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All Journal Jurnal Anestesiologi Indonesia Jurnal Kedokteran Brawijaya Jurnal Anestesi Perioperatif Jurnal Online Mahasiswa (JOM) Bidang Kedokteran Jurnal Medika Malahayati Jurnal Anestesi Obstetri Indonesia JOURNAL LA MEDIHEALTICO
Dino Irawan
Rumah Sakit Umum Daerah Arifin Achmad Propinsi Riau
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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GAMBARAN KEJADIAN KEGAGALAN ANESTESI SPINAL PADA PASIEN SEKSIO SESAREA DI RUMAH SAKIT UMUM DAERAH ARIFIN ACHMAD PROVINSI RIAU PERIODE MEI- JUNI 2014 Hardiyani, Wiwi Hardiyani; Irawan, Dino; Fauzia, Dina
Jurnal Online Mahasiswa (JOM) Bidang Kedokteran Vol 1, No 2 (2014): Wisuda Oktober Tahun 2014
Publisher : Jurnal Online Mahasiswa (JOM) Bidang Kedokteran

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Abstract

Sectio Cesarea is a birth giving of fetus through transabdomen insition in uterus or fetus excretion through the wall of abdomen insition (laparatomy) and the wall of uteus (hysterectomy). In birth giving of this sectiocesarea, the technic that is generally used is the general and regional anaesthesia, but mostly used is the regional one, especially for spinal anaesthesia. The spinal anaesthesia technic has a risk of failure that is known as failed spinal anaesthesia. The type of this research is the descriptive one with cross sectional approach, to see the description of a failed spinal anaesthesia incident to medical patient of section cesarean in General Hospital Arifin Achmad Riau Province on May-June 2014. The result of this research shows that the number of failed spinal anaesthesia incident to medical patient of section cesarean in General Hospital Arifin Achmad Riau Province is 3,4% for 3 cases. The most cause distribution are obtained by a-not-really-good medicine quality for 2 cases (66,67%), followed by unappropriate chemicals for the medicine for 1 case (33,33%). The implementation of pasca failed spinal anaesthesia in every case of this failure is the repetation of spinal anaesthesia procedure.Key words : Spinal anaesthesia, Failed Spinal Anaesthesia, Sectio Cesarea
Kejadian Post Dural Puncture Headache dan Nilai Numeric Rating Scale Pascaseksio Sesarea dengan Anestesi Spinal Irawan, Dino; Tavianto, Doddy; Surahman, Eri
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kejadian nyeri kepala pascaanestesi spinal (post dural puncture headache; PDPH) berhubungan dengan ukuran lubang dura akibat proses penusukan. Tujuan penelitian ini untuk mengetahui kejadian PDPH pada pasien pascaseksio sesarea dengan anestesi spinal di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan Januari–April 2010. Penelitian dilakukan terhadap 115 wanita hamil, status fisik American Society of Anesthesiologist (ASA) II, berusia 18–45 tahun. Penelitian bersifat observasional dengan rancangan cross sectional. Hasil observasi didapatkan kejadian PDPH pada jarum tipe quincke no. 25 sebesar 68,2%, pada jarum tipe quincke no. 27 sebesar 31,8% dan tidak ditemukan pada jarum tipe pencil point no. 27. Nilai numeric rating scale (NRS) dari PDPH pada tipe jarum quincke no. 25 adalah 3–7, pada tipe jarum quincke no. 27 adalah 2–6, dan 0 pada tipe jarum spinal pencil point no. 27. Simpulan penelitian adalah bahwa kejadian PDPH pada pasien seksio sesarea dengan anestesi spinal berdasarkan tipe jarum spinal paling banyak didapatkan pada jarum tipe quincke no. 25, selanjutnya pada jarum tipe quincke no. 27 dan tidak ditemukan pada jarum tipe pencil point no. 27.Kata kunci: Anestesi spinal, numeric rating scale, post dural puncture headacheThe Incidence of Postdural Puncture Headache and Numeric Rating Scale Score After the Caesarean Section with Spinal AnesthesiaAbstractThe incidence of post dural puncture headache (PDPH) is associated with the size of duramater diameter puncture caused by the puncture itself. There are two factors related to this problem, the size of the needle and the shape of the needle’s-end. The purpose of this study was to obtain an overview of incidence of PDPH in patients undergoing caesarean section with regional spinal anesthesia in Dr. Hasan Sadikin Hospital Bandung in January–April 2010. This research was conducted on 115 pregnant woman with physical status of American Society of Anesthesiologist (ASA) II, range of age was 18 to 45 years old. This research was an observational study with cross-sectional design. The incidence of PDPH after the use of Quincke type needle no. 25 was 68.2%, while with Quincke type needle no. 27 was 31.8%, and no PDPH was found on the use of pencil point type needle no. 27. The numeric rating scale (NRS) from PDPH on the use of Quincke type needle no. 25 was 3–7, while on Quincke type needle no. 27 was 2–6, and 0 in pencil point type needle no. 27. As the conclusion, the greatest incidence of PDPH in patients undergoing caesarean section, based on spinal needle type, occurs most with no. 25 Quincke type needles, and less with no. 27 and none with no. 27.Key words: Numeric rating scale, post dural puncture headache, spinal anesthesia DOI: 10.15851/jap.v1n3.197
Prevalensi dan Pola Sensitivitas Enterobacteriaceae Penghasil ESBL di RSUD Arifin Achmad Pekanbaru Anggraini, Dewi; Sholihin, Uswathun Hasanah; Savira, Maya; Djojosugito, Fauzia Andrini; Irawan, Dino; Rustam, Ruza Prima
Jurnal Kedokteran Brawijaya Vol 30, No. 1 (2018)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2018.030.01.9

Abstract

Resistensi antibiotik merupakan masalah besar baik di rumah sakit maupun di masyarakat, resistensi menyebabkan pilihan terapi infeksi menjadi terbatas. Prevalensi resistensi antibiotik cenderung makin meningkat, salah satu diantaranya adalah bakteri ESBL (extended spectrum beta lactamases), suatu kelompok bakteri penghasil enzim yang dapat menghidrolisis antibiotik beta laktam yang mengandung grup oxyimino seperti sefalosporin generasi satu sampai ketiga dan aztreonam. Penelitian ini  dilakukan secara deskriptif retrospektif yang bertujuan untuk mengetahui prevalensi ESBL pada Klebsiella pneumoniae dan Escherichia coli, serta pola sensitivitasnya di RSUD Arifin Achmad Pekanbaru. Data diambil dari hasil kultur bakteri dan uji resistensi antibiotik dari berbagai spesimen klinik yang diperiksa di Laboratorium Mikrobiologi RSUD Arifin Achmad selama tahun 2015. Uji ESBL dilakukan dengan alat VITEK 2 compact yang membandingkan antara proporsi penurunan pertumbuhan bakteri terhadap antibiotik sefalosporin saja dengan antibiotik kombinasi sefalosporin ditambah asam klavulanat. Hasil penelitian menunjukkan ESBL-K. pneumoniae sebesar 66,2%, dan ESBL-E. coli 62,2%, dan total rata-rata pada kedua bakteri 65,2%. Prevalensi ESBL-K. pneumoniae dan ESBL-E. coli paling tinggi berasal dari ruangan Instalasi Perawatan Intensif Anak dan berasal dari spesimen sputum dan pus, namun secara statistik tidak didapatkan perbedaan bermakna proporsi ESBL positif dan negatif berdasarkan asal ruangan dan jenis spesimen. Sensitivitas ESBL-K. pneumoniae dan ESBL-E. coli paling baik dengan antibiotik golongan karbapenem, amikasin dan tigesiklin. Penelitian ini menunjukkan tingginya prevalensi K. pneumoniae dan E. coli penghasil ESBL di RSUD Arifin Achmad dibanding beberapa rumah sakit rujukan nasional dii Indonesia. Saran untuk menurunkan angka ESBL dengan cara mencegah transmisi melalui penerapan kewaspadaan kontak dan kewaspadaan berbasis transmisi, aspek pencegahan dan pengendalian infeksi dan peningkatkan rasionalisasi penggunaan antimikroba harus dilakukan.
Manajemen Anestesi pada Pasien Laparotomi Kista Ovarium Permagna dengan Teknik Rapid Sequence Induction Pardede, Annisaa Shafira; Hidayat, Nopian; Irawan, Dino
Jurnal Anestesi Obstetri Indonesia Vol 7 No 1 (2024): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v7i1.181

Abstract

Kasus kista ovarium permagna merupakan kasus yang jarang. Laporan kasus ini melaporkan manajemen anestesi pada pasien dengan kista ovarium permagna yang dilakukan tindakan laparotomi kistektomi dengan teknik anestesi umum. Pasien perempuan 51 tahun dikonsulkan dengan perut tampak membesar sejak lima belas tahun sebelum masuk rumah sakit. Saat ini pasien terasa sulit berjalan dan berbaring akibat masa yang sangat besar pada abdomen. Pasien direncanakan untuk menjalani laparotomi kistektomi dengan teknik anestesi umum. Tanda-tanda vital dan hasil pemeriksaan durante dan pasca laparotomi kistektomi dalam batas normal. Dalam berbagai literatur, anestesi umum selalu menjadi pilihan utama untuk pasien dengan massa abdomen yang besar. Periode praoperasi adalah periode yang paling penting pada pasien dengan massa abdomen yang besar. Anamnesis dan pemeriksaan fisik adalah langkah prosedur yang vital. Rapid Sequence Induction merupakan prosedur yang bertujuan untuk mengurangi kejadian aspirasi paru selama manajemen jalan napas. Hal ini dapat dicapai dengan meminimalkan waktu antara hilangnya refleks pelindung saluran napas akibat obat dan keberhasilan pemasangan serta penggembungan manset tabung trakea. Pengelolaan anestesi pada pasien kista ovarium permagna menggunakan teknik Rapid Sequence Induction memiliki keuntungan tersendiri, namun demikian tetap diperlukan pertimbangan dan pemahaman yang baik agar menghasilkan hasil keluaran yang optimal.
Thoracic Spinal Anaesthesia for Modified Radical Mastectomy in a Patient with Pulmonary Atelectasis & Pleural Effusion: Case Report Irawan, Dino; Herman, Awanda
Jurnal Medika Malahayati Vol 8, No 4 (2024): Volume 8 Nomor 4
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jmm.v8i4.15986

Abstract

The incidence of breast cancer is the highest malignancy in Indonesia, and this case increases with age, affecting more than 65% of patients over 65 years old.  In geriatric patients, the possibility of coexisting major medical problems is high, which makes anesthetic management challenging, Regional anesthesia is a preferable option for breast cancer surgery for geriatrics with coexisting major medical problems than general anesthesia.Spinal anesthesia has more advantages compared with general anesthesia. These include smaller respiratory and cardiac complications, better intraoperative and postoperative pain control, early recovery of gastrointestinal function, lower postoperative nausea and vomiting, early ambulation and discharge from hospital, a reduced need for blood transfusions, and reduced costs. A significant advantage of spinal anesthesia in this case is the avoidance of airway instrumentation and its possible complications. Studies have demonstrated that up to 15 to 20% of the lung at its base collapses during uneventful anesthesia before any surgical intervention. Pulmonary atelectasis and pleural effusion increase the risk of ventilator dependence after anesthesia.
Anesthesia Management of Patients with Esophageal Atresia/Traceoesophageal Fistula undergoing Thoracostomy and Esophagostomy Procedures Marthendro, Triade; Irawan, Dino; Muharrami, Vera; Hidayat, Nopian; Ananda, Pratama
Journal La Medihealtico Vol. 5 No. 5 (2024): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v5i5.1597

Abstract

Esophageal atresia is a congenital disorder characterized by a disruption in the continuity of the esophageal lumen. Esophageal atresia may be accompanied by tracheoesophageal fistula, which is a lumen connection between the proximal and or distal part of the esophagus and the airway (trachea). Type C atresia is the most prevalent, which is approximately 88.5% to 90% of cases, where there is proximal esophageal atresia with distal tracheoesophageal fistula. In this case, a 9-day-old infant was admitted to Arifin Ahmad Hospital for thoracostomy and esophagostomy surgery due to continuous mucus discharge. The patient underwent awake intubation and was positioned intraoperatively, with a tilt to the right when an orogastric tube was placed. During surgery, the patient maintained stable hemodynamic and was subsequently admitted to the NICU using a ventilator. Infants with esophageal atresia often show symptoms of hypersalivation and shortness of breath caused by aspiration pneumonia. When the nasogastric tube cannot pass through the esophagus, atresia can be suspected. Radiology studies play an important role in diagnosing esophageal atresia, confirming esophageal atresia with or without fistula and diagnosing other anomalies associated with VACTERL.
Management of Anesthesia in Mandibular Tumors with Difficult Airway Marthendro, Triade; Irawan, Dino
Journal La Medihealtico Vol. 5 No. 4 (2024): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v5i4.1604

Abstract

A 39 year old female patient with a diagnosis of mandibular tumor underwent mandibulectomy and Free Fibular Flap reconstruction. Preoperative evaluation is carried out on patients, namely by carrying out anamnesis, physical examination and supporting examinations to determine the problem and conclude the patient's physical status. The patient's physical status is ASA III. The patient was intubated awake with a video laryngoscope. After that, sedation and muscle relaxants are given. The operation lasted 10 hours with stable hemodynamics. Post-operatively, patients are treated in the ICU, vital signs are observed and post-operative pain is managed. A closed study conducted by the Professional Committee of the American Society of Anesthesiologists (ASA) revealed that the risks and serious complications of anesthesia are most often closely related to airway management problems. Success in dealing with complications depends on early detection of symptoms and corrective action to prevent the situation from getting worse. In this patient, airway management was based on the Difficult Airway Algorithm.
Myocardial Injury after Noncardiac Surgery: A Case Report of Acute Chest Pain and Elevated Troponin Levels, Challenges and Management Strategies Ton, Yori Yarson; Anggraeni, Novita; Irawan, Dino; Hidayat, Nopian
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.68386

Abstract

Background: Perioperative myocardial injury is a common complication following noncardiac surgery, linked to significant morbidity and mortality. With over 300 million surgeries performed worldwide annually, this number has increased by more than 100 million in the past two decades.Case: A 42-year-old woman underwent elective craniotomy for a right cerebellar hemangioblastoma and was admitted to the ICU postoperatively. On day three, she developed typical chest pain, inferior ST-elevation myocardial infarction (STEMI), and cardiogenic shock. Her medical history included the use of euthyrox following a total thyroidectomy 15 years prior, with no prior cardiac issues. Upon examination, she was conscious but had low blood pressure (58/41 mmHg), an elevated heart rate (103 bpm), and cold extremities. Her troponin I level was elevated at 9383.0 ng/mL. The diagnosis was major postoperative myocardial infarction.Therapy: The patient received aspirin, atorvastatin, heparin, norepinephrine, and dobutamine for shock management, with close hemodynamic monitoring. By day six, her condition improved, and her electrocardiogram (ECG) was normal. By day nine, she was transferred to the high care unit.Discussion: Myocardial injury after noncardiac surgery (MINS) includes both myocardial infarction and ischemic myocardial injury, which may not meet the Universal Definition of Myocardial Infarction. MINS usually occurs within 30 days of surgery, especially within the first 72 hours. Its causes are multifactorial, including plaque rupture, oxygen supply-demand imbalance, arrhythmias, and pulmonary embolism. Studies suggest that cardiovascular therapy, including aspirin and statins, is effective. Aspirin reduces 30-day mortality, while statins offer long-term benefits through anti-inflammatory effects. Low-dose aspirin, statins, and Renin-Angiotensin System inhibitors are recommended.Conclusion: MINS is a serious postoperative complication, even in patients without a history of cardiovascular disease, as demonstrated in this case. Prompt recognition and appropriate therapy with aspirin, heparin, and statins, along with close monitoring, can lead to significant clinical improvement.
Co-Authors Ananda, Pratama Awanda Herman Dewi Anggraini Dina Fauzia Doddy Tavianto Eri Surahman Fauzia Andrini Hidayat, Nopian Marthendro, Triade Maya Savira Muharrami, Vera Novita Anggraeni Pardede, Annisaa Shafira Ruza Prima Rustam, Ruza Prima Sholihin, Uswathun Hasanah Ton, Yori Yarson Wiwi Hardiyani Hardiyani