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All Journal Jurnal Anestesiologi Indonesia Diponegoro International Medical Journal (DIMJ)
Hari Hendriarto Satoto
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Health Professions Medicine & Pharmacology Neuroscience Public Health

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Mekanisme Kerja Obat Anestesi Lokal Samodro, Ratno; Sutiyono, Doso; Satoto, Hari Hendriarto
JAI (Jurnal Anestesiologi Indonesia) Vol 3, No 1 (2011): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v3i1.6454

Abstract

Anestesi regional semakin berkembang dan meluas pemakaiannya, mengingat berbagai keuntungan yang ditawarkan, diantaranya relatif lebih murah, pengaruh sistemik yang minimal, menghasilkan analgesi yang adekuat dan kemampuan mencegah respon stress secara lebih sempurna. Secara kimiawi obat anestesi lokal dibagi dalam dua golongan besar, yaitu golongan ester dan golongan amide. Perbedaan kimia ini direfleksikan dalam perbedaan tempat metabolisme, dimana golongan ester terutama dimetabolisme oleh enzim pseudo-kolinesterase di plasma sedangkan golongan amide terutama melalui degradasi enzimatis di hati. Perbedaan ini juga berkaitan dengan besarnya kemungkinan terjadinya alergi, dimana golongan ester turunan dari p-amino-benzoic acid memiliki frekwensi kecenderungan alergi lebih besar. Obat anestesi lokal yang lazim dipakai di negara kita untuk golongan ester adalah prokain, sedangkan golongan amide adalah lidokain dan bupivakain. Mekanisme kerja obat anestesi local mencegah transmisi impuls saraf (blokade konduksi) dengan menghambat pengiriman ion natrium melalui gerbang ion natrium selektif pada membrane saraf. Kegagalan permeabilitas gerbang ion natrium untuk meningkatkan perlambatan kecepatan depolarisasi seperti ambang batas potensial tidak tercapai sehingga potensial aksi tidak disebarkan. Obat anestesi lokal tidak mengubah potensial istirahat transmembran atau ambang batas potensial. Farmakokinetik obat meliputi absorpsi, distribusi, metabolisme dan ekskresi. Komplikasi obat anestesi lokal yaitu efek samping lokal pada tempat suntikan dapat timbul hematom dan abses sedangkan efek samping sistemik antara lain neurologis pada Susunan Saraf Pusat, respirasi, kardiovaskuler, imunologi ,muskuloskeletal dan hematologi Beberapa interaksi obat anestesi lokal antara lain pemberian bersamaan dapat meningkatkan potensi masing-masing obat. penurunan metabolisme dari anestesi lokal serta meningkatkan potensi intoksikasi. 
Comparison of Intravenous Ephedrine Administration of 5 mg and 10 mg Doses on Post Spinal Anesthesia Hypotension in Caesarean Section at Dr. Kariadi General Hospital Semarang Alaydrus, Husein; Rayhan, Amar; Arifin, Johan; Satoto, Hari Hendriarto
Diponegoro International Medical Journal Vol 6, No 1 (2025): July 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i1.26813

Abstract

Background: Hypotension after spinal anesthesia or combined epidural anesthesia in caesarean section (CS) causes adverse effects on the mother and fetus/neonatal. Hypotension often occurs therefore vasopressors could be used routinely and should be used as prophylaxisMethods: Simple randomized controlled trial study of 52 patients undergoing CS at RSUP dr. Kariadi Semarang. Subjects revealed two groups, namely intravenous ephedrine at a dose of 5 mg and a dose of 10 mg. Hemodynamic variables were measured every 3 minutes until the operation was completed.Results: In the comparison of mean arterial pressure (MAP) between the ephedrine 5 mg and ephedrine 10 mg groups, a statistically significant difference was obtained at 30 minutes (P < 0.05) while in the measurement of heart rate (HR) between the ephedrine 5 group mg and ephedrine 10 mg, a statistically significant difference was obtained from 3 to 15 minutes. Hypotension was obtained in 1 patient in the ephedrine 10 mg group and 3 patients in the ephedrine 5 mg group.Conclusion: 10 mg intravenous ephedrine as a prophylactic agent after spinal anesthesia for patients undergoing CS has better hemodynamic outcomes and complications than 5 mg intravenous ephedrine. Keywords: spinal anesthesia, ephedrine, SC, hypotension
Cytokine-Mediated Systemic Inflammation in Patient with Sepsis in ICU: A Systematic Literature Review and Meta- Analysis of Interleukin-6 and Tumor Necrosis - Yusuprihastuti, Maulitia Neny; Juniarti, Juniarti; Weni, Linda; Mukhtar, Diniwati; Satoto, Hari Hendriarto
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.v0i0.82097

Abstract

ABSTRACTObjectives: To systematically evaluate and quantify the prognostic value of circulating interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels for mortality and disease severity in adult intensive care unit (ICU) patients with sepsis.Study design: This study was conducted as a systematic review and meta-analysis of observational studies and randomized controlled trials. Evidence quality was assessed using the Newcastle–Ottawa Scale for observational studies. Quantitative synthesis was performed using meta-analytic techniques.Data sources: A comprehensive literature search was performed in PubMed, Scopus, Web of Science, and Embase from database inception to the most recent available date. Reference lists of relevant articles were also manually screened to identify additional eligible studies.Data synthesis: Two studies evaluating IL-6 (196 ICU sepsis patients) demonstrated significantly higher IL-6 levels in non-survivors compared with survivors, with a large and consistent pooled effect size (SMD −1.92; 95% CI −2.27 to −1.57) and no interstudy heterogeneity, supporting IL-6 as a robust prognostic biomarker. TNF-α data from two studies (270 patients) also showed significantly elevated levels in non-survivors (SMD −2.70; 95% CI −3.05 to −2.35); however, substantial heterogeneity and slight funnel plot asymmetry reduced the certainty and generalizability of its prognostic value.Conclusions: Elevated IL-6 and TNF-α levels are associated with increased mortality in ICU patients with sepsis. IL-6 demonstrates more consistent and reliable prognostic performance, supporting its use for early risk stratification in critical care, whereas TNF-α may serve as a complementary biomarker.Registration: This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Prospective registration in the PROSPERO database.Keywords:interleukin-6; intensive care unit; mortality; sepsis; tumor necrosis factor-α
Co-Authors Diniwati Mukhtar Doso Sutiyono Husein Alaydrus, Husein Johan Arifin Juniarti Juniarti Linda Weni Ratno Samodro Rayhan, Amar Yusuprihastuti, Maulitia Neny