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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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Konsiderasi Teknik Anestesi pada Crash Ponek Fetal Distress Apsari, Ratih Kumala Fajar; Uyun, Yusmein; Adrin, Olga Elenska
Jurnal Komplikasi Anestesi Vol 9 No 2 (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.v9i2.8342

Abstract

Neonatal and infants’ mortality rate in Indonesia is still high. Emergency case in comprehensive obstetric and neonatal emergency care is one of the causes related to high mortality rate in pregnancy and neonates. There is a thin line between true emergency which may need emergency surgery, previously known as crash-C-section and emergency that could be optimized before surgery is performed. A true emergency may need considerable anesthesia technique which could be done quickly yet also emphasizes on patient’s safety.
Efek Pemberian Priming Fentanil 1 Μg/Kgbb Terhadap Insidensi Batuk Pasca-Preemptif Analgesia Fentanil 2μg/KgBB di RSUP Dr. Sardjito Prakosa, Nur Hamam; Uyun, Yusmein; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 8 No 2 (2021): Volume 8 Number 2 (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.v8i2.8360

Abstract

Background: Fentanyl is an opioid analgesic that is almost always used in patients undergoing general anesthesia. The use of intravenous fentanyl can cause a cough effect known as fentanyl-induced cough (FIC). Although there have been many studies conducted to reduce the incidence of cough after injection of fentanyl intravenously both pharmacologically and nonpharmacologically, standard therapy has not been established to prevent coughing. Method: Randomized clinical trial with double blindness. The sample was chosen using the non-probability sampling method in a consecutive manner until the sample was fulfilled. Age range 18-65 years, with ASA III physical status, non-active smokers undergoing elective surgery with general anesthesia at Dr. Sardjito General Hospital will be grouped into 2 groups, one group of a priming dose of fentanyl 1 μg/kgbb and the control group without priming dose of fentanyl. Both groups received total fentanyl 2 μg/kgbb with an injection speed of 0.5 cc per second. Data analysis to determine differences in the incidence of cough between the two treatment groups with outcomes in the form of mild cough, severe cough, or not coughing, then the chi-square test is used when the requirements are met. Secondary outcomes and side effects of fentanyl administration were also assessed.is performed Result. Incidence of fentanyl-induced cough (FIC) in the treatment group using priming dose of fentanyl 1 μg/kgbb was 2 patients (2.7%), while the incidence of cough in the group without priming dose of fentanyl was 11 patients (15.1%) with p = 0.009 meaning that there was a statistically significant difference. All patients with cough incidence were in the mild cough category, both in the priming dose of fentanyl group as many as 2 patients and 11 patients in group without priming dose of fentanyl. There is no statistically significant difference in the incidence of apnea, and bradycardia Conclusion. The use of 1 μg/kgbb priming dose of fentanyl can reduce the incidence of cough after fentanyl 2 μg/kgbb analgesia at an injection rate of 0.5 cc per second
Manajemen Anestesi pada Seksio Sesarea pada Pasien COVID-19 Derajat Berat Uyun, Yusmein; Apsari, Ratih Kumala Fajar; Suharso, Pamungkas Hary
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 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.v8i3.8370

Abstract

COVID-19 infection in pregnant patients can lead to premature labor. The most common method of delivery is by caesarean section. Many aspects must be considered in carrying out anesthesia for COVID-19 patients, including physiological changes that occur due to pregnancy and the effects of COVID-19 infection which can aggravate the condition of pregnant patients. Maintaining adequate oxygenation in the blood, choosing the right anesthetic agent, considering its effect on the fetus, and mechanical ventilation management related to ARDS caused by COVID-19 infection are several things that should be concerned in anesthesia management.
Panjang Tulang Belakang dan Indeks Massa Tubuh sebagai Prediktor Terjadinya Hipotensi Pascaanestesi Spinal pada Ibu Hamil yang Menjalani Seksio Sesarea Wirawan, Angga Aditya; Uyun, Yusmein; Apsari, Ratih Kumala Fajar
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 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.v8i3.8374

Abstract

Background: Hypotension is one of the neuraxial anesthesia complications, whereas if not properly managed, might diminish the uteroplacental perfusion, cause fetal hypoxia, acidosis, and neonatal injury. Vertebral column length and body mass index are believed to have a role in predicting the incidence of hypotension after spinal anesthesia in parturients undergoing cesarean section because some research wasmentioned the correlation between vertebral column length and body mass index with sensory block height and vasopressor needs. Methods: This research uses prospective observational, cross-sectional as the design. The sample size is 72parturient of physical status ASA 1 and 2 who will undergo caesarean section with spinal anesthesia. Hypotension is defined as a decrease in systolic blood pressure >20% compared with baseline measurement on the table before spinal anesthesia is given up to 20 minutes after spinal anesthesia. Results: The mean vertebral column length in the hypotension group is 36,1 cm and no hypotension group is 33,6 cm. Statistically, this condition doesn’t show a significant difference (p=0,076). While in body mass index, mean body mass index in hypotension group is 32,7 kg/m2 and no hypotension group is 27,6 kg/m2. Statistically, this shows significant difference (p=0,0001). Conclusion: Vertebral column length was not significant in predicting incidence of hypotension after spinal anesthesia in pregnant women undergoing caesarean section. Whereas, body mass index has significant difference so it can be used to predict the incidence of hypotension after spinal anesthesia in pregnant women undergoing caesarean section.
Cost Effectiveness General Anesthesia Combined with Scalp Block Compared to General Anesthesia in Patients Undergoing Removal Tumor Craniotomyin Dr. Sardjito Hospital Wicaksono, Galih Sahid; Sudadi; Uyun, Yusmein
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
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.v11i1.10199

Abstract

Background. Providers of anesthesia services have many opportunities to reduce these costs, of course with the aim of maintaining balance between profit, security and costs. Craniotomy surgery removal of the scalp block tumor is an alternative option that can be combined with general anesthesia. The scalp block itself can blunt stress response in craniotomy and can maintain unwanted hemodynamic instability. Purpose. Find out the cost effectiveness of the scalp block in craniotomy patients removing tumors at Dr. SARDJITO Hospital. Method. Method. Twenty patients ranging in age from 18 - 65 years with intracranial tumors who underwent tumor binding craniotomy at RSUP Dr. SARDJITO is grouped into two treatment groups with general anesthesia and general anesthesia with a combination of scalp blocks, both techniques are calculated using drugs and consumables during the operation. Results. Total cost on the general anesthesia combined scalp block was Rp. 1,347,276 lower Rp. 377,833 compared to general anesthesia Rp. 1,725,109 with a significant difference (p = 0.005). Similarly, the hourly cost of the group in the combined general anesthesia scalp block was Rp. 286,351 Rp. 97,107 lower than general anesthesia Rp. 383,457 with a significant difference (p = 0.038). Conclusion. Combination of general anesthesia and scalp block using 0.5% levobupivacaine more cost effective than general anesthesia and scalp block with placebo in supratentorial tumor patients undergoing tumor removal craniotomy.
Klasifikasi Modified World Health Organization sebagai Prediktor Mortalitas Ibu Hamil dengan Penyakit Jantung Pasca Persalinan dengan Analgesia/Anestesi Ekuarianto, Donny; Widyastuti, Yunita; Uyun, Yusmein
Jurnal Anestesi Obstetri Indonesia Vol 7 No 3 (2024): November
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v7i3.196

Abstract

Latar Belakang: Kelainan jantung merupakan penyebab utama tingginya angka kematian ibu hamil secara tidak langsung serta potensi luaran merugikan pada janin. Klasifikasi Modified World Health Organization (mWHO) digunakan sebagai sistem penilaian untuk mengidentifikasi komplikasi jantung selama kehamilan. Tujuan: Menilai performa klasifikasi mWHO sebagai prediktor mortalitas ibu hamil dengan penyakit jantung pasca analgesia atau anestesi.Subjek dan Metode: Study kohort retrospektif, data tahun 2019–2023. Performa diskriminasi dengan menilai AUC serta cut off ROC, kalibrasi dengan Hosmer-Lemeshow. Analisis Bivariat memprediksi hubungan mWHO dan variabel perancu terhadap mortalitas dilanjutkan analisis multivariat dengan uji regresi logistik. Signifikan jika p<0,05.Hasil: Didapatkan 123 subjek rerata usia 29,54 tahun, angka kematian 8,1%. AUC 0,756 (95% IK = 0,645 – 0,866) p = 0,007, dengan Cut-off point terbaik pada klasifikasi mWHO kelas III dengan sensitivitas 70%, spesifisitas 70,8%. Uji kalibrasi (HL p= 0,262) dan hasil uji regresi logistik analisis multivariat (p = 0,04; OR = 5,802).Simpulan: Klasifikasi mWHO memiliki performa diskriminasi dan kalibrasi yang valid sebagai prediktor mortalitas maternal yang signifikan pada pasien ibu hamil dengan penyakit jantung pasca persalinan dengan analgesia/anestesia
Manajemen Anestesi pada Seksio Sesarea Ibu Hamil dengan Diabetes Mellitus dan Ketoasidosis Fitriana A, Erna; Uyun, Yusmein
Jurnal Anestesi Obstetri Indonesia Vol 8 No 1 (2025): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v8i1.199

Abstract

Diabetes Mellitus atau disebut diabetes merupakan penyakit gangguan metabolik menahun akibat pankreas tidak memproduksi cukup insulin atau tubuh tidak dapat menggunakan insulin yang diproduksi secara efektif. Diabetes gestasional terjadi pada kurang lebih 7% kehamilan, atau diperkirakan terjadi 200.000 kasus baru tiap tahunnya. Prevalensi kejadian mencapai 1–14% dari seluruh kehamilan. Insiden penyakit ini juga diperkirakan meningkat seiring bertambahnya populasi obesitas.Berdasarkan hasil penelitian disimpulkan bahwa pendidikan ibu, pekerjaan ibu, genetik, body mass indeks (BMI) overweight, glukosuria, dan riwayat pre-eklamsia berpengaruh terhadap kejadian ibu hamil dengan diabetes mellitus serta usia ibu hamil, paritas dan riwayat keguguran tidak berpengaruh terhadap kejadian ibu hamil dengan diabetes mellitus. Untuk meningkatkan kewaspadaan terhadap risiko kehamilan dengan diabetes mellitus dengan pemeriksaan skrining diabetes mellitus. Seorang wanita berusia 37 tahun G5P3A1 hamil 31 minggu mengeluh mual, muntah, diare selama 2 hari, dan penurunan gerakan janin dalam waktu 24 jam terakhir. Pada pemeriksaan fisik didapatkan laju nafas 32 x/menit,bau aseton.Hasil laboratorium didapatkan glukosa serum 400 mg / dL, pH arteri 7,20, pCO2 22, serum bikarbonat 10, serum keton (+). Teknik anestesi yang dipilih anestesi umum dengan rapid sequence induction (RSI).
Left Ventricular Ejection Fraction (LVEF) dan Klasifikasi New York Heart Association (NYHA) sebagai Prediktor Mortalitas Pascaanestesi untuk Persalinan dengan Penyakit Jantung Hartono, Pinter; Yusmein Uyun; Ratih Kumala Fajar Apsari; Rahma, Aulia Zuhria
Jurnal Anestesi Obstetri Indonesia Vol 8 No 1 (2025): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v8i1.201

Abstract

Latar Belakang: Klasifikasi New York Heart Association (NYHA) mengkategorikan pasien berdasarkan tingkat keparahan gejala jantung. Fraksi ejeksi ventrikel kiri Left Ventricular Ejection Fraction (LVEF) juga penting, sebagai prediktor luaran bagi wanita hamil dengan penyakit jantung. Hingga kini, penelitian mengenai hubungan antara LVEF, klasifikasi NYHA, dan luaran anestesi obstetri masih terbatas, terutama di negara berkembang. Tujuan: Menilai apakah LVEF dan klasifikasi NYHA dapat memprediksi mortalitas pasca analgesia dan anestesi pada ibu hamil dengan penyakit jantung.Subjek dan Metode: Studi kohort retrospektif dari data sekunder pasien hamil, penyakit jantung tahun 2019–2022 menggunakan analisis deskriptif dan bivariat untuk mengetahui hubungan variabel bebas dengan luaran mortalitas.Hasil: Pemeriksaan rekam medis antara tahun 2019–2022 terhadap 74 subjek menunjukkan rerata usia 29,3 tahun. Terdapat 6 subjek meninggal. Hubungan signifikan antara klasifikasi NYHA dan mortalitas pasca analgesia atau anestesi (p=0,045), terutama NYHA Kelas IV (p=0,031; OR 16,5; CI95% 1,82 – 149,591). LVEF abnormal (p=0,031; OR 9,167; CI 95% 1,012 – 83,051) juga menunjukkan hubungan positif dengan mortalitas pasca analgesia atau anestesi dibandingkan dengan LVEF normal (LVEF 50–70%). Simpulan: Klasifikasi NYHA dan LVEF dapat memprediksi bermakna mortalitas pasca analgesia atau pasca anestesi pada persalinan ibu hamil dengan penyakit jantung
Patofisiologi Serebrovaskuler dan Implikasi Anestesi pada Preeklampsia/Eklampsia Septica, Rafidya Indah; Uyun, Yusmein; Suryono, Bambang
Jurnal Neuroanestesi Indonesia Vol 4, No 2 (2015)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2701.862 KB) | DOI: 10.24244/jni.vol2i2.118

Abstract

Preeklampsia adalah kelainan multisistim unik pada ibu hamil. Preeklampsia terjadi pada sekitar 3-8% kehamilan, dengan angka mortalitas akibat gangguan serebrovaskuler yang cukup tinggi (67%). Adanya 2 protein antiangiogenik yang diproduksi berlebihan oleh plasenta yang memberi akses masuk ke sirkulasi maternal merupakan molekul yang bertanggung jawab terhadap munculnya preeklampsia, yaitu soluble Fms-like tyrosine kinase, yang merupakan inhibitor endogen vascular endothelial growth factor dan placental growth factor, dan endoglin terlarut (sEng). Faktor-faktor tersebut menyebabkan disfungsi endotel sistemik yang berefek terutama ke hati, otak, dan ginjal. Disfungsi endotel pada otak diasumsikan berperan melalui 2 teori, yaitu sebagai respon terhadap hipertensi berat akut, sehingga regulasi berlebihan serebrovaskuler memicu terjadinya vasospasme; dihipotesakan aliran darah otak (ADO) hilang akibat iskemia, edema sitotoksik, infark dan terjadinya peningkatan mendadak tekanan darah sistemik melebihi kapasitas autoregulasi serebrovaskuler normal, sehingga terjadi kerusakan tekanan ujung kapiler yang menyebabkan kenaikan tekanan hidrostatik, hiperperfusi, ekstravasasi plasma dan sel darah merah melalui endothelial tight junctions yang terbuka mengakibatkan akumulasi edema vasogenik. Walaupun demikian perubahan serebrovaskuler tidak selalu menyebabkan peningkatan tekanan intrakranial. Dengan bantuan teknologi yang lebih baik dan canggih, abnormalitas serebrovaskuler yang dipicu oleh preeklampsia-eklampsia, juga efek hipertensi pada perfusi serebral dapat dijelaskan dengan lebih baik. Pertimbangan khusus pemilihan teknik anestesi pada preeklampsia dimulai dengan persiapan preoperatif berupa penilaian preanestesi, pemilihan manajemen anestesi, teknik induksi pada anestesi umum, dan interaksi antara MgSO4 dan pelumpuh otot nondepolarisasi. Teknik anestesi sesuai kaidah neuroanestesi adalah teknik terpilih pada preeklampsia/eklampsia dengan kenaikan tekanan intrakranialCerebrovascular Pathophysiology and Anesthetic Implication in Preeclampsia/EclamsiaPreeclampsia is a uniqe multisystem disorder in pregnant women. Preeclampsia affecting 3-8% of pregnancies, with high maternal mortality related to cerebrovascular accident (67%). The over produced two antiangiogenic proteins by placenta that gain access to the maternal circulation have become the main molecules responsible for phenotype of preeclampsia; which are soluble Fms-like tyrosine kinase, endogenous inhibitor of vascular endothelial growth factor and placental growth factor, and soluble endoglin (sEng). All these factors cause systemic endothelial dysfunction, mostly affected liver, brain, and kidney. Endothelial cell dysfunction may play role in two theories: as respon to acute severe hypertension thus cerebrovascular overregulation leads to vasospasm; as hypothesized,the diminished cerebral blood flow (CBF) resulted in ischaemia, cytotoxic edema, and infarct and a sudden elevation in systemic blood pressure exceeded the normal cerebrovascular autoregulatory capacity, and lead to disruption of the end-capillary pressure which causes increased hydrostatic pressure, hyperperfusion, and extravasation of plasma as well as red cells through disruption of the endothelial tight junctions leading to the accumulation of vasogenic edema. Nevertheless, cerebrovascular changes not always increase intracranial pressure. With the new and better technologies, the abnormal cerebrovascular related to preeclampsia-ecclampsia, and hypertension effect on cerebral perfusion can be more clearly explained. Special consideration for anesthesia technique in preeclampsia should be begin with preoperative preparation as pre-anesthestia assesment, choosing the anesthestia technique, induction technique and consideration of MgSO4 and nondepolarising muscle relaxant interaction when using general anesthesia. If intracranial pressure increased, neuroanesthesia technique is recommended. In preeclampsia/eclampsia cases.
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