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All Journal Bali Journal of Anesthesiology Warta Penelitian Perhubungan Dinasti International Journal of Education Management and Social Science Jurnal Anestesi Obstetri Indonesia Jurnal Manajemen Transportasi & Logistik (JMTRANSLOG) Jurnal Neuroanestesi Indonesia Halal Tourism and Pilgrimage Islamic Marketing Review Jurnal Komplikasi Anestesi Jurnal Sistem Transportasi & Logistik
Sri Rahardjo
Program Doktor Manajemen dan Bisnis (MB-IPB)- Sekolah Pascasarjana IPB Pasca Sarjana Universitas Sahid Jakarta
Automotive Engineering Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Engineering Environmental Science Health Professions Immunology & microbiology Library & Information Science Medicine & Pharmacology Neuroscience Nursing Public Health Transportation Other

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Manajemen Preoperatif Kehamilan Ektopik Terganggu dengan Syok Hipovolemia Budianti, Nugrahaeni; Rahardjo, Sri; Uyun, Yusmein
Jurnal Komplikasi Anestesi Vol 5 No 1 (2017): Volume 5 Number 1 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i1.7320

Abstract

Had been reported a case of preoperative management for a woman 36 years old, G1P0A0, pregnant 11 weeks with ruptured ectopic pregnancy and run into hypovolemia shock. We assessed physic status patient as ASA (American Society of Anesthesia) 4E (emergency) with hypovolemia shock et causa internal bleeding and patient had been done relaparotomy. Patient had been refered from RSUD Wonosari and when she came to RSUP Sardjito, she feel pain and pale suspicious hypovolemia shock with internal bleeding then had been done laparatomy emergency surgery, dextra salphingectomy et causa ruptured ectopic pregnancy in IGD operation room for 2 hours and then she was observated in resusitation room for 6 hours and then she was transported to PACU. When in PACU, her condition compos mentis, she feel pain and the hemodynamic is blood pressure 90/ 60 mmHg, pulse 165 times/ minutes, respiration rate 32 times/ minutes on NRM 8 liters/ minutes, spO2 99 – 100 %, temperature 36,8 °C and VAS 3 – 4. In abdominal assessment, we found decreased of peristaltic, distended (+), tenderness (+), wound dressing blood seeped (-) and capilarry refill over 2 second and also radialis artery was not detected. We did evaluation to know internal bleeding, we did positive challange test with kristaloid 20 cc/ kg BB in 15 minutes and then in USG, we found free liquid intraabdomen and we planned emergency laparatomy in IGD operation room. Anesthetic technique that we used was general anesthesia. After surgery, patient was transported to ICU in sedation condition and was intubated.
Manajemen Anestesi pada Epilepsi Prayunanto A.N, Eko; Apsari, Ratih Kumala Fajar; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i2.7326

Abstract

Epilepsy is a manifestation of brain disorders with a variety of clinical symptoms, caused by the release of electrical charges from brain neurons excessively and periodically, reversibel with various etiology. Seizures can be localized to specific areas of the brain or thoroughly. Focal seizures may expand into generalized seizures. Physiology epilepsy is a disorder defined cerebral balance between excitation and inhibition is the tip of the uncontrolled excitation. Seizures are also caused by potassium conduction abnormalities, ion channel damage, and ATP deficiency associated with ion transport, may cause instability of neuron membranes. The best anesthetic treatment for epilepsy is with general anesthesia. General anesthesia has therapeutic benefits for seizure patients if the patient has been treated with anti-seizure medication then should be continued until surgery.
Neurophysiology Intraoperative Monitoring (Niom) pada Operasi Deformitiy Correction at Adolesent Scoliosis Herlambang, Panji; Sudadi; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i2.7330

Abstract

The use of neurophysiological intraoperative monitoring (NIOM) during spinal orthopaedic and neurosurgical procedures provides a challenge to the attending anaesthesiologist. Since all anaesthetic agents affect synaptic function, the choice of agent will be determined by the type of surgery and the NIOM modality employed. Had been performed surgery for scoliosis correction of spinal abnormalities in children aged 15 years with using of sensory and motoric NIOM. The surgery going under general anesthesia with the installation monitor invasive arterial line and central venous pressure during surgery for hemodynamic monitoring. Drugs used during anesthesia using balanced anesthesia technique with a combination of opioids, propofol and sevoflurane as inhalation. Muscle relaxants given intermittently for operator leisure and ventilation controls. Postoperative hospitalization in ICU with the aim of assessing the function of the respiratory and neurological of the patients and pain management.
Efektivitas Informasi Multimedia Video (Video Dan Lisan) untuk Menurunkan Tingkat Kecemasan Praanestesi Umum pada Pasien yang akan Dilakukan Tindakan Operasi Elektif dengan Anestesi Umum Teknik Intubasi Budianti, Nugrahaeni; Pratomo, Bhirowo Yudo; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i3.7337

Abstract

Background. Preoperative anxiety is a problem faced by two-thirds patients who would undergo surgery.Anxiety can not be handled properly, will cause adverse pathophysiologic responses. General anesthesiaintubation techniques as one of the anesthetic techniques often lead to an increase in preoperative anxiety. To reduce the level of preoperative anxiety, we can give preoperative information. The health information provided can be well understood by patients and can be used to reduce anxiety situation experienced by the patients. Methods. This studied was Randomized Controlled Trial (RCT). Subjects were patients undergone elective surgery general anesthesia using intubation techniques. The subjects were 110 patients that divided into two groups: the video group and the verbal group. The verbal group received preoperative information verbally, while the video group received preoperative information through a video of general anesthesia intubation technique procedures. The measurement of anxiety level was measured four times, once before the treatment (the level of anxiety/ LA-1) and three times after the treatment, namely when in the ward (LA-2), when in the surgical installation acceptance (LA-3) and when in the operating room prior to general anesthesia intubation techniques (LA-4). The assessment of anxiety used Spielberger State-Trait Anxiety Inventory (STAI) questionnaire of Y-1 form.Results. The percentage of anxiety reduction in video group was bigger than in Verbal group at all measurement times in TK-2 group of 40% video and verbal group 12,7%, in TK-3 video group 41,8% and verbal group 12,7% and at TK-4 video group 41.8% and verbal group 10.9%. Statistically different in the anxiety level between video group and verbal group were obtained in LA-2, LA-3 and LA-4 (p = 0.001, p = 0.001 and p = 0.000).Conclusion. Multimedia video information (video and verbal) is more effective in reducing preanesthesia anxiety levels in patients undergoing elective surgery with general anesthesia of intubation techniques when compared with verbal information.
Manajemen Anestesi Cedera Vertebra Cervical 4,5 dengan Tindakan Laminektomi Dekompresi Stabilisasi Zaki, Wildan Arsyad; Sudadi; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i3.7341

Abstract

Preoperative management of cervical fractures of particular concern include the level of injury, onset of occurrence and cardiorespiratory complications. Then continued the definitive management of laminectomy requiring inline position intubation positions, invasive arterial line monitors and CVC, durante vasoactive drug support in case of hemodynamic decline. Equally important is postoperative intensive care, and treatment of complications of pneumonia, DVT, sepsis due to long immobilization. Treatment of a 54-year-old male patient with a diagnosis of VC IV-V compression fracture, tetraplegi and increased transaminase enzyme. Patients were initially treated in HCU LOC 2 for 10 days with drug support and hemodynamic monitoring, then definitive elective laminectomy, decompression, stabilization. The operation lasted for approximately five hours with bleeding approximately 1200cc, urine output 2.5 cc / kgBW / hour. Post surgery patients treated in ICU with attached tracheostomy, connected with ventilator and vasoactive drug support. During treatment in ICU, hemodynamic monitoring with arterial line, ECG, pulse oximetry, temperature monitor and CVC were performed. Patients are positioned in line mobilization, ureter catheter installed and NGT. Hemodynamic, blood pressure during ICU ranged from syst 100-110 mmHg, diastole blood pressure 50-80 mmHg, pulse 90-110 x / minute and saturation 93-100%. With supportive therapy of ceftriaxone injection, methylprednisolone, fentanyl, mecobalamin, omeprazole, and dobutamine and norepinephrine continue. The patient was treated for 5 days and after stabilizing the patient was returned to the ward.
Tromboemboli pada Kehamilan Agnesha, Fahmi; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i3.7343

Abstract

Thromboembolism is a rare event happen in pregnancy, that if not manage well would be a catastrophic and can cause fatal outcome. Venous thromboembolic event in pregnancy form are deep vein thrombosis and pulmonal thromboembolism. The pathophysiology of thromboembolism explained by Virchow triad that describe the factor contribute are vein stasis, vascular damages and hypercoagulable state. The diagnosis of the new onset thromboembolism can be made by ultrasound examination on proximal vein. Management of thromboembolism in pregnancy is including low molecular weight heparin and unfractioned heparin administration. These treatments can cause neuraxial anesthesia impact on pregnant patient as spinal and epidural hematoma. Thus many guidelines give recommendation for stopping heparin administration before procedure.
Manajemen Anestesi pada Kehamilan Sistemik Lupus Eritematosus Nuryawan, Iwan; Suryono, Bambang; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i3.7345

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune, multisystem disease, which involves complex pathogenetic mechanisms that can occur at all ages, characterized by the presence of direct autoantibodies against the core antigen. Management of lupus in women ideally begins before pregnancy occurs. Adequate analgesia can overcome the response of the organ system due to pain. Regional anesthesia techniques are very popular pharmacological techniques and become the gold standard because they provide optimal analgesia during labor with minimal side effects on the mother and fetus when compared with systemic or inhalation analgesia.
Hubungan antara Kadar Prokalsitonin Serum dan Skor SOFA sebagai Parameter Tingkat Keparahan Disfungsi Organ Pasien Sepsis yang Dirawat di ICU RSUP Dr. Sardjito Setiandari, Kristina; Wisudarti, Calcarina Fitriani Retno; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 6 No 2 (2019): Volume 6 Number 2 (2019)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v6i2.7347

Abstract

Background: Sepsis causes an increase in procalcitonin level by increased secretion of proinflammatory ytokines, increased expression of CD 14 and CD 16, decrease of neutrophil phagocytic activity, suppression of blast transformation from T cells and neutrophil malfunctions. Procalcitonin secretion increase with increasing the severity of sepsis. The severity of sepsis is determined by the severity of organ dysfunction. The more severe the sepsis the more severe the organ dysfunction occurs and the higher the procalcitonin secretion.Objective: The purpose of this study was to determine if there is a relationship between procalcitonin levels and SOFA score as a severity parameter of organ dysfunction in septic patients treated in ICU Dr Sardjito Hospital.Methods: The study design was prospective observational cohort study. A total of 29 septic patients, age above 18 years old treated in ICU Dr Sardjito Hospital Yogyakarta were included in this study. Procalcitonin serum was measured and the SOFA score were calculated at the day of admission or at the day the diagnosis of sepsis was made (Day-0), within 24 hours (Day-1), at Day-3 and at day-5. Spearman correlation was used to analize the correlation between procalcitonin levels and SOFA score.Result: The overall mean of SOFA score was 10.3+3.9 while overall mean of procalcitonin level was 59.2+58.7 ng/ml. Significant positive correlation was found between overall procalcitonin level and SOFA score (r=0.663; p<0.05). The significant positive correlation was also found at Day-0 (r= 0.601; p<0.05), Day-1 (r=0.675; p<0.05), Day-3 (r=0.754; p<0.05) and Day-5 (r=0.718; p<0.05).Conclusion: There is a significant strong positive correlation between procalcitonin levels and SOFA score as a severity parameter of organ dysfunction in septic patients treated in ICU Dr Sardjito Hospital.
Pengaruh Posisi Elevasi Head Of Bed 300 Dibandingkan dengan Elevasi Head Of Bed 600 terhadap Peningkatan PaO2 dan Rasio PaO2/FiO2 pada Pasien dengan Ventilasi Mekanik di ICU RSUP Dr. Sardjito Anindita, Triatma; Wisudarti, Calcarina Fitriani Retno; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 10 No 3 (2023): Volume 10 Number 3 (2023)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v10i3.7349

Abstract

Background: Mechanical ventilation is the frequent reason of admitting patients to the Intensive Care Unit(ICU). Mechanical ventilation was used in resuscitating critical patient with lung disorder where the lung fails to oxygenite arterial blood. Patients with mechanical ventilation are more prone to immobilization because of the decrease of consciousness. Some researches had showed that the position change of patients with several conditions including mechanical ventilation increased the lung function thus resulting better blood oxygenation.Objectives: To compare the benefits of positioning patients with 600 HOB elevation to 300 HOB elevation by evaluating the PaO2 and PaO2/FiO2 ratio.Methods: This research was done with clinical trial using One Group Pretest Posttest. Patients was positioned first in the standard position (supine), elevation position Head of Bed (HOB) 300 and HOB 600. Then we measured the hemodynamic parameters, blood pressure, heart rate, respiratory parameters, peripheral O2 saturation and Blood Gas Analysis.Results: We obtained 21 subjects in this research 10 males and 11 females. We found significant increaseof PaO2 with elevation HOB of 600 compared to 300 (192.2 vs 160.7, p<0,05). The PaO2/FiO2 ratio showedsignificant increase in the HOB 600 (382.3 vs 322.2, p<0,05). The hemodynamic and respiratory parameters, we found that mean MAP, tidal volume, PIP and compliance in position of HOB elevation 600 were highercompared to the HOB elevation of 300 while the heart rate, resistance and PH were lower. But those differences were not statistically significant with p>0.05.Conclusion: The elevation head of bed 600 increase the PaO2 and PaO2/FiO2 ratio compared to the elevation head of bed 300 in patients with mechanical ventilation in ICU of RSUP Dr. Sardjito.
Perbandingan Daya Guna Analgetik antara Tramadol 100 mg dan Natrium Diklofenak 100 mg Suppositoria Rektal untuk Penanganan Nyeri Pascaoperasi Sesar dengan Teknik Pembiusan Blok Subarachnoid Santoso, Arief Hariyadi; Uyun, Yusmein; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 6 No 2 (2019): Volume 6 Number 2 (2019)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v6i2.7350

Abstract

Latar Belakang: Operasi sesar menghasilkan nyeri pasca operasi yang signifikan. Tidak ada teknik standar pengelolaan nyeri pasca operasi sesar. Obat antiinflamasi nonsteroid seperti natrium diklofenak berkerja meng-inhibisi sintesis prostaglandin (PG) dengan menghambat enzim cyclooxygenase. Tramadol dengan aktivitas mu-agonis, tidak hanya bekerja pada reseptor opioid, tetapi juga menghambat serotonin (5-HT) dan reuptake noradrenalin.Tujuan: Mengetahui daya guna analgesi 24 jam pasca operasi sesar antara penggunaan suppositoria rektal tramadol dengan natrium diklofenak.Metode: Prospektif, uji klinis acak terkontrol pada 70 pasien status fisik ASA I-II, berusia 19-40 tahun, hamil aterm 37-42 minggu,, Indeks Massa Tubuh < 35 kg/m2. Pasien dikelompokkan acak ke dalam 2 kelompok : kelompok suppositoria rektal natrium diklofenak (D) dan tramadol (T) dengan teknik single blind. Dilakukan penilaian VAS pada kedua kelompok, jumlah penambahan rescue jika VAS ≥3, dan efek samping pada masing-masing kelompok.Hasil: Selama 24 jam pascaoperasi, rata-rata frekuensi pemberian tambahan fentanyl kelompok T sebanyak 3.13 kali dan kelompok D 1,7 kali, rata-rata dosis tambahan fentanyl kelompok T sebanyak 155,71 mcg dan kelompok D 67,65 mcg (p=0,000). Rata-rata VAS 24 jam pasca operasi pada kelompok T 2,14 dan pada kelompok D 1,74 (p<0,05). Untuk efek samping, kelompok T terdapat 4 kejadian (11,4%) mual muntah, sedangkan pada kelompok D tidak ada. Perbedaan ini bermakna yang ditunjukkan dengan nilai p=0,042 (p<0,05).Kesimpulan: Daya guna analgesi natrium diklofenak 100 mg suppositoria rektal lebih baik dibanding tramadol 100 mg suppositoria rektal, dengan efek samping yang lebih kecil pada 24 jam pasca operasi sesar.
Co-Authors A Himendra Wargahadibrata Adi Hidayat Adi, Erman Noor Adriman, Silmi Afra, Syeda Maria Ahmad Agnesha, Fahmi Ambarini, Ronia Anindita, Triatma Arief, Budi Arshad, Muhammad Aulyan Syah, Bau Indah Ayu, Rifana Bambang Suryono, Bambang Bestari, Viqy Esha Bhirowo Yudo Pratomo Bijaksana, Gena Bimarso, Wahyono Budianti, Nugrahaeni Calcarina Fitriani Retno Wisudarti Chamsudi, Danie Hayam Mada Christanto, Sandhi Dewi Yulianti Bisri Diana C. Lalenoh, Diana C. Diana Lalenoh Dinar Dewi Kania Edhie Budi Setiawan, Edhie Budi Fachrial, Peppy Fadhil, Dimas Nu’man Faturachman, Muhammad Rafli Firdaus, Riyadh Fithrah, Bona Akhmad Fitri Sepviyanti Sumardi Francis Tantri, Francis Fuadi, I Gunawan, Fanny Hamzah, Hanzah Handayani, Sri Hartono, Pinter Herlambang, Panji Hisam, Muhammad Yusuf Ida Bagus Krisna Jaya Sutawan Ikhwandi, Arif Indrawan, Rully Isngadi Iwan Abdul Rachman Iwan Fuadi Jasa, Zafrullah Kany Kadarisman, Muh Laksono, Buyung Hartiyo Lalenh, Diana C. Larasati, Kinanthi Liza, Helda Luky Adrianto Malisan, Johny Mangastuti, Rebecca Sidhapramudita Muhammad Thamrin Mulyono Nasution, Syahrial Nur, Muhammad Ikhwan Nuryawan, Iwan Oetoro, Bambang J. P, Inggita Dyah Parhusip, Veronica Permatasari, Endah Prasadja Ricardianto, Prasadja Prasetya, Sandie Prayunanto A.N, Eko Purwa Saputra, Datep Purwanto, Erfien Puspita, Amelia Tri Putra, Bina Putri, Dini Handayani Putu Pramana Suarjaya Radian Ahmad Halimi Rahayu, Solihah Sari Ratih Kumala Fajar Apsari Restu S, Meta Rini, Isworo Ruddy Suwandi Rudita, Muhammad Rumpoko, Triaji Mudo Saleh, Siti Chasnak Santoso, Arief Hariyadi Sectio, Devin Igel Septika, Rafidya Indah Setiandari, Kristina Setyarto, Aries Siti Helmyati Sitorus, Purbanuara Parlindungan Soeboer, Deni Achmad Subekti, Bambang Eko Sudadi Sudadi Sudadi Suharso, Pamungkas Hary Sujarwanto Sujarwanto, Sujarwanto Sulam, Munyati Sunartejo, Bayu Suyasa, Agus Baratha Syafruddin Gaus Tatang Bisri Widiastuti, Monika - Winarso, Achmad Wahib Wahju Wrgahadibrata, A Himendra Yosiyanto, Robi Yunita Widyastuti Yusmein Uyun Zaki, Wildan Arsyad