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All Journal Jurnal Anestesiologi Indonesia Jurnal Kedokteran Brawijaya Jurnal Anestesi Perioperatif Jurnal Komunikasi Hukum Journal of Anaesthesia and Pain Jurnal Anestesi Obstetri Indonesia Solo Journal of Anesthesi, Pain and Critical Care
Isngadi Isngadi
Bagian Anestesiologi Dan Terapi Intensif, Fakultas Kedokteran, Universitas Brawijaya/ RSUD Dr. Saiful Anwar Malang
Chemical Engineering, Chemistry & Bioengineering Education Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health

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Continuous Ketamine Administration Decreases Monocyte Count in Sepsis Patients in Intensive Care Units Hartono, Ruddi; Jaya, Wiwi; Mayasari, Mayasari; Isngadi, Isngadi
Journal of Anaesthesia and Pain Vol 4, No 1 (2023): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2023.004.01.01

Abstract

Background: Cytokines storm becomes the most common cause of mortality in sepsis patients treated in the intensive care unit (ICU). Cytokines storm is characterized by an excessive elevation in the immunocompetent cells, including monocyte. Ketamine, as a sedating agent, has immunosuppressive properties. This study was conducted to determine the effect of ketamine on monocyte count in septic patients in the ICU.Methods: This is a quantitative case-control  study of 30 patients treated in the ICU. The study subjects were divided into control (n=15) and treatment (n=15) groups. The treatment group received ketamine HCl therapy at 0.3 mg/kg body weight/hour. The mean monocytes were counted at 0, 24, and 48 hours post-therapy. Data analysis used an independent sample t-test with α=5%.Result: Administration of ketamine therapy in septic patients treated in the ICU showed a decrease in the monocytes during observation from 0 to 48 hours post-therapy. Administration of ketamine at 48 hours had a significantly lower monocyte (5.21%) compared to control (7.67%) (p=0.012).Conclusion: Ketamine administration reduces the monocytes count in septic patients treated in the intensive care unit. Ketamine is expected to be a therapeutic option in sepsis patients.
Manajemen Anestesi Gravida dengan Plasenta Akreta yang dilakukan Seksio Sesarea dengan Transarterial Ballooning Azman, Radhillah; isngadi, Isngadi
Jurnal Anestesi Obstetri Indonesia Vol 7 No 3 (2024): November
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.v7i3.153

Abstract

Bleeding before (antepartum) and after (postpartum) delivery remains a major contributor to perinatal mortality and maternal morbidity worldwide. Placenta accreta is a cause of maternal morbidity and mortality, recently becoming the most common reason for emergency postpartum hysterectomy. A 35-year-old woman weighing 55 kg, height 151 cm, G3P1101Ab000 at a gestational age of 34-36 weeks, with a history of antepartum bleeding and suspicion of placenta accreta from the ultrasound, is scheduled for pregnancy termination via cesarean section. Before the surgery, a transarterial balloon catheter is inserted, and the estimated blood loss during the operation is around 10,000 ml. In this patient, the choice of general anesthesia is made considering the history of third-trimester bleeding, a high probability index score of 51% for accreta, and the plan for hysterectomy, leading to an anticipated prolonged operation time. Additionally, the risk of significant bleeding during the surgery prompts the selection of general anesthesia for hemodynamic management, and the placement of a catheter balloon is done to anticipate massive bleeding. To obtain a more comprehensive comparison and understanding of estimated blood loss, a comparison with other cases involving catheter balloon procedures before or after surgery is needed.
Kombinasi Teknik Anestesi Epidural dan Anestesi Umum Intubasi pada Pasien Seksio Sesarea dengan Plasenta Perkreta Yuliandra, Yudhistira; isngadi, Isngadi
Jurnal Anestesi Obstetri Indonesia Vol 7 No 3 (2024): November
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.v7i3.157

Abstract

Plasenta perkreta dikaitkan dengan morbiditas ibu yang lebih tinggi daripada subtipe plasenta akreta lainnya karena invasi plasenta yang lebih luas sehingga menimbulkan perdarahan sulit dikontrol dan sering membutuhkan tranfusi masif. Pada kasus ini dilaporkan seorang pasien perempuan hamil dengan keluhan keluar darah dari jalan lahir disertai riwayat urine bercampur darah yang dilakukan operasi seksio sesarea. Pasien dilakukan anestesi epidural untuk kelahiran bayi yang dilanjutkan dengan anestesi umum intubasi setelah bayi lahir. Saat intraoperatif didapatkan perdarahan masif dan dilakukan protokol tranfusi masif. Hemodinamik bisa dipertahankan stabil sampai setelah operasi. Hasil laboratorium setelah operasi sudah mendekati target dari protokol transfusi masif. Kondisi bayi baik saat dilahirkan. Tatalaksana anestesi, perkiraan jumlah perdarahan intraoperatif, resusitasi cairan yang adekuat dan transfusi darah yang tepat akan memberikan dampak besar terhadap kondisi ibu dan bayi selama operasi dan paska operasi seksio sesarea dengan plasenta perkreta.
Manajemen Anestesi pada Atrial Septal Defect (ASD) Sekundum Bidirectional Shunt Disertai Hipertensi Pulmonal dalam Kehamilan Awal yang Dilakukan ASD Clossure By Device Agung Nugroho, Yusuf; isngadi, Isngadi
Jurnal Anestesi Obstetri Indonesia Vol 8 No 1 (2025): 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.v8i1.161

Abstract

Atrial Septal Defect (ASD) merupakan kelainan jantung asianotik yang sering ditemukan. Kasus kehamilan dengan ASD sebagian besar dapat ditoleransi, namun beberapa kondisi perlu dilakukan tindakan intervensi untuk mengurangi risiko pada ibu dan janin akibat perubahan dari hemodinamik. Pada kasus ini wanita usia 31 tahun dengan diagnosis G3P2A0 hamil 10-11 minggu janin tunggal hidup dengan komorbid penyakit jantung bawaan Atrial Septal Defect sekundum besar dengan hipertensi pulmonal yang akan dilakukan penutupan ASD Clossure by device. Pasien dilakukan tindakan anestesi umum dengan pemberian premedikasi dengan midazolam 2 mg intravena, sufentanyl 30 mcg intravena, ketamin 25 mg intravena, dan atracurium 25 mg serta dilakukan intubasi endotrakheal. Selama intraoperatif, dilakukan pemberian sevoflurane sebagai pemeliharaan anestesi dan tidak terdapat penurunan hemodinamik yang signifikan pada pasien. Pasca operasi pasien dirawat diruang ICU dan tidak terdapat komplikasi. Pasien diberikan metamizole 3x1 gram sebagai analgesik. Tindakan anestesi umum pada kasus ASD clossure dengan device disertai dengan hipertensi pulmonal perlu pemantauan hemodinamik yang ketat untuk mencegah terjadi komplikasi yang tidak diinginkan.
Manajemen Anestesi pada Pasien Preeklampsia Berat dan Eklampsia yang Dilakukan Seksio Sesarea Darurat Nur Sumianto, Ainur Adi; isngadi, Isngadi
Jurnal Anestesi Obstetri Indonesia Vol 8 No 1 (2025): 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.v8i1.164

Abstract

Preeklampsia merupakan penyebab tersering yang menyebabkan mortalitas dan morbiditas maternal. Prevalensi preeklamsia mencapai 3–7% dari keseluhan wanita hamil secara global. Kehamilan dengan preeklampsia menunjukka indikasi dilakukannya prosedur seksio sesaria, yang merupakan tantangan bagi anestesiologis. Tantangan tersebut meliputi risiko terhadap edema saluran nafas, disfungsi sirkulasi jantung, disfungsi sistem serebrovaskular, dan koagulopati. Pasien perempuan, 23 tahun, dengan preeklampsia berat, eklampsia, hiponatremia, hipoalbumin, dan suspek intrauterine growth retriction. Pada pemeriksaan fisik terdapat tekanan darah 172/92 mmHg, nadi 91 kali/menit, dan SpO2 97–98%. Pada pemeriksaan laboratorium didapatkan albumin 2,88 dan natrium 128. Pasien dilakukan prosedur seksio sesarea dengan teknik anestesi umum. Manajemen anestesi yang tepat dalam kehamilan dengan preeklampsia berat dan eklamsia untuk mencegah terjadinya komplikasi yang dapat meningkatkan risiko perburukan kondisi pada pasien
Anestesi Spinal pada Maternal dengan Struma Hipertiroid yang Menjalani Seksio Sesarea secara Emergensi: Satu Laporan Kasus Isda, Mustaqiem; isngadi, Isngadi
Jurnal Anestesi Obstetri Indonesia Vol 8 No 2 (2025): Juli
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.v8i2.159

Abstract

Kehamilan dengan penyakit sistemik merupakan kasus yang menjadi perhatian khusus. Hipertiroid adalah salah satu penyakit sistemik pada kehamilan yang dapat menimbulkan kegawatan pada ibu dan janin. Kami melaporkan kasus wanita 24 tahun dengan G1P1A0 yang menjalani seksio sesarea atas indikasi ketuban pecah dini, hipertiroid dan fetal compromised. Tekanan darah 139/82 mmHg, laju nadi 112 kali per menit,saturasi 99% udara ruang. Pemeriksaan preoperasi didapatkan keluhan berdebar disertai adanya eksoftalmus, tremor, dan benjolan di leher. Pemeriksaan jantung didapatkan bunyi jantung I–II reguler tanpa murmur, suara paru vesikular dengan di kedua lapang paru. Pemeriksaan Leopold didapatkan janin tunggal dengan presentasi kepala, denyut jantung janin 157 kali per menit. Pada pemeriksaan laboratorium didapatkan kadar hemoglobin 12,7 g%, hitung leukosit 12.020/mm3, hitung trombosit 199.000/ mm3. Hasil faal tiroid T3 Total 2,07 (0,8–2,0), Free T4 3,20 (0,93 - 1,7) dan TSH < 0,01 (0,270-4,20). Pemeriksaan laboratorium lain dalam batas normal. Pada pemeriksaan elektrokardiografi didapatkan sinus takikardia 116 x/menit. Pada pemeriksaan foto thorax didapatkan jantung dan paru normal. hasil konsultasi bersama spesialis kardiologi tidak didapatkan kelainan pada jantung pasien. Pasien stabil selama operasi dengan anestesi spinal menggunakan bupivakain 10 mg adjuvan morphin 0.1 mg. Analgetik pascaoperasi diberikan injeksi ketorolak 30 mg setiap 8 jam intravena dan paracetamol 4x750 mg per oral dengan VAS 2 pada hari ke-0. Obat dilanjutkan dengan PTU 3x100 mg dan propanolol 3x40 mg per oral. Pasien di observasi di High Care Unit selama post operasi.
Penggunaan Phenylephrine untuk Mengatasi Hipotensi akibat Epidural Anestesi pada Maternal dengan VSD Bidirectional Shunt yang Dilakukan Seksio Sesarea Tulong, Priscilla; isngadi, Isngadi
Jurnal Anestesi Obstetri Indonesia Vol 8 No 2 (2025): Juli
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.v8i2.169

Abstract

Ventricular Septal Defect (VSD) dengan bidirectional shunt merupakan Sindrom Eisenmenger yang ditandai adanya pirau dua arah (dari kanan ke kiri dan kiri ke kanan). Kondisi ini perlu dilakukan tatalaksana untuk mencegah pirau dari kanan ke kiri, agar pirau dipertahankan dari jantung kiri ke kanan. Salah satu cara untuk mempertahankan agar pirau tetap berjalan dari jantung kiri ke jantung kanan adalah dengan mencegah terjadinya hipotensi. Hipotensi akibat epidural anestesi, dapat dicegah dengan cara memberikan vasopressor yang selektif terhadap reseptor α-1 yaitu phenylephrine. Dalam tulisan ini akan menyajikan kasus seorang primigravida berusia 27 tahun dengan VSD bidirectional shunt datang ke bagian obstetri dan ginekologi, dengan usia kehamilan 30-32 minggu dan riwayat sesak nafas. Pasien dilakukan tindakan terminasi kehamilan secara elektif. Epidural anestesi menjadi pilihan untuk tindakan seksio sesarea pada pasien ini. Pasien mengalami periode hipotensi setelah dilakukan tindakan anestesi epidural, sesaat setelah pasien mengalami hipotensi diberikan terapi syringe phenylephrine 0,25 μg /kgbb/ menit. Pasien stabil sampai operasi selesai. Bayi lahir dengan Apgar score 5-7. Pasien dipindahkan ke ICU dalam kondisi hemodinamik stabil.
Anesthesia Management and Intensive Care in Cesarean Section on a Woman with Placenta Accreta with Placenta Accreta Index (PAI) Score of ≥ 6: A Case Report Prasetyo, Denny; Isngadi, Isngadi
Journal of Anaesthesia and Pain Vol. 6 No. 2 (2025): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Background: Placenta accreta spectrum (PAS) is the leading cause of peripartum hysterectomy. PAS often results in massive postpartum haemorrhage, requiring careful perioperative planning and multidisciplinary coordination. This case report aims to discuss the anesthesia management and intensive care provided to a patient who underwent cesarean section (CS) with a placenta accreta index (PAI) score of ≥6.Case: This case involves a 32-year-old multipara with a history of three previous CS. The patient was scheduled for CS due to breech presentation and suspected total placenta previa/accreta with a PAI score of ≥ 6. A combined spinal-epidural (CSE) was chosen as anesthesia management. During surgery, the patient experienced severe bleeding (3,000 mL) with hypotension (blood pressure 81/44 mmHg) and bradycardia (heart rate 60 beats per minute). Central iliac artery balloon occlusion (CIABO) was performed by a radiologist for temporary blood flow occlusion. Resuscitation included 3,000 mL crystalloids, 1,000 mL colloids, and 1,200 mL blood product. A baby girl was delivered (Apgar 7–9). The patient remained stable in the intensive care unit and was transferred to the regular ward the following day.Conclusion: Comprehensive perioperative planning and multidisciplinary coordination in managing PAS are important. Despite severe intraoperative hemorrhage and hemodynamic instability, the use of combined spinal-epidural anesthesia, prompt fluid and blood resuscitation, and intensive monitoring ensured a favorable outcome. Postoperative lactate value and early transfer from the ICU to the regular ward indicate successful management.
Characteristic Outline of Head Trauma Patients at Dr. Saiful Anwar General Hospital Laksono, Buyung Hartiyo; Pertiwi, Previasari Zahra; Siswagama, Taufiq Agus; Isngadi, Isngadi
Journal of Anaesthesia and Pain Vol. 6 No. 3 (2025): In Press
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Background: Traumatic brain injury is defined as a decline in brain function characterized by a decreased level of consciousness, seizures, and focal sensory and motor neurologic deficits caused by blunt force or penetration by a sharp object into the intracranial space. This reseracrh aims to determine the characteristics of head trauma patients at Dr. Saiful Anwar General Hospital, Malang.Methods: This descriptive observational study sampled all head trauma patients at Dr. Saiful Anwar General Hospital, Malang, from March to August 2023. The study variables included patient demographics, cause of trauma, clinical data, pre-and postoperative procedures, outcomes of trauma patients undergoing treatment, and length of stay. Data were analyzed using Microsoft Excel.Results: A total of 227 head trauma patients were identified, most of whom were men aged 20-39 (71). Students (72) were the most common victims of head trauma, most often due to accidents. There were 156 patients with mild head injuries. 208 patients had normal oxygen saturation. 157 patients had normal hemoglobin, 181 patients had normal sodium, and 196 patients had normal blood glucose levels. 102 patients experienced hypocarbia. A normal CT scan of 141 patients was performed. 206 patients underwent surgery, while 214 patients did not undergo tracheostomy. 149 patients underwent surgery with early emergence. The highest number of patients were patients with a hospital stay of more than 14 days (140 patients). The most common outcome was mild disability (84 patients).Conclusion: Most patients were male, aged 20-39. The most common cause was accidents involving students. Most patients with mild head injuries had normal oxygen saturation, hemoglobin,sodium, and blood glucose levels. Most patients with hypocarbia had no bleeding, and CT scans showed no bleeding. Most patients underwent surgery and early emergence, with a hospital stay of more than 14 days, and the most common outcome was mild disability.
Efektivitas Undang-Undang Nomor 24 Tahun 2007 Tentang Penanggulangan Bencana dan Fikih Kebencanaan Terhadap Perilaku Warga Muhammadiyah (Studi Kasus Covid-19) Isngadi, Isngadi; Khakim, Mufti
Jurnal Komunikasi Hukum Vol 7 No 1 (2021): Februari, Jurnal Komunikasi Hukum
Publisher : Program Studi Ilmu Hukum Fakultas Hukum dan Ilmu Sosial Universitas Pendidikan Ganesha Singaraja

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/jkh.v7i1.31470

Abstract

Disaster management is the obligation of the state in carrying out constitutional duties, namely protecting all spilled Indonesian blood. Disasters have the potential to cause casualties and property. Laws are needed as the basis for government decision making in disaster management. The effectiveness of implementing law number 24 of 2007 can be a benchmark for disaster management. The participation of civil society such as Muhammadiyah mass organizations is a supporting capacity in disaster management. This research is a normative study of the effectiveness of the law on disaster management and Muhammadiyah disaster management case study of Covid 19. The results of the research show that there are many things that need to be evaluated in the implementation of the implementation of the law.
Co-Authors Achmad Haryanto Agung Nugroho, Yusuf Ahmad Feza Fadhlurrahman Aji, Haffidz Wahyu Anton Wuri Handayanto Arie Zainul Fatoni Azman, Radhillah Dadik Prasetya Hutama denny prasetyo Devi Ariani Dewi Puspitorini Husodo Dewi Puspitorini Husodo Djudjuk R Basuki Djudjuk Rahmad Basuki Djudjuk Rahmat Basuki Eko Nofiyanto Fanniyah Fanniyah Frilya Rachma Hari Bagianto Ilham Fadlilah Karmini Yupono Laksono RM Laksono, Buyung Hartiyo Mayasari Mayasari, Mayasari Mufti Khakim, Mufti Muhammad Irzal Muhammad Rizqan Khalidi Muhammad Rodli Mustaqiem Isda, Mustaqiem Nur Sumianto, Ainur Adi Pertiwi, Previasari Zahra Prima, Dian Rachma C Rafidya Indah Septica Rafidya Indah Septica Redhy Sindharta Ristiawan Muji Laksono Rizki, Aulia Nailufar Ruddi Hartono Rudi Hartono Scarpia P Sri Rahardjo Susilo Chandra Syaiful Yudhi Nurachman Taufiq Agus Siswagama Teddy Ferdinand Tulong, Priscilla Utomo, Jeffri Prasetyo Vidya Sulistyawan Wiwi Jaya Wiwi Jaya Yudi Hadinata Yuliandra, Yudhistira Yusmein Uyun Zakiyah Ainun Zulfakhri Zulfakhri