Articles
<![CDATA[Laparotomy Exploration In Pediatric With Severe Thrombocytopenia: A Report ]]>
<![CDATA[Rudy Vitraludyono]]>;
<![CDATA[Arie Utariani]]>
<![CDATA[ Indonesian Journal of Anesthesiology and Reanimation Vol. 3 No. 1 (2021): Indonesian Journal of Anesthesiology and Reanimation (IJAR) ]]>
Publisher : <![CDATA[Faculty of Medicine-Universitas Airlangga ]]>
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DOI: 10.20473/ijar.V3I12021.10-16
<![CDATA[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.]]>
<![CDATA[Opioid-Sparring and Multimodal Analgesia as Parts of Enhanced Recovery After Surgery (ERAS) Applied In The Ksatria Airlangga Floating Hospital ]]>
<![CDATA[Pratama Ananda]]>;
<![CDATA[Bambang Pujo Semedi]]>;
<![CDATA[Christrijogo Sumartono Waloejo]]>;
<![CDATA[Arie Utariani]]>
<![CDATA[ Indonesian Journal of Anesthesiology and Reanimation Vol. 3 No. 1 (2021): Indonesian Journal of Anesthesiology and Reanimation (IJAR) ]]>
Publisher : <![CDATA[Faculty of Medicine-Universitas Airlangga ]]>
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DOI: 10.20473/ijar.V3I12021.17-21
<![CDATA[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.]]>
<![CDATA[PAIN TREATMENT SERVICE AND BASIC MANAGEMENT PAIN TRAINING FOR COMMONS AND MEDICAL PERSONNEL IN SURABAYA ]]>
<![CDATA[Arie Utariani]]>;
<![CDATA[Soni Sulistiawan]]>;
<![CDATA[Robby Dwestu Nugroho]]>;
<![CDATA[Herdiani Sulistyo Putri]]>
<![CDATA[ Jurnal Layanan Masyarakat (Journal of Public Services) Vol. 7 No. 4 (2023): JURNAL LAYANAN MASYARAKAT ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/jlm.v7i4.2023.581-588
<![CDATA[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.]]>
<![CDATA[BACTERIAL COLONY GROWTH IN THE VENTILATOR CIRCUIT OF THE INTENSIVE OBSERVATION UNIT AT RSUD Dr. SOETOMO SURABAYA ]]>
<![CDATA[Perdhana, Fajar]]>;
<![CDATA[Utariani, Arie]]>;
<![CDATA[Semedi, Bambang Pujo]]>;
<![CDATA[Setiawan, Philia]]>
<![CDATA[ Indonesian Journal of Tropical and Infectious Disease Vol. 6 No. 3 (2016) ]]>
Publisher : <![CDATA[Institute of Topical Disease Universitas Airlangga ]]>
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DOI: 10.20473/ijtid.v6i3.3013
<![CDATA[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. ]]>
<![CDATA[CORRELATION BETWEEN THE USE OF ALBUMIN INFUSION AND CONCENTRATIONS OF SERUM ALBUMIN, PROINFLAMMATORY CYTOKINES (TNF-ï¡, IL6) AND SOFA SCORE IN SEPTIC PATIENTS ]]>
<![CDATA[Utariani, Arie]]>;
<![CDATA[Prasetyo, Budi]]>;
<![CDATA[Nugraha, Jusak]]>
<![CDATA[ Folia Medica Indonesiana Vol. 52 No. 4 (2016): OCTOBER - DECEMBER 2016 ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/fmi.v52i4.5481
<![CDATA[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).]]>
<![CDATA[Incidence of Emergence Agitation in Pediatric Patient after General Anesthesia ]]>
<![CDATA[Andriyanto, Lucky]]>;
<![CDATA[Utariani, Arie]]>;
<![CDATA[Hanindito, Elizeus]]>;
<![CDATA[Santoso, Kohar Hari Santoso Hari]]>;
<![CDATA[Hamzah, Hamzah]]>;
<![CDATA[Puspita, Eka Ari]]>
<![CDATA[ Folia Medica Indonesiana Vol. 55 No. 1 (2019): March ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/fmi.v55i1.24340
<![CDATA[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.]]>
<![CDATA[Comparison General Anesthesia And Combined Scalp Block With Ropivacaine 0.5% On Mean Arterial Pressure, Heartrate And Fentanyl Consumption During Craniotomy. ]]>
<![CDATA[Rudi Iskandar Suryadani]]>;
<![CDATA[Hamzah Hamzah]]>;
<![CDATA[Nancy Margarita Rehatta]]>;
<![CDATA[Arie Utariani]]>
<![CDATA[ JURNAL WIDYA MEDIKA Vol. 6 No. 1 (2020): April ]]>
Publisher : <![CDATA[FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA ]]>
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DOI: 10.33508/jwm.v6i1.2499
<![CDATA[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.]]>
<![CDATA[Effects Of Regional Scalp Block With Ropivacaine 0.5% Preincision As A Preemptive Analgesia After Craniotomy Surgery ]]>
<![CDATA[R. Muhammad Aviv Pasa]]>;
<![CDATA[Christrijogo Soemartono]]>;
<![CDATA[Soni Sunarso Sulistiawan]]>;
<![CDATA[Arie Utariani]]>
<![CDATA[ JURNAL WIDYA MEDIKA Vol. 6 No. 1 (2020): April ]]>
Publisher : <![CDATA[FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA ]]>
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DOI: 10.33508/jwm.v6i1.2500
<![CDATA[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.]]>
<![CDATA[ACHIEVEMENT OF COMPETENCY DURING PEDIATRIC ROTATION OF ANESTHESIOLOGY RESIDENTS ACCORDING TO THE EDUCATIONAL STANDARD OF ANESTHESIOLOGY IN FACULTY OF MEDICINE AIRLANGGA UNIVERSITY ]]>
<![CDATA[Meilissa Eka Susanti]]>;
<![CDATA[Arie Utariani]]>;
<![CDATA[Elizeus Hanindito]]>
<![CDATA[ JURNAL WIDYA MEDIKA Vol. 7 No. 1 (2021): April ]]>
Publisher : <![CDATA[FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA ]]>
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DOI: 10.33508/jwm.v7i1.2781
<![CDATA[Background: The advancement and development of science and technology in the field anesthesiology and intensive therapy, has become the basis for the need of quality national guideline that is ethically and professionally accountable. This operational guideline can serve as a national guideline in providing anesthesia and intensive therapy services to patients. Until today, there is still no standardize educational evaluation for the pediatric division of anesthesiology to assess whether it is following the expected standards. Aim: To analyze the competency of anesthesiology residents in the pediatric division based on logbook according to the type of cases and procedures, and the number of patients based on the standard curriculum of the pediatric division of anesthesiology Surabaya. Methods: This study was an observational study with retrospective design, evaluating the competency of anesthesiology residents of Airlangga University in pediatric rotation according to the type of cases and procedures, and the number of patients treated and recorded in residents’ logbook based on the standard curriculum of the pediatric division of anesthesiology Surabaya. Data collection was performed by taking secondary data from April 2018-April 2020. Result: Median total of eletive cases during rotation and emergency cases during shift treated by anesthesiology resident of pediatric division was 9 (5-13) neonates, 35 (26-44) infants, and 56 (48-62) children. Target of neonates cases was achieved by 35%, infants by 100%, and children by 95% residents. Target of caudal anesthesia was achieved by 100%, inhalation induction by 55%, and IV line insertion by 100%. No resident achieved target for CVC insertion. Conclusion: A more formal and comprehensive guideline to standardize log case recording can be beneficial as it can evaluate residents based on the data collected electronically.]]>
<![CDATA[CHARACTERISTIC OF MECHANICALLY VENTILATED CHILDREN IN PEDIATRIC INTENSIVE CARE UNIT (PICU) ]]>
<![CDATA[Sudarmanto, Aisya Azzahra]]>;
<![CDATA[Kusumastuti, Neurinda Permata]]>;
<![CDATA[Utariani, Arie]]>
<![CDATA[ PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 9 No. 1 (2025): APRIL 2025 ]]>
Publisher : <![CDATA[Universitas Pahlawan ]]>
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DOI: 10.31004/prepotif.v9i1.38513
<![CDATA[Ventilator Mekanik (VM) merupakan alat bantu kehidupan yang dapat membantu pasien untuk bernapas dengan menjaga oksigen yang adekuat dan ventilasi yang cukup sampai dengan penyakit yang mendasari terselesaikan. Oleh karena itu, data tentang admisi dan perawatan anak-anak pengguna Ventilator Mekanik dengan penyakit kritis di Ruang Perawatan Intensif Anak (PICU) terutama di negara berkembang sangat penting. Namun, informasi dan data mengenai admisi dan penggunaan VM di Ruang Perawatan Intensif Anak susah untuk dicari dan ditemukan. Hal ini menyebabkan kesulitan untuk meningkatkan pelayan perawatan dan hasil akhir luaran pasien. Penelitian ini bertujuan untuk mengetahui karakteristik admisi dan perawatan pasien anak dengan penggunaan VM di Ruang Perawatan Intensif Anak di RSUD Dr. Soetomo Surabaya, sehingga diharapkan hasil dari penelitian dapat digunakan untuk meningkatkan pelayanan perawatan pasien anak di Ruang Perawatan Intensif Anak di Seluruh Indonesia khususnya di Surabaya. Penelitian ini menggunakan metode penelitian deskriptif retrospektif. Dari pengumpulan data, ditemukan sebanyak 111 pasien memenuhi kriteria inklusi. Mayoritas pasien yang dirawat di Ruang Perawatan Intensif Anak adalah pasien bayi sebanyak 55 pasien (49.55%), dengan pasien laki-laki sebanyak 64 pasien (57.66%) dan dengan status nutrisi kurang sebanyak 35 pasien (53.84%). Mayoritas pasien dirawat di Ruang Perawatan Intensif Anak karena masalah sistem pernapasan sebanyak 46 pasien (41.44%).]]>
