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Bali Journal of Anesthesiology
Published by Bali Journal of Anesthesiology
ISSN : -     EISSN : -     DOI : -
Core Subject : Health, Education,
Health Professions Medicine & Pharmacology Other
Arjuna Subject : -
Articles 6 Documents
 1 
Search results for , issue " Vol 1, No 1 (2017)" : 6 Documents clear
Establishing good rapport in anesthesiarelated doctor-patient communication: bridging the triangular communication between anesthesiologist-surgeon-patient Widnyana, IMG; GA Senapathi, Tjokorda; Cindryani, Marilaeta
Bali Journal of Anesthesiology Vol 1, No 1 (2017)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v1i1.6

Abstract

Doctor-patient communication is central in clinical practice. Communication skill has been an essential component of clinical competence to become a five-star doctor. In the other hand, there are major problems in doctor-patient communication that would lead to medical disputes even malpractice suspicions. With effective communication, a definitive theory would turn into high-quality medical practice and improve patient safety and satisfaction to a whole new level. Based on the Calgary-Cambridge observation guide, there is five point plan of tasks that embrace doctor and patient in daily interviews starting from initiating the session, gathering information, building the relationship, explanation, and planning, and closing. Those tasks would have been easily introduced when you are dealing with a good healthy patient. But in anesthesia-related, wide range of patients are met in different settings and conditions
Anesthesia on Pediatric Laproscopy Wiryana, Made; Sinardja, I Ketut; Kurniyanta, Putu; GdeAgung Senapathi, Tjokorda; Gede Widnyana, I Made; Utara Hartawan, I Gusti Agung Gede; Parami, Pontisomaya; Darma Junaedi, I Made; Putra Pradhana, Adinda
Bali Journal of Anesthesiology Vol 1, No 1 (2017)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v1i1.1

Abstract

Laparoscopic surgery has several advantages compared to a regular surgical procedures. This technique can reduce the stress of surgery, reduce the need for postoperative analgesia, decreased respiratory and wound complications, lowering long hospitalization, including in the intensive therapy, and the patient can go back to eat quickly. The magnitude of changes in vital signs that occur will be influenced by the patients age, cardiovascular function, and anesthetic agents are used. Physiological changes in pediatric laparoscopic surgery were similar to adults. Children have a higher vagal tone and sometimes a stimulus to the peritoneum by insufflation gas or penetration laparoscopic and trocar can lead to bradycardia and asystole. Intra-abdominal pressure is an important determinant for maintaining cardiovascular stability during laparoscopy. Adequate relaxation needed during the duration of the surgery.
Central Venous Pressure Correlates with Inferior Vena Cava Collapsibility Index in Patient Treated in Intensive Care Unit Wiryana, Made; Sinardja, I Ketut; Aryabiantara, I Wayan; GdeAgung Senapathi, Tjokorda; Gede Widnyana, I Made; Mahaalit Aribawa, I Gusti Ngurah; Gede Utara Hartawan, I Gusti Agung; Parami, Pontisomaya; Perangin Angin, Emkel
Bali Journal of Anesthesiology Vol 1, No 1 (2017)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v1i1.2

Abstract

Background: Intravascular volume status is an important parameter in monitoring the patients treated at intensive care unit (ICU), so accuracy and strict monitoring of fluid volume is one factor that influence patient’s health status. Amongst others, two ways to monitor body fluid volume status is central venous pressure (CVP) and collapsibility index of inferior vena cava (IVC) diameter. The purpose of this study is to determine the correlation between CVP with the IVC collapsibility index in patients treated in ICU Sanglah Hospital in Denpasar. Method: Seventy patients treated at Sanglah Hospital ICU with already inserted CVC for appropriate indication, were measured for CVP, then followed by examination the diameter of IVC with ultrasound to measure the maximum and minimum collapsibility index. Spearman’s correlation coefficients was used to assess the correlation between CVP and collapsibility index of the IVC. Results: In 70 patients, we found a very strong negative correlation between CVP and IVC’s collapsibility index (Spearmans rho = -0.854; p <0.001). Conclusion: This study found that there is a very strong negative correlation between CVP and collapsibility index of IVC. This finding indicates that the collapsibility index of the IVC may substitute CVP in determining the status of the intravascular volume.
Effectiveness of Infusion Warmer Use to Prevent the Occurrence of Hypothermia and Shivering After General Anesthesia Action in General Hospital Center Sanglah Denpasar Wiryana, Made; Sinardja, I Ketut; Budiarta, I Gede; Agung Senapathi, Tjokorda Gde; Widnyana, Made; Aryabiantara, I Wayan; Utara Hartawan, I Gusti Agung Gede; Parami, Pontisomaya; Kusuma Wijaya, Andi; Putra Pradhana, Adinda
Bali Journal of Anesthesiology Vol 1, No 1 (2017)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v1i1.3

Abstract

Introduction: Shivering and hypothermia after general anesthesia is a common complication in the recovery room. Heating methods and drugs  widely used, but not yet effective. The purpose of this study was to evaluate the effectiveness of using the infusion warmer in maintaining normal core temperature and prevent shivering. Materials and Methods: The study was a non blindnes randomized control trial study. This study aimed to compare the effectiveness of the use of infusion warmer in preventing the incidence of hypothermia and shivering after general anesthesia. Research conducted at the Sanglah Hospital in October 2016, with sample calculations 58 people who meet the inclusion and exclusion criteria. Both were divided into 2 groups, 29 groups of infusion warmer and 29 people without the infusion warmer Recording the results of assessing multiple parameters vital signs, hemodynamic, aldrette score, body temperature, and shivering from the beginning, after induction, and minutes to 5, 15, 30 , 60 in the recovery room. The data obtained were analyzed with SPSS software with a significance level of p <0.005 expressed significantly, with a relative risk <1 as a preventive. Results: From a comparative picture of events shivering and hypothermia in minutes to 5, 15, 30, 60 in the recovery room seen that the treatment group based on the group lower warmer than in the non warmer. This shows that the use of warmer can prevent the incidence of shivering and hypothermia in patients after general anesthesia. In test statistically significant with p <0.05. Conclusions: The use of infusion warmer can help reduce the incidence of hypothermia and shivering after general anesthesia action.
Low Dose Ketamin Wiryana, Made; Sinardja, I Ketut; Budiarta, I Gede; Agung Senapathi, Tjokorda Gde; Widnyana, Made; Aryabiantara, I Wayan; Utara Hartawan, I Gusti Agung Gede; Parami, Pontisomaya; Novita Pradnyani, Ni Putu; Putra Pradhana, Adinda
Bali Journal of Anesthesiology Vol 1, No 1 (2017)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v1i1.4

Abstract

Ketamine binds non-competitive against a phencyclidine receptors bound N-methyl-D-aspartate (NMDA), a receptor that is involved in the pathophysiology of acute pain. Ketamine has been used as an intravenous anesthesia, analgesia for acute and chronic pain at a dose of subanaesthetic. Ketamine is a dissociative anesthetic produces a state with a characteristic strong analgesia, amnesia, and catalepsy. Dissociative components resulting from the effect on the limbic system and talamoneokortikal. Low-dose ketamine as known as analgesia dose ketamine or subanestesia dose is 0.2 to 0.75 mg / kg IV. At low doses, ketamine does not increase the effect psikomimetik like dissociation or deep sedation. The combination with midazolam provides satisfactory sedation, amnesia and analgesia without significant cardiovascular depression.
Non-Convulsive Status Epilepticus (NCSE) in ICU Wiryana, Made; Sinardja, I Ketut; Aryabiantara, I Wayan; GdeAgung Senapathi, Tjokorda; Gede Widnyana, I Made; Utara Hartawan, I Gusti Agung Gede; Parami, Pontisomaya; Ryalino, Christopher; Putra Pradhana, Adinda
Bali Journal of Anesthesiology Vol 1, No 1 (2017)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v1i1.5

Abstract

Epilepsy is a neurological disorder characterized by recurrent epileptic seizures. Non-convulsive status epilepticus (NCSE) is defined as a persistent change in mental status as opposed to the previous conditions, lasted at least 30 minutes long,  associated with continuous spike wave epileptiform EEG changes. Clinical manifestation of NCSE can present as confusion, personality changes, psychosis, and coma. Indeed NCSE prognosis is dependent on the underlying etiology of persistent EEG changes of. Preferred medication is focus on improving its fundamental pathological changes, such as metabolic disorders, infection, drugs toxicity, and immediate pharmacological treatment. Intravenous benzodiazepine is recommended asthe first drug of choice for NCSE and early recognition of treatment response can help to establish the diagnosis.  This patient has a good outcome which was influenced with short ictal period from the first episode upon arrival on reffered hospital, good initial response and management on emergency department, a conduct and thorough ICU monitoring, as well as the effective treatment response.

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