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Artika, I Gusti Ngurah Rai
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Medicine & Pharmacology

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Anestesi Regional Intravena Farid, Anisa Fadhila; Sudadi; Artika, I Gusti Ngurah Rai
Jurnal Komplikasi Anestesi Vol 2 No 3 (2015): Volume 2 Number 3 (2015)
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.v2i3.7215

Abstract

Intravenous regional anesthesia (IVRA) atau Bier’s block merupakan teknik pemberian anestesi regional yang dilakukan dengan menginjeksikan obat anestesi lokal ke vena ekstremitas atas atau bawah yang telah dieksanguinasi dengan kompresi atau dengan elevasi dan telah diisolasi dengan tornikuet dari sirkulasi sentral. Teknik ini merupakan metode anestesi yang efektif untuk prosedur bedah di ekstremitas, dengan tingkat kesuksesan 94-98%, mudah dikerjakan dan hanya membutuhkan keterampilan kanulasi intravena.
Perbandingan Efikasi Analgesi antara Penambahan Klonidin Konsentrasi Akhir 1,875 mcg/ml dengan Penambahan Fentanil Konsentrasi Akhir 1,25 mcg/ml pada Bupivakain 0,125% Isobarik untuk Analgesi Epidural Infus Kontinu Pascaoperasi Laparotomi Ginekologi Onkol Nur, Rifdhani Fakhrudin; Artika, I Gusti Ngurah Rai; Sudadi
Jurnal Komplikasi Anestesi Vol 3 No 2 (2016): Volume 3 Number 2 (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.v3i2.7236

Abstract

Latar belakang : Belum pernah dilakukan penelitian tentang perbandingan efi kasi analgesi penambahan klonidin dibandingkan fentanil pada obat anestesi lokal untuk analgesi epidural infus kontinu pada pasien pascaoperasi laparotomi ginekologi onkologi.Tujuan : Penelitian ini bertujuan membandingkan efi kasi analgesi antara penambahan klonidin dengan fentanil pada bupivakain 0,125% isobarik untuk analgesi epidural infus kontinu pascaoperasi laparotomi ginekologi onkologiMetode : Penelitian single blind randomized controlled trial ini melibatkan 60 pasien yang menjalani operasi laparotomi ginekologi onkologi dengan anestesi epidural dan analgesi epidural infus kontinu. Sampel dibagi melalui randomisasi menjadi 2 kelompok BF dan BK, masing-masing 30 pasien. Injeksi analgesi epidural pada kelompok BF adalah injeksi bolus 10 ml bupivakain 0,125%+fentanil 50 mcg dilanjutkan infus epidural kontinu bupivakain 0,125%+fentanil 1,25 mcg/ml. Kelompok BK mendapatkan injeksi bolus 10 ml bupivakain 0,125%+klonidin 75 mcg, dilanjutkan infus epidural kontinu bupivakain 0,125%+klonidin1 mcg/ml.Hasil : Nilai VAS saat istirahat dan saat gerakan ringan lebih rendah secara bermakna pada kelompok BK dibandingkan kelompok BF pada menit ke-15, jam ke-6 dan jam ke-12 pascaoperasi dengan nilai p<0,05. Perbedaan nilai VAS saat istirahat dan saat gerakan ringan antara dua kelompok kurang dari 0,9 cm pada semua periode penilaian. Frekuensi tambahan fentanil sebagai rescue analgetik lebih banyak secara bermakna pada kelompok BF (26,7%) daripada kelompok BK (3,3%). Kejadian hipotensi, bradikardi mual muntah dan pruritus tidak berbeda diantara dua kelompok.Kesimpulan : Penambahan klonidin menghasilkan efikasi analgesi lebih baik secara statistik namun tidak menghasilkan efikasi analgesi lebih baik secara klinis daripada penambahan fentanil pada bupivakain 0,125% isobarik untuk analgesi epidural infus kontinu pascaoperasi laparotomi ginekologi onkologi.
Penatalaksanaan Anestesi Colostomy pada Pasien Atresia Ani dengan Tetralogi of Fallot (TOF) Artika, I Gusti Ngurah Rai; Pratomo, Bhirowo Yudo; Setiawan, Yosy Budi
Jurnal Komplikasi Anestesi Vol 3 No 3 (2016): Volume 3 Number 3 (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.v3i3.7260

Abstract

Insiden kejadian penyakit jantung kongenital berkisar antara 0,3% - 1,2% pada neonates. Tetralogi of fallot (TOF) merupakan penyakit jantung congenital tipe sianotik yang paling banyak didapatkan, dimana kelainannya terdiri dari defek septum ventrikel (VSD), overriding aorta, stenosis pulmonal dan hipertrofi ventrikel kanan (RVH). Pengelolaan anestesi pada anak dengan kelainan jantung kongenital untuk operasi non jantung memiliki suatu hal khusus yang harus diperhatikan sesuai dengan defek yang terjadi, agar tidakmemperberat kondisi penderita. Pada kasus berikut dilaporkan penatalaksanaan anestesi pada anak usia enam bulan dengan tetralogi of Fallot yang menjalani operasi kolostomi.
Perioperative Anestesi pada Operasi Drainage Abses Serebri Pasien Pediatri dengan Tetralogy of Fallot Wiratnolo, Ressi Bhakti; Pratomo, Bhirowo Yudo; Artika, I Gusti Ngurah Rai
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.v4i2.7294

Abstract

Dilaporkan penatalaksanaan anestesi pada operasi drainage abses serebri pada seorang anak laki-laki usia 2 tahun 9 bulan, berat badan 10 kg, status fisik ASA III, karena memiliki riwayat tetralogy of fallot dengan general anestesia. Penderita di premedikasi dengan midazolam 0,5 mg dan ketamin 5 mg, induksi dengan sevoflurane dan fasilitas intubasi dengan atracurium 5 mg. Pemeliharaan anestesi dengan Sevolurane, O2, Fentanyl intermitten 1mcg/kgBB dan selama operasi pernafasan di kontrol secara manual. Operasi berlangsung sekitar 2 jam, dengan perdarahan minimal. Selama operasi tidak didapatkan penyulit anestesi maupun pembedahan. Pasca operasi pasien di rawat di bangsal.
Manajemen Cairan Perioperatif pada Pasien Gagal Ginjal Kronis Ikhwandi, Arif; Widodo, Untung; Artika, I Gusti Ngurah Rai
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.v4i2.7295

Abstract

Ginjal memiliki fungsi vital dalam regulasi cairan, detoksifikasi, serta produksi hormon. Kegagalan ginjal menjalankan fungsinya bisa berakibat fatal. Terkait dengan ini, operasi dan anestesi pada pasien gagal ginjal besar pengaruhnya terhadap fungsi ginjal, dengan mayoritas morbiditas dan mortalitas pasien pasca operasi pada pasien gagal ginjal kronis. Mencapai normohidrasi masih menjadi isu utama pada pasien yang menjalani hemodialisis. Target klinisnya yaitu membuat status cairan pasien yang menjalani hemodialisis berada antara overload dan dehidrasi. Walaupun sulit untuk mencapai target ini dalam prakteknya. Parameter objektif dan klinis yang dapat dipakaiuntuk menentukan status hidrasi normal pada basis individu diperlukan untuk menentukan target berat badan yang sesuai. Pemberian cairan pada pasien gagal ginjal kronis sering menjadi perdebatan terutama pada pasien yang anuria yang menjalani dialisis. Untuk itu referat ini dibuat untuk memahami fungsi kerja ginjal dan kaitannya dengan manajemen cairan perioperatif pasien dengan penyakit ginjal kronik.
Gagal Spinal pada Pasien Operasi Amputasi Transfemoral dengan Debridemen dan Penatalaksanaannya Maryani, Nova; Artika, I Gusti Ngurah Rai; Sudadi
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.v5i1.7321

Abstract

A man 64 years old had a traffic accident 12 hours ago, resulting in crush injury on regio left femur and cruris. This man has fasted and for 8 hours and was planned to undergo debridement and transfemoral amputation surgery by orthopedics. The hemodynamic profile of this patient preoperative: stable with HB 8.4, had two colfs of PRC blood transfusion. Vital sign BP 110/55, HR 110x/minute, RR 22x/minute, SpO2 97%. The anesthesia technique planned for the surgery is spinal block anasthesia. Fluid preloading RL 500 ml, intravenous analgesics fentanyl 25 mcq, sitting position, spinal anesthesia L4-L5, CSF (+), blood (-), agent: bupivacaine 0,5 % hyperbaric 15 mg + fentanyl 25 mcq, aspiration (+) barbotage until 4cc. Thus, supine position after spinal anesthesia. Pin Prick result, Sensoric test (-), Motoric Bromage 0, evaluated until 10 minutes, just parasthesia. Pin prick, result sensoric test no sensoric. Block declared failed, conversion to General Anesthesia LMA. Operation held for 2 hours, post-operative patient transfers to High Unit Care.
Penggunaan Teknik Blok Perifer Angkle pada Pasien Papo Digiti 4,5 Pedis Sinistra Triputra, Audhiaz Marthsyal; Mahmud; Artika, I Gusti Ngurah Rai
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (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.v5i2.7329

Abstract

A 75 yearl old woman diagnosed gangrenous 4th – 5th left digiti pedis e.c susp. PAPO went to surgery with amputation of the 4th and 5th left digiti pedis with a peripheral nerve block anesthesia techniques. Preoperative physical status been classified with ASA II, with warfarin therapy has been discontinued since 4 days ago and replaced with UF heparin for one day therapy. The operation takes approximately less than one hour with hemodynamically stable, patients had no complaints of pain to post-surgery. Heparin therapy then continued one day after surgery
Perbandingan Insidensi Kultur Apusan Kulit Positif setelah Pemberian Krim Emla® 5% Diikuti Disinfeksi Povidon IODIN 10% Dibandingkan dengan Disinfeksi Povidon IODIN 10% sebelum Anestesia Regional Prihatna, Hendi; Artika, I Gusti Ngurah Rai; Uyun, Yusmein
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.v5i3.7338

Abstract

Background. Strategies for reducing pain during needle injection include the provision of eutectic mixture of local anesthesia (EMLA) cream, EMLA contains lidocaine that as in vitro experiment believed to have bacteriostatic and bacteriocid effects, EMLA cream can penetrate into deeper layers of skin, EMLA analgesia can penetrate the skin layer with a thickness of 2 mm after 60 minutes and 3 mm after 120 minutes, in which case it can explain the antibacterial effect of EMLA in the long term. Infection that related to spinal anesthesia is a serious complication which may cause meningitis, paralysis and even death. Many studies showed that the skin puncture site was a potential pathogen source during spinal anesthesia procedure. Therefore, effective skin disinfection before the procedure must be performed. Povidone iodine is the most common antiseptic for skin disinfection before spinal anesthesia procedure and has been already stated in Guidelines of Anesthesiology Practice in Sardjito Hospital, Yogyakarta. The aim of this study is to compare positive skin swab culture incidence among patients who are performed with 5% EMLA and 10 % povidone iodine compared with single 10% povidone iodine for skin disinfection in regional anesthesia procedure.Methods. The design of this study were using single blind randomized controlled clinical trial. Thirty-six patients undergoing regional anesthesia (spinal, epidural, combine spinal epidural) and divided into 2 groups, 5% EMLA + 10% povidone iodine (E) group and single 10% povidone iodine (P) group. Pretreatment was done by examination of skin culture and after disinfection was done re-skincare culture examination. The incidence of positive skin swab cultures were recorded then.Result. The incidence of positive skin swab cultures after administration with EMLA followed by 10% povidone iodine is (11.8%) was less than povidone iodine 10% (22.2%) in skin preparation prior to regional anesthesia procedures. However, there was no significant difference in incidence of positive skin swab cultures between administration 5 % EMLA followed by 10% povidone iodine with single 10% povidone iodine (p> 0,05). There was no side effects of 5% EMLA and 10% povidone iodine usage were found in this study.Conclusion. The positive skin swab cultures incidence after administration of 5% EMLA and povidon iodine 10% were less than a single 10% povidon iodine disinfection (11.8% versus 22.2%, p> 0.05).
Co-Authors Anisa Fadhila Farid Bhirowo Yudo Pratomo Ikhwandi, Arif Maryani, Nova Nur, Rifdhani Fakhrudin Prihatna, Hendi Setiawan, Yosy Budi Siti Helmyati Sudadi Triputra, Audhiaz Marthsyal Untung Widodo, Untung Wiratnolo, Ressi Bhakti Yusmein Uyun