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Journal : Jurnal Komplikasi Anestesi

General Anestesi Tonsilektomy pada Pediatri Tjokronolo, Yudistira; Widyastuti, Yunita; Sudadi
Jurnal Komplikasi Anestesi Vol 4 No 1 (2016): Volume 4 Number 1 (2016)
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.v4i1.7270

Abstract

Telah dilakukan General anestesi pada anak usia 6 tahun dengan diagnosis Tonsilitis kronis dan hipertropi adenoid dilakukan adenotonsilektomi.penilaian status fisik ASA 1 dengan berat badan 18 Kg. Durante operasi dilakukan intubasi orotracheal tanpa pelumpuh otot dan ekstubasi dengan sleep ekstubasi. Hemodinamik selama operasi HR 92 -102 x/menit. Saturasi 98 – 99%. Analgesia paska operasi dengan Paracetamol 300 mg.pasien kembali ke bangsal perawatan, setelah dilakukan observasi di recovery room selama 45 menit dengan aldrette score 10. Pasien tidak terjadi perdarahan paska operasi.
Sedasi Sedang pada Pasien Akut Leukemia Limfoblastik yang Mendapatkan Injeksi Methotrexat Intrathekal Anggraini, Diana; Sari, Djayanti; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 4 No 1 (2016): Volume 4 Number 1 (2016)
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.v4i1.7272

Abstract

Dilaporkan pasien An.J umur 3 tahun dengan diagnosis Akut Leukimia Limfoblastik standard risk minggu ke 12 (masa konsolidasi), dilakukan methotrexat intrathekal. Status fisik ASA II karena anemia. Dilakukan sedasi sedang dengan tekhnik TIVA (Total Intravena Anestesi). Lama tindakansepuluh menit, hemodinamik denyut nadi 90-110 x/mnt, saturasi oksigen 94-99%. Desaturasi terjadi setelah sedasi dengan propofol dan posisi fleksi leher saat prosedur dilakukan. Pasien kembali ke ruangan setelah skor Aldrette >9.
Resusitasi Neonatus dan Pediatrik Givano, Muhamad Randy; Widyastuti, Yunita; Sari, Djayanti
Jurnal Komplikasi Anestesi Vol 9 No 1 (2021): Volume 9 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.v9i1.7279

Abstract

Diperkirakan 10% bayi baru lahir membutuhkan bantuan untuk bernafas pada saat lahir dan 1 % saja yang membutuhkan resusitasi yang ekstensif. Penilaian awal saat lahir harus dilakukan pada semua bayi baru lahir. Dengan adanya faktor resiko yang dikenali sejak awal dapat membantu melakukan idenifikasi bayi baru lahir yang membutuhkan resusitasi, walaupun harus selalu dipersiapkan untuk resusitasi pada bayi tanpa faktor resiko. Depresi neonatus paling sering disebabkan oleh asfiksia intrauterin selama proses persalinan, yang dapat disebabkan hipotensi maupun hipoksia maternal, kompresi plasenta, insufisiensi uteroplasenta yang berujung pada hipoksia janin yang progresif dan asidosis laktat. Kebutuhan akan resusitasi jantung paru pada kelompok umur pediatrik dikatakan jarang setelah periode neonates. Kejadian henti jantung pada pediatrik biasanya dikarenakan oleh kondisi hipoksemia yangberhubungan dengan gagal nafas atau obstruksi jalan nafas. Tidak seperti Dewasa, penyebab henti jantungpada infan dan anak biasanya bukan dari hasil suatu penyakit jantung primer. Penilaian jalan nafas, pernafasan dan sirkulasi pada resusitasi merupakan hal yang sederhana. Pastikan jalan nafas terbuka dan bersih. Pastikan pernafasan, dalam keadaan spontan atau dibantu dan sirkulasi darah yang teroksigenasi adekuat.
Resusitasi Neonatus dan Pediatrik Givano, Muhamad Randy; Sari, Djayanti; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 4 No 2 (2017): Volume 4 Number 2 (2017)
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.v4i2.7298

Abstract

Diperkirakan 10% bayi baru lahir membutuhkan bantuan untuk bernafas pada saat lahir dan 1 % saja yang membutuhkan resusitasi yang ekstensif. Penilaian awal saat lahir harus dilakukan pada semua bayi baru lahir. Dengan adanya faktor resiko yang dikenali sejak awal dapat membantu melakukan idenifikasi bayi baru lahir yang membutuhkan resusitasi, walaupun harus selalu dipersiapkan untuk resusitasi pada bayi tanpa faktor resiko. Depresi neonatus paling sering disebabkan oleh asfiksia intrauterin selama proses persalinan,yang dapat disebabkan hipotensi maupun hipoksia maternal, kompresi plasenta, insufisiensi uteroplasenta yang berujung pada hipoksia janin yang progresif dan asidosis laktat. Kebutuhan akan resusitasi jantung paru pada kelompok umur pediatrik dikatakan jarang setelah periodeneonates. Kejadian henti jantung pada pediatrik biasanya dikarenakan oleh kondisi hipoksemia yang berhubungan dengan gagal nafas atau obstruksi jalan nafas. Tidak seperti Dewasa, penyebab henti jantungpada infan dan anak biasanya bukan dari hasil suatu penyakit jantung primer. Penilaian jalan nafas, pernafasan dan sirkulasi pada resusitasi merupakan hal yang sederhana. Pastikan jalan nafas terbuka dan bersih. Pastikan pernafasan, dalam keadaan spontan atau dibantu dan sirkulasi darah yang teroksigenasi adekuat.
Perbandingan Kejadian Laringospasme antara Ekstubasi Endotracheal Tube Sadar Tanpa Sentuhan dan Sadar dengan Sentuhan pada Operasi di Jalan Nafas Hartono, Dedy; Sarosa, Pandit; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 4 No 3 (2017): Volume 4 Number 3 (2017)
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.v4i3.7302

Abstract

Latar Belakang: Laringospasme adalah salah satu komplikasi ekstubasi sadar yang dapat menimbulkan morbiditas maupun mortalitas. Beberapa cara digunakan untuk mengurangi laringospasme akibat dari ekstubasi yang dilakukan secara sadar. Ekstubasi sadar dengan tehnik no touch dapat digunakan untuk mengurangi laringospasme akibat ekstubasi sadar. Dengan teknik ekstubasi “no touch” pasien diposisikan dalam keadaan posisi pemulihan di akhir prosedur. Darah dan sekret dibersihkan dengan suction dan dilakukan dengan hati-hati pada faring sebelum penghentian anestesi volatil atau dalam pengertian lain pasien masih dalam keadaan teranestesi. Tidak ada stimulasi diperbolehkan lebih lanjut, Selain pemantauan terus-menerus dengan oksimetri, sampai pasien spontan terbangun, kemudian dilakukan ekstubasi.Tujuan : penelitian ini adalah untuk mengetahui perbandingan kejadian laringospasme pada ekstubasi sadar dengan tehnik tanpa sentuhan (no touch) dengan ekstubasi sadar dengan sentuhan pada operasi di jalan nafas.Metode : Penelitian ini didesain dengan RCT, dilakukan pada 2 kelompok sampel pada pasien dengan operasi di jalan nafas (kelompok operasi dengan kejadian laringospasme paling tinggi), kelompok T : kelompok kontrol, dilakukan ekstubasi sadar dengan sentuhan,kelompok NT : kelompok perlakuan, dilakukan ekstubasi sadar dengan tehnik no touch. Dengan jumlah sampel masing-masing kelompok 34 pasien. Kriteria inklusi penelitian ini : Pasien berumur 8-60 tahun yang menjalani operasi pada jalan nafas elektif yang dilakukan anestesi umum dengan intubasi endotracheal tube lewat oral/nasal, Status fisik ASA I dan II, Body mass index (BMI) 18 – 25, Bersedia menjadi subyek penelitian, Kriteria Eksklusi : Terdapat perkiraan kesulitan intubasi dan ekstubasi, Pasien dengan penyakit jantung, Pasien dengan ISPA, Pasien riwayat asma/PPOK.Hasil : Penelitian ini didapatkan kejadian laringospasme pada kelompok no touch adalah 0% (0 kasus), sedangkan kejadian laringospasme pada kelompok kontrol adalah 16,7% (6 kasus), dan secara statistik berbeda secara bermakna (p < 0,05).Kesimpulan : Ekstubasi sadar dengan tehnik tanpa sentuhan (no touch) akan mengurangi kejadian laringospasme pada operasi di jalan nafas.
Hipoalbuminemia: Pengaruhnya pada Farmakokinetika Agen-Agen Anestesi Wardhana, Ardyan Prima; Widyastuti, Yunita; Mahmud
Jurnal Komplikasi Anestesi Vol 5 No 1 (2017): Volume 5 Number 1 (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.v5i1.7314

Abstract

Hypoalbuminemia is a condition in which the serum albumin contentration less than 3.5 mg / dL. Albumin serves as a binding protein and carrier of various substances including drugs. This manuscript discusses the effect of plasma albumin levels on pharmacokinetics changes of anesthetic agents. Inhalation and mostly intravenous anesthetic agents are lipophilic and highly protein binding. The albumin concentration is directly proportional to the blood/gas partition coefficient. For the intravenous agent, the unbound drug concentration gradient between plasma and tissue will be increased under conditions of hypoalbuminemia. The changes in volume distribution and elimination half-life occur, but unbound drug concentration in steady conditions does not depend on the amount of drug binding to proteins. Bolus administration of anesthetic agents generally does not require dose adjustment under hypoalbuminemia. It differs in continuous administration. There are few clinical studies of anesthetic agents in patients with hypoalbuminemia. Generally, clinical studies are conducted in patients with cirrhosis, which can be accompanied by hypoalbuminemia. One study was able to demonstrate a change in clinical effects seen in the administration of infusion propofol as well as repeated injections compared with bolus during induction.
Tatalaksana Nyeri Postoperatif pada Infant Hernandes, Crodia; Widyastuti, Yunita; Sari, Djayanti
Jurnal Komplikasi Anestesi Vol 10 No 3 (2023): Volume 10 Number 3 (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.v10i3.7325

Abstract

Postoperative acute pain is an unavoidable problem in postoperative conditions. Effective relief of pain is of the most importance to treating patients undergoing surgery. Effective pain management has significant physiological benefits. Manyways for pain management, althought opioid is general pain management and Regional block is a popular techniques in paediatric pain management recently, wether for surgery or need of adequate analgesic condition.
Validasi European System for Cardiac Operative Risk Evaluation (Euroscore) II sebagai Prediktor Lama Perawatan Intensive Care Unit (ICU) pada Pasien Operasi Bedah Jantung (Kelainan Katup dan Kongenital) di RSUP Dr. Sardjito Febrianti, Skolastika Rani; Widyastuti, Yunita; Jufan, Akhmad Yun
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.v5i3.7336

Abstract

Background. Development quality of care, health care resources, and methods to assess the risk of cardiacsurgery are increasing in this era. Cardiac surgery is high risk procedure and require post-operative intensive care. Our objectives were to validating EuroSCORE II as ICU length of stay predictor for post cardiac surgery patient (valvular and congenital heart disease) in Dr. Sardjito General Hospital.Methods. A cohort retrospective study was conducted. Data were collected from the medical records of postoperative cardiac surgery patients in 2006-2016 at Dr. Sardjito General Hospital. EuroSCORE II values were obtained from all subjects. EuroSCORE II model was used to predict prolonged care in the ICU for >48 hours. Discriminative ability was analyzed using receiver operating characteristic (ROC) curve. Calibration were assessed with areas under the receiver operating characteristic curve (AUC) and the Hosmer– emeshow test.Results. In this study the data were obtained from 92 patients post-cardiac surgery in 2006-2016 at Dr. Sardjito General Hospital. Fifteen patients (16.3%) have prolonged ICU stay>48 hours. In this research, the predictive value is underestimate than actual value. EuroSCORE II showed good discrimination ability to predict prolonged ICU stay (AUC=0.711). However, EuroSCORE II showed poor calibration in predicting prolonged ICU stay (Hosmer-Lemeshow: p<0.05).Conclusion. EuroSCORE II showed good discrimination but poor calibration ability. EuroSCORE II can differentiate the outcome of ICU stay between ≤48 hours and >48 hours groups, but it cannot be used for patient risk stratification of prolonged ICU stay.
Manajemen Anestesi pada Neonatus dengan Atresia Oesophagus Adi, Danis Woro Kuncoro; Sari, Djayanti; Widyastuti, Yunita
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.v5i3.7340

Abstract

A 12-day-old male neonate diagnosed with atresia oesophagus type C was planned to undergo decompression gastrostomy and feeding jejunostomi surgery. The patient’s mother complained that her child always vomit when given breast milk and said the child’s stomach was bloated. Patient was born from G1P1A0 mother with a history of aterm pregnancy, history of routine ANC, birth through normal delivery in midwife with clear amniotic fluid and APGAR SCORE 7/9. Birth weight 2382 grams and body weight is now 2282 grams. Anesthesia management performed under general anesthesia with conscious intubation technique ET No. 2.5 uncuff facilitate with 5mg ketamine. Maintenance anesthesia with O2, air, and sevoflurane. hemodynamics are stable during surgery. The operation lasts for 45 minutes. After the surgery is completed the patient is again treated at the NICU.
Analgesia Multimodal Pascaoperatif pada Pasien Pediatrik Widyastuti, Yunita; Sari, Djayanti; Rizki, Gilar
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.v6i2.7346

Abstract

Acute pain can be found in patient undergoing surgery. Postoperative pain scale is variable from mild to moderate-severe. There are difficulties in assessing pain scale in pediatric, not like adult, pediatric patient can’t say what they feel. Management of postoperative pain, especially in moderate-severe scale needs a multimodal approach to overcome it. The aim of multimodal strategy is to optimize analgetic effect and reduce the adverse effect of the drugs.
Co-Authors . Supomo Adhinugroho, Sudjati Adi, Danis Woro Kuncoro Akhmad Yun Jufan Alqustar, Adam Amelia Ananda Putri Lestari Anggraini, Diana Arifin, Achmad Reza Atmanagara, Dikho Atmojo, Danang Dwi Beni Indra, Beni Bhirowo Yudo Pratomo Budi Yuli Setianto Calcarina Fitriani Retno Wisudarti Cindy Elfira Boom Cornelia Ancilla Darwito, Darwito Denaldi Rananda Saputra Djajantisari Djayanti Sari Ekuarianto, Donny Erwin Kusumastuti Fadhilah Zulfa Fadinie, Wulan Fauzan Imani Ardanto Fauzi, Rizqi Ahmad Febrianti, Skolastika Rani Firman Ardiansyah Getar M, Geza Getar M Givano, Muhamad Randy Gunawan, Fanny Handayani, Donna Hartono, Dedy hendra, hendra hermawan Hernandes, Crodia Hernawan, Agung Diky Hidayat, Fachsyar Ika Puspitasari Ilman, Pesiar Iwan Purnawan Iwan Purnawan Juni Kurniawaty Muhdar Abubakar Djayanti Sari Khoeri, Fatkhur Roofi Krisdiyantoro, Nova Kurniawan, Novianto Mahmud Mahmud Muhammad Brian Ristianto Muhammad Mufti Sofyanoor Napitu, Annika Ngahu, Robby Mesakh Novianto Kurniawan Nugraha, Achmad Fauzani Nur Azza, Kamala Kan Prakosa, Nur Hamam Primastuti, Githa Rizki Priyadi Nugraha P Probosuseno Probosuseno Probosuseno, P Ramsi, Irhash Faisal Ratih Kumala Fajar Apsari Rayhandika Ridha, Ihsanur Rizki, Gilar Romeo Putra Dirama Rumpoko, Triaji Mudo Ruth Sally Sarosa, Pandit SATRIYAS ILYAS Siti Helmyati Sri Rahardjo Sri Setiyarini SRI SETIYARINI, SRI Sudadi Suhanda, Rellig Maret Susi Handayani Taneo, Desy Chery Marlyn Tjokronolo, Yudistira Tomo, Wahyu Kartiko Untung Widodo Untung Widodo, Untung Wardhana, Ardyan Prima Wikantama, Aswin Wisudarti, Calcarina Fitri Retno YP, Bhirowo Yusmein Uyun Zahroh Shaluhiyah