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All Journal Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif Jurnal Kesehatan Tambusai Jurnal Locus Penelitian dan Pengabdian Jurnal Komplikasi Anestesi
Bhirowo Yudo Pratomo
Departemen Anestesiologi Dan Terapi Intensif, Fakultas Kedokteran, Kesehatan Masyarakat, Dan Keperawatan, Universitas Gadjah Mada, Yogyakarta|Universitas Gadjah Mada
Aerospace Engineering Automotive Engineering Decision Sciences, Operations Research & Management Dentistry Education Electrical & Electronics Engineering Health Professions Mathematics Medicine & Pharmacology Nursing Public Health

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Anestesi pada Pasien Anak dengan Penyakit Jantung Kongenital Asianotik (PDA, ASD, VSD) Setiandari, Kristina; Kurniawaty, Juni; Pratomo, Bhirowo Yudo
Jurnal Komplikasi Anestesi Vol 4 No 1 (2016): Volume 4 Number 1 (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.v4i1.7269

Abstract

Penyakit jantung kongenital merupakan kelainan kongenital pada anak yang banyak dijumpai. Mortalitas akan meningkat pada pasien yang berusia < 6 bulan, status emergensi, lesi jantung yang kompleks dan pasien yang menjalani prosedur pembedahan mayor. Penyakit jantung kongenital yang banyak dijumpai dalampraktek sehari-hari di antaranya adalah yang digolongkan pada penyakit jantung asianotik dengan kelainan anatomi berupa atrial septal defect (ASD), ventricular septal defect (VSD) dan patent ductus arteriosus (PDA). Anestesi pada pasien anak dengan PDA, ASD dan VSD memerlukan pemahaman yang baik mengenai anatomi dan patofiologi defek yang terjadi sehingga perencanaan manajemen anestesi dapat mengoptimalkan kondisi pasien serta mengurangi mortalitas maupun komplikasi yang terkait dengan anestesi.
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.
Terapi Oksigen Hiperbarik Synthana, Meta Restu; Wisudarti, Calcarina Fitriani Retno; Pratomo, Bhirowo Yudo
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.v4i2.7296

Abstract

Terapi oksigen hiperbarik merupakan terapi dengan memberikan 100% oksigen pada dua sampai tiga kali dari tekanan pada level air laut. Terapi oksigen hiperbarik efektif dalam mengatasi berbagai penyakit antara lain luka karena trauma akut, ulserasi yang tidak membaik dengan terapi, crush injury, luka bakar, gas gangren, dan sindrom kompartemen dapat pula digunakan pada kasus-kasus keracunan gas misal keracunan gas karbonmonoksida. Terapi oksigen hiperbarik memiliki komplikasi dan efek toksik karena hiperoksia. Terapi ini sering digunakan pada pasien-pasien kritis misal karena keracunan karbonmonoksida, luka bakar, gas gangren, abses intrakranial, emboli, sehingga klinisi khususnya anestesiologist perlu mengetahui mekanisme, efek serta komplikasi terapi oksigen hiperbarik.
Manajemen Anestesi pada Operasi Revaskularisasi Miokardium yudihart, Subhan; Pratomo, Bhirowo Yudo; Kurniawaty, Juni
Jurnal Komplikasi Anestesi Vol 4 No 3 (2017): Volume 4 Number 3 (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.v4i3.7308

Abstract

Pada tahun 1997 di Amerika, setidaknya > 70.000 prosedur operasi jantung dilakukan tiap tahunnya, dan lebih dari 60.000 diantaranya adalah operasi coronary artery bypass grafting (CABG). Pembiusan pada operasi jantung merupakan suatu hal yang menarik sekaligus menantang bagi seorang ahli anestesi. Salah satu prinsip dasar dalam tindakan anestesi bedah revaskularisasi jantung adalah menjaga keseimbangan dua faktor penting, yakni menjaga pasokan suplai oksigen, dan menurunkan kebutuhan / demand oksigen. Persiapan pembiusan pada operasi jantung harus dilakukan dengan matang, mulai dari persiapan premedikasi, pilihan obat yang harus diberikan atau dihentikan, persiapan monitor baik invasif maupun non invasif. Induksi dilakukan dengan pengawasan monitor dan gejolak hemodinamik yang signifikan sebisa mungkin dihindari dengan pemilihan obat dan penyesuaian terhadap pasien. Setelah teranestesi, pasien yang mengalami prosedur opersi revaskularisasi koroner konvensional harus mengalami proses shunting aliran darah dengan alat cardiopulmonary bypass (CPB) yang bertujuan agar aliran darah dari seluruh tubuh tidak melewati aliran jantung paru. Menjelang operasi selesai, penyapihan CPB perlu dilakukan agar mendapatkan hasil postoperasi yang baik. Beberapa teknik dikembangkan untuk mengurangi lama waktu rawat operasi jantung koroner, yakni teknik fastrack dan offpump coronary artery bypass (OPCAB).
Hubungan antara Lama CPB dan Aortic Cross Clamp dengan Mortalitas dan Lama Rawat di ICU pada Pasien Pascaoperasi Katup Jantung di RSUP Dr. Sardjito Anggraini, Diana; Widodo, Untung; Pratomo, Bhirowo Yudo
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.v5i2.7333

Abstract

Background: CPB (cardiopulmonary bypass) results a non physiologic circulation and AOX (aortic cross clamp) causes a hypoxic condition of myocard. The length of CPB and AOX are probably factors that influence the ICU outcome after valvular heart surgery. Objective: To determine whether CPB and AOX time have significant effect on postoperative ICU length of stay (LOS) and ICU mortality. Methods: Data were collected from hospital medical record from period 2010 until 2016. After inclusion and exclusion 57 patients were analyzed for mortality and LOS in ICU. Results: Among 57 patients, 9 (15%) had ICU stay > 3 days, the mean+SD CPB was 119,2+32,5 min, AOX 92,7+27,7 min, while 7 (12,3%) had mortality in ICU, the mean+SD CPB was 113,7+37,3 min, AOX 79,3+36 min. Statistically showed that there were no correlation between duration of CPB and AOX with LOS and mortality in ICU, but we found that increased LOS in patient with comorbid (CHF+other) (p=0,019 OR 7,7 CI 95% 1,39-42,66) while ICU mortality increased with value of APACHE II (p=0,015 OR 1,69 CI 95% 1,11-2,58). Conclusion: There were no correlation of CPB and AOX time against ICU LOS and in mortality ICU, but preoperative factor (CHF+other) and postoperative factor (APACHE II score) respectively have a factor correlation.
Efektivitas Informasi Multimedia Video (Video Dan Lisan) untuk Menurunkan Tingkat Kecemasan Praanestesi Umum pada Pasien yang akan Dilakukan Tindakan Operasi Elektif dengan Anestesi Umum Teknik Intubasi Budianti, Nugrahaeni; Pratomo, Bhirowo Yudo; Rahardjo, Sri
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.v5i3.7337

Abstract

Background. Preoperative anxiety is a problem faced by two-thirds patients who would undergo surgery.Anxiety can not be handled properly, will cause adverse pathophysiologic responses. General anesthesiaintubation techniques as one of the anesthetic techniques often lead to an increase in preoperative anxiety. To reduce the level of preoperative anxiety, we can give preoperative information. The health information provided can be well understood by patients and can be used to reduce anxiety situation experienced by the patients. Methods. This studied was Randomized Controlled Trial (RCT). Subjects were patients undergone elective surgery general anesthesia using intubation techniques. The subjects were 110 patients that divided into two groups: the video group and the verbal group. The verbal group received preoperative information verbally, while the video group received preoperative information through a video of general anesthesia intubation technique procedures. The measurement of anxiety level was measured four times, once before the treatment (the level of anxiety/ LA-1) and three times after the treatment, namely when in the ward (LA-2), when in the surgical installation acceptance (LA-3) and when in the operating room prior to general anesthesia intubation techniques (LA-4). The assessment of anxiety used Spielberger State-Trait Anxiety Inventory (STAI) questionnaire of Y-1 form.Results. The percentage of anxiety reduction in video group was bigger than in Verbal group at all measurement times in TK-2 group of 40% video and verbal group 12,7%, in TK-3 video group 41,8% and verbal group 12,7% and at TK-4 video group 41.8% and verbal group 10.9%. Statistically different in the anxiety level between video group and verbal group were obtained in LA-2, LA-3 and LA-4 (p = 0.001, p = 0.001 and p = 0.000).Conclusion. Multimedia video information (video and verbal) is more effective in reducing preanesthesia anxiety levels in patients undergoing elective surgery with general anesthesia of intubation techniques when compared with verbal information.
Tatalaksana Anestesi pada Pediatrik dengan Obesitas Widyastuti, Yunita; Pratomo, Bhirowo Yudo; Taneo, Desy Chery Marlyn
Jurnal Komplikasi Anestesi Vol 6 No 3 (2019): Volume 6 Number 3 (2019)
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.v6i3.7358

Abstract

Anesthetic management of obese pediatric patients is challenging. With increasing prevalence, more childwith severely obese and comorbidities present for surgery everyday. Definition of obesity is based on bodymass index percentiles spesific to age and sex. The precursors of adult obesity-related comorbidities are often seen in obese children. Respiratory and cardiovascular comorbidities increase perioperative risk in the severely obese child. Optimal and safe anesthetic management of an obese child requires thoughtful pre prosedure assessment and meticulous perioperative management tailored to associated comorbidities, with hieghtened wareness of potential perioperative complications. There are remains a need for improved guidelines for risk stratification, drug dosing and postoperative disposition in this patient population.
Manajemen Anestesi pada Pasien dengan Malformasi Arnold-Chiari tipe I dan Siringomielia Pratomo, Bhirowo Yudo; Widyastuti, Yunita; Ngahu, Robby Mesakh
Jurnal Komplikasi Anestesi Vol 6 No 3 (2019): Volume 6 Number 3 (2019)
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.v6i3.7361

Abstract

Arnold–Chiari malformation (ACM) type I in syringomyelia patients can present with autonomic dysfunction.Anesthesia management requires careful preoperative assessment, precise identification of potential problems, and appropriate planning. We present a case report of a 29 years-old woman diagnosed with ACM type I with siringomielia associated with autonomic dysfunction. The patient was underwent suboccipital decompressive craniotomy. Patient exhibited symptoms of weakness in her upper limbs since 3 years ago, unable to hold items, paresthesia, and gradually progressed loss of temperature and pain sensation. Routine preoperative investigation were within normal limits. After intubation, the patient was placed in prone position. Thus, patient had hypotension with tachycardia, managed with intravenous (IV) fluid and vassopressor. During surgery the patient experiences instability of hemodynamics profile.
Monitoring Hemodinamik Non Invasif Perioperatif Kurniawaty, Juni; Pratomo, Bhirowo Yudo; Khoeri, Fatkhur Roofi
Jurnal Komplikasi Anestesi Vol 7 No 1 (2019): Volume 7 Number 1 (2019)
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.v7i1.7377

Abstract

In perioperative medicine, hemodynamic management aims at an optimization of perfusion pressure and oxygen delivery in order to maintain or restore adequate cellular metabolism. To optimize cardiopulmonary function, hemodynamic management triggers the administration of fluids and vasoactive agents according to predefined target values of hemodynamic variables. Besides basic hemodynamic variables (blood pressure and heart rate), include advanced hemodynamic variables such as pressure- or volume-based cardiac preload variables, dynamic cardiac preload variables, and blood flow variables (stroke volume, cardiac output). A variety of invasive, less-invasive, and non-invasive hemodynamic monitoring technologies are nowadays available to assess hemodynamic variables in the operating room or the intensive care unit.
Manajemen Praoperatif pada Pasien Emergensi dengan Perdarahan Internal Adiyanto, Bowo; Pratomo, Bhirowo Yudo; Sarjono, Pramuditya Haryo
Jurnal Komplikasi Anestesi Vol 8 No 1 (2021): Volume 8 Number 1 (2021)
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.v8i1.7487

Abstract

Bleeding is one of the most common cases that will be encountered by an anesthesiologist. Patients with internal bleeding have a high mortality rate and tend to detoriate quickly. The patient should get immediate and proper treatment. Preoperative management from an anesthesiologist has important role to the outcome of the patients. Management of patients with internal bleeding should be based on recent studies. Damage Controlled Resuscitation (DCR) and permissive hypotension is now the recommended concept of managing bleeding patients. Further studies should be conducted for the best management of patients.
Co-Authors Akhmad Yun Jufan Anggraini, Diana ANUGRAH DANANG IFNU RIZAL Anwar, Yusuf ‘Alim Musthofa Artika, I Gusti Ngurah Rai Asep Indah Wuddi Arief Bambang Suryono, Bambang Bowo Adiyanto Budianti, Nugrahaeni Calcarina Fitriani Retno Wisudarti Djayanti Sari Fakhrudin Nur, Rifdhani Ferdiansyah, David Hapsari, Paramita Putri Hermawan, Hendra Hernawan, Agung Diky Husein, Akhmad Syaiful Fatah IG Ngurah Rai Artika Ilman, Pesiar Juni Kurniawaty Muhdar Abubakar Djayanti Sari Khoeri, Fatkhur Roofi Kurniaji Kurniaji Kusuma, Danur Adi Meta Restu Synthana Ngahu, Robby Mesakh Nurdiansyah, Elba Putro, Bambang Novianto rade, agrawijaya Rahman, Farhan Ali Rani, Hajar Rafika Ressi Bhakti W Rifdhani Fakhrudin Nur Rifdhani Fakhrudin Nur Rinaldi Tri Frisianto Saputra, Dya Sari, Dhanty Dwita Sarjono, Pramuditya Haryo SATRIYAS ILYAS Setiandari, Kristina Setiawan, Yosy Budi Sri Rahardjo Sudadi Taneo, Desy Chery Marlyn Untung Widodo, Untung Utomo, Wandito Gayuh Wiratnolo, Ressi Bhakti yudihart, Subhan Yunita Widyastuti Yusmein Uyun