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All Journal Jurnal Anestesiologi Indonesia Journal of Anaesthesia and Pain Solo Journal of Anesthesi, Pain and Critical Care Jurnal Neuroanestesi Indonesia
Laksono, Buyung Hartiyo
Departemen Anestesiologi Dan Terapi Intensif, Fakultas Kedokteran, Universitas Brawijaya, RSUD Dr. Saiful Anwar, Malang, Indonesia
Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Perioperative Management of Neuroanesthesia in Patients with Supratentorial Tumors Who Have Excised Tumors Using Neuroprotection Technique and Total Intravenous Anesthesia Aditiarso, Candra; Laksono, Buyung Hartiyo
Journal of Anaesthesia and Pain Vol 5, No 2 (2024): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.02.04

Abstract

Background: Neuroanesthesia management presents a unique challenge for anesthesiologists. They must provide an optimal surgical condition without worsening the patient's neurological deficits. Therefore, we need drugs with neuroprotective abilities. This case report explains the perioperative management of neuroanesthesia in patients with supratentorial tumors who have excised tumors using a neuroprotection technique and total intravenous anesthesia (TIVA).Case: A 43-year-old female patient with space-occupying process cerebri with the differential diagnosis of meningioma frontotemporal dextra, post trepanation frontal sinistra tumor excision, edema cerebri, and hydrocephalus on ventriculoperitoneal shunt. On physical examination, Glasgow coma scale E3M6Vaphasia, aphasia and left hemiparesis were found. She underwent a tumor excision procedure with total intravenous anesthesia modified with neuroprotection techniques and total intravenous anesthesia techniques using 300 mg thiopental, 2 mg midazolam, 150 µg fentanyl, 80 mg lidocaine, and 50 mg rocuronium. Intraoperative anesthesia management was carried out by administering propofol 50 mg/hour, fentanyl 50 µg/hour, and atracurium 15 mg/hour.Conclusion: Total intravenous anesthesia is a complete general anesthesia method used in all intravenous agents, where the benefits of this method are used in neurosurgery, including accelerating the patient's return from the effects of anesthesia, faster recovery of cognitive function, as well as reducing intracranial pressure and the risk of ischemia.
Manajemen N-IOM (Manajemen Neurologi-Intraoperatif) pada Eksisi Tumor Myelum dan Dekompresi Stabilisasi Servikal C2-C6 Rusly, Andri; Laksono, Buyung Hartiyo
Jurnal Neuroanestesi Indonesia Vol 11, No 1 (2022)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2753.631 KB) | DOI: 10.24244/jni.v11i1.442

Abstract

Pemantauan neurofisiologis intraoperatif (N-IOM) berkembang menuju standar perawatan untuk meminimalkan risiko cedera jalur saraf selama prosedur bedah saraf. Pentingnya tidak hanya terletak dalam mendiagnosis cedera pada periode perioperatif untuk pasien yang berisiko tinggi serta komplikasi neurologis dari operasi tetapi juga dalam menciptakan kesempatan untuk menyelamatkan jaringan saraf yang berisiko sebelum kerusakan menjadi ireversibel. Operasi pada tulang belakang merupakan salah satu operasi dengan tingkat resiko tinggi untuk mencederai jaringan sehat sekitar, oleh sebab itu teknik anestesi dengan N-IOM akan sangat membantu mengurangi komplikasi durante operasi. Beberapa penelitian sebelumnya meneliti tentang kombinasi yang berbeda dari teknik N-IOM (seperti somatosensory evoked potentials [SEPs], motor evoked potentials [MEPs], direct wave, free- running electromyography). Hasilnya didapatkan bahwa penggunaan N-IOM multimodal untuk operasi tumor sumsum tulang belakang memberikan hasil yang lebih baik daripada penggunaan N-IOM dengan satu teknik. Teknik N-IOM dengan menggunakan sedasi seperti propofol dan dexmedetomidine yang dikombinasikan dengan opioid seperti fentanyl dapat menjaga kedalaman anestesi pasien tanpa mengganggu sinyal N-IOM itu sendiri. Untuk memaksimalkan nilainya, penting tim operasi untuk memiliki pemahaman dasar tentang prinsip-prinsip neuromonitoring dan ahli anestesi untuk memahami bagaimana hal itu dapat dipengaruhi oleh anestesi. Oleh karena itu, diperlukan teknik anestesi yang optimal dimana hemodinamik pasien tetap terjaga selama pembedahan dan monitoring IOM tetap dapat dilakukan.Management N-Iom (Neurology-Intraoperative Management) at Tumor Myelum Exition Decompression and Stabilization Cervical C2-C6AbstractIntraoperative neurophysiological monitoring (IOM) is advancing towards the standard of care for the risk of neural pathway injury during neurosurgical procedures. The importance lies not only in finding a diagnosis in the perioperative period for high-risk patients as well as neurologic complications from surgery but also in creating opportunities to salvage neural tissue before the damage becomes irreversible. Surgery on the spine is one of the operations with a high level of risk for injuring the surrounding health tissue, therefore the anesthetic technique with N-IOM will greatly help reduce complications during surgery. Several previous studies investigated different combinations of N-IOM techniques (such as somatosensory evoked potentials [SEPs], motor evoked potentials [MEPs], direct wave, free-running electromyography). The results showed that the use of multimodal N-IOM for spinal cord tumor surgery gave better results than the use of a single technique N-IOM. N-IOM techniques using sedatives such as Propofol and Dexmedetomidine in combination with Opioids can maintain the depth of anesthesia without interfering with the N-IOM signal itself. To maximize its value, it is important for the operating team to have a basic understanding of the principles of neuromonitoring and the anesthesiologist to understand how it can be affected by anesthesia. Therefore, an optimal anesthetic technique is needed where hemodynamics is maintained during surgery and IOM monitoring can still be performed.
Diabetes Insipidus pada Pasien Pascaoperasi Tumor Hipofisis Cahyanti G, Ramadina Putri; Nofiyanto, Eko; Laksono, Buyung Hartiyo
Jurnal Neuroanestesi Indonesia Vol 12, No 3 (2023)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v12i3.553

Abstract

Pembedahan pada tumor hipofisis dapat menyebabkan penurunan fungsi hipofisis, salah satunya adalah defisiensi antidiuretic hormone (ADH) yang dapat menyebabkan diabetes insipidus. Laporan kasus: Pasien perempuan 48 tahun, dengan diagnosis tumor sella-suprasella disertai visual loss, hipotiroid, hipoprolaktin, dan hipokortisol. Operasi berjalan 4 jam dengan tatalaksana general anestesi teknik proteksi otak. Pasca operasi pasien mengalami diabetes insipidus dengan klinis poliuriaa sampai lebih dari 6000 cc perhari. Dilakukan perawatan intensif dengan pemantauan ketat di Intensive Care Unit (ICU). Penggantian cairan dan pemberian desmopressin acetate kombinasi dengan vasopressin dilakukan sebagai terapi. Setelah perawatan 12 hari terjadi perbaikan klinis dan laboratoris. Tatalaksana dan monitoring yang tepat akan kejadian diabetes insipidus yang dapat mencegah terjadinya perburukan kondisi pada pasien.Diabetes Insipidus in Patient with Postoperative Pituitary TumorAbstractSurgery on a pituitary tumor can cause a decrease in pituitary function,: like deficiency antidiuretic hormone which cause diabetes insipidus. Case report: A 48-year-old female patient, with a diagnosis of sella-suprasella tumor accompanied by visual loss, hypothyroidism, hypoprolactin, and hypocortisol. The operation lasted 4 hours under general anesthesia with brain protection techniques. Postoperatively the patient had diabetes insipidus with clinical poliuriaa up to more than 6000 cc per day. Intensive care is carried out with close monitoring in the Intensive Care Unit. Fluid replacement and administration of desmopressin acetate in combination with vasopressin is performed as therapy. After 12 days of treatment, there was clinical and laboratory improvement. Appropriate management and monitoring of the incidence of diabetes insipidus can prevent the worsening of the patient's condition.
Manajemen Perioperatif Trepanasi Dekompresi Subdural Hemorrhage (SDH) dengan Hemofilia A Praniarda, Andika Satria; Laksono, Buyung Hartiyo
Jurnal Neuroanestesi Indonesia Vol 11, No 1 (2022)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2501.004 KB) | DOI: 10.24244/jni.v11i1.379

Abstract

Haemofilia A is congenital blood disease with female carrier, usualy found in male patient and happened for life. When one coagulation factor is lost or disfunction, coagulation mechanism will be disturbed and the bleeding difficult to stop. In this day, brain injury caused by trauma is the first cause of death in patient with haemophilia. Surgery in intracranial bleeding must be done as much as possible to get better prognosis. Blood evacuation must undergo quickly but very risky for rebleeding. Factor VIII must be given as soon as possible for treatment in severe haemophiliaA patient with acute bleeding. Maintenance anesthesia also include decrease risk of hypertension and tachicardia for minimalize the ongoing bleeding.Male 17thyears old diagnose with brain injury 2x4 caused by subdural hemorrhage (SDH) left frontotemporoparietal region and cerebral edema followed by subfalcine herniation to the right and haemophilia A planned for decompression evacuation of SDH. Patient got factor VIII 4000unit before operation. Intraoperative bledding are 1100cc and get 1940cc of blood product for stabilize the haemodynamic. Post operative was observe in Intensive Care Unit and went for extubation after 8thday after in good condition.Hemofilia adalah kelainan darah bawaan yang serius dengan wanita sebagai pembawa, terutama didapatkan pada pria dan berlangsung sepanjang hidup dimana hemofilia A merupakan tipe hemofilia tersering. Ketika salah satu faktor yang diperlukan untuk pembekuan darah hilang atau memiliki fungsi yang tidak memadai, mekanisme koagulasi yang terganggu menyebabkan perdarahan yang tidak dapat dihentikan. Saat ini, penyebab kematian paling umum di antara pasien hemofilia adalah perdarahan otak karena trauma kepala. Kasus perdarahan intrakranial sebisa mungkin dilakukan tindakan operasi segera untuk mendapatkan prognosis yang lebih baik. Tindakan evakuasi perdarahan harus dikerjakan dalam waktu singkat namun memiliki resiko tinggi terjadinya perdarahan ulang. Pemberian penggantian faktor VIII rekombinan untuk pengobatan perdarahan akut pada pasien hemofilia A berat harus dilakukan segera. Rumatan anestesi juga harus mencakup penurunan resiko hipertensi dan takikardia untuk meminimalkan terjadinya perdarahan. Laki-laki usia 17 tahun dengan diagnosa penurunan kesadaran cedera kepala 2x4 karena perdarahan intracranial subdural hemorrhage (SDH) regio frontotemporoparietal sinistra dan edema cerebri hari ke 4 disertai herniasi subfalcine ke kanan dengan hemofilia A direncanakan tindakan trepanasi dekompresi evakuasi SDH. Pasien mendapatkan injeksi faktor VIII 4000 unit sebelum operasi. Durante operasi perdarahan 1100cc dan mendapat transfusi 1940cc produk darah hingga hemodinamik stabil. Post operatif pasien dilakukan perawatan di ICU selama 8 hari, dilakukan extubasi setelah kondisi membaik.Perioperative Management Trepanation and Decompression Subdural Hemorrhage with Haemophilia AAbstractHaemofilia A is congenital blood disease with female carrier, usualy found in male patient and happened for life. When one coagulation factor is lost or disfunction, coagulation mechanism will be disturbed and the bleeding difficult to stop. In this day, brain injury caused by trauma is the first cause of death in patient with haemophilia. Surgery in intracranial bleeding must be done as much as possible to get better prognosis. Blood evacuation must undergo quickly but very risky for rebleeding. Factor VIII must be given as soon as possible for treatment in severe haemophilia A patient with acute bleeding. Maintenance anesthesia also include decrease risk of hypertension and tachicardia for minimalize the ongoing bleeding. Male 17th years old diagnose with brain injury 2x4 caused by subdural hemorrhage (SDH) left frontotemporoparietal region and cerebral edema followed by subfalcine herniation to the right and haemophilia A planned for decompression evacuation of SDH. Patient got factor VIII 4000unit before operation. Intraoperative bledding are 1100cc and get 1940cc of blood product for stabilize the haemodynamic. Post operative was observe in Intensive Care Unit and went for extubation after 8th day after in good condition.
Comparison of Intermittent Epidural Bolus and Continuous Epidural Infusion for Postoperative Pain Management in Abdominal Surgery Patients Siswagama, Taufiq Agus; Asmoro, Aswoco Andyk; Subagyo, Houdini Pradanawan; Laksono, Buyung Hartiyo
Journal of Anaesthesia and Pain Vol 5, No 3 (2024): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.03.02

Abstract

Background: Abdominal surgery often leads to high postoperative pain scores, which are commonly managed using epidural analgesia through either continuous infusion or intermittent bolus administration. This study aimed to compare the effectiveness of intermittent epidural bolus and continuous epidural infusion in managing postoperative pain among patients who underwent abdominal surgery.Methods: This cross-sectional study included 90 patients who underwent abdominal surgery and were randomly assigned to two groups. Group one received intermittent epidural bolus analgesia with ropivacaine 0.1875% and fentanyl 50 µg, administered as 10 cm³ every 8 hours (n=45). Group two received continuous epidural infusion analgesia with ropivacaine 0.1875% and fentanyl 100 µg, in a total volume of 50 cm³ at a rate of 3 cm³/hour (n=45). Pain levels were assessed using the numerical rating scale (NRS) at rest and during movement, measured every 12 hours for 84 hours. Statistical analysis was conducted using the independent t-test with a significance level of α=0.05 and a 95% confidence interval.Result: At 24 hours postoperatively, the NRS at rest was significantly lower in the continuous infusion epidural (0.15 ± 0.36) compared to the intermittent bolus (0.91 ± 0.35) (p=0.000), and this trend persisted at subsequent time points (36, 48, 60, 72, and 80 hours postoperatively). For movement, the NRS at 36 hours was also lower in the continuous infusion epidural (1.00 ± 0.00) compared to the intermittent bolus (1.29 ± 0.45) (p=0.000), with similar differences observed at other time points.Conclusion: Continuous epidural infusion provides superior analgesia to intermittent epidural bolus administration in abdominal surgery patients. This method is associated with faster and sustained reductions in pain intensity at rest and during movement.
Optical Nerve Sheath Diameter (ONSD) Ultrasonography as Intracranial Non-Invasive Pressure Measurement in PostOperative Patient EDH Evacuation in ICU Saputro, Ramadhan; Adipurna, Resa Putra; Laksono, Buyung Hartiyo
Jurnal Neuroanestesi Indonesia Vol 14, No 1 (2025)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i1.582

Abstract

Intracranial Pressure (ICP) monitoring is an important component in the management of severe Traumatic Brain Injury (TBI) in ICU. Periodic ICP monitoring in patients with severe TBI who were treated in ICU resulted in lower mortality rates than those who were not measured. ICP can be measured by invasive or non-invasive methods. Invasive measurements related to higher cost, while non-invasive tests such as MRI and CT scans are associated with radiation exposure. ONSD ultrasound is an alternative examination that is practical, inexpensive, without radiation, and can be performed bedside. We report a case in the ICU of RSUD Dr. Saiful Anwar Malang, male, 44 years old, had a traffic accident, and was diagnosed with severe TBI with GCS E2V2M4, right frontotemporal 36cc epidural hematoma, cerebral edema, and left posterolateral 4th rib fracture. The patient underwent epidural hematoma surgical evacuation. Postoperatively, the patient was treated in ICU. We performed periodic ONSD ultrasound and with the guidance of these examinations the patient's management could be adjusted. Within 48-hours postoperatively the patient could be extubated and then moved to ward. ONSD ultrasound could be done bedside so that clinicians could quickly and precisely adjusted the management according to the dynamic condition of the patient.
Characteristic Outline of Head Trauma Patients at Dr. Saiful Anwar General Hospital Laksono, Buyung Hartiyo; Pertiwi, Previasari Zahra; Siswagama, Taufiq Agus; Isngadi, Isngadi
Journal of Anaesthesia and Pain Vol. 6 No. 3 (2025): In Press
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Background: Traumatic brain injury is defined as a decline in brain function characterized by a decreased level of consciousness, seizures, and focal sensory and motor neurologic deficits caused by blunt force or penetration by a sharp object into the intracranial space. This reseracrh aims to determine the characteristics of head trauma patients at Dr. Saiful Anwar General Hospital, Malang.Methods: This descriptive observational study sampled all head trauma patients at Dr. Saiful Anwar General Hospital, Malang, from March to August 2023. The study variables included patient demographics, cause of trauma, clinical data, pre-and postoperative procedures, outcomes of trauma patients undergoing treatment, and length of stay. Data were analyzed using Microsoft Excel.Results: A total of 227 head trauma patients were identified, most of whom were men aged 20-39 (71). Students (72) were the most common victims of head trauma, most often due to accidents. There were 156 patients with mild head injuries. 208 patients had normal oxygen saturation. 157 patients had normal hemoglobin, 181 patients had normal sodium, and 196 patients had normal blood glucose levels. 102 patients experienced hypocarbia. A normal CT scan of 141 patients was performed. 206 patients underwent surgery, while 214 patients did not undergo tracheostomy. 149 patients underwent surgery with early emergence. The highest number of patients were patients with a hospital stay of more than 14 days (140 patients). The most common outcome was mild disability (84 patients).Conclusion: Most patients were male, aged 20-39. The most common cause was accidents involving students. Most patients with mild head injuries had normal oxygen saturation, hemoglobin,sodium, and blood glucose levels. Most patients with hypocarbia had no bleeding, and CT scans showed no bleeding. Most patients underwent surgery and early emergence, with a hospital stay of more than 14 days, and the most common outcome was mild disability.
Comparison of Intermittent Epidural Bolus and Continuous Epidural Infusion for Postoperative Pain Management in Abdominal Surgery Patients Siswagama, Taufiq Agus; Asmoro, Aswoco Andyk; Subagyo, Houdini Pradanawan; Laksono, Buyung Hartiyo
Journal of Anaesthesia and Pain Vol. 5 No. 3 (2024): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.03.02

Abstract

Background: Abdominal surgery often leads to high postoperative pain scores, which are commonly managed using epidural analgesia through either continuous infusion or intermittent bolus administration. This study aimed to compare the effectiveness of intermittent epidural bolus and continuous epidural infusion in managing postoperative pain among patients who underwent abdominal surgery.Methods: This cross-sectional study included 90 patients who underwent abdominal surgery and were randomly assigned to two groups. Group one received intermittent epidural bolus analgesia with ropivacaine 0.1875% and fentanyl 50 µg, administered as 10 cm³ every 8 hours (n=45). Group two received continuous epidural infusion analgesia with ropivacaine 0.1875% and fentanyl 100 µg, in a total volume of 50 cm³ at a rate of 3 cm³/hour (n=45). Pain levels were assessed using the numerical rating scale (NRS) at rest and during movement, measured every 12 hours for 84 hours. Statistical analysis was conducted using the independent t-test with a significance level of α=0.05 and a 95% confidence interval.Result: At 24 hours postoperatively, the NRS at rest was significantly lower in the continuous infusion epidural (0.15 ± 0.36) compared to the intermittent bolus (0.91 ± 0.35) (p=0.000), and this trend persisted at subsequent time points (36, 48, 60, 72, and 80 hours postoperatively). For movement, the NRS at 36 hours was also lower in the continuous infusion epidural (1.00 ± 0.00) compared to the intermittent bolus (1.29 ± 0.45) (p=0.000), with similar differences observed at other time points.Conclusion: Continuous epidural infusion provides superior analgesia to intermittent epidural bolus administration in abdominal surgery patients. This method is associated with faster and sustained reductions in pain intensity at rest and during movement.
Manajemen Anestesia pada Evakuasi Epidural Haemorrhage (EDH) dengan Pendarahan Masif Huda, Nurul; Laksono, Buyung Hartiyo
Jurnal Neuroanestesi Indonesia Vol 10, No 1 (2021)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (40.26 KB) | DOI: 10.24244/jni.v10i1.329

Abstract

Cedera otak traumatik menjadi penyebab dari mortalitas dan morbiditas di seluruh dunia. Epidural Haemorrhage (EDH) merupakan salah satu bentuk cedera otak traumatik dimana waktu adalah indikator yang harus diperhatikan dalam tatalaksananya. Fokus utama selama penatalaksanaan kasus cedera otak traumatik adalah stabilisasi pasien dan mengendalikan tekanan intrakranial, serta mempertahankan oksigenasi dan perfusi otak. Selanjutnya dilakukan dekompresi dengan pembedahan. Evakuasi dan kontrol perdarahan harus dikerjakan dalam waktu singkat untuk menghindari cedera lebih lanjut. Praktik neuroanastesi, sebagai penunjang dalam tatalaksana cedera otak traumatik, sering diasosiasikan dengan kejadian kehilangan darah yang mengakibatkan kondisi anemia selama periode intra operatif dan pasca operatif. Meskipun anemia berkorelasi dengan hasil akhir yang buruk pada pasien cedera otak, transfusi sel darah merah untuk mengoreksi kondisi anemia juga berkorelasi dengan hasil akhir yang buruk pada pasien. Masih belum ada rekomendasi yang jelas mengenai pemberian transfusi, apakah restriksi atau masif, terkait dengan manfaat yang diberikan. Pasien laki-laki, usia 51 tahun dengan keluhan penurunan kesadaran dan muntah-muntah, rujukan dari rumah sakit sebelumnya dengan diagnosis cedera kepala sedang 225 dengan EDH temporoparietal 96cc, midline shift 11mm ke kanan, edema serebri. Selama durante operasi terjadi perdarahan masif yang mengganggu status hemodinamik sehingga diberikan transfusi komponen darah sampai didapatkan status hemodinamik yang stabil. Pada perawatan pasca operasi di ICU, kondisi pasien relatif baik.Blood Transfusion Management for Epidural Haemorrhage (EDH) Evacuation with Massive BleedingAbstractTraumatic brain injury causes mortality and morbidity worldwide. Epidural Haemorrhage (EDH) is a form of head injury where time is an indicator that must be considered in its management. The main focus during traumatic brain injury management is patient stabilization and control of intracranial pressure, as well as maintaining brain oxygenation and perfusion. Subsequently, surgical decompression was performed. Evacuation and bleeding control should be done in a short time to avoid further injury. The practice of neuroanesthesia, as a support in the management of traumatic brain injuries, is often associated with blood loss that results in anemia during the intraoperative and postoperative periods. Although anemia correlates with poor outcome in brain-injured patients, red blood cell transfusion to correct anemia also correlates with poor outcome in patients. There are still no clear recommendations regarding the administration of transfusions, whether restrictive or massive, regarding the benefits provided. Male patient, age 51 years with complaints of decreased consciousness and vomiting, referred from the previous hospital with a diagnosis of moderate head injury 225 with 96cc temporoparietal EDH, 11mm midline shift to the right, and cerebral edema. During the operation period, there was massive bleeding that interfered with the hemodynamic status so that blood components were transfused until a stable hemodynamic status was obtained. In postoperative care in the ICU, the patient is relatively in good condition.
Transcranial Doppler Ultrasonography: Diagnosis dan Monitoring Non Invasif pada Neuroanesthesia dan Neurointesive Care Laksono, Buyung Hartiyo
Jurnal Neuroanestesi Indonesia Vol 6, No 2 (2017)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (421.252 KB) | DOI: 10.24244/jni.vol6i2.47

Abstract

Transcranial Doppler (TCD) adalah pemeriksaan ultrasonografi yang telah digunakan secara luas dibidang neuroanestesi dan perawatan intensif. Pada bidang perawatan intensif neurologi, pemeriksaan TCD sangat berguna untuk evaluasi dan monitoring perubahan sirkulasi pembuluh darah penting di otak, seperti arteri serebri media (middle cerebral artery-MCA), arteri serebri anterior (anterior cerebral artery-ACA), arteri carotis interna (internal carotid artery-ICA) cabang terminalis, arteri cerebri posterior (posterior cerebral artery-PCA), arteri vertebralis dan arteri basilaris. Selain kecepatan aliran, pemeriksaan ini juga dapat digunakan untuk evaluasi perubahan diameter pembuluh darah. TCD digunakan untuk pemeriksaan penunjang diagnostik perdarahan subarachnoid, monitoring vasospasme dan deteksi peningkatan tekanan intrakranial (TIK), evaluasi hemodinamik cerebral pada kasus trauma kepala, serta sebagai alat bantu penentuan kasus kematian otak. Pada tindakan pembedahan saraf atau neurosurgery, TCD sangat berguna dalam deteksi dini adanya mikroemboli.Transcranial Doppler Ultrasonography: Diagnosis and Monitoring non Invasive in Neuroanesth and Neurointensive CareTranscranial Doppler (TCD) is ultrasound examination which is already widely used in the field of neuroanesthesia and intensive care. In the field of neurology intensive care, TCD examination is very useful for the evaluation and monitoring of significant changes in the circulation of main cerebral blood vessels, such as the middle cerebral artery (MCA), anterior cerebral artery (ACA), terminal branches of internal carotid artery (ICA), posterior cerebral artery (PCA) , the vertebral artery and the basilar artery. In addition to the flow velocity, the examination can also be used to evaluate changes in the diameter of blood vessels. TCD is used for diagnostic investigation of subarachnoid hemorrhage, vasospasm monitoring and detection of elevated intracranial pressure (ICP), evaluation of cerebral hemodynamics changes in cases of head injury, as well as aids for determination of brain death cases. In neurosurgery, TCD is very useful in the early detection of microemboli.
Co-Authors Adipurna, Resa Putra Aditiarso, Candra Andika Satria Praniarda Arie Zainul Fatoni Aswoco Andyk Asmoro Aswoco Andyk Asmoro Bambang J. Oetoro Cahyanti G, Ramadina Putri Candra Aditiarso Dadik Prasetya Hutama Eko Nofiyanto Emilia Tiara Shantikaratri Haffidz Wahyu Aji Isngadi Isngadi Isngadi, M. Isngadi, M. Marsudi Rasman Mirza Koeshardiandi Muhammad Rizqan Khalidi Nazaruddin Umar Nurul Huda Oetoro, Bambang J. Pertiwi, Previasari Zahra Praniarda, Andika Satria Priscilla Tulong Putu Pramana Suarjaya Rasman, Marsudi Razi Ageng Pratama Ristiawan Muji Laksono Ruddi Hartono Rusly, Andri Saleh, Siti Chasnak Saleh, Siti Chasnak Saputro, Ramadhan Siti Chasnak Saleh Sri Rahardjo Sri Rahardjo Subagyo, Houdini Pradanawan Tamam, Abdul Rasyid Tatang Bisri Taufiq Agus Siswagama Taufiq Agus Siswagama Ulil Abshor Umar, Nazaruddin Vilda Prasastri Yuwono Wiwi Jaya Wiwi Jaya Yudhistira Yuliandra Yudi Hadinata