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All Journal Jurnal Anestesi Perioperatif Majalah Anestesia dan Critical Care Jurnal Neuroanestesi Indonesia
Ruli Herman Sitanggang
Departemen Anestesiologi Dan Terapi Intensi Fakultas Kedokteran Universitas Padjadjaran /RSHS Bandung
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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Journal : Majalah Anestesia dan Critical Care

 1 
Duration of Analgesia and Blood Pressure by Giving Midazolam 2 mg Compared to Fentanyl 25 mcg in Hyperbaric Bupivacaine 10 mg During Cesarean Delivery Sitanggang, Ruli Herman; Harniati, Siti; Redjeki, Ike Sri
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
Publisher : Perdatin Pusat

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Pain free episode after Cesarean deliveryis needed by the mother to take care the baby. Opioid is the most common adjuvant used in spinal anesthesia, but still has unpleasant side effects, while Midazolam 2 mg is known to prolong analgesia. This study was using randomized double-blind experimental design. The subject of this study is 40 pregnant women with ASA II who underwent Cesarean delivery with spinal anesthesia. Research subjects are divided into 2 groups of study. The first group was given a combination of Fentanyl 25 mcg + 0.5% Bupivacaine 10 mg (BF) while the second group was given Midazolam 2mg+0,5% Bupivacaine 10 mg (BM). The duration of analgesia in 2 groups was assessed using a numeric rating scale (NRS). Then the data were analyzed using T-test, Mann Whitney test and Chi square test. The results showed no significant difference in both groups in a decrease of systolic blood pressure (p>0.05). Duration of analgesia in Midazolam group is 217.5 (39.32) minutes longer than Fentanyl group 124.0 (10.83) minutes. The conclusion is additional Midazolam 2 mg may prolong analgesia compared with Fentanyl 25 mcg without a decrease in blood pressure in Caserean delivery.
Respiratory Failure due to Transfusion Related Acute Lung Injury (TRALI) and Atelectasis and Acute Kidney Injury Post Cardiac Surgery: A Case Report wullur, caroline; Sitanggang, Ruli Herman
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
Publisher : Perdatin Pusat

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Postoperative pulmonary complications and acute kidney injuries are the most frequent and significant contributor to morbidity, mortality and costs associated with hospitalization. Despite the prevalance of these complications in cardiac surgery patients, recognition, diagnosis and management of this problem vary widely. Many factors may contribute to the pathogenesis of lung complications include atelectasis, Transfusion Related Acute Lung Injury (TRALI) and Acute Respiratory Distress Syndrome (ARDS). While haemodynamic, inflammatory and nephrotic factors are involved and overlap each other in leading to kidney injury. A 54-year-old patient with history of hypertension and diabetes melitus underwent coronary artery bypass graft. On postoperative day 1, he had worsening respiratory and renal function with suspected atelectasis and TRALI. Alveolar lung recruitment maneuvers as well as Sustained Low-Efficiency Dialysis (SLED) were conducted. He was transferred to regular ward on postoperative day seven and discharged uneventfully two days later. Early recognition and management including alveolar recruitment maneuvers and dialysis have an important role in the prevention and treatment of these complications.
Weil’s Disease dengan Perdarahan Pulmonal Harly, Patra Rijalul; Sitanggang, Ruli Herman; Maskoen, Tinni T.
Majalah Anestesia dan Critical Care Vol 34 No 3 (2016): Oktober
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Leptospirosis adalah zoonosis akibat leptospira yang banyak ditemukan di daerah tropis dengan curah hujan yang tinggi. Manifestasi klinis bervariasi mulai dari penyakit yang self-limited dengan tanda dan gejala yang tidak spesifik, meningitis aseptik benigna, Weil’s disease (ikterus, disfungsi renal, dan perdarahan), hingga perdarahan pulmonal yang memiliki mortalitas tinggi. Seorang laki – laki 18 tahun datang ke unit gawat darurat Rumah Sakit Dr. Hasan Sadikin pada bulan Juni 2016 dengan Weil’s disease yang disertai perdarahan pulmonal. Terjadi kegagalan fungsi organ multipel yang memberat, sehingga dikonsulkan ke ICU pada hari ke 2 perawatan di rumah sakit. Didapatkan APACHE II Score 17 dengan prediksi mortalitas 25% pada saat masuk ICU. Kegagalan fungsi organ yang didapatkan adalah respirasi (P/F Ratio 52,6), ginjal (Kreatinin 5,36mg/dL), dan hati (bilirubin total 26,26 mg/dL). Diagnosis leptospirosis ditegakkan dengan skor Modified Faine Criteria 31. Manajemen di ICU pada pasien ini dilakukan dengan ventilasi mekanis, hemodialisis, meropenem dan methylprednisolone. Kortikosteroid diberikan mengingat patofisiologi leptospirosis yang diperkirakan akibat reaksi autoimun. Terjadi perbaikan pada fungsi respirasi (P/F Ratio 445), ginjal (Kreatinin 0,52/dL), dan hati (bilirubin total 10,76 mg/dL). Pasien diekstubasi pada hari ke 7 perawatan di ICU dan pindah ke ruang perawatan pada hari ke 8 perawatan di ICU. Kata kunci: Weil’s disease, Perdarahan Pulmonal, Methylprednisolone Weil’s Disease with Pulmonary HemorrhageLeptospirosis is a zoonosis caused by leptospira spp. mainly found in high rainfall tropical area. Clinical manifestation greatly varies from self limited non specific disease, benign aseptic meningitis, Weil’s disease (jaundice, acute kidney injury, and hemorrhage), to a highly lethal pulmonary hemorrhage. An 18 years old male came to the Dr. Hasan Sadikin Hospital emergency department on June 2016, diagnosed as Weil’s disease with pulmonary hemorrhage. He has a worsening multiple organ failure, and consulted to the ICU at the 2nd day of hospitalization.Apache II score at ICU admission is 17 with predicted mortality 25%. Organ failure at ICU admission were respiration (P/F Ratio 52,6), kidney (Creatinine 5,36mg/dL), and liver (Total Bilirubin 26,26 mg/dL). Diagnosis of leptospirosis is made based on Modified Faine Criteria score of 31. ICU management consist of menchanical ventilation, hemodialysis, meropenem, and methylprednisolone. Rationale of corticosteroid administration is due to pathophysiology of leptospirosis, which is believed to be related to an autoimmune process. Respiration function (P/F Ratio 445), kidney function (Creatinine 0,52/dL), and liver function (Total Bilirubin 10,76 mg/dL)were resolved. Patient was extubated on the 7th day after ICU admission, and discharged to the ward on the 8th day after ICU admission. Key words: Weil’s disease, Pulmonary Hemorrhage, Methylprednisolone
Co-Authors - Elvidiansyah - Elvidiansyah - Suwarman A. Himendra Wargahadibrata A. Himendra Wargahadibrata Afifuddin Afifuddin Afifuddin Afifuddin, Afifuddin Akhmad Rhesa Sandy Annisa Isfandiary Ismandiya Annisa Isfandiary Ismandiya, Annisa Isfandiary Anthon Vermana Ritonga Anthon Vermana Ritonga Ara Guntara Ara Guntara Ardi Zulfariansyah Ardi Zulfariansyah Ariaty, Geeta Maharani Aris Gunawan Arnanto, Yodi Suryo Budi Hartanto Budi Hartanto Budiana Rismawan Cindy E. Boom Cindy E. Boom Dadang Mulyawan Dadang Mulyawan Dedi Fitri Yadi Dewi Yulianti Bisri Doddy Tavianto Erias, Muhammad Erik Efendi Erik Efendi Erwin Pradian Ezra Oktaliansah Geeta Maharani Ariaty Gunawan Mutiara Gunawan Mutiara, Gunawan Gunawan, Aris Harly, Patra Rijalul Harniati, Siti Ike Sri Redjeki Indriasari Indriasari Iwan Fuadi Lira Panduwaty M. Andy Prihartono M. Erias Erlangga M. Erias Erlangga, M. Erias Mahathir Harry Permana Muhammad Erias Nurita Dian Kestriani Oka Endarto Oktofina K. Mose Oktofina K. Mose Raditya Fauzan Raditya Fauzan, Raditya Ratu Lewi Ratu Lewi, Ratu Reza Widianto Sudjud Robert Sihombing Ronald Tikuali Salukanan Salukanan, Ronald Tikuali SATRIYAS ILYAS Selly Oktarina Rosita Selly Oktarina Rosita Sihombing, Robert Suryadi Suryadi Suryadi Suryadi Suwarman Suwarman Suwarman Suwarman Suwarman Suwarman, Suwarman Tatang Bisri Tatang Bisri Tatang Bisri Tinni T. Maskoen Tinni T. Maskoen Udin Sabarudin Udin Sabarudin Viana Wijayanti Viana Wijayanti Wirawijaya, Dear Mohtar Wirawijaya, Dear Mohtar Wirawijaya Wullur, Caroline Yodi Suryo Arnanto