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All Journal Medicina E-Jurnal Medika Udayana Jurnal Anestesiologi Indonesia Bali Journal of Anesthesiology Medicinus : Jurnal Kedokteran Bioscientia Medicina : Journal of Biomedicine and Translational Research PREPOTIF : Jurnal Kesehatan Masyarakat Neurologico Spinale Medico Chirurgico JOURNAL LA MEDIHEALTICO Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Neuroanestesi Indonesia Majalah Anestesia & Critical Care (MACC) Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif

Putu Pramana Suarjaya

Faculty Of Medicine Anesthesiology & Therapy Intensif Universitas Udayana Denpasar

Author-ID : 386627

Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Physics Public Health Veterinary Other

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Manajemen Anestesi Untuk Koreksi Skoliosis pada Pasien Chiari Malformasi Post Dekompresi Foramen Magnum I. D. G. Tresna Rismantara; I Putu Pramana Suarjaya
JAI (Jurnal Anestesiologi Indonesia) Vol 6, No 1 (2014): Jurnal Anestesiologi Indonesia
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Latar belakang: Terdapat penyulit pada manajemen anestesi untuk koreksi skoliosis thorakalis pada pasien chiari malformasi post dekompresi foramen magnum karena terdapat permasalahan periopoeratif kompleks yang menyertainya.Kasus: Digunakan tindakan anestesi untuk koreksi skoliosis pada pasien dengan Chiari Malformasi post dekompresi foramen magnum dengan keterbatasan mobilisasi leher. Pada pemeriksaan rontgen didapatkan semirigid sublaminer instrumentasi pada leher. pada MSCT terlihat skoliosis thorakalis dengan pusat kelengkungan pada Thorakal 9 dengan Cobb’s Angle 60º. Pemeriksaan kardiovaskular, respirasi dan neurologis dalam batas normal.Derajat kelengkunan skoliosis pada pasien ini masih dibawah 70º sehingga tidak menekan jantung dan paru, tetapi terdapat penyulit untuk melakukan intubasi, hal ini bisa diatasi dengan memakai alat fiberoptik dalam kondisi sleep non apneu menggunakan fentanyl 50mcg dan propofol 50 mg dilanjutkan dengan balance anestesia menggunakan propofol kontinyu, N2O, O2, vecuronium dan fentanyl intermittnent serta tekhnik hipotensi kendali.Pasca anestesi pasien mendapat analgesi dengan 2 kateter epidural dengan ujung kateter setinggi Thorakal 3 dan ujing kateter lainnya setinggi Thorakal 12. Masing-masing memakai 0,5mg morfin dan bupivacaine 0,1%. Pasien dievaluasi 2 hari di ICU, tidak ada defek neurologis dan bebas nyeri kemudian di pindah ke ruang perawatan.Ringkasan: Manajemen anestesi pada operasi Koreksi skoliosis thorakalis menjadi suatu hal yang sangat penting karena begitu kompleksnya permasalahan perioperatif yang menyertainya. Fungsi kardiovaskular dan respirasi adalah yang paling mungkin terganggu sehingga perlu mendapat perhatian khusus. Penilaian terhadap derajat keparahan dari skoliosisnya dapat memberikan suatu nilai prediksi terhadap permasalahan yang mungkin terjadi perioperatif. Pasien dengan gangguan pada mobilitas dari leher dapat menjadi penyulit saat melakukan laringoskopi-intubasi. Post operasi jika fungsi kardiovaskular dan respirasi baik, pertimbangan ekstubasi dapat menjadi pilihan. Analgetik post operasi harus adekuat untuk menangani nyeri karena nyeri dapat dapat menimbulkan instabilitas kardiovaskular dan respirasi yang menjadi penyulit paska operasi.

Manajemen Perioperatif Epidural Hemorrhage Akibat Cedera Otak Traumatik I Putu Pramana Suarjaya; A. Himendra Wargahadibrata
Jurnal Neuroanestesi Indonesia Vol 1, No 1 (2012)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Epidural hemorrhage (EDH) adalah perdarahan yang terjadi pada ruang epidural, biasanya terjadi pada fossa kranii media karena adanya laserasi arteri meningea media, walaupun bisa juga terjadi pada fossa anterior ataupun posterior. Bentuknya biasanya lentikuler dan dibatasi oleh garis sutura di mana lapisan perikranial dura melekat ke kranium. Secara klasik, pasien EDH memiliki lucid interval, yakni periode adanya kesadaran yang jernih sebelum terjadinya penurunan kesadaran. Gejala klinis sebagai akibat dari hematoma intrakranial seperti EDH, terutama tergantung pada besarnya volume dan kecepatan hematoma ini terbentuk. Bila hematoma terbentuk dengan cepat, terjadi peningkatan tekanan intrakranial (TIK) yang akan menimbulkan perburukan neurologis sampai dapat mengancam kehidupan. Pengelolaan perioperatif pasien dengan cedera otak traumatik yang mengalami EDH bertujuan mempertahankan perfusi dan oksigenasi otak, mengendalikan TIK serta dekompresi dan evakuasi perdarahan dengan pembedahan pada sebagian kasus. Kami membahas manajemen perioperatif pada 2 orang pasien, seorang anak dan seorang remaja yang mengalami EDH karena cedera otak traumatik yang menjalani kraniotomi emergensi untuk evakuasi perdarahannya. EDH sangat penting untuk cepat didiagnosa, karena bila terdeteksi segera dan dilakukan evakuasi perdarahan, biasanya hasilnya baik dengan mortalitas kurang dari 10%. Evakuasi dan kontrol perdarahan segera sangat penting untuk keselamatan pasien dan menghindari cedera neurologis yang permanen.Perioperative Management of Epidural Hemorrhage Due to Traumatic Brain InjuryEpidural hemorrhages (EDH) are bleeding in epidural space, usually occur in the middle cranial fossa via laceration of the middle meningeal artery, although they can also occur in the anterior and osterior fossae. They are usually lenticular shaped and are bounded by suture lines where the pericranial ayer of dura attaches to the skull. Classically patients suffered from EDH experience a lucid interval which is a period of intact consciousness prior to deterioration.Clinical symptom of intracranial hematoma such as EDH, mainly depend on volume and rate the hematoma formed. If the intracranial hematoma formed rapidly, there will be a sudden rise on ICP which led to neurologic deterioration that could be deleterious. Perioperative management of intracranial hematoma such as EDH is to maintain brain perfusion and oxygenation, control the ICP, and surgical decompression in some cases. We are scussing perioperative management of two cases suffered from EDH due to traumatic brain injury who underwent emergency craniotomy for clott evacuation.These are important injuries to identify;if detected early they are usually associated with good outcome and have a mortality of less than 10%. Early bleeding control and hematoma evacuation are very important to patient safety and avoid any permanent neurologic injury.

The use of CONOX as a guide to the general anesthesia on laparotomy patients compared with standard clinical care – A pilot study Brillyan Jehosua Toar; I Putu Pramana Suarjaya; IGAG Utara Hartawan; Tjokorda Gde Agung Senapathi
Neurologico Spinale Medico Chirurgico Vol 4 No 2 (2021)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v4i2.158

Background: Avoiding excessive doses of anesthesia was fundamental, mainly to reduce the adverse effect of anesthesia. Electroencephalography (EEG)-based monitors can be used to measure the depth level of anesthesia and guide intraoperative hypnosis drug and opioid administration. This study aims to evaluate the benefit of using CONOX monitor when administering anesthesia drugs in laparotomy procedures. Method: Twenty patients aged 18-65 years with physical status ASA I-III who underwent major laparotomy surgery with general anesthesia total intravenous anesthesia (TIVA) were divided into two groups. Group A received general anesthesia guided with the CONOX monitor, while group B using standard clinical care. We later evaluate the total use of propofol and fentanyl, intraoperative hemodynamic profile, postoperative cognitive disorder (POCD), intraoperative awareness, postoperative nausea and vomiting (PONV), and moderate to severe pain in the post-anesthesia care unit (PACU). Results: The mean total propofol used is lower in CONOX group (63.6 ± 11.7 mcg/kg/min vs. 74 ± 17.87 mcg/kg/min). A similar result was obtained with fentanyl. The CONOX group use a lower total of fentanyl (212.5 ± 32.3 mcg vs. 249 ± 54.6 mcg) than the control group. POCD was found to be more prevalent in the control group (5 vs 2 patients). While there is no report of intraoperative awareness. Conclusion: The incidence of PONV and moderate to severe pain in PACU was similar between the two groups. This pilot study is a preliminary study to evaluate the benefit of using EEG-based monitors to adjust anesthesia drugs.

Manajemen Perioperative pada Pasien Tumor Craniopharygioma Andika Metrisiawan; Nova Juwita; I Putu Pramana Suarjaya
Majalah Anestesia & Critical Care Vol 41 No 1 (2023): Februari
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v41i1.275

Craniopharyngiomas are benign histological brain tumors originating less frequently fromembryonic pituitary gland tissue that are seen most frequently in children between the ages of 5and 10 years. In this case report we present a 25-year-old patient with a craniopharyngiomatumor. Patients with decreased consciousness since 4 months before admission to the hospital,which started with memory loss that was getting worse and more difficult to communicate. Thepatient was diagnosed with a brain tumor and underwent surgery for tumor therapy in 2018. Theprocedure was performed using a transcranial approach. Considerations for preoperativeanesthesia should include evaluation of radiological features to identify tumor mass andpreoperative neurologic status. Other examinations of concern include examination of blood gasanalysis and examination of electrolytes. The goals of treatment can be to remove the tumor,reduce or control the size of the tumor.

Effectiveness of Postoperative Pain Management and Postoperative Emergency Pain Management at Prof.Dr. I.G.N.G. Ngoerah General Hospital I Putu Pramana Suarjaya
Majalah Anestesia & Critical Care Vol 41 No 1 (2023): Februari
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v41i1.295

Background: Early postoperative recovery has undergone many developments. Early mobilization, early nutritional intake, and adequate postoperative pain management are the scope of early postoperative recovery. The principle of postoperative pain management starts from preoperative evaluation which includes medical and psychological conditions, medication history, history of chronic pain, drug abuse, and previous postoperative treatment regiments to guide postoperative pain management plans. Method: This research is an analytical observational study, carried out at Sanglah Hospital Denpasar from June 2021 to December 2021. The accessible population of this study was all postoperative patients at the Central Surgical Installation and the Emergency Room at Sanglah Hospital Denpasar who were consulted by the Acute Pain Service (APS) team. Inclusion criteria were all patients who underwent surgical procedures under general and regional anesthesia, ASA physical status 1-3, and age above 18 years. Results: There were 166 patients managed by continuous intravenous postoperative analgesia (73.1%), 43 patients by epidural postoperative analgesia (18.9%), and 18 patient-controlled analgesia/PCA (7.9%). The most widely used intravenous regiment was fentanyl by 85 (37.4%).Conclusion: This study shows incidences number of acute postoperative pain in the elective and emergency department at Sanglah Hospital Denpasar gave good results with a much lower incidence of pain compared to the existing literature.

Perbandingan Efektivitas Campuran Propofol dengan Ketamin, Fentanil dan Lidokain dalam Mengurangi Nyeri dari Injeksi Propofol: Telaah Sistematis Christopher, Michael; Senapathi, Tjokorda Gde Agung; Suarjaya, I Putu Pramana; Dewi, Dewa Ayu Mas Shintya
E-Jurnal Medika Udayana Vol 11 No 8 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i8.P02

Propofol merupakan obat sedasi yang sering digunakan di prosedur di rumah sakit. Propofol memiliki efektivitas yang baik dalam menginduksi efek sedasi dan memiliki efek samping yang sangat minimal. Kekurangan dari penggunaan propofol ini adalah nyeri, dan nyeri ini memiliki insiden yang tinggi. Nyeri ini dapat dikurangi dengan berbagai faktor, salah satunya adalah menggunakan obat analgesia lokal lainnya seperti lidokain, fentanil dan ketamin. Telaah sistematis ini bertujuan merekam dari berbagai uji klinis acak yang terdapat di berbagai sumber literatur. Tahun penelitian dibatasi dari tahun 2016 hingga 2020. Penulis menggunakan kriteria kelayakan PICOS. Obat yang akan digunakan adalah lidokain, fentanil dan ketamin. Penulis juga menggunakan Jadad Scale untuk mengetahui risiko bias dari masing-masing penelitian yang sudah masuk kriteria inklusi. Penulis menggunakan Funnel Plot untuk mengetahui publikasi bias dari masing-masing studi. Telaah sistematis ini telah meneliti sebanyak 2130 sampel manusia yang didapat dari 25 penelitian. Penelitian-penelitian ini memiliki kelompok penelitian lagi untuk membandingkan hasil percobaan klinis oleh peneliti terkait. Hasilnya adalah induksi sedasi dengan kejadian nyeri paling rendah adalah penggunaan propofol 0,33% 6 ml dengan dosis 2,5 mg/kgBB dengan skor rata-rata nyeri 0,08. (p>0,05) Kata kunci : propofol, nyeri, skala nyeri

INDEKS KOLAPSIBILITAS (CI) SEBAGAI PREDIKTOR HIPOTENSI PADA PASIEN DENGAN ANESTESI UMUM Pranata, I Made Harry; Adi, Made Septyana Parama; Suarjaya, I Putu Pramana; Kurniyanta, Putu
E-Jurnal Medika Udayana Vol 12 No 10 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i10.P02

Intraoperative hypotension (IOH) is important to identify early because it is associated with high morbidity and mortality in old age. Ultrasonographic measurement of the inferior vena cava collapsibility index (IVCCI) can detect volume responsiveness in circulatory shock. The purpose of this study was to examine the collapsibility index (CI) as a predictor of hypotension in patients under general anesthesia. This study was an observational cross-sectional design in adult patients who underwent elective surgery under general anesthesia at Sanglah General Hospital from December 2021 to January 2022 using a consecutive sampling technique. Immediate postinduction changes in systolic and mean blood pressure were compared. The performance of the IVC CI as a diagnostic tool for predicting hypotension (systolic pressure?<?90?mmHg or a???30% drop from the baseline) was evaluated by ROC curve analysis. At the point of collapsibility index (CI) ? 47, there were 29 patients (96.7%) with hypotension. At the point of collapsibility index (CI) < 47, there was 1 patient (3.3%) with hypotension and 24 patients (100%) without hypotension. The cut-off level of collapsibility index (CI) is obtained with the Receiver Operating Curve (ROC) curve, below 0.985. The cut-off CI level for hypotension was 47.0 with a sensitivity of 96.7% and specificity of 100%. There is a significant relationship between IVC CI with a decrease in MAP before and after induction at 4,8, and 10 minutes (p<0,05). The collapsibility index (CI) 50 can be used as a predictor of the incidence of hypotension in patients under general anesthesia. Keywords : hypotension, collapsibility index, general anesthesia.

EFEKTIVITAS TEKNIK ANESTESI LOW FLOW DIBANDINGKAN TEKNIK ANESTESI INHALASI STANDAR PADA ANAK USIA 1-6 TAHUN YANG MENJALANI OPERASI DI PROF. DR. I.G.N.G. NGOERAH DENPASAR Kurniyanta, Putu; Suarjaya, Putu Pramana; Narakusuma, Fajar
E-Jurnal Medika Udayana Vol 12 No 6 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i06.P04

Since the discovery of sevoflurane, it has been commonly used due to its many advantages, including its safety profile for pediatric anesthesia practice. However, currently no ideal recommendation for how much gas flow should be used during induction in children. High fresh gas flow (FGF) causes waste of anesthetic and oxygen gases, making it both uneconomical and environmentally polluting. To date, there have been very few studies on low FGF in children, so there is no best and efficient method for reducing the need for large amounts of induction gas. The aim of this study is to determine the effectiveness of the low low anesthesia (LFA) technique in reducing sevoflurane volume, induction time, and hemodynamics during surgery in children undergoing surgery. This is a case-control study conducted at Prof. Dr. I.G.N.G Ngoerah Hospital in Denpasar. Forty-six children aged 1 - 6 years underwent elective surgery and were anesthetized with sevoflurane and randomly divided into two groups: the case group using the low-flow anesthesia technique and the control group using the standard anesthesia technique. The case and control groups were statistically similar in terms of demographic data. However, the volume of sevoflurane used from the time of premedication to intubation was significantly different (p > 0.05) between the two groups (35.5 ml vs 44.5 ml). The induction times were not significantly different (209s vs 201s, p<0.05). Additionally, no significant difference was observed regarding hemodynamic stability during anesthesia. Keywords : anesthesia induction, hemodynamic stability, low flow anesthesia, sevoflurane

Pengendalian Urine Output pada Diabetes Insipidus Sentral dengan Hipernatremia Berat Pasca Traumatic Brain Injury Pratana, Yolanda Jenny; Suarjaya, I Putu Pramana; Senapathi, Tjokorda GA; Sinardja, Cynthia Dewi
Majalah Anestesia & Critical Care Vol 42 No 2 (2024): Juni
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v42i2.347

Pendahuluan: Diabetes insipidus sentral (DIS) merupakan komplikasi cedera sekunder pada traumatic brain injury (TBI). Cedera neurohipofisis menyebabkan insufisiensi hipofisis posterior untuk mensekresi arginine vasopressin (AVP) dalam kondisi hiperosmolalitas. Prevalensi hipernatremia pada pasien dengan TBI lebih dari 35% dengan kemungkinan penyebab dehidrasi dan hipovolemia dengan tingkat mortalitas mencapai 86,8%.Ilustrasi Kasus: Kami melaporkan sebuah kasus dari pria berusia 20 tahun dengan DIS dan hipernatremia berat pasca TBI. Pasien menjalani operasi pemasanganan ventriculoperitoneal shunt dengan perawatan pasca operasi di ruang rawat intensif. Ditemukan poliuria dengan urine output 3,2 ml/kg/jam dengan kadar natrium 190 mmol/L. Koreksi hipernatremia dengan KA-EN 3B intravena dan intake cairan per oral diberikan sebagai pengganti free water deficit. Desmopressin oral diberikan sebagai kompensasi defisiensi AVP untuk mengurangi kehilangan cairan yang berlangsung. Respon baik tercapai pada hari kedua perawatan, ditunjukkan dengan penurunan urine output hingga 1,4 ml/kg/jam dan penurunan kadar natrium dengan target 10-12 meq/L/hari. Efek samping pemberian desmopressin tidak ditemukan pada pasien ini.Simpulan: Kasus ini menunjukkan bahwa pemantauan ketat dan terapi yang sesuai menghasilkan luaran yang baik pada pasien DIS dengan hipernatremia berat pasca TBI.

Endotracheal Intubation without Neuromuscular Blocking Agent in Patient with Fracture Cervical Spine C1 and C4 Underwent Fusion C12 and C46 Suarjaya, I Putu Pramana; Purwanto, Osmond; Aldy, Aldy; J. Sutawan, Ida Bagus Krisna
Jurnal Neuroanestesi Indonesia Vol 13, No 1 (2024)
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.v13i1.584

About 30% of cervical spine fractures involve injuries to the C1 and C2 vertebrae, which are considered unstable. Ensuring the stability of the injured cervical spine throughout perioperative period, including preoperative examinations, anesthesia induction, laryngoscopy, and intubation, is crucial for anesthesiologists. A 40-year-old woman suffered neck pain following a motorcycle accident, suffering a Spinal Cord Injury ASIA Impairment Scale (SCI AIS) E, a fracture of the C5 vertebral body (CV) classified as AO Spine Type A2, a Jefferson Type IV fracture, and mild head trauma. She underwent surgical fusion of the C1C2 and C4C6 vertebrae under general anesthesia, which included dexmedetomidine, propofol, sevoflurane, and fentanyl without any neuromuscular blocking agents (NMBA). The primary goal of perioperative airway management in cervical injury is a secured airway, while maintaining cervical stability without inflicting secondary injury. The cervical muscle group is essential for maintaining cervical stability, and the use of NMBA may jeopardize this stability, necessitating external cervical stabilization, especially during laryngoscopy and intubation. Induction agents in combination with opioid, widely used to facilitate laryngoscopy and intubation without using NMBA. Anesthesiologists must precisely arrange the management of cervical spine injuries patient to avoid secondary injury and improve surgical outcomes.

Co-Authors A Himendra Wargahadibrata A. Himendra Wargahadibrata A. Himendra Wargahadibrata Adi, Made Septyana Parama Adinda Putra Pradhana Adityawarma, Anak Agung Ngurah Agung Harawikrama Agung Bagus S. Satyarsa Aldy, Aldy Andika Metrisiawan Aryasa EM, Tjahya Aulyan Syah, Bau Indah Aulyan Syah, Bau Indah Brillyan Jehosua Toar Budiarta, Gede Chandra, Steven Okta Christanto, Sandhi Christanto, Sandhi Christopher Ryalino Christopher, Michael Chriswidarma, Dewa Gede Cynthia Dewi Sinardja D.H., Asterina Damayanti, Elok Demoina, I Gede Patria Dewi, Dewa Ayu Mas Shintya Dewi, I Dewa Ayu Mas Shintya Eka Nantha Kusuma, Putu Eric Makmur, Eric Firdaus, Riyadh Firdaus, Riyadh Gd. Harry Kurnia Prawedana Gde Agung Senapathi, Tjokorda Giovanni, Malvin Hartawan, IGAG Utara Hendrikus Gede Surya Adhi Putra Hengky Hengky, Hengky I Gede Catur Wira Natanagara I Gusti Agung Gede Utara Hartawan I Gusti Ngurah Mahaalit I Ketut Sinardja I Made Gede Widnyana I Made Stepanus Biondi Pramantara I Putu Agus Surya Panji I Wayan Ade Punarbawa I Wayan Niryana I Wayan Suranadi I. D. G. Tresna Rismantara Ida Bagus Alit Saputra Ida Bagus Krisna Jaya Sutawan J Sutawan, Ida Bagus Krisna J. Sutawan, IB Krisna J. Sutawan, Ida Bagus Krisna Jeanne, Bianca Jimmy Wongkar Johanes, Kevin Paul Juwita, Nova Kadek Agus Heryana Putra, Kadek Agus Katipana, Madyline Victorya Ketut Yudi Arparitna, Ketut Yudi Khamandanu, Kadek Fabrian Kharisma, Chau Febriani Krisna J. Sutawan, Ida Bagus Krisnayanti, Ida Ayu Arie Kumaat, Garry D. Chrysogonus Kurniawan Komala, Tomas Ari Kurniawan Komala, Tomas Ari Kurniyanta, I Putu Kusuma, Oscar Indra Laksono, Buyung Hartiyo Lauren, Christopher Made Septyana Parama Adi Made Wiryana Marilaeta Cindryani Lolobali, Marilaeta Cindryani MD, Burhan MD, Patricia Michael Humianto Muhammad Aris Sugiharso, Muhammad Aris Muliadi, Win Mulyadi, Win Narakusuma, Fajar Ni Made Supradnyawati, Ni Made Ni Putu Wardani Nova Juwita Nyoman Golden Paramartha, Bagus Patricia, Yoshie Permatasari, Endah Permatasari, Endah Pontisomaya Parami Prabowo, Pratama Yulius Pranata, I Made Harry Pratana, Yolanda Jenny Purwanto, Osmond Putu Herdita Sudiantara, Putu Herdita Putu Kurniyanta Ratu, Tiffani Richard Richard Saleh, Siti Chasnak Saleh, Siti Chasnak Santo, Budi Sidabutar, Beny Pratama Sidemen, IGP Sukrana Sista Satyarsa, Agung Bagus Sista Soerodjotanojo, Simson Samuel Sri Maliawan Sri Rahardjo Suastika, I Gede Juli Sucandra, I Made Agus Kresna Supradnyana, I Nyoman Novi Suranadi , I Wayan Sutawan, IB Krisna Krisna Jaya Taopan, Damatus Try Hartanto Tatang Bisri Tini, Kumara Tirta, Ian Tjokorda Gde Agung Senapathi Tjokorda Gde Bagus Mahadewa Virayanti, Luh Putu Diah Wanda, Aprilia Wargahadibrata, A. Hmendra Widyana, I Made Gede Wiryawan, I Nyoman Wundiawan, Kristian Felix Yani, Jancolin Yani

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