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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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Protokol Transfusi Masif pada Obstetrik Uyun, Yusmein; Pratomo, Bhirowo Yudo; Hernawan, Agung Diky
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.v8i1.7488

Abstract

World population’s access to safe blood is limited. Only 30% of countries in the world have comprehensive transfusion services in their countries. Meanwhile, massive transfusion therapy has poor survival rate with mortality rate of about 45-67%. The patient’s age, duration and severity of shock, Disseminated Intravascular Coagulation (DIC), and the amount of blood transfused affect the fnal outcome. Coagulopathy has a high mortality rate within 4-6 days after hospitalization. Many obstetrics and gynecology patients have the potential to require blood transfusions. Cesarean section (SC) and hysterectomy are two of the surgical procedures that are frequent and potentially bleeding, requiring blood transfusion. Other conditions are postpartum hemorrhage, placenta previa, and ruptured ectopic pregnancy. Bleeding in the obstetric feld is still a highest cause of maternal death in Indonesia.
Anestesi Inhalasi dengan Teknik Low Fresh Gas Flow Pratomo, Bhirowo Yudo; Kurniawaty, Juni; Kusuma, Danur Adi
Jurnal Komplikasi Anestesi Vol 10 No 2 (2022)
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.v10i2.8292

Abstract

Any technique that employs a fresh gas flow that is less than the alveolarventilation can be classified as low-flow anesthesia. The complexities involvedin the calculation of uptake of anesthetic agents during the closed-circuitanesthesia made this technique less popular. However, the awareness of thedangers of operating theatre pollution with trace amounts of the anestheticagents and the prohibitively high cost of the new inhalational agents, havehelped in the rediscovery of low-flow anesthesia.
Patient Safety in Non-Operating Room Anesthesia (Nora) Pratomo, Bhirowo Yudo; Sudadi; Hermawan, Hendra
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
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.v10i1.8303

Abstract

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.
Manajemen Anestesi Pasien dengan Low Ejection Fraction yang Menjalani Operasi Tumor Ovarium Pratomo, Bhirowo Yudo; Kurniawaty, Juni; Sari, Dhanty Dwita
Jurnal Komplikasi Anestesi Vol 10 No 2 (2022)
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.v10i2.8305

Abstract

Anesthetic management of patients with dilated cardiomyopathy (DCM) is a challenge to the anesthesiologist, due to poor left systolic function, ventricular enlargement, risk of malignant arrhythmias and sudden cardiac death. Therefore, preoperative assessment and appropriate anesthetic management are important in patients with DCM. Patients with a low EF <35% may be at risk for life-threatening irregular heart rhythms. Any arrhythmia in these patients requires immediate treatment because otherwise it can lead to sudden cardiac arrest and sudden death. In summary, the optimal anesthetic management of patients with dilated cardiomy- opathy requires good preoperative assessment, close perioperative monitoring, suitable anesthetic, optimization fluid management, and stable hemodynamic status.
Manajemen Pasien dengan Hoarseness Paskatiroidektomi Total Dipacu Kusuma, Danur Adi; Pratomo, Bhirowo Yudo; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
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.v10i1.8324

Abstract

look at the clinical appearance of the patient who appears hoarse after extubation, thevoice becomes softer, the ability to cough is not strong but the respiration rate is stillnormal 18 times/minute with a saturation of 98% then The probability of injury isunilateral. Pathophysiologically hoarseness can mean there is a possibility of injury toeither the bilateral superior laryngeal nerve or unilateral recurrent laryngeal nerve (RLN).Then the possibility of injury is unilateral RLN unilateral in this patient. Ideally thedifferential diagnosis of postoperative hoarseness requires examination such as simplelaryngoscopy, stroboscopy or intra and extralaryngeal electromyography. In practice it isdifficult to distinguish between damage caused by thyroid surgery and anaestheticfactors. There are a number of anesthetic-related factors that may predispose to hoarseness in these patients such as the risk of doubling in patients who are intubated for3-6 hours (in patients 3.5 hours). This could be ruled out if we could measure the ET cuffpressure during surgery. While from the surgical factor there are several risk factors suchas surgery on the neck area (thyroid surgery), excessive neck extension during surgery,pulling the RLN causing injury. In the last operation the position of the neck extended, forRLN in the operation report has been identified. It is better to assess vocal cord functionprior to extubation, such as a cuff leak test or insertion of a flexible intubation scopethrough the lumen of the ET tube.
Manajemen Preoperatif pada Pasien dengan Hipertiroid Pratomo, Bhirowo Yudo; Widodo, Untung; Ferdiansyah, David
Jurnal Komplikasi Anestesi Vol 9 No 3 (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.v9i3.8332

Abstract

Gangguan tiroid adalah kelainan endokrin yang paling sering ditemukan setelah diabetes melitus. Prevalensi kelainan tiroid di wilayah dengan defisiensi iodin lebih tinggi, salah satunya wilayah Asia Tenggara. Hormon tiroid memiliki banyak efek pada beberapa organ di dalam tubuh seperti meningkatkan pertumbuhan, sistem saraf pusat, kardiovaskuler, dan laju metabolisme. Stres, yang salah satunya diakibatkan oleh prosedur operatif, dapat mengeksaserbasi kelainan tiroid sehingga dapat menyebabkan dekompensasi atau bahkan mortalitas. Semua prosedur operasi elektif harus ditunda hingga pasien berada pada kondisi eutiroid dengan terapi medikamentosa. Pasien harus memiliki kadar T3 dan T4 yang normal dan tidak mengalami takikardi pada kondisi istirahat.
Perbandingan Efektivitas Anestesi Spinal Menggunakan Levobupivakain Isobarik 0,5% 7,5 Mg Dibandingkan Levobupivakain Isobarik 0,5% 10 Mg pada Pasien Kanker Serviks yang Menjalani Brakiterapi Intrakaviter di RSUP Dr. Sardjito Rani, Hajar Rafika; Pratomo, Bhirowo Yudo; Kurniawaty, Juni
Jurnal Komplikasi Anestesi Vol 8 No 2 (2021): Volume 8 Number 2 (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.v8i2.8359

Abstract

Background: Levobupivacaine is an S-enantiomer of bupivacaine, has a similar effect but less cardiotoxic than bupivacaine. The aim of this study was to evaluate the effectiveness of 7,5 mg levobupivacaine compared with 10 mg levobupivacaine in terms of sensory block, motor, recovery, and the incidence of hypotension in intracavitary brachytherapy. Methods: A prospective, randomized, single-blinded study with inclusion criteria: ASA I-II, 140-165 cm of height, 18-65 years, BMI <30 kg/m2. One hundred fifteen samples were randomized and divided into 2 groups: 0,5% isobaric levobupivacaine 7,5 mg and 10 mg. Results: In both groups, there were no significant differences for sensory block height reaching T10 and the incidence of hypotension (p> 0.05), there were significant differences for the onset, the duration of sensory block, bromage score, and recovery time (p <0.005). The 7,5 mg levobupivacaine group and 10 mg levobupivacaine group had 18±16 minutes and 15±20 minutes for sensory blockonset (p=0,009) in which it was not clinically significant. The 7,5 mg levobupivacaine group and 10 mg levobupivacaine group had 128±26 minutes and 152±39 minutes for sensory block duration (p=0,005), both groups sensory block duration was sufficient for brachytherapy (97±39 minutes). The 7,5 mg levobupivacaine group and 10 mg levobupivacaine group had 107±28 minutes dan 148±24 minutes for recovery (p=0,000). Both groups had no hypotension. Clinically, intracavitary brachytherapy worked well with sensory block heights <T10 and bromage scores <2. Conclusion: Spinal anesthesia with levobupivacaine 7.5 mg group was as effective as10 mg levobupivacaine group for cervical cancer patients who underwent intracavitary brachytherapy.
Panduan Pemeriksaan Analisis Gas Darah Menggunakan Bedside Poct (I‐STAT®) dan Laboratorium Sentral (NOVA PHOX®) dI RSUP Dr. Sardjito Nurdiansyah, Elba; Pratomo, Bhirowo Yudo; Kurniawaty, Juni
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 3 (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.v8i3.8373

Abstract

Background: Proper postoperative ventilator weaning requires regular monitoring of the patient's blood gas analysis (BGA). Delays in getting the results of the BGA test will be an obstacle in guiding the weaning procedure and affect the length of use of the ventilator. The central laboratory examination (NOVA pHOx®) requires more blood samples, a longer examination time and process compared to POCT which uses fewer blood samples and processes faster results. Methods: This study used a prospective observational design, cohort study, and unpaired comparative analytics. The samples were divided into 2 groups for blood gas analysis i-STAT® and a central laboratory (Nova pHOx®). The inclusion criteria were patients aged 5-60 years who underwent post-open heart surgicaltreatment with a ventilator and a EURO Score <5, The exclusion criteria were patients with ventilator problems, acquired pneumonia, and adult patients with severe chest restriction spirometry. Results: The number of samples was 46 people (POCT: n = 23, Central Laboratory (Nova pHOx®): n = 23).The length of time using the ventilator in the i-STAT group was 1122.8 minutes while the central laboratory group (Nova pHOx®) was 1291.4 minutes with a mean difference of 168.8 minutes but both showed no significant difference with p = 0.303 (p> 0.05). Conclusion: The length of time of using the ventilator in post-cardiac surgery patients with the guidance of blood gas analysis in the i-STAT group and central laboratory (Nova pHOx®). showed no evidence of interaction and no significant effect on the two test modalities
Tata Laksana Badai Tiroid di Instalasi Gawat Darurat Sudadi; Pratomo, Bhirowo Yudo; Utomo, Wandito Gayuh
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 3 (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.v8i3.8375

Abstract

A thyroid storm is one of endocrinology emergency. Its incidence is very rare but has a very high mortality. Early diagnosis and aggressive treatment must be made in this case so that the patient has a good prognosis. Thyroid storm is often occurring in patients with hyperthyroidism who are not given adequate treatment and are triggered by infection, trauma, thyroid surgery, or uncontrolled diabetes mellitus. Initial treatment in Emergency Department includes assessment and management of the ABCDSs, appropriate intravenous (IV) fluid resuscitation, electrolyte replacement, precipitate factors management, and thyroid-specific therapy (include Anti Thyroid Drugs [ATDs], inorganic iodine, corticosteroid, betaAdrenergic Agonists [beta-AAs]). After getting proper treatment in Emergency Department, the patient must continue his care in the Intensive Care Unit (ICU) for clinical and treatment close monitoring. Therapeutic plasmapheresis (TPE) should be considered if clinical improvement is not noted within 24–48 hours of initial treatment.
Enhanced Recovery After Surgery (ERAS) pada Pediatrik yang Menjalani Operasi Kolorektal Pratomo, Bhirowo Yudo; Widyastuti, Yunita; Ilman, Pesiar
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 3 (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.v8i3.8376

Abstract

Enhanced recovery after surgery (ERAS) was first described by Henrik Kehlet as a tool for optimizing perioperative care. The general scope of ERAS includes perioperative counseling, limiting the fasting hours before surgery, postoperative enteral intake, early mobilization, use of non-opioid pain medications, and restriction of intravenous fluids, drainage, and catheters. Colorectal surgery in pediatrics has a higher infection rate in the surgical area than in adults, thereby the implementation of ERAS in this operation canhave a big impact. There are few studies on the implementation of ERAS in pediatrics. Despite that, the available data shows the implementation of ERAS in pediatrics undergoing colorectal surgery is positive.
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 BHIMO PRIAMBODO 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