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Low Flow Practice for Laparoscopic Colorectal Surgery in Pediatric Patients Yadikusumo, Andrian; Senapathi, Tjokorda Gde Agung; Shintya Dewi, Dewa Ayu Mas; Pradhana, Adinda Putra; Sumanti, Alan F. A.
Bali Journal of Anesthesiology Vol 2, No 1 (2018)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v2i1.56

Low flow anesthesia and laparoscopic technique in pediatric patients are kinds many kind of modern medical field development.Â Both technique were made to support environment friendly, safety, and comfortable anesthesia practice for patients.Â In three cases presented in this case series, laparoscopy was done in all three cases (two digestive cases, and one urology case).Â All three cases performed with general anesthesia by low flow anesthesia technique with volatile sevoflurane combined with caudal block regional anesthesia.Â In all those cases, no morbidity was found after anesthesia or operation that influence in patientâs outcome.Â Improvement in outcome of pediatric patients was seen with low flow anesthesia technique, which are significant reduction of volatile used, faster wake up time, and reduction of agitation condition after anesthesia.

The interaction of neuroimmunology, neuromodulator, and neurotransmitter with nociceptor and MAPK signaling Dewi, Dewa Ayu Mas Shintya; Wiryana, Made
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

ABSTRACTPhysiological pain is a protection mechanism against tissue damage or potential tissue damage. Inflammation pain is followed by tissue damage due to temperature, mechanical and chemical stimuli which increase crosstalk between neuron nociceptor, immune system, neuromodulator and neurotransmitter, and MAPK (Mitogen Activating Protein Kinase) signal. Initially, immune cell is produced at the primary afferent nerve endings and spinal cord, modulate thermal sensitivity and mechanic through MAPK signaling, then neuromodulator and neurotransmitter at the afferent nerve endings will regulate the innate immune response, adaptive and vascular

Profil penurunan tekanan darah pasca induksi dengan anastesi umum di RSUP Sanglah periode Juli-Desember 2016 Gusti Ayu Amalindasari Prabayastita Masta; I Wayan Suranadi; Dewa Ayu Mas Shintya Dewi
E-Jurnal Medika Udayana Vol 7 No 5 (2018): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (158.301 KB)

Induction of intravenous anesthesia is the process of lulling the patient through anesthetic drugs until the patient enters the anesthesia stage. One of the common anesthesia drugs used in the induction of anesthesia is propofol and the induction of fentanyl. The use of propofol at induced doses causes a significant change in hemodynamic stability in the form of decrease in hemodynamic. Decrease in that parameter can lead to tissue hypoxia, myocardial ischemia, shock to death. The design of cross-sectional descriptive research obtained through secondary data is medical records in the period from June 2016 to December 2016 Sanglah Hospital in patients with elective surgical upper arm fractures with general anesthesia induction. The subjects were 39 patients who met the inclusion and exclusion criteria and received treatment with general anesthesia. Then, recording parameters of hemodynamic changes in systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP) were assessed at the time of induction of anesthesia. In patients with upper arm bone surgery most were men in 39 cases in the 20-40 year age range with ASA I and received general anesthetic induction of propofol and fentanyl. Post induction in the hemodynamic parameters decreased at systolic blood pressure of 10.42%, then diastolic blood pressure decreased by 2.5%, mean arterial pressure (MAP) decreased by 5.9%. There is a decrease of hemodynamic parameters of both systolic, diastolic and MAP blood pressure in post-induced patients with propofol and fentanyl induction. Keywords: propofol, fentanyl, hypotension

The characteristic of anxiety disorder among medical students of Universitas Udayana, Bali, Indonesia in the 2019 period Kuganesh Ravichandran; Dewa Ayu Shintya Dewi; I Wayan Aryabiantara
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Anxiety is a normal stress reaction and can be beneficial in some dangerous situations. The symptoms are individual, whereas most of them include restlessness, feeling keyed up on edge, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance. This study aims to determine the characteristic of anxiety disorder among medical students of Universitas Udayana, Bali, Indonesia, in the 2019 periodMethods: A cross-sectional study was conducted among 75 medical students who met the inclusion criteria in this study. The characteristic of anxiety disorders depicted in this study was the prevalence, anxiety severity, characteristic of anxiety, and possible stressors. Depression Anxiety and Stress Scale- 21 (DASS-21) used to assess anxiety among medical students. Data were analyzed descriptively using SPSS version 21 for Windows and presented in percentages.Results: From 75 medical students, 11 (14.67%) students were batch 2016, 25 (33.33%) students were batch 2017, and 39 (52.0%) students were batch 2018. Based on the DASS-21 score, there were 53 students (70.7%) experienced anxiety. According to the severity of anxiety, we found that the vast majority of students (45.3%) belong to the extremely severe anxiety group, followed by severe anxiety (20.8%), moderate anxiety (15.1%) and mild anxiety (11.3%).Conclusion: The characteristic of anxiety disorder among medical students were predominant by the severe anxiety group based on the DASS-21 score.

Opioid-Free Anesthesia (OFA) as a Safe Anesthetic Choice for Epilepsy Patient Walujo, Albertus Medianto; Dewa Ayu Mas Shintya Dewi; FX. Adinda Putra Pradhana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 12 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i12.901

Background: The opioid-free anesthesia (OFA) approach, although not widely employed in anesthesia, offers distinct benefits for some populations, such as epilepsy patients, due to the propensity of opioids to trigger seizures. Hence, the objective of this study was to conduct an opioid-free anesthesia (OFA) procedure on the left lateral rhinotomy in a patient with concurrent epilepsy. Case presentation: Our patient is a 59-year-old woman suffering from epilepsy with a left nasal cavity tumor, scheduled for a left midfacial degloving rhinotomy. Given the patient's epilepsy comorbid, we have opted for an opioid-free anesthesia (OFA) procedure. OFA procedures are not yet widely employed in anesthesia; however, they offer advantages for specific patient populations, including epilepsy patients, as opioids have the potential to induce seizures. Conclusion: The various OFA protocols being conducted worldwide require refinement, and the potential interactions of each component should be explored further.

Anesthetic Management of Wilms’ Tumor Patient Using Thoracal Epidural Block: A Case Report Tenggara, Alamsyah; Dewa Ayu Mas Shintya Dewi
Journal of Anesthesiology and Clinical Research Vol. 4 No. 2 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.306

Introduction: Wilms’ tumor or nephroblastoma is an embryonal tumor that develops from the remaining immature kidney and is the fourth most common primary renal tumor malignancy in children. An asymptomatic abdominal mass is present in more than 90% and hematuria in 30% of patients. Preoperative workup includes complete laboratory blood tests and imaging to ensure intrarenal mass. This study aimed to describe the anesthetic management of Wilms’ tumor patients. Case presentation: A two-year-old girl was diagnosed with Wilms' tumor with the main complaint of intermittent hematuria. An abdominal CT scan showed an enlargement mass in the right kidney with a size of +/- 7.4 x 5.9 x 9.5 cm. The patient was planned for radical nephrectomy. In addition to general anesthesia, an epidural catheter is placed at the 10th-11th thoracic level (T10-T11). Conclusion: Epidural placement in pediatrics undergoing abdomen surgery have various beneficial considerations, such as superior analgesia, minimal opioid use, reduced intraoperative bleeding, and decreased postoperative ventilator requirements.

Anesthetic Approach to Placenta Previa with Associated Bladder Rupture: A Case Report Putra, Made Bagus Cahya Maha; IGAG Utara Hartawan; Dewa Ayu Mas Shintya Dewi
Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 3 (2025): JATI Desember 2025
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/nqk01d22

This case report outlines the anesthetic management of total placenta previa with high-risk features of placenta accreta spectrum (PAS) complicated by bladder rupture, representing a rare but clinically significant form of invasive placentation. A 29-year-old G2P1001 at 35+3 weeks’ gestation presented with recurrent antepartum bleeding and ultrasonographic features consistent with PAS, including grade III lacunae, bridging vessels, severe myometrial thinning, and a Placenta Accreta Indeks (PAI) score of 6. Spinal anesthesia was initiated for delivery, followed by a controlled conversion to general anesthesia to facilitate hysterectomy, two-layer bladder repair, ureteral reconstruction, and Double-J stent placement. Hemodynamic stability was maintaned using tranexamic acid, colloid co-loading, invasive arterial monitoring, and norepinephrine titration. An estimated blood loss of 2,300 mL was managed with targeted transfusion, resulting in favourable maternal recovery and neonatal outcomes (Apgar 7 and 9). This case underscores the importance of early PAS recognition, structured anesthetic planning, and coordinated multidisciplinary care, supporting the benefit of a staged neuraxial-to-general anesthesia strategy in complex PAS with urologic involvement.

Anesthetic Approach to Placenta Previa with Associated Bladder Rupture: A Case Report Putra, Made Bagus Cahya Maha; IGAG Utara Hartawan; Dewa Ayu Mas Shintya Dewi
Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 3 (2025): JATI Desember 2025
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/nqk01d22

This case report outlines the anesthetic management of total placenta previa with high-risk features of placenta accreta spectrum (PAS) complicated by bladder rupture, representing a rare but clinically significant form of invasive placentation. A 29-year-old G2P1001 at 35+3 weeks’ gestation presented with recurrent antepartum bleeding and ultrasonographic features consistent with PAS, including grade III lacunae, bridging vessels, severe myometrial thinning, and a Placenta Accreta Indeks (PAI) score of 6. Spinal anesthesia was initiated for delivery, followed by a controlled conversion to general anesthesia to facilitate hysterectomy, two-layer bladder repair, ureteral reconstruction, and Double-J stent placement. Hemodynamic stability was maintaned using tranexamic acid, colloid co-loading, invasive arterial monitoring, and norepinephrine titration. An estimated blood loss of 2,300 mL was managed with targeted transfusion, resulting in favourable maternal recovery and neonatal outcomes (Apgar 7 and 9). This case underscores the importance of early PAS recognition, structured anesthetic planning, and coordinated multidisciplinary care, supporting the benefit of a staged neuraxial-to-general anesthesia strategy in complex PAS with urologic involvement.

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