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All Journal BALI MEDICAL JOURNAL (BMJ) E-Jurnal Medika Udayana Bali Journal of Anesthesiology Syntax Literate: Jurnal Ilmiah Indonesia PREPOTIF : Jurnal Kesehatan Masyarakat Scientia Psychiatrica Neurologico Spinale Medico Chirurgico Jurnal Kesmas Asclepius Archives of The Medicine and Case Reports COMSERVA: Jurnal Penelitian dan Pengabdian Masyarakat Journal of Anesthesiology and Clinical Research Riwayat: Educational Journal of History and Humanities Jurnal Anestesi dan Terapi Intensif Udayana
Pontisomaya Parami
Department Of Anesthesiology And Intensive Care, Faculty Of Medicine, Udayana University, Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences Other

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The correlation between the depth extent of Tuohy epidural needle with body mass index (BMI) to achieve loss of resistance in patients undergoing epidural anesthesia Hartawan, I Gusti Agung Gede Utara; Senapathi, Tjokorda Gde Agung; Aribawa, I Gusti Ngurah Mahaalit; Parami, Pontisomaya; Pradhana, Adinda Putra; Syamsuddin, Johanis Bosco Troy
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (172.208 KB) | DOI: 10.15562/bjoa.v3i1.119

Abstract

ABSTRACTBackground: Anesthesia management in obesity is quite challenging. Epidural anesthesia become one of the choices. The attention should be addressed in order to prevent the misidentification of epidural space. The estimation of the depth extent of epidural space becomes crucial, especially in obese patients due to an accumulation of subcutaneous and epidural adipose tissue, which consequently complicate the epidural catheter insertion. This study aimed to analyze the correlation of the depth extent of Tuohy epidural needle to achieve loss of resistance between normal-weighted and obese patients.Method: This study was conducted with 56 adult patients aged 17 to 65 years who underwent elective surgery by epidural anesthesia inserted at level L2-L3 or L3-L4 interspace. Subjects are divided into normal and obese groups. Shapiro-Wilk and chi-square tests were used in the normality test. For normally distributed data, an independent t-test was used to test the hypothesis, otherwise, we used Mann-Whitney test  Results: The results showed that the loss of resistance in epidural needle insertion procedures was 60 mm in a patient with BMI more than 30 kg/m2 and 50 mm in those with BMI <30 kg/m2 (p<0.001).Conclusion: The loss of resistance depth in epidural Tuohy needle insertion is significantly determined by BMI. 
Cost Minimization Analysis of Hypnotic Drug: Target Controlled Inhalation Anesthesia (TCIA) Sevoflurane and Target Controlled Infusion (TCI) Propofol Wiryana, Made; Aribawa, I Gusti Ngurah Mahaalit; Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Hartawan, I Gusti Agung Gede Utara; Sucandra, Made Agus Kresna; Parami, Pontisomaya; Putra, Kadek Agus Heryana; Sutawan, IB Krisna Jaya; Arimbawa, IGNA Putra; Jaya, Ketut Semara; Semarawima, Gede
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
Publisher : BALI MEDICAL JOURNAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (379.823 KB)

Abstract

Background: Cost minimization analysis is a pharmaco-economic study used to compare two or more health interventions that have been shown to have the same effect, similar or equivalent. With limited health insurance budget from the Indonesian National Social Security System implementation in 2015, the quality control and the drug cost are two important things that need to be focused. The application of pharmaco-economic study results in the selection and use of drugs more effectively and efficiently. Objective: To determine cost minimization analysis of hypnotic drug between a target controlled inhalation anesthesia (TCIA) sevoflurane and a target controlled infusion (TCI) propofol in patients underwent a major oncologic surgery in Sanglah General Hospital. Methods: Sixty ASA physical status I-II patients underwent major oncologic surgery were divided into two groups. Group A was using TCIA sevoflurane and group B using TCI propofol. Bispectral index monitor (BIS index) was used to evaluate the depth of anesthesia. The statistical tests used are the Shapiro-Wilk test, Lavene test, Mann- Whitney U test and unpaired t-test (? = 0.05). The data analysis used the Statistical Package for Social Sciences (SPSS) for Windows. Results: In this study, the rate of drug used per unit time in group A was 0.12 ml sevoflurane per minute (± 0.03) and the group B was 7.25 mg propofol per minute (±0.98). Total cost of hypnotic drug in group A was IDR598.43 (IQR 112.47) per minute, in group B was IDR703.27 (IQR 156.73) per minute (p>0.05). Conclusions: There was no statistically significant difference from the analysis of the drug cost minimization hypnotic drug in a major oncologic surgery using TCIA sevoflurane and TCI propofol.
Effectivity battle between C-MAC and McGrath® video laryngoscope in a patient with general anesthesia at Sanglah Hospital: A pilot study Jhoni Pardomuan Pasaribu; Tjokorda Gde Agung Senapathi; Pontisomaya Parami
Neurologico Spinale Medico Chirurgico Vol 4 No 2 (2021)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v4i2.161

Abstract

Background: Intubation is a common essential procedure to maintain the airway during general anesthesia. Various video laryngoscopes (VL) on the market today assist anesthesiologists in improving intubation success rates and also in complicated airway cases. There are two types of VL found in our institution, which are C-MAC and McGrath®. Each of them has its pros and cons, which withdrawn our curiosity to compare their effectiveness. Methods: A pilot study was conducted in our center; we included all patients undergoing general anesthesia with physical status ASA I-III and consent to the study and divide them into two groups, C-MAC and McGrath®. We compare C-MAC and McGrath® VL effectiveness in terms of time for intubation, ease of intubation, total attempt, failure to intubate, Cormack Lehane degree, POGO Score, and hemodynamic stability. Results: A total of 20 patients were intubated with two different VL, ten patients for each group. Both VLs accommodate ease of intubation, and overall first attempt successful intubation, though C-MAC showed better laryngeal and glottic visualization, shorter tracheal intubation times, and less hemodynamic change. Conclusion: C-MAC gives better results in laryngeal and glottic visualization, shorter tracheal intubation times, and less hemodynamic change.
Prothrombin Complex Concentrate as a Key Adjunct in Massive Hemorrhage Management in Placenta Accreta Spectrum Disorder: A Case Report Pramana, Putu Bagus Gin Gin; Tjokorda Gde Agung Senapathi; Pontisomaya Parami; Tjahya Aryasa
Archives of The Medicine and Case Reports Vol. 5 No. 3 (2024): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v5i3.599

Abstract

Placenta accreta spectrum disorder (PASD) is a severe obstetric complication associated with significant hemorrhage risk. This report highlights the successful use of prothrombin complex concentrate (PCC) as part of a multidisciplinary approach to managing a case of massive hemorrhage in PASD. A 36-year-old woman, G3P2002, at 33 weeks gestation, diagnosed with placenta previa totalis and suspected PASD, underwent a planned cesarean hysterectomy. The surgery was complicated by 5200 mL hemorrhage due to placental invasion and bladder injury. Hemodynamic instability was managed with massive transfusion protocol activation, including PCC, tranexamic acid, and packed red blood cells. Intra-abdominal packing was performed for hemostasis, and the bladder injury was repaired. Continued PCC administration in the ICU, along with other supportive measures, resulted in hemorrhage control and stabilization. The patient was successfully extubated and discharged after a second surgery to remove packing. This case emphasizes the vital role of PCC in the multidisciplinary management of massive hemorrhage in PASD. Early recognition of PASD risk factors and prompt intervention, including PCC administration, are crucial for optimal maternal outcomes.
Angka kejadian nyeri kepala pasca anestesia spinal pada pasien paskaoperasi seksio sesarea Parami, Pontisomaya; Wiryana, Made; Senapathi, Tjokorda Gde Agung; Ryalino, Christopher; Pradhana, Adinda Putra; Narakusuma, I Putu Fajar
E-Jurnal Medika Udayana Vol 11 No 12 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i12.P02

Abstract

Nyeri kepala pasca anestesia spinal merupakan salah satu resiko dari anestesi neuraksial yang terjadi setelah prosedur anestesi spinal akibat tusukan dural atau robekan selama dilakukannya anestesi yang dapat disertai dengan gejala mual, muntah, serta gangguan pendengaran dan penglihatan. Tujuan penelitian ini adalah untuk melihat angka kejadian nyeri kepala pasca spinal anestesia pada pasien pasca operasi seksio sesarea di RSUP Sanglah Denpasar. Penelitian ini merupakan penelitian deskriptif potong lintang yang dilakukan terhadap semua pasien yang menjalani operasi dengan teknik anestesia spinal di RSUP Sanglah Denpasar selama periode tiga bulan di tahun 2021. Sebanyak tiga sampel dieksklusi karena sebelumnya telah memiliki riwayat nyeri kepala, sehingga diperoleh total 109 sampel. Kuisioner diisi sesuai jawaban responden pada hari ke-2 dan ke-5 paskaoperasi. Hasil penelitian menunjukkan angka kejadian nyeri kepala pasca anestesia spinal pada hari kedua dan hari kelima paskaoperasi adalah sama yaitu sebesar 2%, seluruhnya merupakan nyeri kepala dengan derajat ringan.
INCIDENCE OF HYPOTENSION AND NAUSEA VOMITING IN SUBARACHNOID BLOCK ANESTHESIA TECHNIQUE IN CESAREAN SURGERY Nandaswari, Ni Made Nilam; Parami, Pontisomaya; Suranadi, I Wayan; Senapathi, Tjokorda Gde Agung
E-Jurnal Medika Udayana Vol 13 No 3 (2024): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2024.V13.i03.P03

Abstract

Hypotension and nausea vomiting are common side effects in patients undergoing cesarean surgery with subarachnoid block anesthesia techniques. Cases of hypotension and nausea vomiting in this case are often found but research data in Indonesia, especially in Bali, is still very limited. Therefore, this research is important to do with the aim of knowing the incidence of hypotension and nausea vomiting in cesarean surgery with the subarachnoid block anesthesia technique at Prof. Dr. I.G.N.G Ngoerah General Hospital Denpasar. This study used a prospective cross-sectional observational descriptive method. The study data were taken from the presence or absence of hypotension and nausea vomiting during and after cesarean surgery from April 2022 – June 2022. The data were analyzed using Microsoft Excel 2013 software to obtain characteristics of patient demographic data in the form of maternal age and gestational age, patient distribution based on height of sensory blockade, type and dose of antiemetics, type and dose of opioids, bleeding, incidence of hypotension, and incidence of nausea vomiting. The results showed that the number of patients who experienced hypotension was 13 people (28.3%), and those who did not experience hypotension were 33 people (71.7%). A total of 30 people (65.2%) patients did not experience nausea vomiting, 8 people (17.4%) experienced nausea and 8 people (17.4%) experienced vomiting. By taking good precautions, it can reduce the side effects of hypotension and nausea vomiting.
Overview of Acute Kidney Injury (AKI) in the Intensive Care Unit: Observational Study at Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar, Indonesia Pontisomaya Parami; Tjokorda Gde Agung Senapathi; Gede Wirya Kusuma Duarsa; Pramana, Putu Bagus Gin Gin
Journal of Anesthesiology and Clinical Research Vol. 5 No. 3 (2024): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v5i3.555

Abstract

Introduction: Acute kidney injury (AKI) is a serious clinical syndrome with complications that can be life-threatening. AKI is associated with increased length of stay and mortality in patients in the intensive care unit (ICU). This study aims to determine the incidence and characteristics of AKI in ICU patients at Prof. Dr. I.G.N.G Ngoerah General Hospital Denpasar. Methods: This descriptive observational research was conducted by collecting data from medical records of ICU patients for three months. Data were analyzed to determine the incidence of AKI, stage of severity, and mortality rate. Results: Of the 388 patients treated in the ICU, 87 (22.37%) experienced AKI. The mortality rate in AKI patients was 12.9% (n=50). A total of 11.05% (n=25) of AKI patients were classified as stage 1, 5.91% (n=17) as stage 2, and 5.40% (n=8) as stage 3. Conclusion: The incidence of AKI in the ICU of Prof. Dr. I.G.N.G Ngoerah General Hospital Denpasar. is quite high (22.37%). AKI is associated with a significant mortality rate (12.9%). This study provides a preliminary description of the incidence and characteristics of AKI in the ICU of this hospital, which may be useful for improving the quality of patient care and prevention of AKI.
Risk Factors of Perioperative Anxiety Levels in Sectio Caesarea Patients: A Cross-Sectional Study in Single Center, Bali, Indonesia Anak Agung Angga Pringga Dana; Pontisomaya Parami; Kadek Agus Heryana Putra; I Gusti Agung Gede Utara Hartawan
Scientia Psychiatrica Vol. 6 No. 3 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i1.181

Abstract

Introduction: Anxiety is a prevalent emotional response in patients undergoing surgical procedures, including cesarean sections. Perioperative anxiety can negatively impact patient outcomes, affecting physiological parameters and postoperative recovery. This study aimed to identify the prevalence and risk factors associated with perioperative anxiety levels in patients undergoing cesarean section at Prof. Dr. I.G.N.G. Ngoerah Hospital, Bali, Indonesia. Methods: This cross-sectional study involved 37 patients scheduled for elective cesarean section at Prof. Dr. I.G.N.G. Ngoerah Hospital. Anxiety levels were assessed using the Perioperative Anxiety Scale (PASS), a validated instrument for measuring anxiety related to surgery. Data on sociodemographic characteristics, obstetric history, and medical history were collected through a questionnaire. Descriptive statistics and logistic regression analysis were used to analyze the data. Results: The majority of participants (59.5%) experienced mild to moderate anxiety levels. Age, occupation, education level, history of emergency surgery, previous surgical history, and gravidity were identified as potential risk factors associated with higher anxiety levels. Patients aged 25-29 years, housewives, those with a high school education, a history of emergency surgery, previous surgical experience, and primiparity were more likely to report mild to moderate anxiety. Conclusion: Mild to moderate anxiety is prevalent among cesarean section patients. Identifying risk factors associated with perioperative anxiety can aid healthcare providers in implementing targeted interventions to reduce anxiety and improve patient well-being.
Tinjauan Post Operative Cognitive Dysfunction (POCD) pada Pasien Geriatri Pasca Anestesi: Perspektif Klinis Darma Putri, Anak Agung Pranikencana; Kresna Sucandra, I Made Agus; Parami, Pontisomaya
Jurnal Kesmas Asclepius Vol 7 No 1 (2025): Jurnal Kesmas Asclepius
Publisher : Institut Penelitian Matematika, Komputer, Keperawatan, Pendidikan dan Ekonomi (IPM2KPE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31539/jka.v7i1.13229

Abstract

This study aims to determine the incidence and characteristics of POCD in geriatric patients’ post-anesthesia at RSUP Prof. Dr. I.G.N.G. Ngoerah using a descriptive prospective method. The results showed a POCD incidence rate of 60.5%, highest among patients aged ≥70 years. Females experienced POCD more frequently (77.8%) than males (48%). POCD was most prevalent among respondents without formal education (100%). The highest incidence was found in oncology, trauma, and vascular surgeries. Based on duration, the highest POCD occurrence was in medium-duration surgeries (71.4%), followed by major (60%) and minor surgeries (50%). General anesthesia showed a higher POCD incidence (63.6%) compared to regional anesthesia (57.1%). The conclusions of this study emphasize the importance of focusing on geriatric patients, especially those aged ≥70 years, females, and certain surgery types. The implications of this study emphasize the need for safer anesthesia protocols and personalized recovery strategies to reduce the risk of POCD. Keywords: Geriatric, POCD, Post-Anesthesia.
Penggunaan Anestesi Bebas Opioid pada Operasi Modified Radical Mastectomy Pamudji, Ivan Sebastian; Sidemen, I Gusti Putu Sukrana; Parami, Pontisomaya
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i3.57751

Abstract

Manajemen nyeri pada kanker payudara merupakan proses yang kompleks dan melibatkan berbagai faktor, di mana penggunaan opioid sering kali menjadi terapi standar. Meskipun opioid efektif untuk mengatasi nyeri, penggunaannya dapat menyebabkan efek samping seperti depresi pernapasan, nyeri kronik pascaoperasi, dan ketergantungan. Anestesia tanpa opioid (OFA) adalah teknik anestesi yang tidak menggunakan opioid sistemik, neuraksial, atau intrakavitas selama prosedur intraoperatif dan perioperatif. Laporan kasus ini membahas penerapan OFA pada mastektomi radikal modifikasi, dengan tujuan untuk mengeksplorasi alternatif pengelolaan nyeri yang lebih aman dan efisien bagi pasien kanker payudara. Metode yang digunakan dalam laporan ini adalah observasi klinis pada pasien yang menjalani mastektomi radikal modifikasi dengan menggunakan OFA sebagai pendekatan anestesi utama. Hasil dari laporan ini menunjukkan bahwa penerapan OFA dapat memberikan pengelolaan nyeri yang efektif tanpa menambah risiko efek samping yang terkait dengan opioid. Kesimpulannya, pemahaman dan penerapan OFA dapat meningkatkan efisiensi dan keamanan anestesi pada pasien bedah kanker, khususnya pada prosedur mastektomi radikal modifikasi.
Co-Authors Adi, Made Septyana Parama Adinda Putra Pradhana Anak Agung Angga Pringga Dana Andi Irawan Andi Kusuma Wijaya, Andi Christopher Ryalino Cynthia Dewi Sinardja Darma Putri, Anak Agung Pranikencana Dharmawan, IGB Adi EM, Tjahya Aryasa Emkel Perangin Angin, Emkel Fikrawan, Putu Filla Jaya Gede Semarawima, Gede Gede Wirya Kusuma Duarsa Hartanto, Wijaya Hartawan , I.G.A.G. Utara Hengky Hengky, Hengky I Gede Budiarta I Gusti Agung Gede Utara Hartawan I Gusti Agung Made Wibisana Kurniajaya, I Gusti Agung Made I Gusti Ngurah Mahaalit Aribawa I Gusti Putu Sukrana Sidemen I Ketut Sinardja I Made Darma Junaedi, I Made I Made Gede Widnyana I Putu Agus Surya Panji I Wayan Aryabiantara, I Wayan I Wayan Suranadi Ida Bagus Krisna Jaya Sutawan IGNA Putra Arimbawa, IGNA Putra Jhoni Pardomuan Pasaribu Junaedi, Made Darma Kadek Agus Heryana Putra Kadek Agus Heryana Putra, Kadek Agus Ketut Semara Jaya, Ketut Semara Kresna Sucandra, I Made Agus Labobar, Otniel Adrians Lusyana*, Lya Made Agus Kresna Sucandra, Made Agus Kresna Made Widnyana Made Wiryana Mahaalit, I Gusti Ngurah Marilaeta Cindryani Lolobali, Marilaeta Cindryani Nandaswari, Ni Made Nilam Narakusuma, I Putu Fajar Ni Putu Novita Pradnyani, Ni Putu Pamudji, Ivan Sebastian Pande Nyoman Kurniasari, Pande Pramana, Putu Bagus Gin Gin Prastiti, Ni Ketut Devi Widhi Putu Kurniyanta Putu Pramana Suarjaya Sidemen, I.G.P.Sukrana Syamsuddin, Johanis Bosco Troy Tirta, Ian Tjahya Aryasa Tjahya Aryasa Tjokorda Gde Agung Senapathi Wardani, Dinar Kusuma