistiawan; Robby Dwestu Nugroho; Herdiani Sulistyo Putri
Jurnal Layanan Masyarakat (Journal of Public Services) Vol. 7 No. 4 (2023): JURNAL LAYANAN MASYARAKAT
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jlm.v7i4.2023.581-588

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. The lack of up-to-date basic knowledge of pain management, especially among healthcare professionals in Primary Health Care Facilities in Surabaya, often leads to the perception that pain is trivial and consequently inadequately addressed. The objective of this social service activity in pain treatment and basic pain management training is to provide appropriate treatment for the community's pain scale and impart current knowledge on pain management that can be applied in daily practice by healthcare professionals and the general public in Surabaya. This initiative involves two methods: treating pain in non-medical community members and providing basic pain management training for healthcare professionals. Examination and anamnesis are conducted for each patient according to the examination questionnaire, which includes the Pain Questionnaire for Laypersons, the Physical Examination Form for Pain Management Social Service, and the Quality of Life Scoring. The initial examination and anamnesis results will determine whether the patient falls into the acute or chronic pain category, allowing for tailored interventions based on patient grouping. As for the basic pain management training, it is conducted by a pain management consultant, comprising the Socialization of the Pain Management Center, a General Lecture on the New Paradigm of Pain Management in the Community, and a Hands-On Pain Management Workshop for patients in pain.

BACTERIAL COLONY GROWTH IN THE VENTILATOR CIRCUIT OF THE INTENSIVE OBSERVATION UNIT AT RSUD Dr. SOETOMO SURABAYA Perdhana, Fajar; Utariani, Arie; Semedi, Bambang Pujo; Setiawan, Philia
Indonesian Journal of Tropical and Infectious Disease Vol. 6 No. 3 (2016)
Publisher : Institute of Topical Disease Universitas Airlangga

Ventilator-associated pneumonia (VAP) remains a problem with the highest cos, morbidity and mortalityt in the Intensive Care Unit (ICU). The correlation between mechanical ventilation and pneumonia is considered as common sense, yet scientific evidence to support this statement is still needed. This research aims to analyze the bacterial colony grows in mechanical ventilation circuit and those grew in the patient's sputum culture. We performed an observational study. Samples for bacterial culture were taken from ventilator circuit and patient sputum on Day-0, Day-3 and Day-7. Sputum samplings are collected using double catheter tracheal aspiration technique; Results are then analyzed with Chi-square test. While the similarity of bacteria species in ventilator circuit to patient's sputum is analyzed with Binomial test. Two samples are dropped out immediately due to the rate of bacterial growth on Day-0. Bacterial colony growth in ventilator circuit shows a significant difference on Day-3 and Day-7 at 50% and 92% respectively (p = 0.05). A comparison for the bacterial similarity of the ventilator circuit and patient's sputum shows that the bacterial growth on Day-3 is 7 out of 14 (50%) and 3 with more than 105 CFU/ml colony; while on Day-7, there are 13 out of 14 positive bacterial growth, both in the circuit and the patient's sputum. Among them, 5 out of 14 (35%) of the bacterial colony which grow in the circuit have the same species as those grow in patient's sputum. The recent study shows that there is bacteria colony growth in the ventilator circuit after Day-3 and a significant increase on Day-7. Almost half of the colony illustrates similar species from both ventilator circuit and patient's sputum. This suggests that the bacterial growth on Day-7 in the ventilator circuit might be related to those growth in patient's sputum.

CORRELATION BETWEEN THE USE OF ALBUMIN INFUSION AND CONCENTRATIONS OF SERUM ALBUMIN, PROINFLAMMATORY CYTOKINES (TNF-ï¡, IL6) AND SOFA SCORE IN SEPTIC PATIENTS Utariani, Arie; Prasetyo, Budi; Nugraha, Jusak
Folia Medica Indonesiana Vol. 52 No. 4 (2016): OCTOBER - DECEMBER 2016
Publisher : Universitas Airlangga

Sepsis is a major problem causing high morbidity and mortality in patients who hospitalized in intensive care. In sepsis, there is a change in the distribution of albumin in the intravascular and extravascular compartment, so hipoalbumin is occured. Using albumin in septic patients from several studies that have been done are still controversial. Analyzing albumin infusion with changes in levels of albumin, cytokines and SOFA score in septic patients in intensive care dr. Soetomo. The design of this study is a prospective longitudinal observational. The study was conducted in the intensive care unit or ICU dr. Soetomo in February 2015. The inclusion and exclusion criteria were determined that obtained 15 research subjects. They were examined with serum albumin and proinflammatory cytokines as well as evaluating the SOFA score. Then, it measure with ANOVA test methods. Infusion of albumin positively correlated with increased levels of serum albumin and a negative correlation with the levels of IL6, TNF-a and SOFA score. It also found a correlation between changes in levels of albumin with changing levels of IL6 (p <0:01) and changes in SOFA score (p <0.05).

Incidence of Emergence Agitation in Pediatric Patient after General Anesthesia Andriyanto, Lucky; Utariani, Arie; Hanindito, Elizeus; Santoso, Kohar Hari Santoso Hari; Hamzah, Hamzah; Puspita, Eka Ari
Folia Medica Indonesiana Vol. 55 No. 1 (2019): March
Publisher : Universitas Airlangga

Post anesthesia agitation is common problem in pediatric post anesthesia care unit. The incidences range from 10 to 80%. EA has been described as a dissociated state of consciousness in which the child is inconsolable, irritable, and uncooperative typically thrashing, crying, moaning or incoherent. This study was done to determine the incidence of emergence agitation and associated risk factors in pediatric patients who underwent general anesthesia. This descriptive and analytic study was performed on 105 pediatric patient aged 1-12 years that underwent general anesthesia for various elective diagnostic and surgeries at Dr. Soetomo Hospital between January and February 2016. The presence of emergence agitation was recorded using Pediatric Anesthesia Emergence Delirium (PAED) scale. The factors that linked with Emergence Agitation were recorded in a questionnaire. The data were analyzed using SPSS software with logistic regression. p - values less than 0.05 were considered as significant. Forty two (40%) children had Emergence Agitation. Preoperative anxiety (p = 0.006) and Pain (p=0.035) were associated with higher rates of post anesthetic emergence agitation. This study identified preoperative anxiety and pain as risk factors, which are associated with emergence agitation in children. To minimize the incidence of post anesthetic emergence agitation, these risk factors should be considered in the routine care by anesthetist.

Comparison General Anesthesia And Combined Scalp Block With Ropivacaine 0.5% On Mean Arterial Pressure, Heartrate And Fentanyl Consumption During Craniotomy. Rudi Iskandar Suryadani; Hamzah Hamzah; Nancy Margarita Rehatta; Arie Utariani
JURNAL WIDYA MEDIKA Vol. 6 No. 1 (2020): April
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v6i1.2499

Surgical craniotomy such as skin incisions, head pinning, periosteal-dural contact, dura closure, bones and skin can cause of nociceptive stimulation. These actions are stimuli to the nerves that can stimulate stress response. The stress response to surgery is characterized by increased secretion of the pituitary hormone and activation of the sympathetic nervous system. Hypothalamic activation of the sympathetic autonomic nervous system results in increased secretion of catecholamines from the adrenal medulla and the release of norepinephrine from the presynaptic nerve terminal. Objectives: This study is a single blind experimental, 14 patients with ages 18-60 years physical status ASA (American Society of Anesthesiologists) 1-3, with elective craniotomy surgery. This study was divided into two groups of subjects, group A with seven craniotomy subjects with general anesthesia and group B with seven craniotomy subjects combined with scalp block using ropivacaine 0.5%. Data collected then analyzed with SPSS. We found a decrease in MAP (Mean Arterial Pressure) and heart rate in the scalp block group during scalp incision (MAP p=0.002; HR p=0.029), periosteal contact (MAP p=0.025; HR p=0.039) significantly, as well as the use of fentanyl during surgery was significantly decreased (p=0.0001). General anesthesia with scalp block is more effective in reducing the increase in MAP, heart rate and fentanyl consumption during craniotomy.

Effects Of Regional Scalp Block With Ropivacaine 0.5% Preincision As A Preemptive Analgesia After Craniotomy Surgery R. Muhammad Aviv Pasa; Christrijogo Soemartono; Soni Sunarso Sulistiawan; Arie Utariani
JURNAL WIDYA MEDIKA Vol. 6 No. 1 (2020): April
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v6i1.2500

Studies reported that more than 55% of patients complained of moderate to severe pain up to 48 hours post craniotomy. Fentanyl is the drug of choice to manage acute pain with disadvantages. Regional scalp block (RSB) technique using local anesthesia may be an alternative for post craniotomy pain management. Objective: to analyze the effects of RSB using ropivacaine 0.5% before incision compared to general anesthesia alone on the pain scale and opioid requirements 24-hour post craniotomy. This is a single-blind randomized experimental study. 14 Subjects were divided into two intervention groups. Patients were 18–64 years, GCS (Glasgow Coma Scale) 15, physical status ASA (American Society of Anesthesiologists) 1–3, undergoing craniotomy. In this study, the mean of fentanyl dose in RSB group was smaller than the group without RSB, which was statistically significant (p=0.017). Pain was also significantly reduced in RSB group at 30 minutes (p=0.009), 1 hour (p=0.003), 2 hours (p=0.003), 4 hours (p=0.001), 8 hours (p=0.050), and 12 hours (p=0.003) post-surgery. There was no difference in pain scale between the two groups at 24 hours post-surgery (p=0.393). RSB using ropivacaine 0.5% preincision is more effective in reducing pain scale up to 12 hours and also reduced the requirement of fentanyl within 24-hours post craniotomy compared to general anesthesia alone.

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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