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All Journal Jurnal Kedokteran Brawijaya Journal of Anaesthesia and Pain Jurnal Neuroanestesi Indonesia
Eko Nofiyanto
Puskesmas Ngantang Kabupaten Malang
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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Perbedaan Persepsi Sehat-sakit Pasien Menjadi Alasan Utama Kejadian Pulang Paksa Nofiyanto, Eko; Koeswo, Mulyatim; Utami, Endah Woro
Jurnal Kedokteran Brawijaya Vol 28, No 1 (2014)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (512.557 KB) | DOI: 10.21776/ub.jkb.2014.028.01.35

Abstract

Pulang paksa merupakan salah satu indikator kurangnya mutu pelayanan kesehatan karena dapat mempengaruhi kesembuhan, dan biaya. Penelitian ini bertujuan untuk mengetahui faktor-faktor penyebab kejadian pulang paksa di ruang Dahlia II RSUD Ngudi Waluyo Wlingi Kabupaten Blitar. Penelitian dilakukan dengan metode survei pada 30 responden. Instrumen penelitian menggunakan kuesioner dengan pertanyaan terbuka dan tertutup. Hasil penelitian menunjukkan 46,67% pasien setuju bahwa persepsi sehat-sakit menjadi alasan utama kejadian pulang paksa dan bukan mutu maupun keterjangkauan biaya.Kata Kunci: Kejadian pulang paksa, persepsi sehat-sakit, rawat inap
Perilaku Komunikasi Petugas Berhubungan dengan Persepsi Sehat-Sakit Pasien Rawat Inap Nofiyanto, Eko; Andarini, Sri; Koeswo, Mulyatim
Jurnal Kedokteran Brawijaya Vol 28, No 4 (2015)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (590.178 KB) | DOI: 10.21776/ub.jkb.2015.028.04.17

Abstract

Kegagalan proses komunikasi menyebabkan ketidakpuasan,kurangnya pemahaman pasien pada penyakit, memicu keinginan menghentikan pengobatan dan melakukan pulang paksa. Pada studi pendahuluan didapatkan sebanyak 46,67% pasien pada tempat studi melakukan pulang paksa yang disebabkan persepsi sehat-sakit. Penelitian bertujuan untuk mengkaji perilaku komunikasi petugas rawat inap, mengkaji persepsi sehat-sakit pasien rawat inap dan mengetahui hubungan antara perilaku komunikasi petugas dari sudut pandang pasien dengan persepsi sehat-sakit pasien rawat inap pada RSUD X. Penelitian dilakukan dengan pendekatan cross sectional. Instrumen yang digunakan adalah kuesioner dengan skala Likert dan data dianalisis menggunakan uji chi square. Hasil penelitian menunjukkan bahwa responden mempunyai tingkat pendidikan dan status social ekonomi rendah dan berada pada usia produktif. Sebagian besar responden memiliki persepsi sehat-sakit kategori sedang dan memberikan penilaian perilaku komunikasi petugas pada kategori baik. Hasil uji analisis menunjukkan perilaku komunikasi petugas berhubungan dengan persepsi sehat sakit.Faktor lain yang diduga berpengaruh terhadap persepsi sehat-sakit adalah karakteristik pasien.Kata Kunci: Komunikasi petugas, pasien, persepsi sehat-sakit
Neuroanesthesia Management in Transspenoidal Pituitary Cyst Surgery Subagyo, Houdini Pradanawan; Nofiyanto, Eko
Journal of Anaesthesia and Pain Vol 5, No 1 (2024): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.01.03

Abstract

Background: Neuroanesthesia management of patients with masses in the sella area undergoing transspenoidal surgery is a challenge for anesthesiologists. Good preoperative, intraoperative and postoperative management is shown to improve the patient’s quality of life.Case: A 45-year-old man with chief complaints of headache and visual disturbances, from the results of the vision examination obtained visus 1/60 (count fingers) and narrowed visual field area. From computerized tomography (CT) scan and Magnetic resonance imaging (MRI) images of the Head obtained a picture of cystic mass of the suprasellar sella pressing the optic chiasm. The patient was planned for surgical excision of pituitary cyst per transspenoidal. The patient underwent general anesthesia with endotracheal intubation with intravenous induction fentanyl, propofol, atracurium and lidocaine, followed by maintenance with sevoflurane inhalation agent with 60% oxygen. During the operation the hemodynamic condition was stable and postoperatively the patient was extubated in the operating room and then treated in the intensive care unit.Conclusion: In pituitary cyst patients undergoing transspenoidal surgery, the preoperative evaluation is mainly aimed at airway assessment, neurological disorders and hormonal disorders in patients. During intraoperative, the anesthesiologist is expected to optimize cerebral oxygenation, maintain hemodynamic stability, facilitate the surgical area, prevent and manage intraoperative complications and rapid recovery of consciousness. Postoperatively a good neuroendocrine evaluation is required
Diabetes Insipidus pada Pasien Pascaoperasi Tumor Hipofisis Cahyanti G, Ramadina Putri; Nofiyanto, Eko; Laksono, Buyung Hartiyo
Jurnal Neuroanestesi Indonesia Vol 12, No 3 (2023)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v12i3.553

Abstract

Pembedahan pada tumor hipofisis dapat menyebabkan penurunan fungsi hipofisis, salah satunya adalah defisiensi antidiuretic hormone (ADH) yang dapat menyebabkan diabetes insipidus. Laporan kasus: Pasien perempuan 48 tahun, dengan diagnosis tumor sella-suprasella disertai visual loss, hipotiroid, hipoprolaktin, dan hipokortisol. Operasi berjalan 4 jam dengan tatalaksana general anestesi teknik proteksi otak. Pasca operasi pasien mengalami diabetes insipidus dengan klinis poliuriaa sampai lebih dari 6000 cc perhari. Dilakukan perawatan intensif dengan pemantauan ketat di Intensive Care Unit (ICU). Penggantian cairan dan pemberian desmopressin acetate kombinasi dengan vasopressin dilakukan sebagai terapi. Setelah perawatan 12 hari terjadi perbaikan klinis dan laboratoris. Tatalaksana dan monitoring yang tepat akan kejadian diabetes insipidus yang dapat mencegah terjadinya perburukan kondisi pada pasien.Diabetes Insipidus in Patient with Postoperative Pituitary TumorAbstractSurgery on a pituitary tumor can cause a decrease in pituitary function,: like deficiency antidiuretic hormone which cause diabetes insipidus. Case report: A 48-year-old female patient, with a diagnosis of sella-suprasella tumor accompanied by visual loss, hypothyroidism, hypoprolactin, and hypocortisol. The operation lasted 4 hours under general anesthesia with brain protection techniques. Postoperatively the patient had diabetes insipidus with clinical poliuriaa up to more than 6000 cc per day. Intensive care is carried out with close monitoring in the Intensive Care Unit. Fluid replacement and administration of desmopressin acetate in combination with vasopressin is performed as therapy. After 12 days of treatment, there was clinical and laboratory improvement. Appropriate management and monitoring of the incidence of diabetes insipidus can prevent the worsening of the patient's condition.
Dexmedetomidine as an Adjunct in Anesthesia for Adolescent Idiopathic Scoliosis (AIS) Surgery: A Case Series Nofiyanto, Eko; Halimi, Radian Ahmad; Fuadi, Iwan; Abdul rachman, Iwan
Jurnal Neuroanestesi Indonesia Vol 14, No 2 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i2.682

Abstract

Scoliosis is a spinal curvature deformity 10, with Adolescent Idiopathic Scoliosis (AIS) affecting those aged 10-18 years. The global prevalence of AIS is between 1%-2%, while in Indonesia, it stands at 2,93%, with a female-to-male ratio of 4.7:1. Perioperative challenges include nerve damage, bleeding, and postoperative pain. Neuromonitoring (MEP and SSEP) helps prevent injury, while careful drug selection supports spinal protection. Three female patients scoliosis reconstructions were performed under general anesthesia. All received target- controlled infusion (TCI) propofol, dexmedetomidine, and fentanyl, with stable hemodynamics and no neurological changes post-surgery. Epidemiological data showed that AIS predominantly affects females. The study included patients with curve progression impacting activity, with no motor or sensory abnormalities observed. Anesthesia was induced with propofol TCI (4 ?g/mL) and dexmedetomidine (0.3-0.7 mcg/kg/hr), reducing propofol and opioid use. Dexmedetomidine targets ?2-adrenergic receptors, reducing sympathetic outflow, stabilizing hemodynamics, blocking pain transmission, and improving recovery by reducing blood loss and inflammation. Dexmedetomidine provides sedation, analgesia, and stable hemodynamics in scoliosis surgery, minimizing blood loss and transfusion needs. It supports neurophysiological monitoring, reduces postoperative pain, and enhances recovery.
Co-Authors Abdul rachman, Iwan Cahyanti G, Ramadina Putri Endah Woro Utami Iwan Fuadi Laksono, Buyung Hartiyo Mulyatim Koeswo Radian Ahmad Halimi Sri Andarini Subagyo, Houdini Pradanawan