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All Journal Jurnal Anestesi Perioperatif Indonesian Journal of Medicine Jurnal Anestesi Obstetri Indonesia Jurnal Kedokteran Mulawarman Solo Journal of Anesthesi, Pain and Critical Care Cermin Dunia Kedokteran Jurnal Neuroanestesi Indonesia
Ardana Tri Arianto
Bagian Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Sebelas Maret/RSUD Dr Moewardi Surakarta
Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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POLA BAKTRI DARI JAM TANGAN DAN KACAMATA YANG DIBAWA KE INSTALASI BEDAH SENTRAL RUMAH SAKIT Dr. MOEWARDI SURAKARTA Siregar, Geovaldy; Arianto, Ardana Tri; Putro, Bambang; Wicaksono, Nefrizal
Jurnal Kedokteran Mulawarman Vol 10, No 3 (2023): Jurnal Kedokteran Mulawarman
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30872/jkm.v10i3.7662

Abstract

Ruang bedah berperan sebagai penyebab infeksi nosokomial terutama akibat luka bedah. Transmisi patogen oleh tangan petugas kesehatan berperan penting dalam rute infeksi silang. Beberapa jam tangan mengandung bakteri patogen, namun efeknya sebagaipembawa bakteri belum dapat dijelaskan. Penelitian ini bertujuan untuk mengetahui pola bakteri jam tangan dan kacamata yang dibawa ke kamar operasi di Rumah Sakit Dr. Moewardi Surakarta. Penelitian menggunakan metode kuantitatif dengan pendekatan deskriptif laboratorik di Instalasi Bedah Sentral RSUD Dr. Moewardi Surakarta pada Juni - Juli 2018. Sampel adalah seluruh hardware yang dibawa masuk ke ruang bedah umum dan memenuhi kriteria inklusi. Pengambilan sampel menggunakan metode swab dan dibawa ke Laboratorium Mikrobiologi Fakultas Kedokteran Universitas Sebelas Maret untuk diidentifikasi. Data dianalisis dengan Uji Fhiser Exact Test. Hasil penelitian terhadap 40 hardware yaitu 19 jam tangan dan 21 kacamata yang dipakai dan dibawa ke kamar operasi Instalasi Bedah Sentral RS Dr. Moewardi Surakarta. Hardware yang dibawa dan mengandung bakteri patogen sebanyak 33 hardware (82,5%). Hardware yang terkontaminasi patogen paling banyak adalah kacamata, (p= 0,040). Jenis bakteri yang paling banyak ditemukan adalah Staphylococcus              hominis sebanyak 16 hardware (40,0%). Staphylococcus haemolyticus ditemukan pada 7 hardware (17,5%). Staphylococcus epidermidis ditemukan pada 4 hardware (10,0%). Kesimpulan dari penelitian ini adalah hardware yang diteliti dan terdapat pathogen ada 33 hardware (82,5%).Jenis bakteri yang paling banyak ditemukan adalah Staphylococcus hominis pada 40,0% hardware.
Dexmedetomidine Adjuvant in Awake Intubation as Difficult Airway Management for Submandibular Abscess with Mediastinum Infiltration Arianto, Ardana Tri; Utama, Sigit Prastya; Faras, Asaduddien
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 4, No 2 (2024): October 2024
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v4i2.67811

Abstract

Background: Maintaining a secure airway in difficult airway settings is important due to morbidity and mortality. Conventional intubation relies on benzodiazepines, opioids, and propofol which have a respiratory depression effect. Dexmedetomidine has a minimal to no central respiratory depression effect. A submandibular abscess can result in laryngeal edema which narrows or occludes the airway.Case Ilustration: A 65-year-old male complained of difficulty breathing and shortness of breath accompanied by neck and right jaw pain that radiated to the right cheek. The patient also complained of a salty taste every time the patient swallows. Obtained blood pressure 112/73 mmHg on norepinephrine support syringe pump 0.1 mcg/kg/minute (5.4 cc/hour), pulse rate 120 bpm, respiratory rate 32 times per minute with the help of respiratory muscles. The patient’s temperature was 36.7oC. The patient’s initial Glasgow Coma Scale was E3V5M6. Difficult airway was observed due to submandibular mass, 1-2 finger mouth opening, trismus, mallampati was difficult to evaluate, limited neck motion due to pain, and missing teeth. Imaging showed a soft tissue mass in the neck region. The patient underwent awake intubation using a video laryngoscope and Nasoendotracheal tube number 6.5 was installed with 70 mcg of dexmedetomidine syringe pump in 10 minutes (with pump rate of 105 ml per hour) and lidocaine mouth rinse. The intubation process went smoothly and the patient was admitted to the Intensive Care Unit for further monitoring.Conclusion: Management of difficult airway settings is important due to morbidity and mortality. The use of dexmedetomidine is considered safe and effective in securing the airway in patients with difficult airway.
Effect of Preoperating Maltodextrin 12.5% Carbohydrate Drink on High Sensitive C Reactive Protein Levels Post-Brachytherapy Purwoko, Purwoko; Arianto, Ardana Tri; Putra, Eka Satrio; Purnomo, Frederick Johan
Indonesian Journal of Medicine Vol. 10 No. 3 (2025)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2025.10.3.853

Abstract

Background: Brachytherapy is radiation therapy that will cause inflammation and tissue damage that leads to inflammation, characterized by the release of pro-inflammatory cytokines, including hs-CRP levels in the plasma. Preoperative administration of glucose solution is known to reduce the increase in cortisol, and is thought to reduce postoperative hs-CRP levels. So far there has been no research that specifically examines the effect of preoperative carbohydrate administration on hs-CRP values after brachytherapy. This study aims to determine the effect of preoperative carbohydrate administration on post-brachytherapy hs-CRP values. Subjects and Method: This study was designed a double-blind randomized controlled trial was conducted at the Radiotherapy Unit of Dr. Moewardi General Hospital, Surakarta, from April to September 2022. Sixty-four cervical cancer patients with ASA physical status I or II undergoing brachytherapy under general anesthesia were recruited using consecutive sampling. Participants were randomly assigned into two groups: an intervention group receiving 12.5% maltodextrin solution and a control group receiving mineral water. The independent variable was preoperative carbohydrate administration, and the dependent variable was hs-CRP level measured 2 hours before and 4 hours after brachytherapy. Data were analyzed using paired t-test Results: Post-brachytherapy hs-CRP levels were significantly lower in the treatment group (mean = 2.565 ± 2.0 mg/dL) compared to the control group (mean = 3.69 ± 2.58 mg/dL; p = 0.019). Both groups showed significant increases in hs-CRP from pre- to postoperative values (p < 0.001). The change in hs-CRP (Δhs-CRP) was also significantly lower in the treatment group (p = 0.025). Conclusion: The administration of maltodextrin was able to significantly reduce post-brachytherapy hs-CRP levels compared to placebo.
Pengelolaan Neuroanestesi pada Pasien dengan Pentalogy of Fallot Putra, Eka Satrio; Suryandari, Retno; Purwoko, Purwoko; Arianto, Ardana Tri
Jurnal Neuroanestesi Indonesia Vol 9, No 3 (2020)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2770.473 KB) | DOI: 10.24244/jni.v9i3.273

Abstract

Pentalogy of Fallot (POF) salah satu jenis cacat jantung bawaan sianotik langka yang berpotensi tinggi komplikasi abses cerebri. Abses cerebri sering dijumpai pada kelainan jantung sianotik karena terjadinya hipoksia kronis dan yang kedua adalah hiperviskositas karena berkurangnya aliran mikrosirkulasi ke otak. Kami melaporkan seorang anak laki-laki berusia 6 tahun, berat badan 14 kg dengan abses otak multiple yang disertai dengan Pentalogy of Fallot (POF) yang akan dilakukan kraniotomi evakuasi abses. Pemeriksaan fisik preoperatif didapatkan GCS E4V5M6, SpO2 preductal 88%, post ductal 84 % dalam posisi supine. Pada sistem kardiovaskular didapatkan bunyi jantung I-II regular, bising sistolik terkuat di parasternal kiri ICS 3 grade 3, clubbing finger. Nilai hemoglobin 14,4gr%, hematokrit 43%, leukositosis 13,200/mm Tujuan anestesi pada penyakit jantung sianotik POF adalah menjaga curah jantung dengan mempertahankan denyut jantung, kontraktilitas juga preload, mencegah peningkatan rasio PVR:SVR serta menghindari hipersianosis akibat peningkatan mendadak kebutuhan oksigen sistemik. Pilihan agen anestesi harus didasarkan pada fisiologi pasien dan tujuan menyeimbangkan aliran darah paru dan sistemik. Rehidrasi yang adekuat sebelum induksi dan penggunaan diuretik manitol dapat dipertimbangkan mengingat hiperviskositas menurunkan pengiriman oksigen ke otak. Peningkatan TIK dari ketamine dapat dikurangi dengan hiperventilasi, kombinasi dengan benzodiazepin dan dengan pencegahan hipercapnia. Maka dari itu monitoring end tidal CO2 (ETCO2) perlu diperhatikan. Pengelolaan perioperatif pasien POF pada kasus evakuasi abses cerebri pada anak laki- laki usia 6 tahun pada laporan berikut ini menuliskan pentingnya pemahaman akan patofisiologi POF dan teknik neuroanestesi untuk mendapatkan luaran yang baik.Neuroanesthesia on Patient with Pentalogy of FallotAbstractPentalogy of Fallot (POF) is a rare type of cyanotic congenital heart defect with high risk of having cerebral abscesses as one of its complications. Cerebral abscesses are often found in cyanotic heart disease due to chronic hypoxia and hyperviscosity reduced microcirculatory flow to the brain. We report a 6-year-old boy, 14 kg body weight with multiple brain abscesses accompanied by Pentalogy of Fallot (POF) who undergone a craniotomy to evacuate the abscess. Preoperative physical examination found GCS E4V5M6, other vital signs within normal limits, preductal oxygen saturation 88%, post ductal oxygen saturation in supine position 84%. The I-II heart sounds are regular with grade 3 systolic murmur in the left parasternal third intercostal space and clubbing finger was found. The laboratory shows a hemoglobin value of 14.4gr%, hematocrit of 43%, leukocytosis 13,200/mm. The goal of anesthesia in cyanotic heart disease is to maintain cardiac output by stabilize heart rate, contractility as well as preload, prevent the increase of PVR:SVR ratio and avoid hypercyanotic due to sudden increase in systemic oxygen demand. The choice of anesthetic agent must be based on the patient's physiology. Adequate rehydration before induction and use of mannitol diuretics can be considered to reduce hyperviscosity that decrease oxygen delivery to the brain. Increased intracranial pressure from ketamine can be reduced by hyperventilation, in conjunction to benzodiazepines and prevention of hypercapnia. Therefore, monitoring end tidal CO2 (ETCO2) needs to be done. This case report delineating the perioperative management of a 6 years old boy with POF underwent evacuation of cerebral abscesses, will highlight the importance of understanding the pathophysiology of POF and neuroanesthesia techniques in order to receive a good outcome.
Co-Authors Alfianto, Untung Anindita Anindita Arif Ramadhan, Alriztya Arif Wahyu Widayat Bambang Novianto Putro Budi Santosa, Sugeng Djoko Tjahyo Nugroho Faras, Asaduddien Fritzky Indradata Hadian, Ingga Heri Dwi Purnomo Heri Dwi Purnomo Indra Chuandy Kaligis, Stephanus Andy Prakasa Muh. Husni Thamrin Muhammad Husni Thamrin Muhammad Husni Thamrin, Muhammad Husni Purnomo, Frederick Johan Purwoko Purwoko Purwoko Purwoko Putra, Eka Satrio Putro, Bambang RTH Supraptomo Siregar, Geovaldy Stephanus Andy Prakasa Kaligis Sudjito, M. H Sudjito, M.H Sugeng Budi Santosa Sugeng Budi Santosa Sugeng Budi Santoso Suryandari, Retno Syarif Afif Utama, Sigit Prastya Wicaksono, Nefrizal Yani, Yusri