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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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Tehnik Proteksi Otak pada Pembedahan Non Neurosurgery (Radical Neck Dissection) dengan Premorbid Space Occupying Lesion (SOL) dan Infark Serebri Laksono, Buyung Hartiyo; Saleh, Siti Chasnak
Jurnal Neuroanestesi Indonesia Vol 3, No 3 (2014)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2391.959 KB) | DOI: 10.24244/jni.vol3i3.144

Abstract

Insidensi kasus tumor dengan metastase otak berkisar antara 100.000 sampai 170.000 pertahun. Metastase otak bersifat multiple dengan 80% terletak pada hemis ferserebri. Pendesakan akibat lesi tersebut mengakibatkan gangguan neurologis dan peningkatan tekanan intrakranial (TIK). Seorang laki-laki, 62 tahun dengan tumor sub mandibula direncanakan radical neck dissection. Pada pasien didapatkan proses metastase pada serebri dan cerebropontine angle disertai infark serebri daerah pons dan otak tengah. Defisit neurologis berupa kelemahan ekstremitas kanan dan disartria. Preoperatif diberikan kortikosteroid untuk menurunkan edema perifokal. Tatalaksana anestesi dengan prinsip tehnik proteksi otak, dilakukan induksi kombinasi dengan midazolam, fentanyl, lidokain, propofol dan rocuronium. Kontrol ventilasi target paCO2 3035 mmHg. Pemeliharaan anestesi dengan kombinasi sevofluran dan propofol. Pembedahan berjalan 7 jam, temperature selama pembedahan 3536 C dan MAP dijaga 70 mmHg. Dilakukan ekstubasi, setelah menilai status neurologis dan hemodinamik, difasilitasi dengan lidokain. Pascabedah tidak didapatkan perburukan defisit neurologis. Pasien dirawat di ICU selama 2 hari kemudian ke ruangan dengan perbaikan status neurologis. Tehnik proteksi otak bertujuan mencegah cedera sekunder dari SOL dan iskemia. Tindakan anestesi dan pembedahan dapat menambah perburukan cedera sekunder. Penatalaksanaan anestesi yang baik dengan prinsip proteksi otak akan menghasilkan outcome pembedahan sesuai yang diharapkan. Brain Protection Technique in Non Neurosurgical Procedure (Radical Neck Dissection) on a Patient with Space Occupying Lession (SOL) and Cerebral InfarctionThe incidence of tumors with brain metastases ranged from 100,000 to 170,000 per year. Brain metastases are multiple with 80% of lesion located on the cerebral hemispheres. These lesions could cause neurological disorders and increase intracranial pressure (ICP). A 62 years old male, diagnosed with sub mandibular tumour was scheduled for radical neck dissection. From preoperative evaluation he hadcerebral metastasis at the cerebrum and cerebro-pontine angle with cerebral infarction at pons and middle brain regions. Neurological deficits were weakness of the right limband dysarthria. The patient received corticosteroids pre-operatively to reduce perifocal edema. Anesthesia management was given using brain protection principles. Induction was done by using midazolam, fentanyl, lidocaine, propofol and rocuronium. Ventilation was controlled with a target PaCO2 of 3035 mmHg. Sevoflurane and propofol was given as anesthesia maintenance. Surgery was done for 7 hrs, temperature was 3536 C during surgery and MAP was maintained 70 mmHg. Extubation was done after assessing the neurologic and hemodynamic status,facilitated with lidocaine. There was no worsening of neurologic deficits post surgery. Patients was managed in the ICU for 2 days and transferred to ward with increased neurological state. The technique of brain protection aims to prevent further process of secondary injury from SOL and ischemia. Anesthesia and surgery itself could increase the progression of secondary injury. Anesthesia management usingbrain protection principles will provide better outcomes as expected.
Pembedahan Tumor Cerebellopontine Angle: Tehnik Proteksi Otak, Pengawasan Sistem Kardiorespirasi dan Efek Manipulasi Posisi True Lateral Laksono, Buyung Hartiyo
Jurnal Neuroanestesi Indonesia Vol 8, No 3 (2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (3849.096 KB) | DOI: 10.24244/jni.v8i3.217

Abstract

Tumor cerebellopontine angle (CPA) merupakan jenis neoplasma terbanyak yang ditemukan di fossa posterior. Wanita 32 tahun dengan diagnosa CPA tumor dilakukan pembedahan trepanasi reseksi. Posisi pembedahan true lateral. Tehnik anestesi proteksi otak menggunakan kombinasi total intra vena (TIVA) dan inhalasi. Dilakukan pemasangan pengawasan invasif untuk memantau perubahan sistem kardiorespirasi selama pembedahan. Dilakukan pencegahan dan pemantauan terhadap akibat dari posisi pembedahan. Hasil dari pembedahan didapatkan pengurangan skala nyeri dan peningkatan fungsi neurologis. Tindakan pembedahan pada tumor di daerah CPA merupakan tindakan pembedahan yang sulit dan dapat menimbulkan komplikasi yang fatal. Pengelolaan anestesi untuk tindakan bedah fossa posterior memerlukan pertimbangan yang matang dan sudah ditentukan sebelum dilakukan anestesi. Persiapan pada pasien dengan lesi fossa posterior adalah evaluasi prabedah, premedikasi, induksi, posisi durante, pengelolaan anestesi dan monitoring. Manipulasi selama pembedahan pada batang otak dan saraf kranialis akan menimbulkan akibat pada sistem kardiorespirasi dan dapat fatal. Posisi true lateral mempunyai resiko tersendiri terhadap pasien selama dan pascapembedahan, hal tersebut harus menjadi perhatian khusus oleh ahli anestesi. Anestesi mempunyai peranan yang sangat penting dalam manajemen secara keseluruhan pada pasien ini untuk memberikan manajemen proteksi otak yang maksimal selama pembedahan sehingga memperoleh hasil akhir pembedahan yang sukses.Cerebellopontine Angle Tumor Surgery: Brain Protection Techniques, Cardiorespiratory System Monitoring and True Lateral Position Manipulation EffectsAbstractCerebellopontine angle (CPA) tumors are the most common neoplasm found in the posterior fossa. A 32-year-old woman diagnosed with CPA tumor underwent resection. The surgery position is true lateral. Brain protection anesthetic techniques use total intravenous (TIVA)-inhalation combination. Invasive monitoring is performed to monitor the cardiorespiratory system during surgery. Prevention and monitoring are done to manage the effect of surgical position. There is a reduction in pain scale and increased neurological function after the surgery. CPA tumor surgery is a difficult procedure and potentially cause fatal complications. The anesthesia management for posterior fossa surgery must be determined before anesthesia. The surgery preparation for posterior fossa lesions-patients consists of surgery evaluation, premedication, induction, durante position, anesthesia management, and monitoring. The brainstem and cranial nerve surgery cause a fatal complication in the cardiorespiratory system. The true lateral position impact the patients' condition during and after surgery. Anesthesia is important to provide maximum brain protection and successful surgery.
Chula Formula is recommended in Estimating the Length of Tracheal Tube Insertion in Patients Receiving Mechanical Ventilation in Intensive Care Units in the Absence of Chest X-Ray Laksono, Buyung Hartiyo; Hartono, Ruddi; Tamam, Abdul Rasyid; Jaya, Wiwi
Journal of Anaesthesia and Pain Vol. 4 No. 2 (2023): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2023.004.02.01

Abstract

Background: Chest X-Ray (CXR) is one of the most effective ways of confirming the length of the tracheal tube (TT) insertion. However, some intensive care unit in developing countries has no sufficient facilities. This study aims to evaluate the accuracy of TT length insertion using the Chula formula and Colombian formula in patients receiving mechanical ventilation in intensive care units.Methods: This study is a comparative observational study of 50 adults in the Intensive care unit, divided into two groups. Group A used the Chula formula for TT length insertion (n= 25) and Group B used the Colombian formula (n= 25). The TT length insertion accuracy was evaluated using radiological parameters. Statistical analysis used: Data were analyzed statistically using the T-test and Chi-square test.Result: The Chula formula is significantly more precise than the Colombian formula in estimating the length of TT insertion based on the radiographic parameters of the TT length insertion right midway between the medial tip of the clavicle and TT located in the T3 or T4 vertebrae (p <0.05), but not significantly different in the two other parameters.Conclusion: Both the Chula formula and the Colombian formula can estimate the length of TT insertion in adult patients. However, the Chula formula is more recommended in the length of TT insertion and benefit in the ICU with insufficient CXR.
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.
Tatalaksana Anestesi pada Prosedur Minimal Invasive Neurosurgery: Kasus Perdarahan Intraserebral Traumatika Laksono, Buyung Hartiyo; Suarjaya, I Putu Pramana; Rahardjo, Sri; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 5, No 2 (2016)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2321.139 KB) | DOI: 10.24244/jni.vol5i2.68

Abstract

Traumatic brain injury (TBI) menyumbang 70% kematian akibat trauma. Penyebab yang tersering adalah kecelakaan lalu lintas 49%. Tehnik minimal invasif cukup berkembang pada beberapa dekade ini, demikian juga pada bidang bedah saraf. Tujuan utama tatalaksana anestesia adalah immobilisasi intraoperatif, stabilitas kardiovaskuler, minimal komplikasi pascaoperasi, fasilitasi intraoperatif neurologi monitoring, kolaborasi tatalaksana peningkatan tekanan intrakranial (TIK) dan rapid emergence untuk pemeriksaan neurologis dini. Kasus laki-laki 50 tahun dengan perdarahan intraserebral (ICH) direncanakan operasi minimal invasive neuroendoscopy evakuasi hematom. Posisi selama operasi adalah true lateral yang juga menjadi perhatian tersendiri. Komplikasi akibat posisi harus dihindari karena rentan mempengaruhi luaran operasi. Operasi berjalan selama 3 jam dengan luaran optimal. Beberapa masalah penting menjadi perhatian khusus selama operasi dan pascaoperasi. Prinsip tatalaksana anestesi pada minimal invasif yang harus dicapai adalah pemeriksaan dan perencanaan preoperatif yang baik, kontrol hemodinamik serebral untuk menjamin tekanan perfusi otak (cerebral perfusion presure/CPP) optimal, immobilisasi penuh, dan dapat dilakukan rapid emergence untuk menilai status neurologis. Komunikasi antara operator dan ahli anestesi penting untuk keberhasilan kasus ini.Anesthesia Management in Minimally Invasive Neurosurgery Procedure: Traumatic Intracerebral Hemorrhage CaseTraumatic brain injury (TBI) accounted for 70% of deaths from trauma. The most common causes of traffic accidents is 49%. Minimally invasive techniques sufficiently developed in the past few decades, as well as in the field of neurosurgery. The main objective is the treatment of immobilization intraoperative anesthesia, cardiovascular stability, minimal postoperative complications, facilitating intraoperative neurological monitoring, collaborative management of an increase in intracranial pressure (ICP) and the rapid emergence of early neurological examination. The case of a man 50 years with intracerebral hemorrhage (ICH) minimally invasive surgery neuroendoscopy planned evacuation of hematoma. Position during operation is true lateral is also a concern in itself. Complications due to the position should be avoided because it is vulnerable affect the outcome of the operation. Operations run for 3 hours with optimal outcomes. Some important issue is of particular concern during surgery and postoperatively. Procedural principle in minimally invasive anesthesia to be achieved is the examination and good preoperative planning, cerebral hemodynamic control to ensure optimal cerebral perfussion pressure (CPP), full immobilization, and can do rapid emergence to assess the neurological status. Communication between the operator and the anesthetist is important to the success of this case.
Perioperative Management of Subdural Hemorrhage (SDH) Trepanation Decompression with Hemophilia A Praniarda, Andika Satria; Laksono, Buyung Hartiyo
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 1, No 2 (2021): October 2021
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (879.454 KB) | DOI: 10.20961/soja.v1i2.54642

Abstract

Hemophilia is a serious inherited blood disease, transmitted by women, that affects mainly men and lasts for a lifetime. Hemophilia A is the most common form. If any of the factors necessary for blood clotting are absent or insufficient, the clotting mechanism is disturbed, causing insatiable bleeding. The most common cause of death in hemophilia patients is cerebral hemorrhage due to head trauma. In cases of intracranial hemorrhage, surgery should be performed immediately to obtain a better prognosis. A 17-year-old man diagnosed with a 2x4 loss of consciousness due to intracranial subdural hemorrhage (SDH) in the left frontotemporoparietal region and cerebral edema on day 4 accompanied by subfalcine herniation to the right with hemophilia A, planned trepanation decompression for SDH evacuation. The patient received 4000 units of factor VIII injection before surgery. Bleeding during surgery was 1100cc and he received a transfusion of 1940cc blood products until hemodynamically stable. In the postoperative phase, he was admitted to the ICU for 8 days, extubation was performed after the condition improved. In patient with hemophilia, evacuation of bleeding should be performed immediately, but there is a high risk of rebleeding. A recombinant factor VIII substitute should be administered immediately for the treatment of acute bleeding in patients with severe haemophilia A. Anesthetic maintenance should include reducing the risk of hypertension and tachycardia to minimize bleeding.
Pain Management with Ganglion Impar Block in Adenocarcinoma Recti Yogo, Wi; Laksono, Ristiawan Muji; Asmoro, Aswoco Andyk; Isngadi, Isngadi; Laksono, Buyung Hartiyo; Jaya, Wiwi
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 4, No 1 (2024): April 2024
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v4i1.68927

Abstract

Background:Colorectal cancer is a type of malignant neoplasm that is often found with the third highest mortality rate in the world after breast cancer and lung cancer. Adenocarcinoma is the most common type of colorectal cancer which cause pain to the patient. The pain from this disease was described as chronic pain. Chronic pain can result from ongoing nerve inflammation and central sensitization. Inflammation begins with a mechanical injury which then turns into chronic inflammation. This situation changes the responsiveness of neurons to pain in the sympathetic ganglion. Sympathetic ganglia block is more effective in controlling visceral pain. This impar ganglion is the only sympathetic nervous system ganglion that is not attached to the sacrococcygeal. In this case report, the transsacrococcygeal joint approach was used to locate the ganglion accurately by injecting contrast and viewing the vertical dispersion called inverted commas along the ganglion laterally.Case Illustration: A 60-year-old female patient was admitted with complaints of pain around the anus. The patient has been diagnosed with Adenocarcinoma recti two years ago.  Pain is felt like being stabbed and persists in the anal area. Pain intensity increases on sitting and defecation. The patient has undergone chemotherapy 12 times and is taking pain relievers that have been prescribed regularly. The patient's Numeric Rating Scale (NRS) score is 6-7, which is categorized as severe pain. This patient underwent ganglion impar block using the trans sacrococcygeal joint approach with the help of fluoroscopy to relieve the severe pain.Conclusion: Ganglion Impar Block (GIB) can be performed with significant results in reducing opioid use and reducing pain in patients with Adenocarcinoma recti. The technique of administering neurolysis agents with the help of fluoroscopy can be an option because it is very effective and simple
The Effectiveness of Basic Life Support Training on the Level of Knowledge of Teachers in Islamic Boarding Schools Yusuf, Muhammad Farlyzhar; Jaya, Wiwi; Isngadi, Isngadi; Asmoro, Aswoco Andyk; Laksono, Ristiawan Muji; Laksono, Buyung Hartiyo; Hartono, Ruddi; Siswagama, Taufiq Agus; Fatoni, Arie Zainul; Vitraludyono, Rudy; Fadhlurrahman, Ahmad Feza; Agustina, Ayu Yesi; Nofiyanto, Eko; Sidiq, Muhamad Akbar; Fanniyah, Fanniyah; Sawitri, Dewi Arum
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 6, No 1 (2026): April 2026
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v6i1.98730

Abstract

Background: Teachers in Islamic boarding schools (pesantren) must be prepared for emergencies. Basic Life Support (BLS) training is essential for improving their knowledge. This study evaluated the effectiveness of BLS training in enhancing teachers' knowledge.Methods: A pre-experimental study with a pretest-posttest design involving 15 teachers. Respondent receive BLS training by anesthesiologist team. Respondent's knowlegde were assesed before and after BLS training using questionnair. Data were analyzed using Shapiro-Wilk and paired T-tests.Result: This study enroll 15 respondent (teacher) from boarding school. The average score increased from 56.67 to 66.00 (p = 0.048), indicating a significant improvement.Conclusion: BLS training is effective in increasing teachers' knowledge and is recommended for regular implementation
Co-Authors Adipurna, Resa Putra Aditiarso, Candra Agustina, Ayu Yesi Arie Zainul Fatoni 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 Fadhlurrahman, Ahmad Feza Fanniyah, Fanniyah 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 Sawitri, Dewi Arum Sidiq, Muhamad Akbar 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 Vitraludyono, Rudy Wiwi Jaya Wiwi Jaya Yogo, Wi Yudhistira Yuliandra Yudi Hadinata Yusuf, Muhammad Farlyzhar