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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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The Non-Pharmacological Management of Shivering Post-Spinal Anesthesia rade, agrawijaya; Sudadi, Sudadi; Yudo Pratomo, Bhirowo
Jurnal Komplikasi Anestesi Vol 11 No 2 (2023)
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.v11i2.12641

Abstract

Shivering is a side effect of hypothermia which includes involuntary movements and contractions of one or more muscle groups that the patient cannot control. Perioperative shivering is a common problem during surgery under spinal anesthesia. Spinal anesthesia can cause shivering in patients because it causes distribution of internal body heat from the core of the body to the environment. Active non-pharmacological treatments for shivering post spinal anesthesia include the use of IV fluid warmed, forced-air warming, and Lower and Upper Body Forced Air Blankets. Key words: shivering, spinal anesthesia, warming of infusion fluids, forced air warming, and forced air blankets of the lower and upper body.
Tatalaksana Komplikasi Prosedur Laparoskopi pada Pasien dengan Komorbid Obesitas Saputra, Dya; Pratomo, Bhirowo Yudo; Sudadi
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
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.v11i1.12663

Abstract

The main problems with laparoscopy are related to cardiopulmonary effects due to pneumoperitoneum, systemic absorption of carbon dioxide, extraperitoneal gas insufflation, venous gas embolism, injury to intra-abdominal structures and position of the patient, especially in laparoscopic cholecystectomy which is a procedure performed in the upper abdominal region.Therefore the author will discuss the complications of anesthesia in laparoscopic procedures and the management that can be done to prevent and treat these complications. Characteristics of the hemodynamic response begins with a decrease in cardiac index after intraperitoneal insufflation of CO2 gas and is followed by recovery. Compression of the abdominal organs as a result of increased intra-abdominal pressure and increased sympathetic may be one of the causes of increased cardiac filling pressure which can also be associated with increased intrathoracic pressure due to pneumoperitoneum. Insufflation of the intraperitoneal space with CO2 gas produces a pneumoperitoneum, a systemic effect of CO2 absorption and a reflex increase in vagal tone that can develop into arrhythmias
SERIAL KASUS EKSTUBASI FAST-TRACK PADA BEDAH JANTUNG TERBUKA Hapsari, Paramita Putri; Pratomo, Bhirowo Yudo; Putro, Bambang Novianto
Jurnal Komplikasi Anestesi Vol 12 No 1 (2024)
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.v12i1.14651

Abstract

Fast-track extubation (FTE) has been shown to reduce the incidence of prolonged mechanical ventilation, resulting in shorter hospitalization, lower morbidity, mortality, and hospital costs. We present a case series of fast-track extubation involving two females aged 31 and 33 with Atrial Septal Defect (ASD) and a 33-year-old male with Ventricular Septal Defect (VSD) scheduled for defect closure. These patients were in good clinical condition with normal biventricular function and a low probability of pulmonary hypertension. The anesthesia and surgery procedures proceeded smoothly, with cardiopulmonary bypass time < 90 minutes, aortic cross-clamp time < 60 minutes, no residual shunt, acceptable lactate and blood gas analysis, stable hemodynamic with low doses of vasoactive agents, and adequate analgesia. Following the successful execution of the fast-track extubation protocol in the operating theatre, the patients were transferred to the intensive care unit (ICU) where they received postoperative management. The total ICU length of stay was < 24 hours, demonstrating the safety and efficacy of FTE for simple cardiac procedures and favourable outcomes. This approach is aimed at accelerating patient recovery, reducing complications, and enhancing overall surgical outcomes.
ANESTHESIA FOR PATENT DUCTUS ARTERIOSUS LIGATION SURGERY IN ADULT Kurniaji, Kurniaji; Pratomo, Bhirowo Yudo; Kurniawaty, Juni
Jurnal Kesehatan Tambusai Vol. 5 No. 4 (2024): DESEMBER 2024
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jkt.v5i4.35551

Abstract

Patent Ductus Arteriosus (PDA) adalah suatu kondisi jantung bawaan yang terjadi ketika pembuluh darah normal janin yang disebut ductus arteriosus, yang menghubungkan arteri pulmonalis dan aorta di dalam rahim, gagal menutup setelah bayi lahir. Laporan kasus ini berfokus pada manajemen anestesi pada pasien PDA dewasa yang menjalani operasi ligasi PDA, kemudian dilakukan teknik deep hypothermic circulatory arrest  (DHCA) yang tidak terencana karena terjadi ruptur aorta. Seorang wanita berusia 33 tahun, mengalami gejala kelelahan, sesak napas, dan intoleransi latihan yang memburuk sejak pertama kali didiagnosis 12 tahun lalu. Setelah pemeriksaan menyeluruh, pasien didiagnosis dengan PDA bidirectional shunt, hipertensi pulmonal dengan high flow high resistance, dan tes oksigen reaktif. Prosedur pembedahan pasien meliputi penutupan PDA melalui median sternotomi dengan mesin cardiopulmonary bypass (CPB). Anestesi yang digunakan yaitu anestesi berbasis opioid dengan DHCA selama 9 menit.  Beberapa faktor yang perlu diperhatikan dalam DHCA yang tidak terencana antara lain: (1) respon, keterampilan, dan kemampuan adaptasi terhadap situasi dari ahli bedah; (2) pembagian waktu yang baik; (3) pemberian es blok di area sekitar kepala pasien; dan (4) pemberian agen-agen farmakologis seperti midazolam, steroid dan manitol untuk menekan laju konsumsi oksigen serebral serta memberikan proteksi serebral pada kondisi ini. CPB dan DGCA yang disertai dengan tindakan neuroprotektif dan pemantauan yang tepat, dapat menjadi metode anestesi yang aman untuk pasien dewasa penderita PDA dan hipertensi pulmonal yang menjalani operasi ligasi PDA.
Tatalaksana Anestesi Pada Large Aortopulmonary Window, Pulmonary Hypertension, Dan Patent Foramen Ovale Yang Dilakukan Operasi Operasi Ap Window Closure Dan Pfo Dipertahankan Rizal, Anugrah Danang Ifnu; Fakhrudin Nur, Rifdhani; Pratomo, Bhirowo Yudo
Jurnal Locus Penelitian dan Pengabdian Vol. 4 No. 8 (2025): JURNAL LOCUS: Penelitian dan Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v4i8.4668

Abstract

Aortopulmonary window (AP window) is a rare congenital heart defect (0.2%-0.6%), due to failure of the conotruncal septum, and should be repaired as early as possible, ideally before 3 months of age, to prevent irreversible pulmonary hypertension (PH), heart failure, and death. We report a 2-year-6-month-old boy with a large aortopulmonary window, high flow–high resistance pulmonary hypertension (PH), and atrial septal defect/patent foramen ovale (ASD/PFO). Echocardiography showed a 13–15 mm AP window, left-to-right shunt, PFO, and 17 mm Tricuspid Annular Plane Systolic Excursion (TAPSE). CT scan detected an 8 mm ASD primum, PH, bilateral pneumonia, and minimal pericardial effusion. Catheterization showed high-flow-high-resistance PH. The patient was planned for aortopulmonary (AP) window closure and patent foramen ovale (PFO) was maintained under general anesthesia. Preoperative management involves a thorough evaluation, with premedication given in the form of midazolam 1 mg and induction using fentanyl 40 mcg and rocuronium 10 mg. Intubation was successful, SIMV-PC ventilation was maintained optimally (SpO? 99–100%). Invasive monitoring was used (ECG, TEE, arterial line, and CVC). During cardiopulmonary bypass (CPB) there was no severe hypoperfusion, but post-CPB there was severe vasoplegia and mild respiratory acidosis, managed with milrinone. Postoperative care focused on maintaining adequate cardiac output. Coagulation disorders were managed with FFP, PRC, and tranexamic acid. Pulmonary hypertension was prevented with high FiO? and correction of acidosis. Ventilator weaning was performed gradually and stably.
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