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All Journal Solo Journal of Anesthesi, Pain and Critical Care Jurnal Neuroanestesi Indonesia Jurnal Ekonomi Kesehatan Indonesia
Himawan Sasongko
Bagian Anestesi dan Terapi Intensif Fakultas Kedokteran Universitas Diponegoro/ RSUP Dr. Kariadi Semarang
Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Pengaruh Pengadaan Barang dan Jasa pada Masa Pandemi Corona Virus Disease 2019 (COVID-19) Terhadap Kondisi Keuangan Rumah Sakit di RSUP Dr. Kariadi Semarang Sasongko, Himawan
Jurnal Ekonomi Kesehatan Indonesia Vol. 6, No. 1
Publisher : UI Scholars Hub

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Abstract

The mechanism for procuring goods and services in handling emergencies is different from regular/ordinary conditions. The main difference is in the stage of the procurement implementation. Today's problems are the enormous price disparity, the increasing availability and demand, especially for personal protective equipment (PPE). The disparity has resulted in more significant expenses in hospital spending, this condition impact hospital finances. This research is an observational study. The method is qualitative with interviews and data collection. The data taken are primary data and secondary data. Informants consist of main informants and triangulation informants. The data collection instrument was an in-depth interview guide. From the research results obtained: before the COVID-19 pandemic, two methods of implementing procurement (E-Catalogue and Direct Procurement) while procurement during the pandemic used three methods (E-Catalogue, Direct Procurement and Direct Appointment). The procurement process is following the established rules. The procurement process that is carried out has complied with the procurement principles and ethics. There has been a change in the General Procurement Plan for 2020 due to the pandemic. The realization of revenue for Dr Kariadi Hospital in 2020 exceeded the predetermined target, so it can be said that the financial condition of Dr Kariadi Hospital during the COVID-19 pandemic was considered healthy. This study concludes that the procurement process in the COVID-19 pandemic condition follows the principles, ethics and regulations that have been set, as well as the financial condition of Dr Kariadi during the COVID-19 pandemic, was considered healthy.
Relationship Between Spinal Anesthesia Injection Speed and the Incidence of Hypotension in Patients Undergoing Cesarean Section Mafazi, Fikri Alim; Novrinta, Donatila; Sasongko, Himawan
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 4, No 2 (2024): October 2024
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v4i2.67198

Abstract

Background : The incidence of post-spinal hypotension in pregnancy is very high 50-85%. There have been many studies preventing hypotension but still considered unsatisfactory. Reducing the speed of injection of spinal anesthetic drugs can prevent hypotension, but still controversial.Objective : to determine the incidence of hypotension, onset of achieving sensory blocks, and the association of injection rate with the occurrence of post-spinal anesthetic hypotension.Methods: A Randomised Control Trial Study, including 48 patients underwent caesarean delivery who fulfil inclusion criteria. Samples were divided into fast and slow groups. Spinal anesthesia was given using hyperbaric bupivacain 0.5% of 10mg, Fentanyl 25mcg, and 100mcg morphine total volume of 3 cc. Group A received fast injection for 10 seconds, while group B for 30 seconds. The incidence of hypotension, onset of block and incidence of side effects after spinal anesthesia were recorded.Result : The incidence of hypotension in the fast group was 70.4%, while in slow group was 23.8%. There was a significant association between injection rate with post-spinal anesthetic hypotension (p = 0.004). Onset of Block T6 post-spinal anesthesia is faster in the fast group. Furthermore, there was no significant difference in nausea, vomiting, and chills between two groups.Conclusion: Slow injection rate may reduce the incidence of post-spinal anesthetic hypotension. However, the onset of sensory block was faster achieved with fast rate injection, with no difference in other side effects.
Awake Endospine Disektomi pada Pasien Lumbar Spinal Stenosis karena Hernia Nucleus Pulposus Laras, Nuzulul Widyadining; Sasongko, Himawan
Jurnal Neuroanestesi Indonesia Vol 9, No 3 (2020)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2947.924 KB) | DOI: 10.24244/jni.v9i3.282

Abstract

Lumbar spinal stenosis (LSS) merupakan gejala penyakit yang berhubungan dengan berkurangnya ukuran canalis spinalis vertebra lumbal menyebabkan penekanan saraf yang terletak di dalamnya. Berdasar penyebabnya dibagi jadi dua, kongenital dan degeneratif. Pasien dapat merasakan fase nyeri yang tidak dapat diprediksi dan juga fase stabil tanpa nyeri. Salah satu contoh LSS degeneratif adalah pembengkakan diskus intervertebralis atau HNP. Penyakit HNP merupakan salah satu penyebab dari nyeri punggung bawah dan merupakan salah satu masalah kesehatan yang utama. Prevalensi HNP berkisar antara 12 % dari populasi. Terapi yang dilakukan salah satunya endospine disektomi. Operasi ini dapat dikerjakan dengan general anestesia (GA) atau neuroaksial anestesia (spinal, epidural). GA lebih dipilih karena lebih aman dari komplikasi gangguan jalur nafas. Deksmedetomidine memiliki efek sedasi tanpa risiko depresi respirasi serta memiliki efek analgesi dapat digunakan untuk metode awake endospine pada disektomi. Pada penulisan ini, dilakukan pemilihan teknik anestesi awake untuk mengakomodasi operator untuk menilai respon nyeri dan fungsi motorik pasien saat operasi.Awake Endospine Dissectomy in Patient with Lumbar Spine Stenosis caused by Hernia Nucleus PulposusAbstractLumbar spinal stenosis (LSS) are symptoms from degradation canalis spinalis vertebraes size which pressured nerve inside it. Based on its cause, there are two types of LSS, congenital and degenerative. The patient can experience an unpredictable pain phase as well as a stable phase without pain. Bulging of intervertebralis disc or HNP is one of degenerative LSS. HNP disease is one of the causes of low back pain and is a major health problem. HNP prevalention is 1-2 % from population. One of therapy use to medicate LSS is endospine discectomy. This operation done with general anesthesia (GA) or neuroaxial anesthesia (spinal, epidural). GA preferably used because it caused less side effect like airway obstruction or neural injury. Dexmedetomidine has a sedative effect without the risk of respiratory depression and has an analgesic effect. It can be used to awake endospine methods in dissectomy. In this case report, the writer did awake endospine method to accommodate operator so they could know level of pain and motoric function of patient durante operation.
Anestesi Untuk Pasien dengan Perdarahan Intrasereberal yang Dilakukan Kraniektomi Dekompresi Darurat Sasongko, Himawan; Harahap, M. Sofyan
Jurnal Neuroanestesi Indonesia Vol 1, No 2 (2012)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (718.738 KB) | DOI: 10.24244/jni.vol1i2.94

Abstract

Perdarahan intraserebral (intracerebral hemorrhage/ICH) adalah penyakit yang cukup sering terjadi, dan dapat diklasifikasikan menjadi dua berdasar sudut pandang, yaitu anatomis dan etiologis. Secara etiologis, dapat dibedakan menjadi perdarahan primer atau sekunder. Kraniektomi dekompresi akan menurunkan TIK secara cepat dan menetap serta menghindari terjadinya herniasi otak. Posisi telungkup atau tengkurap yang dilakukan pada pasien selama tindakan anestesi akan berhubungan dengan perubahan fisiologis maupun komplikasi yang dapat timbul terhadap pasien. Seorang wanita usia 49 tahun dengan perdarahan intraserebelum, yang akan dilakukan tindakan darurat kraniektomi dekompresi. Premedikasi yang diberikan adalah midazolam dan ondansetron. Induksi anestesi menggunakan propofol, fentanyl dan vekuronium. Pemeliharaan anestesi dengan sevofluran 1,5-2,0 vol%, oksigen dan vekuronium. Semua tindakan ini bertujuan untuk proteksi otak. Selama pembedahan dilakukan pemantauan tekanan darah, laju nadi, saturasi O2 dan elektrokardiografi. Pembedahan dilakukan pada posisi tengkurap. Selama 120 menit pembedahan, hemodinamik stabil. Pascaoperasi, pasien diekstubasi dan dikirim ke High Care Unit (HCU). Selama pengelolaan di HCU, hemodinamik stabil dan setelah 2 hari perawatan, pasien dipindahkan ke bangsal perawatan biasa. Salah satu cara untuk menangani pasien dengan perdarahan intrasereberal akibat trauma adalah dengan kraniektomi dekompresi. Tujuannya adalah untuk menurunkan tekanan intrakranial dan mencegah terjadinya herniasi otak. Evaluasi perioperasi dan perhatian yang baik sebelum, selama dan sesudah pembedahan, akan menghasilkan kondisi yang baik dengan angka kesakitan dan kematian yang minimal.Anesthesia for Patient with Intracereberal Hemorrhage Underwent Decompressive Craniectomy EmergencyIntracerebral hemorrhage (ICH) is a common disease, and can be classified by anatomical or etiological aspect. According to etiological aspects can be differenced by primary or secondary hemorrhages. Decompessive craniectomy will decreased intracranial pressure at once and prevent brain herniation. Prone position patient during anaesthesia is associated with physiological changes and also with number of complications. A forty nine years old female with intracereberal hemorrhage, undergone emergency decompressive craniectomy. Premedication with midazolam and ondancetron was given. Induction of anesthesia used propofol, fentanyl, and vecuronium. Maintenance of anesthesia used oxygen, sevoflurane 1.5-2.0 vol% and rocuronium. All this maneuver is for brain protection. Monitoring of BP, HR, SpO2 and ECG was done. During 120 minutes of surgery, hemodynamic was stable. Post operation, patient was extubated and admitted to High Care Unit (HCU). During management in HCU, hemodynamic was stable and after 2 days, patient moved to the ward. Decompressive craniectomy is one methode to handle patient with intracereberal hemorrhage. The purpose is to decreased intracranial pressure and prevent brain herniation. Perioperative evaluation and good attention before procedure, will produce outcome with minimal adverse effect and less mortality.
Penggunaan Calcium Channel Blocker pada Tatalaksana Anestesi Clipping Aneurisma Otak Rindiati, Fanda Ayyu; Sasongko, Himawan; Harahap, M Sofyan
Jurnal Neuroanestesi Indonesia Vol 8, No 3 (2019)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2754.016 KB) | DOI: 10.24244/jni.v8i3.232

Abstract

Perdarahan subarachnoid dapat diartikan sebagai proses pecahnya pembuluh darah di ruang yang berada dibawah arakhnoid (subarachnoid). Prevalensi terjadinya perdarahan subaraknoid dapat mencapai hingga 33.000 orang per tahun di Amerika Serikat. Penyebab paling sering perdarahan subarachnoid adalah ruptur aneurisma salah satu arteri di dasar otak dan adanya malformasi arteriovena (MAV). Pada umumnya aneurisma terjadi pada sekitar 5% dari populasi orang dewasa, terutama pada wanita. Penanganan pada aneurisma pembuluh darah otak salah satunya dengan clipping aneurisma. Tindakan tersebut beresiko terjadi vasospasme serebral. Nimodipine adalah suatu calcium chanel blocker yang penting dalam pengelolaan operasi aneurisma karena mempunyai efek vasodilatasi pembuluh darah serebral dan termasuk dalam bagian dari manajemen vasospasme serebral. Pada laporan ini, dilaporkan dua kasus tindaan clipping aneurisma. Pasien pertama adalah wanita usia 69 tahun, berat badan 60 kg dengan diagnosa SAH hari ke 18 yang mengalami defisit neurologi berupa hemiparese dextra dan afasia motorik. Pasien kedua adalah wanita usia 57 tahun berat badan 60 kg dengan diagnosa SAH hari ke 20 dan mengalami defisit neurologi hemiparese kanan dan afasia sensorik. Pada kedua pasien dilakukan tindakan pembedahan kraniotomi clipping aneurisma. Kedua pasien memiliki hasil akhir yang baik. Akan tetapi, ada perbedaan lama perawatan antara pasien yang menjalani terapi awal nimodipine dan yang tidak menerima terapi tersebut.Administration of Calcium Channel Blocker in Anaesthesia Management of Cerebral Aneurysm ClippingAbstractSubarachnoid hemorrhage can be interpreted as the process of rupture of blood vessels in the space under the arachnoid (subarachnoid). The prevalence of subarachnoid hemorrhage can reach up to 33,000 people per year in the United States. The most common causes of subarachnoid bleeding are ruptured aneurysm in one of the arteries at the base of the brain and the presence of arteriovenous malformations (MAV). In general, aneurysms occur in about 5% of the adult population, especially in women.Therapy in cerebral vascular aneurysms, one of which is clipping aneurysms. These actions are at risk of cerebral vasospasm. Nimodipine is a calcium channel blocker which is important in the management of aneurysm surgery because it has a vasodilating effect on cerebral vessels and is included in the management of cerebral vasospasm. In this report, two cases of clipping aneurysm are reported. The first patient was a woman aged 69 years, body weight 60 kg with a diagnosis of SAH day 18 who had a neurological deficit in the form of hemiparese dextra and motor aphasia. The second patient was a 57-year-old woman weighing 60 kg with a diagnosis of SAH day 20 and had a neurological deficit in the form of right hemiparese and sensory aphasia. In both patients, clipping aneurysm was performed by craniotomy surgery. Both patients had good results. However, there is a difference in the length of stay between patients who underwent initial nimodipine therapy and who did not receive it.
Co-Authors Harahap, M Sofyan M. Sofyan Harahap Mafazi, Fikri Alim Novrinta, Donatila Nuzulul Widyadining Laras Rindiati, Fanda Ayyu