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All Journal Jurnal Anestesiologi Indonesia Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Anestesi Perioperatif Mutiara Medika: Jurnal Kedokteran dan Kesehatan JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Jurnal Anestesi Obstetri Indonesia Jurnal Neuroanestesi Indonesia Jurnal Komplikasi Anestesi
Yusmein Uyun
Departemen Anestesiologi Dan Terapi Intensif; Fakultas Kedokteran; Universitas Gadjah Mada; Yogyakarta
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Penggunaan Ultrasound di Anestesi Obstetri Apsari, Ratih Kumala Fajar; Uyun, Yusmein
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i3.7342

Abstract

The incidence of complex medical problems in obstetric populations is is rising, and anesthesia for parturient patients add another problem in this complexity. Ultrasound provides an accurate visualization of the internal anatomical structures that may help assess clinical conditions and improve the safety of therapeutic interventions. Ultrasound procedures in obstetric anesthesia have been used in guiding the neuraxial block, transversus abdominis plane block for post-caesarean section pain control, and vascular access. Ultrasound may also be performed to assess gastric volume, airway evaluation in critical obstetric patients, lung evaluation, transesophageal echocardiography, and intracranial pressure assessment as a surrogate marker of preeclampsia. To succeed in ultrasound guidance techniques, it requires familiarity with relevant cross sectional anatomy. Knowledge of anatomy, without any understanding of its structural formation on ultrasound will hamper the understanding of ‘sonoanatomy’.
Anestesi Spinal pada Seksio Sesaria Wanita dengan Karsinoma Nasofaring Supraptomo; Uyun, Yusmein
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i3.7344

Abstract

Introduction. Regional anesthesia and general anesthesia can be performed in patients with nasopharyngeal cancer, although spinal anesthesia is more aggressive lowering the patient’s hemodynamic state, but the likelihood of difficult intubation in these patients becomes a consideration for regional anesthesia. Case. 35-year-old woman, G3P1A1, 37 weeks pregnant in hospital wanted to give birth. Pasr medical history was difficult to swallow with pain and diagnosed with nasopharyngeal carcinoma. Spinal anesthesias was performed with lidocaine 5% dose 75 mg with adjuvant fentanyl 25 ug. Block achieved until dermatome thorakal. The duration of surgery is 60 minutes with systolic between 90-120 mmHg, diastolic between 55-80 mmHg and pulse between 100-112 times / min. Baby born with APGAR score 8-9, weight 3300 gram. Post surgery patients are treated at the Intensive Care Unit, and during treatment the hemodynamic condition is stable. Summary. The technique of spinal block anesthesia with lidocaine 5% 75 mg with adjuvant fentanyl 25 mcg was considered quite satisfactory as anesthesia management in this case. Synergistic effects of local anesthesia and opiod provide great benefits for obtaining adequate anesthesia, thereby reducing the risk of difficult intubation if general anesthesia is performed
Perbandingan Daya Guna Analgetik antara Tramadol 100 mg dan Natrium Diklofenak 100 mg Suppositoria Rektal untuk Penanganan Nyeri Pascaoperasi Sesar dengan Teknik Pembiusan Blok Subarachnoid Santoso, Arief Hariyadi; Uyun, Yusmein; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 6 No 2 (2019): Volume 6 Number 2 (2019)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v6i2.7350

Abstract

Latar Belakang: Operasi sesar menghasilkan nyeri pasca operasi yang signifikan. Tidak ada teknik standar pengelolaan nyeri pasca operasi sesar. Obat antiinflamasi nonsteroid seperti natrium diklofenak berkerja meng-inhibisi sintesis prostaglandin (PG) dengan menghambat enzim cyclooxygenase. Tramadol dengan aktivitas mu-agonis, tidak hanya bekerja pada reseptor opioid, tetapi juga menghambat serotonin (5-HT) dan reuptake noradrenalin.Tujuan: Mengetahui daya guna analgesi 24 jam pasca operasi sesar antara penggunaan suppositoria rektal tramadol dengan natrium diklofenak.Metode: Prospektif, uji klinis acak terkontrol pada 70 pasien status fisik ASA I-II, berusia 19-40 tahun, hamil aterm 37-42 minggu,, Indeks Massa Tubuh < 35 kg/m2. Pasien dikelompokkan acak ke dalam 2 kelompok : kelompok suppositoria rektal natrium diklofenak (D) dan tramadol (T) dengan teknik single blind. Dilakukan penilaian VAS pada kedua kelompok, jumlah penambahan rescue jika VAS ≥3, dan efek samping pada masing-masing kelompok.Hasil: Selama 24 jam pascaoperasi, rata-rata frekuensi pemberian tambahan fentanyl kelompok T sebanyak 3.13 kali dan kelompok D 1,7 kali, rata-rata dosis tambahan fentanyl kelompok T sebanyak 155,71 mcg dan kelompok D 67,65 mcg (p=0,000). Rata-rata VAS 24 jam pasca operasi pada kelompok T 2,14 dan pada kelompok D 1,74 (p<0,05). Untuk efek samping, kelompok T terdapat 4 kejadian (11,4%) mual muntah, sedangkan pada kelompok D tidak ada. Perbedaan ini bermakna yang ditunjukkan dengan nilai p=0,042 (p<0,05).Kesimpulan: Daya guna analgesi natrium diklofenak 100 mg suppositoria rektal lebih baik dibanding tramadol 100 mg suppositoria rektal, dengan efek samping yang lebih kecil pada 24 jam pasca operasi sesar.
Manajemen Anestesi pada Seksio Sesar Pasien G5P4A0 dengan Severe Pulmonal Stenosis Uyun, Yusmein; Kurniawaty, Juni; Daniswara
Jurnal Komplikasi Anestesi Vol 7 No 1 (2019): Volume 7 Number 1 (2019)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i1.7378

Abstract

Pada pasien ini terdapat PS severe dan TR moderate yang menunjukan bahwa PS severe sudah cukup lama, tetapi tidak ada manifestasi klinisdari pasien, hanya ditemukan bising jantung saat dilakukan auskultasi dan tidak ada limitasi aktifitas pasien. Target hemodinamik pada pembiusan pasien dengan PS dan TR hampir sama, sehingga target tersebut digunakan untuk membius pasien seperti pada kasus ini yaitu dengan menjaga preload tinggi, heart rate tinggi, kontraktilitas normal, SVR normal, dan PVR normal rendah. Pemilihan pembiusan dari beberapa literatur menyebutkan bahwa dapat dilakukan dengan anestesi umum maupun regional dengan targettarget hemodinamik seperti diatas. Persiapan obatobatan untuk menjaga target hemodinamik juga harus ada sebelum operasi, bisa juga diberikan profilaksis seperti pada suatu case report yang sudah disebutkan diatas untuk menjaga SVR tetap normal.
Anestesi pada Pembedahan Non-Obstetri dalam Kehamilan Apsari, Ratih Kumala Fajar; Uyun, Yusmein; Suryasaputra, Wahyu
Jurnal Komplikasi Anestesi Vol 7 No 1 (2019): Volume 7 Number 1 (2019)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i1.7392

Abstract

Non-obstetric surgery during pregnancy posts additional concerns to anesthesiologists. The chief goals are to preserve maternal safety, maintain the pregnant state and achieve the best possible fetal outcome. The choice of anesthetic technique and the election of appropriate anesthetic drugs should be guided by indication for surgery, type, and site of the surgical procedure. Anesthesiologist must consider the effects of the disease process itself and inhibit uterine contractions and avoid preterm labour and delivery. Fetal safety requires avoidance ofpotentially dangerous drugs and assurance of continuation of adequate uteroplacental perfusion. Until date, no anesthetic drug has been shown to be clearly dangerous to the human fetus. The decision on proceeding with surgery should be made by multidisciplinary team involving anesthesiologists, obstetricians, surgeons and perinatologists. This referral aims to discuss the physiological changes of pregnant patients who will undergo non-bstetric surgery and anesthesia management for non-obstetric operations of pregnant patients.
Efek Pemberian Premedikasi Deksametason Terhadap Durasi Rokuronium Dibanding Placebo pada Anestesi Umum Intubasi Adi, Danis Woro Kuncoro; Uyun, Yusmein; Apsari, Ratih Kumala Fajar
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7447

Abstract

Background: Dexamethasone is often used as prevention and treatment for postoperative nausea and vomiting, reducing the severity of postoperative pain and analgesic requirements. The study of dexamethasone effects on the rocuronium duration might be beneficial in patients who have contraindications to neostigmine or atropine reversal. Purpose: To evaluate the relation between rocuronium duration with dexamethasone premedication compare with placebo in patient with general anesthesia intubation procedure with rocuronium neuromuscular blocking agent in GBST RSUP Dr. Sardjito. Methods: An experimental research design, randomized clinical trial with double blind. The sample was chosen using the non-probability sampling method in a consecutive manner in 3 months. Sample was divided into two groups: group receiving dexamethasone premedication and group receiving placebo NaCl 0.9%. Time monitoring starts after the TOF shows the number 0 until it reaches TOF 0.9. Results: The study was conducted on 58 research subjects. Numeric data was analysed using independent T test and categorical data was analysed using chi square. Dexamethasone premedication was found to reduce the duration of rocuronium with the time needed to reach TOF 0.9 was 111±14.33 minutes compared with 123±14.57 minutes in the placebo group (P = 0.003). Conclusion: Dexamethasone premedication shortens the duration of rocuronium compared to the administration of placebo under intubation general anesthesia.
Manajemen Anestesi pada Seksio Sesaria Emergensi dengan Kelainan Faktor Koagulasi Uyun, Yusmein; Apsari, Ratih Kumala Fajar; Hendra, Maijoni
Jurnal Komplikasi Anestesi Vol 7 No 3 (2020): Volume 7 Number 3 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i3.7476

Abstract

The selection of anesthesia techniques for caesarian section is determined by various factors, namely the indication of the operation, the choice of the patient and surgeon, and the technical ability (skill) of the surgeon. Clinical evaluation of patients with coagulopathy is very important to determine the anesthetic technique. Clinical evaluation must be individualized, taking into account the risks and benefits of anesthesia techniques. The risk of spinal hematoma or epidural in patients has not been completely eliminated, but it remains a factor that must be considered individually in determining whether neuraxial anesthesia is appropriate for that patient.
Protokol Transfusi Masif pada Obstetrik Uyun, Yusmein; Pratomo, Bhirowo Yudo; Hernawan, Agung Diky
Jurnal Komplikasi Anestesi Vol 8 No 1 (2021): Volume 8 Number 1 (2021)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v8i1.7488

Abstract

World population’s access to safe blood is limited. Only 30% of countries in the world have comprehensive transfusion services in their countries. Meanwhile, massive transfusion therapy has poor survival rate with mortality rate of about 45-67%. The patient’s age, duration and severity of shock, Disseminated Intravascular Coagulation (DIC), and the amount of blood transfused affect the fnal outcome. Coagulopathy has a high mortality rate within 4-6 days after hospitalization. Many obstetrics and gynecology patients have the potential to require blood transfusions. Cesarean section (SC) and hysterectomy are two of the surgical procedures that are frequent and potentially bleeding, requiring blood transfusion. Other conditions are postpartum hemorrhage, placenta previa, and ruptured ectopic pregnancy. Bleeding in the obstetric feld is still a highest cause of maternal death in Indonesia.
Gagal Spinal pada Operasi Sectio Caesarea Wisudarti, Calcarina Fitriani Retno; Uyun, Yusmein; Utomo, F uad Cipto
Jurnal Komplikasi Anestesi Vol 9 No 3 (2021)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v9i3.8331

Abstract

Subarachnoid block is the most convenient and safe anesthesia to undergo cesarean section. It provides excellent anesthesia, avoids risks associated with general anesthesia and increase level of parturients' satisfaction, associated with low occurrence of intra-operative and post-operative morbidities. It's simplicity to institute, rapid onset of sensory blockage, its reliability, ease of mastering and producing optimal surgical conditions are some of the frequent reasons to choose spinal anesthesia over other techniques. Despite this significant move towards spinal anesthesia, it has a risk of failure reported in the range of 1-17%. Failed spinal anesthesia can be defined as partial or incomplete spinal block within 15-20 min after injection and requiring supplemental analgesia or conversion to general anesthesia. Failed spinal leads to maternal discomfort and it is a cumbersome event for the anesthetist. Management of failed spinal during caesarean section by repeat, sedation or conversion to general anesthesia may negatively impact maternal and fetal outcome. This may result in decreased maternal satisfaction, inadequate pain management, fetal sedation (incases of general anesthesia), suboptimal surgical anesthesia and may also pose to risks of general anesthesia on the parturient. Keywords: Caesarean Section; failed spinal anesthesia; management of failed spinal; spinal anesthesia
Faktor-Faktor Risiko Terjadinya Pneumonia pada Pasien Covid-19 Di RSUP Dr Sardjito Yogyakarta Perwira, Rendra; Uyun, Yusmein; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 9 No 3 (2021)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v9i3.8334

Abstract

Background: Globally, more than three million confirmed cases of COVID-19 have been reported. According to the WHO report on May 6, 2020, the number of world cases that were confirmed positive was 3 588 773, and the death toll was 247 503 people. Pneumonia appears to be one of the serious manifestations of COVID-19 infection. It is necessary to know the risk factors for COVID-19 pneumonia Methods: The study used a retrospective cohort method, the research subjects were taken from March 2020 to March 2021 with the status of inpatients and confirmed Covid-19 at Dr Sardjito Hospital. Results: In this study, the total sample was 630 patients.The results of the multivariate analysis showed that the factors of age, type II DM, hypertension and male sex were significant for COVID-19 pneumonia. Age 60 years is at risk of pneumonia 1.6 times the risk of developing pneumonia (p=0.041 OR 1.6 95% CI=1.02-2.77), DM Ttype II has a risk of COVID-19 pneumonia 2.48 times (p=0.001 OR 2.48, 95%CI=1.44-4.29), hypertension risk of pneumonia 1.68 times (p=0.042 OR 1.68, 95%CI=1.01-2.77), male gender men were at risk of pneumonia 1.74 times (p=0.004, OR 1.74, 95%CI=1.2-2.57). Conclusion: Age 60 years, hypertension, type II DM and male are significant risk factors for pneumonia in patients with COVID-19 infection.
Co-Authors . Mujahidin Adi Hidayat Adi, Danis Woro Kuncoro Adrin, Olga Elenska Akhmad Yun Jufan Annemarie Chrysantia Melati Ardi Pramono Arief Hariyadi Santoso Arif Ikhwandi Arif Supriyono Artika, I Gusti Ngurah Rai Ayu Rosema Sari Bambang Suryono Bambang Suryono Bambang Suryono Bambang Suryono, Bambang Bhirowo Yudo Pratomo Budianti, Nugrahaeni Calcarina Fitriani Retno Wisudarti Dadik Wahyu Wijaya Daniswara Dewi Yulianti Bisri Djoko Wahyono Djoko Wahyono Djoko Wahyono Dwiana Sulistyanti Ekuarianto, Donny Erna Fitriana A Fadinie, Wulan Fitri Hapsari Dewi Fitri, Lillah Fitriana A, Erna Gutama, Bayu Satria Hartono, Pinter Hayati, Farida Helmina Wati Hendra, Maijoni Hernawan, Agung Diky Hidayat, Nopian Isngadi Isngadi Isngadi Juni Kurniawaty Muhdar Abubakar Djayanti Sari Liza, Helda Mahisa, Orizanov Mahmud Mahmud Muhammad Iqbal Noegroho, Wahyu Nopian Hidayat Nova Maryani Nugroho, Alfan Mahdi Nurul Ulfah Hayatunnisa Perbatasari, Inggita Dyah Perwira, Rendra Prakosa, Nur Hamam Prihatna, Hendi Purnomo, Dedi Pujo Rahma, Aulia Zuhria Ratih Kumala Fajar Apsari Redhy Sindharta Rizqi Adhelia Rose Mafiana RTH Supraptomo Ruddi Hartono Sandi, Dita Ayulia Dwi Sandi, Dita Ayulia Dwi Santoso, Arief Hariyadi Satrio Adi Wicaksono SATRIYAS ILYAS Septica, Rafidya Indah Septica, Rafidya Indah Septika, Rafidya Indah Siti Helmyati Sri Rahardjo Sri Rahardjo Sri Rahardjo Sudadi Suharso, Pamungkas Hary Sunartejo, Bayu Supraptomo Suryasaputra, Wahyu Untung Widodo Untung Widodo, Untung Utomo, F uad Cipto Wicaksono, Galih Sahid Wirawan, Angga Aditya Yunita Widyastuti Yusmalinda Yusmalinda