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All Journal BALI MEDICAL JOURNAL (BMJ) E-Jurnal Medika Udayana MNJ (Malang Neurology Journal) Bali Journal of Anesthesiology Syntax Literate: Jurnal Ilmiah Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research PREPOTIF : Jurnal Kesehatan Masyarakat Neurologico Spinale Medico Chirurgico Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Anesthesiology and Clinical Research Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif
I Gusti Ngurah Mahaalit Aribawa
Department Of Anesthesiology, Pain Management, And Intensive Care, Faculty Of Medicine, Udayana University, Sanglah General Hospital, Denpasar-Bali, Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Physics Public Health Social Sciences Other

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STUDI POLA PENANGANAN NYERI BERAT KANKER DI RSUP SANGLAH OLEH TIM ANESTHESIA PAIN SERVICE (APS) Ni Made Ayu Candrayuni; IGN Mahaalit Aribawa; I Wayan Aryabiantara
E-Jurnal Medika Udayana Vol 8 No 8 (2019): Vol 8 No 8 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (265.98 KB)

Abstract

Nyeri kanker merupakan salah satu manifestasi klinis yang kerap dirasakan oleh pasien kanker, baik berupa akut maupun kronis. Rumah Sakit Umum Pusat Sanglah sebagai rumah sakit rujukan diharapkan dapat memberikan penanganan nyeri yang efektif kepada pasien dan diwujudkan dengan terbentuknya tim Anesthesia Pain Service (APS). Tujuan dari penelitian ini untuk mengetahui pola penanganan nyeri berat kanker di RSUP Sanglah dan tingkat kepuasan pasien. Penelitian ini merupakan longitudinal non-eksperimental. Pengambilan data dilakukan secara prospektif terhadap pasien pada bulan Juni hingga Agustus 2017. Sampel berjumlah 50 orang yang ditentukan dengan teknik total population sampling. Responden terbanyak merupakan pasien perempuan dengan kelompok umur lansia awal. Regimen analgetika yang diberikan adalah opioid kuat dan kombinasi yang diberikan dengan teknik yang beragam meliputi Patient Controlled Analgesia (PCA), oral, IV, syringe pump, dan patch. Penanganan nyeri berat kanker di RSUP Sanglah menggunakan analgetika opioid dan kombinasi dengan konsep multimodalitas dengan berbagai teknik dan pola perubahannya. Kata kunci: Nyeri kanker, teknik pemberian analgetik, tingkat kepuasan
MANAGEMENT OF ACUTE PAIN IN PATIENT WITH PATIENT-CONTROLLED ANALGESIA Siska Permanasari Sinardja; IGN Mahaalit Aribawa
E-Jurnal Medika Udayana vol 2 no 9 (2013):e-jurnal medika udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (190.401 KB)

Abstract

Acute and chronic pain each has its own challenges because these patients are often dependent on opioids and have many psychosocial factors. None of these methods of pain control are superior than others. However, one method to gain control quickly to acute pain is to use a patient-controlled analgesia (PCA). PCA is generally assumed that intravenous opioid administration, on-demand, intermittent under the control of patients. There are some advantages and disadvantages of using PCA for acute or chronic pain management. Therefore shall consider pathways, opioid type, dose and dosage regimen initial adjustment, and management of side effects.
GAMBARAN INTENSITAS NYERI PASIEN PASCA-OPERASI ABDOMEN BAWAH DI RSUP SANGLAH Komang Alit Artha Wiguna; I Gusti Ngurah Mahaalit Aribawa; I Wayan Aryabiantara; Tjokorda Gde Agung Senapathi
E-Jurnal Medika Udayana Vol 10 No 8 (2021): Vol 10 No 08(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i8.P17

Abstract

ABSTRAK Pelaporan nyeri masing-masing individu sangat subjektif. Banyak studi yang telah mempelajari faktor-faktor yang mempengaruhi intensitas nyeri pasca-operasi. Penelitian ini dilakukan guna mengetahui gambaran intensitas nyeri pada pasien pasca-operasi abdomen bawah di RSUP Sanglah. Desain penelitian ini merupakan deskriptif cross-sectional. Teknik pengambilan sampel berupa total sampling yang berasal dari rekam medis pasien pasca operasi abdomen bawah di RSUP Sanglah periode Januari hingga Juli 2018 yang memenuhi kriteria inklusi dan tidak memenuhi kriteria eksklusi. Sampel yang terkumpul sejumlah 99 pasien. Tercatat nyeri ringan mendominasi kejadian nyeri baik pada pasien perempuan dan laki-laki. Begitupula pada semua kelompok umur yang sebagian besar lebih banyak mengalami nyeri ringan. Pada pasien berpendidikan rendah dan tinggi, nyeri ringan juga paling sering terjadi. Serta pada pasien dengan dan tanpa premedikasi, nyeri ringan juga lebih banyak terjadi. Dan pada kelompok pasien pasca-appendectomi dan laparotomi TAH, nyeri ringan lebih banyak dikeluhkan dari intensitas nyeri lainnya.Nyeri ringan merupakan intesitas nyeri yang paling sering dialami oleh pasien pasca-operasi abdomen bawah. Kata kunci: Jenis kelamin, usia, tingkat pendidikan, premedikasi, jenis operasi, intensitas nyeri, pasien pasca-operasi abdomen bawah, RSUP Sanglah
GAMBARAN INTENSITAS NYERI PASIEN PASCA-OPERASI ABDOMEN BAWAH DI RSUP SANGLAH Komang Alit Artha Wiguna; I Gusti Ngurah Mahaalit Aribawa; I Wayan Aryabiantara; Tjokorda Gde Agung Senapathi
E-Jurnal Medika Udayana Vol 9 No 11 (2020): Vol 9 No 11(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2020.V09.i11.P11

Abstract

ABSTRAK Pelaporan nyeri masing-masing individu sangat subjektif. Banyak studi yang telahmempelajari faktor-faktor yang mempengaruhi intensitas nyeri pasca-operasi. Penelitian inidilakukan guna mengetahui gambaran intensitas nyeri pada pasien pasca-operasi abdomen bawah diRSUP Sanglah. Desain penelitian ini merupakan deskriptif cross-sectional. Teknik pengambilansampel berupa total sampling yang berasal dari rekam medis pasien pasca operasi abdomen bawahdi RSUP Sanglah periode Januari hingga Juli 2018 yang memenuhi kriteria inklusi dan tidakmemenuhi kriteria eksklusi. Sampel yang terkumpul sejumlah 99 pasien. Tercatat nyeri ringanmendominasi kejadian nyeri baik pada pasien perempuan dan laki-laki. Begitupula pada semuakelompok umur yang sebagian besar lebih banyak mengalami nyeri ringan. Pada pasienberpendidikan rendah dan tinggi, nyeri ringan juga paling sering terjadi. Serta pada pasien dengandan tanpa premedikasi, nyeri ringan juga lebih banyak terjadi. Dan pada kelompok pasien pascaappendectomi dan laparotomi TAH, nyeri ringan lebih banyak dikeluhkan dari intensitas nyerilainnya.Nyeri ringan merupakan intesitas nyeri yang paling sering dialami oleh pasien pasca-operasiabdomen bawah. Kata kunci: Jenis kelamin, usia, tingkat pendidikan, premedikasi, jenis operasi, intensitas nyeri,pasien pasca-operasi abdomen bawah, RSUP Sanglah
STUDI POLA PENANGANAN NYERI BERAT KANKER DI RSUP SANGLAH OLEH TIM ANESTHESIA PAIN SERVICE (APS) Ni Made Ayu Candrayuni; IGN Mahaalit Aribawa; I Wayan Aryabiantara
E-Jurnal Medika Udayana Vol 8 No 8 (2019): Vol 8 No 8 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (265.98 KB)

Abstract

Nyeri kanker merupakan salah satu manifestasi klinis yang kerap dirasakan oleh pasien kanker,baik berupa akut maupun kronis. Rumah Sakit Umum Pusat Sanglah sebagai rumah sakit rujukandiharapkan dapat memberikan penanganan nyeri yang efektif kepada pasien dan diwujudkan denganterbentuknya tim Anesthesia Pain Service (APS). Tujuan dari penelitian ini untuk mengetahui polapenanganan nyeri berat kanker di RSUP Sanglah dan tingkat kepuasan pasien. Penelitian ini merupakanlongitudinal non-eksperimental. Pengambilan data dilakukan secara prospektif terhadap pasien pada bulanJuni hingga Agustus 2017. Sampel berjumlah 50 orang yang ditentukan dengan teknik total populationsampling. Responden terbanyak merupakan pasien perempuan dengan kelompok umur lansia awal.Regimen analgetika yang diberikan adalah opioid kuat dan kombinasi yang diberikan dengan teknik yangberagam meliputi Patient Controlled Analgesia (PCA), oral, IV, syringe pump, dan patch. Penanganannyeri berat kanker di RSUP Sanglah menggunakan analgetika opioid dan kombinasi dengan konsepmultimodalitas dengan berbagai teknik dan pola perubahannya. Kata kunci: Nyeri kanker, teknik pemberian analgetik, tingkat kepuasan.
Antifungals patterns in critical patients with candidiasis in the intensive care units at Sanglah General Hospital 2019 Komang Ady Widayana; I Wayan Aryabiantara; Tjokorda Gde Agung Senapathi; I Wayan Suranadi; I Gusti Ngurah Mahaalit Aribawa
Neurologico Spinale Medico Chirurgico Vol 2 No 3 (2019)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (378.685 KB) | DOI: 10.36444/nsmc.v2i3.83

Abstract

Abstract Introduction: The prompt initiation of appropriate antifungal therapy is essential in controlling invasive candidiasis and improving the prognosis in critical patients undergoing treatment in the Intensive Care Unit. Candida Score can assess patients at risk of candidiasis and is expected to assist clinicians in starting antifungal therapy in patients suspected Candidiasis. The purpose of this study was to determine the pattern of antifungal administration in critically ill patients with candidiasis in the Intensive Care Unit at Sanglah General Hospital. Patients and Methods: The design of this study is a cross-sectional descriptive study involving critically ill patients who were under treatment in Intensive Care Unit of Sanglah General Hospital from Januari to June 2019. The patients included in this study were patients who were ≥ 18 years old and under treatment in ICU for at least 7 days. Results: There are 64 patients undergoing treatment in the Intensive Care Unit. From 64 patients, 6 pasien had CS = 0, 29 patients had CS = 1, 13 patients had CS = 2, 11 patients had CS = 3, 5 patients had CS = 4, and no patients had CS = 5. Eleven patients received empirical antifungal therapy. All empirical antifungal therapies use the Triazole group. Conclusion: In this study was found that 11 of 16 patients with a CS value of ≥ 2.5 were given empirical antifungal therapy, while 48 patients with a CS value of <2.5 were not given empirical antifungal therapy. Keywords: Invasive Candidiasis, Candida Score, Empirical Antifungal Therapy.
The relation between sex, age, education level, and premedication towards lower-abdominal postoperative pain intensity at Sanglah General Hospital Komang Alit Artha Wiguna; I Gusti Ngurah Mahaalit Aribawa; I Wayan Aryabiantara; Tjokorda Gde Agung Senapathi
Neurologico Spinale Medico Chirurgico Vol 3 No 1 (2020)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v3i1.93

Abstract

Introduction: Pain reporting is very subjective. Several studies reveal sex, age, education level, and premedication have impacts on postoperative pain intensity. However, other studies report no relationship between these factors to pain intensity. There only a few researches on pain predictors in Bali, so this study conducts to determine relation between sex, age, education level, and premedication towards lower-abdominal postoperative pain intensity at Sanglah Hospital. Patients and Methods: This is an analytic cross-sectional study. The data were collected from medical records of patients after lower abdominal surgery at Sanglah Hospital from January to July 2018 and fit to inclusion criteria and did not suit to exclusion criteria. Data of patients characteristic were collected to indentify their relation toward pain intensity on the first day. Results: There were 99 patients post-lower abdominal surgery included in this study. The mean pain intensity based on sex was 2.83±0.87 for males and 2.98 ± 1.16 for females. Whereas based on ages were 3.04±1.11 for young, 2.90±0.95 for adults, and 2.40±0.96 for elderly. Based on the education level 2.40±1.26 in elementary educated patient, 2.72±1.27 in patients with junior high education, 2.96±1.04 in patients with high school education, and 3.15±0.74 in college patients. The average of pain in patients with premedication is 2.81±0.94 while the patient without premedication is 3.81±1.16. After performing correlation test, only the premedication factor showed a significant impact (p <0.05) to the pain intensity. Conclusion: Therefore, premedication has a greater impact than the other factor toward postoperative pain intensity at Sanglah Hospital.
Contact force exerted on the maxillary incisors by direct laryngoscopy with mcgrath video laryngoscope in predicted difficult intubation Doddy Setiawan; Tjokorda Gde Agung Senapathi; I Gede Budiarta; I Gusti Ngurah Mahaalit Aribawa
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.v4i2.162

Abstract

Patients with difficult airways who are going to undergo surgery under general anesthesia require special consideration from an anesthesiologist. Knowing the most significant risk of morbidity and mortality is often due to difficult cases of airway management. One of the most common complications and often becomes lawsuits in the field of anesthesia is dental trauma that occurs during the intubation process due to contact from laryngoscope blade to the teeth. This descriptive study will show the measured force exerted on the maxillary incisors at the time of performing laryngoscopy using a McGrath video laryngoscope in patients with a potentially difficult intubation (LEMON criteria ≥ 3). The contact force exerted on the maxillary incisors is measured using a special instrument. The contact force exerted on the maxillary incisors in patients with a potentially problematic airway was discovered to vary.
CEREBRAL VENOUS SINUS THROMBOSIS WITH GOOD RESPONSE TO HEPARINIZATION THERAPY: TWO CASE REPORT AND DIAGNOSTIC ALGORITHM Indah, Carolin Tiara Lestari; Tini, Kumara; Susilawathi, Ni Made; Wijayanti, Ida Ayu Sri; Mahadewi, Ni Putu Ayu Putri; Pramaswari, Anak Ayu Agung; Mahaalit Aribawa, I Gusti Ngurah; Dewi, Putu Utami; Krisnawardhani Kumbara, Cokorda Istri Yuliandari
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.02.17

Abstract

Cerebral venous sinus thrombosis (CVST) is an uncommon condition of cerebral venous sinus thrombosis with a varied clinical presentation that can be diagnostically challenging. Intravenous heparin is the optimal immediate anticoagulant according to the European Academy of Neurology (EAN) guideline 2017. This report aims to describe highly suspicious CVST clinical features and suggest a diagnostic algorithm based on two cases of CVST found in our center. The first case is a 52-year-old man who presented with serial seizures preceded by subacute headache and diparesis. Non-contrast head CT (NCCT) showed multifocal haemorrhages and cord signs. The second case is a 19-year-old woman who presented with slowly decreased consciousness, headache, and a history of upper respiratory infection. Diffuse cerebral edema was revealed in NCCT. Both of these patients had thrombosis in superior sagittal sinus, right transverse, and sigmoid sinus. Heparinization was conducted and continued with rivaroxaban with a good response. CVST is rare case and often unrecognized; since it has serious complications, early diagnosis and treatment improve prognosis and survival.
Successful Post-Resuscitation Care in End-Stage Renal Disease Patients: A Case Report Merry; Made Septyana Parama Adi; I Gusti Agung Gede Utara Hartawan; I Gusti Ngurah Mahaalit Aribawa; I Putu Fajar Narakusuma; I Gusti Agung Made Wibisana Kurniajaya
Journal of Anesthesiology and Clinical Research Vol. 6 No. 1 (2025): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v6i1.673

Abstract

Introduction: Cardiac arrest in end-stage renal disease (ESRD) patients presents unique challenges due to their complex medical conditions. Post-resuscitation care for these patients requires careful management of various factors, including hemodynamic instability, electrolyte imbalances, and fluid overload. This case report describes the successful post-resuscitation care of an ESRD patient who experienced cardiac arrest and achieved a return of spontaneous circulation (ROSC). Case presentation: A 50-year-old female with ESRD on hemodialysis (HD) presented with acute dyspnea and cardiac arrest. After 8 minutes of cardiopulmonary resuscitation (CPR), ROSC was achieved. The patient was managed with a comprehensive post-resuscitation care protocol, including brain resuscitation (targeted temperature management, ventilation optimization, and hemodynamic control) and sustained low-efficiency dialysis for fluid balance. Despite the severity of her condition, the patient showed significant neurological recovery and was successfully extubated after 7 days of mechanical ventilation. She was discharged after 12 days with follow-up for her chronic conditions. Conclusion: This case highlights the importance of individualized management strategies for ESRD patients post-cardiac arrest, including the need for prolonged resuscitation and careful monitoring to improve patient outcomes.
Co-Authors Adinda Putra Pradhana Anak Agung Gde Adistaya Christopher Ryalino Dewi, Dewa Ayu Mas Shintya Dewi, Putu Utami Doddy Setiawan Eka Nantha Kusuma, Putu Elisma Nainggolan, Elisma Emkel Perangin Angin, Emkel Gede Semarawima, Gede Gusti Agung Made Wibisana Kurniajaya Hengky Hengky, Hengky I Gede Budiarta I Gede Prima Julianto I Gusti Agung Gede Utara Hartawan I Gusti Agung Made Wibisana Kurniajaya I Ketut Sinardja I Ketut Wibawa Nada I Made Gede Widnyana I Made Prema Putra I Putu Agus Surya Panji I Putu Fajar Narakusuma I Wayan Aryabiantara, I Wayan I Wayan Suranadi Ida Ayu Sri Wijayanti Ida Bagus Krisna Jaya Sutawan IGNA Putra Arimbawa, IGNA Putra Indah, Carolin Tiara Lestari Kadek Agus Heryana Putra Kadek Agus Heryana Putra, Kadek Agus Ketut Semara Jaya, Ketut Semara Komang Ady Widayana Komang Alit Artha Wiguna Komang Alit Artha Wiguna Krisnawardhani Kumbara, Cokorda Istri Yuliandari Leton, Yohanes PT Made Agus Kresna Sucandra, Made Agus Kresna Made Bagus Cahya Maha Putra Made Septyana Parama Adi Made Wiryana Mahadewi, Ni Putu Ayu Putri Merry Ni Made Ayu Candrayuni Pande Nyoman Kurniasari, Pande Parama Adi, Made Septyana Pontisomaya Parami Pramaswari, Anak Ayu Agung Ra Ratumasa, Marilaeta Cindryani Riko Riko Saputra, Darmawan Jaya Sidemen, I Gusti Ayu Eka Para Santi Siska Permanasari Sinardja Sonni Soetjipto, Sonni Susilawathi, Ni Made Syamsuddin, Johanis Bosco Troy Tini, Kumara Tjokorda Gde Agung Senapathi Togi Stanislaus Patrick Yuliana, Astrid