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<![CDATA[Pemberian Opioid Sebagai Manajemen Nyeri pada Pasien Pediatrik ]]>
<![CDATA[Sari, Djayanti]]>;
<![CDATA[Sudadi]]>;
<![CDATA[Hanafi, Irham]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 6 No 3 (2019): Volume 6 Number 3 (2019) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v6i3.7375
<![CDATA[Pain is a complex phenomenon that occurs due to the transmission of nociceptive stimuli from the peripheral nervous system through the spinal cord to the cerebral cortex. Given the complexity of the pain mechanism, effective treatment of pain requires the use of multimodal therapies that target multiple sites along the pain pathways. Opioid receptors decrease the release of excitatory neurotransmitters from terminals carrying nociceptive stimuli.The use of opioids in the management of acute pain in children must be considered when the intensity and the duration of the pain does not respond to the other classes of analgesic drugs. The increase in the knowledge of physiologic and pharmacologic of these medications has reduced the fear of their application in the pediatric field and helped in the recognition and management of side effects, where excessive sedation and severe respiratory depression are the most serious adverse effects of opioids.]]>
<![CDATA[Pengaruh Midazolam Dosis 10 mg/kgbb dan 40 mg/kgbb pada Ekspresi m-RNA Gen BAX di Otak Tikus Wistar ]]>
<![CDATA[Irawan, Tony]]>;
<![CDATA[Sudadi]]>;
<![CDATA[Sari, Djayanti]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 7 No 1 (2019): Volume 7 Number 1 (2019) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v7i1.7391
<![CDATA[Latar Belakang: Neurotransmiter GABA dan NMDA berperan penting pada sel otak yang masih mengalami perkembangan saraf. Secara umum, agen anestesi bekerja pada kedua neurotransmiter tersebut. Midazolam menghambat neurotransmisi dengan cara potensiasi reseptor GABA. Paparan pada reseptor GABA mengganggu perkembangan sel saraf dan memicu terjadinya proses apoptosis yang ditandai dengan peningkatan gen pro apotosis seperti Bax, Bak dan Bim.Metode: Penelitian ini merupakan penelitian experimental control trial, sampel dibagi menjadi 3 kelompok. 27 tikus dibagi menjadi kontrol NaCl 0,9% (n= 9), midazolam 10 mg/kgbb (n= 9), midazolam 40 mg/kgbb (n= 9) disuntikkan secara intraperitoneal. Kemudian otak tikus di setiap kelompok diambil dengan potong beku. Ekspresi gen proapoptosis mRNA Bax kemudian diukur dengan PCR.Hasil: Pemberian midazolam dengan dosis 10 mg/kgbb dan midazolam dosis 40 mg/kgbb terjadi peningkatan ekspresi gen-Bax dan bernilai signifikan < 0,05 jika dibandingkan kelompok kontrol.Kesimpulan : Terdapat peningkatan signifikan ekspresi gen bax pada pemberian midazolam dosis 10 mg/kgbb dan 40 mg/kgbb pada otak tikus wistar yang masih mengalami perkembangan saraf.]]>
<![CDATA[Eras pada Lower Abdominal Surgery ]]>
<![CDATA[Pratomo, Bhirowo Y.]]>;
<![CDATA[Sudadi]]>;
<![CDATA[Gentong, Metia Gledis G.]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v7i2.7460
<![CDATA[Enhanced Recovery After Surgery (ERAS) also known as fast track surgery or Enhanced Recovery Protocol (ERP) is a multimodal-based perioperative management designed to reduce morbidity, length of hospitalization, improve postoperative recovery time and minimize postoperative complications. Key elements of the ERAS protocol include pre-operative counseling, nutrition optimization, analgesic standards and anaesthesia regimens and early mobilization. Lower abdominal surgery and colorectal resection have traditionally been associated with high morbidity and length of hospital stay. ERAS has been shown to improve postoperative recovery, reduce length of stay and increase early return to normal function when compared to traditional colorectal surgical protocols. Recommendations for anaesthesia treatment in patients undergoing gastrointestinal surgery in the ERAS program are issued in an integrated protocol, which can facilitate the involvement of anesthesiologists in the implementation of the ERAS program.]]>
<![CDATA[Manajemen Hemodinamik Menggunakan Electrical Cardiometry (EC) dengan Mempertimbangkan Parameter Makrosirkulasi dan Mikrosirkulasi ]]>
<![CDATA[Sudadi]]>;
<![CDATA[Mahmud]]>;
<![CDATA[Rani, Hajar Rafika]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v7i2.7462
<![CDATA[A 62-year-old woman with peritonitis suspected of intestinal perforation who underwent exploratory laparotomy. Patients with ASA 2 physical status with geriatrics, leukocytosis, hypokalemia, hypoalbuminemia. The patient was under general anesthesia with epidural analgesia. The surgery rans for 5 hours. Postoperative patients were transferred to post-anesthesia care unit (PACU) and EC measurements were carried out before and after postoperative hemodynamic management. Changes in cardiac output seen by EC measurements by considering lactate values as microcirculation parameters can be used to predict hemodynamic responses to fluids.]]>
<![CDATA[Sistem Revised Trauma Score (RTS) sebagai Prediktor Mortalitas Pasien Cedera Otak Traumatik di RSUP Dr. Sardjito ]]>
<![CDATA[Wikantama, Aswin]]>;
<![CDATA[Sudadi]]>;
<![CDATA[Widyastuti, Yunita]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 7 No 3 (2020): Volume 7 Number 3 (2020) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v7i3.7469
<![CDATA[Background: Mortality predictor scores are important as prognosis tool for patients and families and to improve the quality of patient services in hospitals. RTS is easy to use and has been studied in several centers to estimate the prognosis of mortality in traumatic brain injury patients. Dr. Sardjito Hospital has never been investigated regarding the use of RTS mortality predictions in cases of traumatic brain injury. Objective: To validate the Revised Trauma Score (RTS) to predict mortality rates of traumatic brain injury patients in Dr. Sardjito General Hospital. Method: The study was conducted in the Medical Records Installation of Dr. Sardjito General Hospital Yogyakarta by searching the data of patients who were admitted to treatment at the Dr. Sardjito with a diagnosis of traumatic brain injury from 1 January 2018 to 31 December 2018 retrospectively. The RTS prediction number used to predict the number of deaths compared to the actual death rate of the sufferer group (observed death) with the Hosmer and Lemeshow (HL) test. Results: The number of inclusion samples in this study was 325 patients. Discrimination in this study obtained an AUC value of 0.030 (CI 95%: 0.012-0.048)]. The ability of RTS discrimination on the mortality of traumatic brain injury patients is 1-0.030 = 0.970 or 97%. With youden index, a cut of point for a significant RTS value with a mortality outcome for traumatic brain injury patients at Sardjito General Hospital 6.43 with a sensitivity value of 87% and a specificity of 94,6% and RR value of 32,73. HL test obtained p value = 0.976 (p> 0.05). Conclusion: The Revised Trauma Score (RTS) system has a very high discrimination ability and good calibration so that the Revised Trauma Score (RTS) has a high prognosis ability in predicting the mortality of patients with traumatic brain injury at RSUP Dr. Sardjito.]]>
<![CDATA[Efektivitas Anestesi Umum Kombinasi Teknik Blok Skalp Menggunakan Levobupivakain 0,5 % terhadap Jumlah Fentanil Intraoperatif pada Pasien Kraniotomi Tumor Supratentorial di RSUP Dr. Sardjito ]]>
<![CDATA[Hernandes, Crodia]]>;
<![CDATA[Sudadi]]>;
<![CDATA[Widyastuti, Yunita]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 8 No 1 (2021): Volume 8 Number 1 (2021) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v8i1.7494
<![CDATA[Background: High dose opioid has been clinically proven to provide effective blockage of stimuli during head incision but it has several unwanted side effects. Scalp block is an alternative modality which has been used as an adjunct to general anesthesia aimed to blunt stress response throughout craniotomy while maintaining more stable condition in terms of less hemodynamic fuctuation. Objective: The study is aimed to compare fentanyl comsumption in general anesthesia combined with scalp block using saline and general anesthesia combined with scalp block using levobupivacaine 0.5% in patient which underwent craniotomy. Method: Twenty patients suffered from intracranial tumor with age ranging from 18 - 65 years who underwent craniotomy tumor removal at RSUP Dr. Sardjito were divided into 2 treatment groups in which the Levobupivacaine 0.5% block group received general anesthesia with a combination of scalp blocks using Levobupivacaine 0.5% while the control group received general anesthesia with a combination of scalp blocks using saline. Patients with local anesthetic allergy and uncontrolled bleeding were excluded from data collection. Result: The mean of fentanyl addition in patients with Levobupivacaine block was 513.0 mcg with a standard deviation of 164.2 mcg. Whereas in patients with Levobupivacaine block the average fentanyl addition was 1149.5 mcg with a standard deviation of 318.4 mcg. The mean difference in the addition of fentanyl between the two groups of 636.5 mcg showed a signifcant difference p = 0.001 (p <0.05). Conclusion: Combination of scalp blocks using Levobupivacaine 0,5% with general anesthesia showed reduction of fentanyl consumption alongside with statistically insignifcant hemodynamic fuctuation compared to general anesthesia and saline block in supratentorial brain tumor patient undergoing craniotomy. Hemodynamic profle in Levobupivacaine 0,5% group was maintained better than control group.]]>
<![CDATA[Faktor-Faktor yang Berhubungan Dengan Mortalitas dan Morbiditas pada Pasien Geriatri yang Menjalani Prosedur Anestesi Di RSUP Dr. Sardjito ]]>
<![CDATA[Arifin, Achmad Reza]]>;
<![CDATA[Widyastuti, Yunita]]>;
<![CDATA[Sudadi]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 10 No 2 (2022) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v10i2.8299
<![CDATA[Background: Geriatrics is defined as someone who reaches the age of 60 years and over. With the increase in the level of the economy and health, the geriatric population will increase. So that surgery and anesthesia in geriatric patients also increased. Geriatric patients tend to have more comorbidities accompanied by a decrease in physiological function and cognitive function so that it has an impact on mortality and morbidity. Objective: To identify the factors related to mortality and morbidity in geriatric patients undergoing anesthesia procedures at Dr. Sardjito General Hospital. Method: This study was conducted in a prospective analytical observational to identify risk factors in geriatric patients undergoing anesthesia at Dr. Sardjito General Hospital. The affordable population was all geriatric patients aged 60 years and over, who underwent anesthesia in the operating room and the time of the study was carried out for 3 months. In this study, variables that are thought to have a relationship with mortality and morbidity of geriatric patients will be tested using a univariate test using the Student's t-test if the data is numerical, while if the data is categorical using the Chi Square test. If the results of p<0.25 will be continued with the logistic regression test of each variable. And if p<0.05 then the variable is included in the multivariate analysis and if p<0.05 is considered significant. Results: The factors identified as factors affecting mortality of geriatric patients undergoing anesthesia at Dr. Sardjito General Hospital are age ≥75 years, dementia, and digestive surgery with p <0.05 in both univariate and multivariate tests. In the multivariate logistic regression test, factors affecting morbidity of geriatric is digestive surgery with p < 0,05. Conclusion: Patients’ age≥75 years, dementia and digestive surgery are the identified factors affecting mortality and morbidity of geriatric patients undergoing anesthesia at Dr. Sardjito General Hospital.]]>
<![CDATA[Manajemen Nyeri pada Pasien Kanker Payudara Stadium Paliatif dengan Cancer Pain ]]>
<![CDATA[Mahmud]]>;
<![CDATA[Sudadi]]>;
<![CDATA[Ristianto, Muhammad Brian]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 10 No 2 (2022) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v10i2.8302
<![CDATA[Pain is one of the most common and feared symptoms in patients with cancer, and even though good or complete pain control can be achieved in 80–90 % of cancer patients, cancer-related pain continues to be a major public health problem globally. Cancer pain becomes one of palliative care’s aspect. Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life threatening illness. Palliative care needs early identification, examination, and therapy. There is screening for palliative care, such as 5-point palliative score. Cancer pain therapy uses step-ladder WHO guideline, with NRS or Numeric Rating Scale as its pain assessment. Breast cancer has the highest incidence in Indonesia, with bone metastatic becomes its most common occurrence in its late phase. Cancer pain management generally becomes important, particularly towards breast cancer and its bone metastatic manifestation..]]>
<![CDATA[Patient Safety in Non-Operating Room Anesthesia (Nora) ]]>
<![CDATA[Pratomo, Bhirowo Yudo]]>;
<![CDATA[Sudadi]]>;
<![CDATA[Hermawan, Hendra]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 10 No 1 (2022) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v10i1.8303
<![CDATA[Practice in the field of non-operating room anesthesia (NORA) is associated with the risks of injury or death. The number of NORA cases recently has increased with more than half of claims related to death, due to lack of anesthetic care standard. The need for implementation standard of NORA such as equipments, staffs and facilities must meet the criteria of safety. So it is an important concern in preventing those complications. The three paradigm steps towards a systematic NORA approach encompass patient, procedures and the environment. The first step to improve patient safety in the case of NORA includes measuring preparation with adequate facilities, introductions of the location, equipments and available personnels. The training skill and communication between the anesthetist team and other support personnel are required. In addition, procedural preparation must be prepared for possible emergencies and adverse outcomes.]]>
<![CDATA[Manajemen Anestesi pada Pasien Hamil G1P0 UK 26 Minggu Yangmenjalani Craniotomy Removal Tumor Fossa Posterior ]]>
<![CDATA[Sudadi]]>;
<![CDATA[Kurniawaty, Juni]]>;
<![CDATA[Utomo, F uad Cipto]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 10 No 1 (2022) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v10i1.8322
<![CDATA[Brain tumor during pregnancy are very rare and presents several challenges to the neurosurgeons, obstetricians and anaesthesiologist in not only establishing the diagnosis, but also in the perioperative management as it requires a careful plan to balance both maternal and fetal well-being. We report the anaesthetic management of a 26-week pregnant patient with brain tumor meningioma. As the patient was 26 weeks pregnant with sign and symptoms of raised intracranial pressure (ICP) with progressive neurological deficits, not manageable with drugs, elective craniotomy was planned for decompression of the brain tumor. We held a multidisciplinary meeting before the operation and made a detailed plan for how to proceed. During the operation, our team ensured intensive monitoring, provided adequate oxygen and achieved hemodynamic stability. Anaesthetic drugs like fentanyl, rocuronium, propofol and sevoflurane were carefully chosen in order to ensure the safety of both the mother and fetus. Under the careful and successful anaesthetic management, the patient underwent the surgery smoothly neither the mother nor baby experienced pre- or post-operative complications. Neurosurgeries in pregnancy are sparse, and careful planning with cross-disciplinary specialist was need in advanced of the operation. Moreover, when dealing with such surgeries, we should consider the safety of both the mother and fetus, which challenging but important.]]>
