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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina E-Jurnal Medika Udayana Jurnal Anestesiologi Indonesia Bali Journal of Anesthesiology Syntax Literate: Jurnal Ilmiah Indonesia Medicinus : Jurnal Kedokteran ISM (Intisari Sains Medis) : Jurnal Kedokteran Bioscientia Medicina : Journal of Biomedicine and Translational Research PREPOTIF : Jurnal Kesehatan Masyarakat Neurologico Spinale Medico Chirurgico Journal of Anaesthesia and Pain JOURNAL LA MEDIHEALTICO Archives of The Medicine and Case Reports Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Anesthesiology and Clinical Research Jurnal Neuroanestesi Indonesia Majalah Anestesia & Critical Care (MACC) Journal of Global Pharma Technology Eduvest - Journal of Universal Studies Jurnal Komplikasi Anestesi Journal of Medicine and Health Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif
Tjokorda Gde Agung Senapathi
Departemen Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Udayana – RSUP Sanglah Denpasar, Indonesia
Aerospace Engineering Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences Veterinary Other

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Managemen Anestesi pada Congenital Diapragmatic Hernia dengan Ventrikel Septal Defek dan Atrium Septal Defek pada Pasien Pediatrik : Laporan Kasus Mauritius Septa; Adinda Putra Pradhana; I Putu Kurniyanta; Ketut Wibawa Nada; Novandi Kurniawan; Tjokorda Gde Agung Senapathi
Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 2 (2025): JATI Agustus 2025
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JATI.2025.v01.i02.p06

Abstract

Congenital diaphragmatic hernia (CDH) merupakan kelainan kongenital pada diafragma yang terjadi pada pediatri. Insiden terjadinya hernia tipe Borchdalek lebih sering terjadi pada sisi kiri dari pada sisi kanan. Penyulit lain pada CDH adalah hipoplasia paru, hipertensi paru dan kelainan pada jantung. Pada kasus ini kami mendiskusikan bayi 12 hari dengan kelainan CDH sisi kanan dengan kelainan jantung berupa ventrikel septal defek (VSD) dan atrium septal defek (ASD) yang dilakukan operasi laparotomi hernia. Manajemen anestesi pada pasien ini menggunakan  inhalasi sevoflurane, fentanil, volume tidal rendah, obat inotropik dengan kondisi hemodinamik yang stabil selama pembedahan. Kami melaporkan management anestesi dengan  sevoflurane yang dikombinasi dengan volume tidal rendah dan inotropik dobutamine pada operasi congenital diaphragmatic herdia dengan VSD dan ASD membantu dalam keberhasilan intraoperatif. Setelah operasi, pasien dilakukan perawatan di NICU untuk  perawatan secara ketat.
External Oblique Intercostal Plane Block (EOIPB) sebagai Tambahan Analgesia Multimodal Pasca Laparoskopi Kolesistektomi: Tinjauan Naratif David Rendra Mahardika; Made Agus Kresna Sucandra; Tjokorda Gde Agung Senapathi
Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 2 (2025): JATI Agustus 2025
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JATI.2025.v01.i02.p07

Abstract

Pendahuluan: Nyeri pascaoperasi, terutama setelah kolesistektomi laparoskopi, adalah masalah signifikan yang meningkatkan morbiditas dan memperpanjang masa rawat inap. Penanganan nyeri sering kali melibatkan opioid sistemik yang memiliki efek samping merugikan. Oleh karena itu, pendekatan analgesia alternatif yang minim opioid sangat dibutuhkan. Tinjauan naratif ini bertujuan mengevaluasi efektivitas External Oblique Intercostal Plane Block (EOIPB) sebagai tambahan analgesia multimodal pasca kolesistektomi laparoskopi, berfokus pada kualitas analgesia, pemulihan pasien, dan respons inflamasi sistemik. Metode: Tinjauan naratif ini didasarkan pada penelusuran literatur terstruktur dari PubMed, Scopus, ScienceDirect, Cochrane Library, dan Google Scholar. Pencarian menggunakan kombinasi kata kunci seperti "external oblique intercostal plane block", "laparoscopic cholecystectomy", "postoperative pain", "quality of recovery", "neutrophil to lymphocyte ratio", dan "platelet to lymphocyte ratio". Publikasi dibatasi pada tahun 2019–2024, berbahasa Inggris atau Indonesia. Kriteria inklusi meliputi studi primer peer-reviewed (RCT, kohort, observasional) yang mengevaluasi EOIPB atau blok interfasial sebanding, serta melaporkan skor nyeri pascaoperasi, konsumsi opioid, skor quality of recovery (QoR-15), dan/atau nilai neutrophil to lymphocyte ratio (NLR) / platelet to lymphocyte ratio (PLR). Hasil: EOIPB secara konsisten memperpanjang durasi analgesia, menurunkan intensitas nyeri dengan skor visual analog scale (VAS), dan mengurangi konsumsi opioid pascaoperasi secara signifikan. Studi juga menunjukkan profil keamanan EOIPB yang baik dengan insiden efek samping minimal. Bupivakain, agen anestesi lokal yang umum digunakan, tidak hanya memblok transmisi nyeri tetapi juga menunjukkan sifat anti-inflamasi. Meskipun demikian, terdapat heterogenitas dalam teknik dan jenis anestesi yang digunakan antar studi. Kesimpulan: EOIPB adalah teknik blok interfasial yang efektif dan aman untuk manajemen nyeri pasca kolesistektomi laparoskopi, memberikan analgesia yang lebih baik dan mengurangi kebutuhan opioid. Namun, masih diperlukan penelitian lanjutan berskala besar, terstandarisasi, dan multicenter untuk memperkuat bukti ilmiah dan mengevaluasi dampak jangka panjangnya.
Combined Lumbar Plexus and Sciatic Nerve Blocks Improve Postoperative Recovery in Lower Extremity Surgery: A Randomized Controlled Trial Wiranata, Jeremia Alvian; Aribawa, I Gusti Ngurah Mahaalit; Parami, Pontisomaya; Senapathi, Tjokorda Gde Agung; Hartawan, I Gusti Agung Gede Utara; Adi, Made Septyana Parama; Kurniajaya, I Gusti Agung Made Wibisana; Pradhana, Adinda Putra
Journal of Anaesthesia and Pain Vol. 7 No. 1 (2026): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Background: Patients undergoing lower extremity orthopedic surgery often experience moderate to severe postoperative pain, commonly managed with opioids. Regional anesthesia techniques, such as peripheral nerve blocks, offer promising alternatives. This study evaluates the efficacy of combined lumbar plexus block (LPB) and sciatic nerve block (SNB) versus intravenous opioid analgesia in enhancing postoperative recovery and pain control. Methods: In a single-blind, randomized controlled trial, 42 patients scheduled for lower extremity orthopedic surgery under spinal anesthesia were allocated to two groups. Group P1 received postoperative LPB and SNB using 20 mL of 0.25% bupivacaine, while group P2 received intravenous opioids. Outcomes at 24 hours included quality of recovery (QoR-40) scores, total morphine consumption, duration of analgesia, and monitored adverse events. Result: Group P1 showed significantly better recovery scores [QoR-40: 183 (178–188) vs. 152 (136–161.5), p < 0.001], reduced morphine consumption [4 (4–6.5) mg vs. 18 (16–22) mg, p < 0.001], and longer analgesia duration [480 (340–600) min vs. 75 (60–110) min, p < 0.001]. No adverse events were observed. Conclusion: Combined LPB and SNB significantly improve postoperative recovery quality and analgesia in patients undergoing lower extremity orthopedic surgery, reducing opioid requirements and extending pain-free duration compared to intravenous opioids.
TRIAL FIBRILASI SETELAH INFILTRASI EPINEFRIN PADA PEMBEDAHAN RINOTOMI : SEBUAH LAPORAN KASUS Sunto, Sunto; Dewi, Dewa Ayu Mas Shintya; Senapathi, Tjokorda Gde Agung
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 10 No. 1 (2026): APRIL 2026
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v10i1.54234

Abstract

Atrial fibrilasi merupakan salah satu aritmia supraventrikular yang paling sering ditemukan pada periode perioperatif. Penggunaan agen vasokonstriktor seperti epinefrin dalam pembedahan, khususnya pada pasien dengan riwayat penyakit kardiovaskular atau aritmia, dapat menimbulkan perubahan hemodinamik dan gangguan irama jantung yang bermakna. Laporan kasus ini bertujuan untuk menggambarkan kejadian atrial fibrilasi dengan respons ventrikel cepat setelah infiltrasi epinefrin pada tindakan rinotomi. Kami melaporkan seorang pria berusia 56 tahun dengan diagnosis karsinoma sinonasal bilateral stadium IVc dengan metastasis tulang yang menjalani pembedahan rinotomi bilateral. Pasien memiliki riwayat gagal jantung kelas fungsional II dan atrial fibrilasi normoventrikular pada EKG praoperasi. Anestesi umum dilakukan dengan teknik standar dan pemeliharaan menggunakan sevofluran. Selama pembedahan dilakukan infiltrasi submukosa epinefrin 1:200.000. Setelah infiltrasi epinefrin, irama jantung berubah menjadi atrial fibrilasi dengan respons ventrikel cepat dengan frekuensi 120–140 kali per menit. Pasien segera ditangani dengan pemberian amiodaron intravena bolus 150 mg sehingga irama kembali menjadi atrial fibrilasi normoventrikular. Operasi dapat diselesaikan tanpa komplikasi lanjutan dan pasien dirawat di HCU tanpa kejadian ulang. Infiltrasi epinefrin dapat memicu atrial fibrilasi dengan respons ventrikel cepat pada pasien berisiko. Kewaspadaan anestesiologis dan penatalaksanaan aritmia yang cepat sangat penting untuk mencegah komplikasi serius perioperatif.
The Association Between Preoperative Anxiety and Pain Severity, Opioid Requirement, Neutrophil-to-Lymphocyte Ratio, and Postoperative Blood Glucose After Gynecologic Laparotomy at Ngoerah Hospital Bora, Fivilia Anjelina; Dewi, Dewa Ayu Mas Shintya; Kurniyanta, I Putu; Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Suarjaya, Putu Pramana; Aribawa, I Gusti Ngurah Mahaalit; EM, Tjahya Aryasa; Parami, Pontisomaya; Labobar, Otniel Andrians
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10969

Abstract

Background: We assessed whether preoperative anxiety is associated with postoperative pain severity, opioid requirement, neutrophil-to-lymphocyte ratio (NLR), and blood glucose after gynecologic laparotomy. Methods: Prospective cohort at Ngoerah Hospital (May to June 2025). Anxiety was measured preoperatively with APAIS and categorized as non-anxious, mild, moderate, or severe. Outcomes were NRS pain at 6, 12, and 24 hours, total fentanyl in the first 24 hours, and NLR and blood glucose at 6 hours postoperatively. Multivariable analysis used MANCOVA (99% confidence intervals). Result: Fifty-four patients were included (mean age 41.78 ± 10.58 years). Anxiety distribution was 46.3% non-anxious, 25.9% mild, 24.1% moderate, and 3.7% severe. Higher anxiety was associated with higher NRS at 6 hours (B 0.842; 99% CI 0.475 to 1.209; p < 0.001), 12 hours (B 0.381; 0.247 to 0.515; p < 0.001), and 24 hours (B 0.158; 0.048 to 0.269; p = 0.048). Anxiety was associated with higher 24-hour fentanyl requirement (B 147.8 microg; 99% CI 124.062 to 171.651; p < 0.001), higher postoperative NLR (B 4.31; 99% CI 0.609 to 8.027; p = 0.024), and higher postoperative blood glucose (B 19.4 mg/dL; 99% CI 7.912 to 30.912; p = 0.001). Conclusions: Higher preoperative anxiety was independently associated with worse pain, greater opioid requirement, and higher postoperative NLR and blood glucose after gynecologic laparotomy.
Regional Anesthesia and Ultrasound-Guided Peripheral Nerve Blocks in Current Practice Tjokorda Gde Agung Senapathi
Jurnal Anestesiologi dan Terapi Intensif Vol. 2 No. 1 (2026): JATI APRIL
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/8p9ktj40

Abstract

This editorial underscores the increasing centrality of regional anesthesia in contemporary anesthesiology, as reflected in the current issue. Peripheral nerve blocks and ultrasound-guided techniques are highlighted as key drivers of a broader shift toward precision, safety, and patient-centered perioperative care. Regional anesthesia has evolved beyond its traditional role, contributing to improved postoperative outcomes through optimized analgesia, reduced opioid use, and enhanced recovery. The integration of ultrasound has further strengthened accuracy, reproducibility, and educational value in clinical practice. However, the expansion of these techniques must be supported by adequate training, standardization, and vigilant attention to patient safety. Overall, this issue illustrates an evolving discipline in which innovation must remain aligned with evidence-based practice and clinically meaningful outcomes.
Regional Anesthesia and Ultrasound-Guided Peripheral Nerve Blocks in Current Practice Tjokorda Gde Agung Senapathi
Jurnal Anestesiologi dan Terapi Intensif Vol. 2 No. 1 (2026): JATI APRIL
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/8p9ktj40

Abstract

This editorial underscores the increasing centrality of regional anesthesia in contemporary anesthesiology, as reflected in the current issue. Peripheral nerve blocks and ultrasound-guided techniques are highlighted as key drivers of a broader shift toward precision, safety, and patient-centered perioperative care. Regional anesthesia has evolved beyond its traditional role, contributing to improved postoperative outcomes through optimized analgesia, reduced opioid use, and enhanced recovery. The integration of ultrasound has further strengthened accuracy, reproducibility, and educational value in clinical practice. However, the expansion of these techniques must be supported by adequate training, standardization, and vigilant attention to patient safety. Overall, this issue illustrates an evolving discipline in which innovation must remain aligned with evidence-based practice and clinically meaningful outcomes.
Co-Authors A A Gde Putra Semara Jaya Adi, Made Septyana Parama Adinda Putra Pradhana Albert Albert Anak Agung Gde Agung Adistaya Andi Irawan Andi Kusuma Wijaya, Andi Anggreni, Anak Agung Ayu Aprilnita, Aida Aryasa EM, Tjahya Astawa N. M., Astawa N. Astawa P., Astawa Astuti, Mira Kusuma Astuti, Mira Kusuma Bayu Saputra, Ida Bagus Prema Satia Bora, Fivilia Anjelina Brillyan Jehosua Toar Budiadnyana, I Made Pasek Budiarta, Gede Cahyono, Ardy Wibowo Christopher Ryalino Christopher, Michael Cindryani Ra Ratumasa, Marilaeta Cung Flavyanto, Eugenius Silvester Cynthia Dewi Sinardja D.H., Asterina David Rendra Mahardika Dewa Ayu Mas Shintya Dewi Dewi, Dewa Ayu Mas Shintya Dewi, I Dewa Ayu Mas Shintya Doddy Setiawan Ekaputra Ekaputra, Ekaputra Elisma Nainggolan, Elisma EM, Tjahya Aryasa Emkel Perangin Angin, Emkel Eric Makmur, Eric Ery Oktadiputra Estrada, Ronald Eugenia, Michelle Ferry, Ferdinand Gede Semarawima, Gede Gede Wirya Kusuma Duarsa Giovanni, Malvin Hadiwijono, Vanessa Juventia Hartanto, Wijaya Hartawan , I.G.A.G. Utara Hartawan, IGAG Utara Hengky Hengky, Hengky Humianto, Michael I Dewa Made Sukrama I Gede Budiarta I Gede Prima Julianto I Gusti Agung Gede Utara Hartawan I Gusti Ayu Putri Purwanthi I Gusti Ngurah Mahaalit Aribawa I Ketut Sinardja I Ketut Wibawa Nada I Made Agus Kresna Sucandra I Made Bakta I Made Darma Junaedi, I Made I Made Gede Widnyana I Made Prema Putra I Made Subagiartha I Made Wiryana, I Made I Putu Agus Surya Panji I Putu Fajar Narakusuma I Wayan Aryabiantara, I Wayan I Wayan Suranadi Ida Bagus Krisna Jaya Sutawan IGNA Putra Arimbawa, IGNA Putra Jayantha Ananda, I Gusti Ngurah Bagus Jeanne, Bianca Jhoni Pardomuan Pasaribu Jimmy Wongkar Johanes, Kevin Paul Junaedi, I Made Darma Kadek Agus Heryana Putra Kadek Agus Heryana Putra, Kadek Agus Kamaswari, Ida Ayu Dwi Kenzi, Ignatio Armando Ketut Semara Jaya, Ketut Semara Ketut Wibawa Nada Ketut Yudi Arparitna, Ketut Yudi Komang Ady Widayana Komang Alit Artha Wiguna Komang Alit Artha Wiguna Kurnia, Prajnaariayi Prawira Kurniajaya, I Gusti Agung Made Wibisana Kurniyanta, I P Kurniyanta, I Putu Kusuma, Oscar Indra Labobar, Otniel Adrians Labobar, Otniel Andrians Leo, Joseph Nelson Lesmana, Pita Mora Leton, Yohanes PT Made Agus Kresna Sucandra Made Agus Kresna Sucandra, Made Agus Kresna Made Bagus Cahya Maha Putra Made Widnyana Made Wiryana Marilaeta Cindryani Marilaeta Cindryani Lolobali, Marilaeta Cindryani Marilaeta Cindryani, Marilaeta Marting, Millenia Mauritius Septa Murti, Dede Taruna Kreisnna Nada, I Ketut Wibawa Nandaswari, Ni Made Nilam Narakusuma, I Putu Fajar Ni Nyoman Sri Budayanti Ni Putu Novita Pradnyani, Ni Putu Novandi Kurniawan Pande Nyoman Kurniasari, Pande Panji, I PAS Patricia, Yoshie Pontisomaya Parami Pramana, Putu Bagus Gin Gin Pranoto, Theodorus Pascalis Yullie Pratana, Yolanda Jenny Putu Agus Surya Panji Putu Gede Ary Sanjaya Putu Herdita Sudiantara, Putu Herdita Putu Kurniyanta Putu Pramana Suarjaya Ra Ratumasa, Marilaeta Cindryani Raka-Sudewi A. A. Ratumasa, Marilaeta Cindryani Ra Reynaldi Reiky Hadiwijaya Riko Riko Santo, Budi Saputra, Darmawan Jaya Satoto D., Satoto Satria Pinanditas S Sidabutar, Beny Pratama Sidemen, I Gusti Ayu Eka Para Santi Sidemen, I.G.P.Sukrana Sidemen, IGP Sukrana Sonni Soetjipto, Sonni Sri Maliawan Stefanus Taofik stefanus taofik, stefanus Suarjaya, I PP Suastika, I Gede Juli Sucandra, I Made Agus Kresna Sucandra, I MK Sumanti, Alan F. A. Sunanda Naibaho Sunto, Sunto Suranadi , I Wayan Suryadi N. T., Suryadi N. Suryana, I Ketut Syamsuddin, Johanis Bosco Troy Tanuwijaya, Tommy M Tirta, Ian Tjahya Aryasa Tjahya Aryasa Tjahya Aryasa E M Tjokorda Gde Bagus Mahadewa Togi Stanislaus Patrick Virayanti, Luh Putu Diah W. A., W. Wardani, Dinar Kusuma Welly, Julian Widnyana, I MG Widyana, I Made Gede Wiranata, Jeremia Alvian Wiryana M., Wiryana Yadikusumo, Andrian Yustisia, Putu Ngurah Krisna Denta