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All Journal Jurnal Anestesiologi Indonesia Majalah Kedokteran Bandung Jurnal Anestesi Perioperatif Majalah Anestesia dan Critical Care Jurnal Anestesi Obstetri Indonesia Interdisciplinary Social Studies Jurnal Neuroanestesi Indonesia International Journal of Health Science and Technology Acta Medical and Health Sciences (AMHS)
Dewi Yulianti Bisri
Departemen Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/ RSUP Dr. Hasan Sadikin Bandung
Humanities Biochemistry, Genetics & Molecular Biology Education Engineering Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Comparison of Preemptive Post-Intubation 15 Mg/KgBW Paracetamol to 0.35 Mg/KgBW Meperidine in Incidence of Post-Anesthetic Shivering Nataputra, Mario; Bisri, Dewi Yulianti; Budipratama, Dhany
Majalah Kedokteran Bandung Vol 55, No 3 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n3.3047

Abstract

Post anesthesia shivering (PAS) is a repetitive involuntary movement of one or more muscle groups as a result of a decrease in core body temperature. Pharmacological therapy in preventing PAS may include meperidine and paracetamol. This study compared the effectiveness of paracetamol to meperidine in reducing the incidence of post-anesthesia shivering. This study used an experimental randomized double-blind comparative analytic design on patients underwent exploratory laparotomy surgery under general anesthesia at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from September 2021 to August 2022. Patients with 50 ASA 1-2 physical status were included and divided into two groups. One group received 15 mg/kg group paracetamol and the other received 0.35 mg/kg meperidine. Data on tympanic membrane temperature and hemodynamics before and after induction and after extubating were collected. Furthermore, data on the results of the assessment of the incidence and grade of shivering in each treatment group were also collected. The results of this study showed that there was a decrease in the frequency of PAS in patients receiving intravenous 15 mg/kg paracetamol (p<0.05), as well as less side effects in the form of nausea and vomiting (p < 0.05). The incidence and degree of shivering after general anesthesia using intravenous 15 mg/kg paracetamol was lower compared to the use of 0.35 mg/kg meperidine. In the meperidine group, the decrease in body temperature was lower than in the paracetamol group, while the incidence of nausea and vomiting in the paracetamol group was lower than in the meperidine group. In conclusion, paracetamol reduces the incidence of post-anesthesia shivering better than meperidine.
Target-Controlled Infusion (TCI) Propofol in Ventriculoperitoneal (VP) Shunt Surgery during the First Trimester of Pregnancy Cobis, Albinus Yunus; Bisri, Dewi Yulianti; Rachman, Iwan Abdul
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.v0i0.73897

Abstract

Background: The use of target-controlled infusion (TCI) propofol in pregnant patients undergoing ventriculoperitoneal (VP) shunt surgery during the first trimester due to hydrocephalus presents a rare and complex challenge in neuroanesthesia. TCI propofol is favoured for its ability to maintain hemodynamic stability and effectively control intracranial pressure (ICP), both of which are crucial in neuro-obstetric management.Case: A 23-year-old woman, five weeks pregnant, with a history of communicating hydrocephalus and bilateral VP shunts, presented with severe headache. She underwent emergency VP shunt revision under general anesthesia using TCI propofol (Schnider model, target effect-site concentration 2.5–5 mcg/mL), fentanyl (2 mcg/kg), atracurium (0.5 mg/kg), and lidocaine (1.5 mg/kg). Intraoperative hemodynamics remained stable throughout the two-hour procedure. Postoperatively, her neurological status improved significantly, and no complications were observed.Discussion: Compared to inhalational agents such as sevoflurane, TCI propofol demonstrates superior control of ICP, maintains cerebral blood flow stability, and facilitates faster postoperative recovery. Fentanyl, atracurium, and lidocaine were selected due to their favourable safety profiles for short-term use in pregnancy. Postoperatively, progesterone was administered to support pregnancy maintenance by reducing uterine contractility and mitigating the risk of miscarriage associated with surgical and anesthetic stress.Conclusion: TCI propofol is an effective and safe anesthetic strategy for managing VP shunt procedures during the first trimester of pregnancy. A multidisciplinary approach is essential to achieve optimal neurological and obstetric outcomes. 
Phenytoin Administration Following Early Postoperative Seizure After Brain Tumor Surgery Nugroho, Andy; Bisri, Dewi Yulianti; Rachman, Iwan Abdul
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 3 (2025): 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.v0i0.73402

Abstract

Background: Early postoperative seizures (EPS), defined as seizures occurring within seven days following brain surgery, are a common and serious complication, particularly in patients with high-grade gliomas. EPS can prolong hospitalization, impair neurological recovery, and increase the risk of further brain injury. The optimal prophylactic strategy for seizure prevention remains controversial, especially in settings where access to second-generation antiepileptic drugs is limited.Case: A 53-year-old female presented with progressive headaches and was diagnosed with a supratentorial intra-axial tumour consistent with high-grade glioma. She underwent subtotal tumour resection. Four hours postoperatively, the patient developed two episodes of generalized seizures. Immediate management included intravenous administration of midazolam, endotracheal intubation, and phenytoin administration. Diagnostic evaluations excluded metabolic or infectious causes. Near-infrared spectroscopy (NIRS) monitoring indicated stable cerebral oxygenation throughout the postoperative course. The patient experienced no further seizures and demonstrated full neurological recovery. Oral phenytoin was continued for 21 days.Discussion: EPS are associated with multiple risk factors, including tumour location, size, and incomplete resection. In this case, the tumour’s frontal and parietal lobe involvement, large volume, and subtotal excision likely contributed to seizure onset. Phenytoin, despite being a first-generation antiepileptic drug, proved effective in managing EPS and preventing recurrence in the absence of levetiracetam. NIRS served as a useful non-invasive adjunct to monitor cerebral oxygenation after a seizure.Conclusion: Effective early recognition and treatment of EPS are critical in preventing secondary neurological complications. In resource-limited settings, phenytoin remains a viable monotherapy for seizure control post-craniotomy. Individualized, protocol-driven management strategies, supported by neuromonitoring tools such as NIRS, can optimize outcomes in brain tumor surgery.
Co-Authors A Himendra Wargahadibrata A. Himendra Wargahadibrata A. Hmendra Wargahadibrata Achmad Adam Adriman, Silmi Adriman, Silmi Ahmado Oktaria Alifahna, Muhammad Rezanda Alifan Wijaya Alkadia Alfasha Andy Hutariyus Anwar, Tabihul Arief Cahyadi Arif, Izhar Muhammad Arif, Izhar Muhammad Arna Fransisca Arshad, Muhammad Ayu Rosema Sari Bangun, Chrismas Gideon Basuki, Wahyu Sunaryo Basuki, Wahyu Sunaryo Boesoirie, M. Adli Boesoirie, M. Adli Budiana Rismawan Cecep Eli Kosasih Cobis, Albinus Yunus Daneswara, Andika Deni Nugraha Dhany Budipratama Doddy Tavianto Emas, Bagas Eri Surahman Firdaus, Riyadh Firdaus, Riyadh Fitri Sepviyanti Sumardi Fitri Sepviyanti Sumardi Gaus, Syaruddin Giovanni, Cindy Giovanni, Cindy Hana Nur Ramila Harahap, M Sofyan Hengki Saputra Munthe Hermin Aminah Usman Ida Bagus Krisna Jaya Sutawan Ike Sri Redjeki Indrayani, Ratih Rizki Indria Sari Iqbal Pramukti Irina, Rr. Sinta Iwan Abdul Rachman Iwan Fuadi Jasa, Zafrullah Khany Krisna J. Sutawan, Ida Bagus Lalenoh, Diana C Limawan, Michaela Arshanty Lira Panduwaty Lisda Amalia Longdong, Djefri Frederik M, Mutivanya Inez M, Mutivanya Inez M. Sofyan Harahap Maharani, Mutivanya Inez Maharani, Nurmala Dewi Mangastuti, Rebecca Sidhapramudita Mangastuti, Rebecca Sidhapramudita Michaela Arshanty Limawan Mirza Oktavian Muhammad Habibi Nataputra, Mario Nopian Hidayat Nugroho, Andy Nuryanda, Dian Oetoro, Bambang J. Oetoro, Bambang J. Okky Harsono Oktaria, Ahmado Permatasari, Endah Permatasari, Endah Putri, Dini Handayani Putri, Dini Handayani Radian Ahmad Halimi Rasman, Marsudi Rasman, Marsudi Renaldy Sobarna Riki Punisada Riyadh Firdaus Robert Sihombing Ruli Herman Sitanggang Saleh, Siti Chasnak Saleh, Siti Chasnak Saputra, Tengku Addi Saputra, Tengku Addi SATRIYAS ILYAS Septiani, Gusti Ayu Pitria Sihombing, Robert Siti Chasnak Saleh Soefviana, Stefi Berlian Sri Rahardjo Sugiyanto, Endy Susanto, Yunita Susanto, Yunita Sutaniyasa, I Gede Sutanto, Sigit Sutanto, Sigit Suwarman Suwarman Syafruddin Gaus Syahpikal Sahana Syifa, Nadia Syifa, Nadia Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Uhud, Akhyar Nur Umar, Nazaruddin Utama, M Lucky Wargahadibrata, A. Hmendra Wargahadibrata, A. Hmendra Widiastuti, Monika Winarso, Achmad Wahib Wahju Wullur, Caroline Wullur, Caroline Yuanda Rizawan Putra Yusmein Uyun Zaka Anwary, Army