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Jurnal Anestesiologi Indonesia
Published by Universitas Diponegoro
ISSN : 23375124     EISSN : 2089970X     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
Jurnal Anestesiologi Indonesia (JAI) diterbitkan oleh Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) dan dikelola oleh Program Studi Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Diponegoro (UNDIP) bekerjasama dengan Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) cabang Jawa Tengah.
Arjuna Subject : -
Articles 341 Documents
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Compliance in Filling Surgical Safety Checklist at The Central Surgical Installation Noprianty, Richa; Putri, Riski Anisa; Manuopo, Hilmy
JAI (Jurnal Anestesiologi Indonesia) Vol 16, No 3 (2024): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.61515

Abstract

Background: One indicator to reduce unwanted events in the operating room is to implement the filling of the surgical safety checklist (SSC) sheet.Objective: The purpose of the study was to identify the level of compliance in filling SSC in the sign in, time out, and sign out phases at the central surgical installation.Methods: The research method uses quantitative descriptive with an observational study approach. The sampling technique used purposive sampling with 72 respondents. The research instrument uses SSC sheets according to Hospital’s SOP which refer to World Health Organization (WHO) standards. This research has received ethical approval from RS X with number 070/17/Ethical Clearance/RS X/III/2023. Data collection was carried out by researchers and research assistants, namely anesthesia students who were practicing at the hospital. In addition, this data was also checked by the anesthesia management team before analysis. Data analysis uses univariate analysis with the form of data presentation using categorical data, the results of which are frequency distributions and percentages using computer software.Results: The results showed that in the SSC filling the sign in phase had the highest non-compliance rate on aspiration risk items and complicating factors (63%), while in the time out phase the highest non-compliance rate on the estimated length of operation item (90%), and in the sign out phase the highest non-compliance rate on verbal confirmation items of instrument completeness, the number of gauze or sponges, number of needles/other sharp tools (68%).Conclusion: The filling of SSC sheets has not been fully carried out and the filling is done at the end after the operation is completed due to the workload and lack of labor resources. In addition, to speed up the process of transferring patients from the pre-anesthesia room to the operating table. It is expected that the surgery team (doctors, anesthesiologists, and surgical nurses) can be used as input so that the filling of the SSC sheet can be applied according to the sign in, time out, and sign out phases to minimize the possibility of surgical risk errors.
Comparison of Fluoxetine (20 Mg) and Amitriptyline (12.5 Mg) As Adjuvants for The Combination of Paracetamol and Morphine in Cancer Patients' Pain Relief Ramud, Samawi Husein; Hamdi, Tasrif; Bangun, Chrismas Gideon; Yunanda, Yuki
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 1 (2025): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.59070

Abstract

Background: Pain is one of the most common symptoms in cancer which affects 30–50% of patients on average and rises to 70–90% in cases of advanced disease. As cancer advances, so does the frequency of discomfort associated with the illness. When cancer is detected in its terminal stage, 30–40% of patients report experiencing moderate pain, and 60–100% report experiencing severe pain. Tricyclic antidepressants (TCAs), selective serotonin and norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), and monoamine oxidase inhibitors (MAOIs) are the four families of antidepressant medications that have been investigated for use in the treatment of neuropathic pain.Objective: This research was conducted at the pain clinic of Adam Malik Hospital, this study intends to compare the effectiveness of fluoxetine with amitriptyline as an adjuvant to the combination of paracetamol and morphine in reducing pain symptoms in cancer patients.Methods: This study was designed as a randomized, double-blind clinical experiment. The study was carried out in 2023 between July and September. Two groups of forty research participants receiving outpatient care at the pain clinic were formed. Fluoxetine, morphine, and paracetamol were administered to group A (n = 20), whereas amitriptyline, morphine, and paracetamol were administered to group B (n = 20). PainDETECT was used to measure the subjects' pain scores. Both univariate and bivariate data analysis was done. The Chi-Square test, Independent T-test, Paired T-test, and Mann-Whitney were used to examine the bivariate data.Result: The delivery of amitriptyline and fluoxetine resulted in a substantial reduction in PainDETECT scores, with a p-value of less than 0.05.Conclusion: This study show that PainDETECT score was statistically reduced in both the fluoxetine and amitriptyline groups but the reduction was not clinically meaningful because the target score drop was less than 4 on a scale of 0–10, or a 50% reduction in pain.
Anesthetic Choice and Management in Cesarean Section for a Patient with Post Laminectomy and Inferior Stabilization: A Case Report Aifunan, Inggar Nastiti; Kusuma, Donni Indra
JAI (Jurnal Anestesiologi Indonesia) Vol 16, No 3 (2024): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.62541

Abstract

Background: Deciding the choice of anesthetic choice and management for a cesarean section is a relatively complex procedure. In this case report we examine a patient undergoing cesarean section who has a significant history of laminectomy with inferior stabilization, the complexities of the patient's conditions may influenced the choice of anesthetic strategy.Case: A 29-year-old female patient undergoing a cesarean section with a complex medical history, including two previous cesarean sections and a laminectomy with inferior stabilization, presenting unique challenges in obstetric and anesthetic care. The patient was admitted to K.M.R.T Wongsonegoro Hospital, Semarang, at 40 weeks of gestation, with symptoms of intense abdominal tightening, active fetal movement, and bloody mucus. Her medical history was further complicated by a laminectomy with inferior stabilization performed in 2019.Discussion: Laminectomy and inferior stabilization is one of the choice treatments for bone tuberculosis. Laminectomy is a surgery that creates space by removing bone spurs and tissues associated with spondylosis of the spine and adding Inferior stabilization to maintain the space. In our patient with complex post-laminectomy and lumbar inferior stabilization, it caused anatomical and neurological changes in the patient. The patient was going to have a cesarean section because the time is nearly expected to be the delivery date of her third pregnancy. Because of the complex background of her past laminectomy surgery, we decided to use the general anesthesia technique for this cesarean section.Conclusion: In this case report we can reaffirm that this case contributes to the medical community's understanding of managing cesarean sections in patients with previous spinal surgeries and underscores the need for evolving clinical guidelines and practices in obstetric anesthesia to enhance patient care and safety. The case is a valuable addition to the literature, providing insights for healthcare professionals in similar complex scenarios.
Comparison of Laryngeal Mask Airway and Endotracheal Tube on Intraocular Pressure in Vitrectomy Villyastuti, Yulia Wahyu; Wicaksono, Indrawan
JAI (Jurnal Anestesiologi Indonesia) Vol 16, No 3 (2024): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.65469

Abstract

Background: Increased intraocular pressure (IOP) is a common complication after vitrectomy. Tracheal intubation and insertion of a laryngeal mask airway (LMA) are noxious stimuli that can increase IOP.Objective: To analyze the difference between the use of LMA and an endotracheal tube (ETT) on the increase in IOP in vitrectomy.Method: Experimental study with a randomized controlled trial design in 28 patients undergoing vitrectomy who met the inclusion and exclusion criteria. Subjects were divided into 2 groups with the use of LMA and ETT. Intraocular pressure (IOP) was measured using a Schiotz tonometer before induction of anesthesia, 5 minutes after intubation, 5 minutes before extubation, 5 minutes after extubation and 24 hours after vitrectomy in healthy eyes. The analysis was carried out with the unpaired T-test and the alternative Mann Whitney test, the results were significant if the p value <0.05.Results: The mean IOP in the LMA group was 11.71 ± 1.90 mHg before induction of anesthesia; 11.04 ± 1.71 mmHg 5 min after induction; 10.86 ± 1.44 mmHg 5 min before discharge; 12.11 ± 1,49 mmHg after removal and 12.21 ± 2.63 mmHg 24 hours after discharge. The mean IOP in the ETT group was 11.05 ± 2.57 mHg before induction of anesthesia; 14.26 ± 2.59 mmHg 5 min after induction; 11.71 ± 1.90 mmHg 5 min before extubation; 14.70 ± 0,98 mmHg after extubation and 12.74 ± 1.82 mmHg 24 hours after extubation. A significant difference in IOP was found after ETT intubation and extubation (p < 0.05).Conclusion: Endotracheal tube (ETT) significantly increases IOP compared to LMA during intubation and extubation in vitrectomy surgery.
Anesthetic Management of Supraglottic Tumors Undergoing Direct Laryngoscopy Ajie, Astrandaya; Listiarini, Dian Ayu; Alfaruq, Ahmad Umar
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 1 (2025): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.63062

Abstract

Background: Supraglottic tumors are a type of tumor in the larynx that often causes airway obstruction. Comorbidities such as pulmonary tuberculosis (TB) and malnutrition can threaten patient safety during surgery. Comprehensive special perioperative anesthetic management involving multidisciplinary procedures and good communication between anesthesiologists and surgeons is needed. The aim of this case report is to understand the anesthetic management of a patient with a supraglottic laryngeal tumor with comorbid pulmonary TB, atelectasis and malnutrition.Case: A 44-year-old man came to the ear, nose and throat (ENT) clinic with complaints of shortness of breath since the previous month accompanied by pain while swallowing. The patient had a history of smoking and pulmonary TB. Computed tomography (CT) revealed a supraglottic tumor that was suspected to be malignant. The patient was programmed to undergo direct laryngoscopy for tissue biopsy.Discussion: The patient was intubated with a size 5 nonkinking endotracheal tube (ET tube) on the inside, which was connected to a size 7 kinking ET tube on the outside because the glottis rima was narrowed because of a tumor in the supraglottis so that only a small ET tube could pass to secure the airway. In this patient, induction therapy was performed with propofol and opioids. Muscle relaxants are not given to maintain respiratory muscle tone, especially in patients with pulmonary TB and atelectasis, who require full function of the respiratory muscles due to impaired lung development.Conclusion: Special perioperative management is needed in patients with supraglottic tumors with comorbid pulmonary TB, atelectasis and malnutrition. Airway management and the drugs and anesthesia induction techniques chosen must be agents that have minimal side effects on the respiratory tract and maintain respiratory muscle tone.
Effectiveness and Efficiency of Peripheral Nerve Blocks as Adjunct to General Anaesthesia for Open Reduction and Internal Fixation Surgery at Primary Hospital in Tangerang Ramadhan, Yoga; Sari, Wilujeng Puja; Setiawan, Andy
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 1 (2025): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.65516

Abstract

Background: Pain management is essential for postoperative patients. Effective management involves considerations such as the type of Anesthesia. It affects the total cost of spent, quality of pain control, and side effects. This study will evaluate the addition of peripheral nerve blocks (PNB) in orthopedic surgery patients.Objective: The objective of this study is to evaluate the efficacy and efficiency of PNB as an adjunct in general anesthesia (GA). Variables to be assessed the total cost of drugs, pain score and side effects after surgery.Methods: This study is an analytic study with a case-control approach that includes 116 patients. Secondary data were obtained through patient medical record data. Data in the form of types of anesthesia, total cost of drugs used before and 24 hours after surgery, pain scale before and during 24 hours after surgery and side effects in patients.The samples were divided into two groups: the GA group and the GA with PNB (GA-PNB) group. The intensity of pain was evaluated by a numeric rating scale. The total cost was calculated based on the drugs administered prior to and within 24 hours after surgery. The assessment of side effects was converted into scores to the following criteria: 0 = no symptoms, 1 = one symptom, and 2 = multiple symptoms.Result: The results showed that the total cost of drugs spent for GA-PNB group was 18.3% less than GA group. GA-PNB produces lower pain scores and lower incidence of side effects. The average pain scale in GA patients was 3.8 points and GA with PNB was 2.8 points.Conclusion: The addition of PNB has the potential to improve patient satisfaction. Lower pain scores, lower side effects and lower costs will encourage patients to choose Primaya Hospital Pasar Kemis for their treatment.
Prevention and Management of Stress Ulcers in Critically ill Patients Zulfakhri, Zulfakhri; Jufan, Akhmad Yun; Wisudarti, Calcarina Fitriani Retno
JAI (Jurnal Anestesiologi Indonesia) Vol 16, No 3 (2024): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.61232

Abstract

Stress ulcers or stress related mucosal damage (SRMD) is a term defining inflammation, erosion, and ulceration in the upper gastrointestinal tract complicating patients with critical illness. Stress ulcers occur because of imbalance between the aggressive factors in stomach (gastric acid, pepsin, and bile salt) and the defensive factors (mucous, bicarbonate, microcirculation, epithelial layer, and prostaglandin). The most common clinical feature of stress ulcers is upper gastrointestinal tract bleeding in which the incidence rate is 2.6% in critically ill patients. Stress ulcers commonly happen after a gastrointestinal mucosal break in 75–100% of intensive care unit (ICU) patients in the first 24 hours of admission. The classification of stress ulcers includes asymptomatic stress ulcers, stress ulcers with occult and overt bleeding, and stress ulcers with clinically significant gastrointestinal bleeding. The diagnosis of stress ulcers can be made by assumption only and do not need an endoscopy. Some cases of stress ulcers that need an endoscopy are patients with overt and clinically significant gastrointestinal bleeding stress ulcers. Thus, the treatment of stress ulcers is similar to upper gastrointestinal bleeding. Stress ulcers can be prevented by administering stress ulcers prophylaxis such as histamine H2 receptor antagonist, proton pump inhibitor, cytoprotective agent (sucralfate), and usage of enteral feeding method.
Predictors of Severity and Management of Severe Leptospirosis Patients in Intensive Care Unit Kusumawardani, Dwi Indriati; Jufan, Akhmad Yun
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 1 (2025): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.62735

Abstract

Background: Severe leptospirosis or Weil's syndrome occurs in 10% of leptospirosis cases, with a mortality rate of 5-40%. Misdiagnosis of leptospirosis often occurs due to nonspecific symptoms. Discussion of risk factors, causative agents, pathogenesis, clinical manifestations, diagnostic techniques, and predictors of disease severity are crucial for successful management.Cases: We report 3 cases of leptospirosis with various clinical manifestations and management. In these 3 cases, older age was associated with severe leptospirosis and poor outcomes. The SPiRO score can identify patients with severe leptospirosis requiring intensive care. All three cases of leptospirosis were severe with complications in the kidneys, lungs, and hematological system requiring intensive care in the intensive care unit (ICU).Discussion: Early and appropriate management can reduce patient mortality rates. ICU management of leptospirosis includes antibiotics, fluid balance, and support for affected organs. Patients with respiratory failure are given oxygenation using high-flow nasal cannula (HFNC), non-invasive ventilation (NIV), or invasive mechanical ventilation with endotracheal intubation (ETT). Acute kidney failure in leptospirosis can be managed with hemodialysis as indicated or may improve with conservative therapy. Corticosteroids may be administered for thrombocytopenia associated with leptospirosis.Conclusion: The three cases of leptospirosis were severe with complications in the kidneys, lungs, and hematological system requiring intensive care in the ICU. Early and appropriate management can reduce patient mortality rates. In these 3 cases, older age, mechanical ventilation, acute kidney failure, septic shock, thrombocytopenia, and elevated transaminase enzymes were associated with severe leptospirosis and poor outcomes.
Low Dosage Regional Anesthesia for Bladder Tumors in Aortic Stenosis Patient Pinem, Emmysri Ninta Karina B.; Thedja, Maha Swardwipayana Putra; Poddala, Max Norman; Dharmayana, Ida Bagus Gede Dwi
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 1 (2025): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.63167

Abstract

Background: Aortic stenosis (AS) is a narrowing of the heart's aortic valve. The most common cause of AS in adults is degenerative calcification of the aortic valve, which increases with age.Most patients with AS experience gradual increase in obstruction over many years and will remain asymptomatic until the 6th to 8th decade of life. The prognosis being poor when symptoms appear. Patients with AS present a challenge of hemodynamic disturbance for anesthesiologists. The use of regional anesthesia in patients with severe AS is contraindicated because of the sympatholytic effect which causes loss of vascular tone and a significant reduction in cardiac output.Case: A 77 years old male with a height of 155 cm and a weight of 35 kg with moderate aortic stenosis (EF 65%), ventricular heart disease (VHD), hypertensive heart disease (HHD), heart failure (HF) with therapy, underwent bladder tumor surgery with low dose regional anesthesia using bupivacaine 0.5% heavy 7.5 mg (1.5 ml) with adjuvant fentanyl 25 mcg with total volume 2 ml regional block was achieved within 5 minutes and hemodynamically stable perioperatively. There was no acute HF or worsening of postoperative hemodynamics.Discussion: The main principle of anesthesia in AS patient is to avoid tachycardia, maintain sinus rhythm and avoid a decrease in systemic vascular resistance (SVR) which will cause compensation in the form of an increase in heart rate, thereby making the heart work harder, avoiding hypovolemia and fluid overload.Conclusion: Low dose regional anaesthesia can become an option. In cases of AS due to fewer side effects, with more stable haemodynamics compare with convensional regional anaesthesia. This condition may need furthere studies.
Adductor Canal Block (ACB) as an Adequate Analgesia Post Anterior Cruciate Ligament Repair Utama, Sigit Prasetya; Kuntoadi, Danang; Yuliana, Friskha
JAI (Jurnal Anestesiologi Indonesia) Vol 16, No 3 (2024): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.61865

Abstract

Background: Anterior cruriate ligament (ACL) injury is one of the most common cases in knee injury. Inadequate pain management will cause a decrease in quality of life, daily living abilities, increase hospitalization costs, and progressively causing chronic pain. Selection of inappropriate peripheral nerve block (PNB) can reduce range of movement ROM. Abductor canal block (ACB) is expected to facilitate adequate analgetic, improve early mobilization and ambulation, reduce the risk of post operative nausea vomiting (PONV), and needs for other analgeticsCase: A 21-year-old male patient with a diagnosis of ACL rupture knee (S) who will be performed anterior cruriate ligament recontruction (ACLR) procedure with physical status ASA II, premedication ondancentron 4 mg and dexamethasone 5 mg intravenously. Regional anesthesia subarachnoid block, at L3-L4 interspatium with bupivacaine hyperbaric 0.5% 15 mg and fentanyl 25 mcg as the adjuvant for subarachnoid block. Adductor canal block using ultrasound guide using 20 ml levo bupivacaine 0.25%. The outcome assessed using nurmmeric rating score (NRS), PONV, rescue analgetics, and ambulation score which includes: time up to go (TUG) with partial weight bearing, s-CST, 5xSST, 6 WMT straight leg raising (SLR) assessed at more than 48 hours.Discussion: PNB is proven to be reliable and effective for postoperative pain control, ambulation, rehabilitation and mobilization are also faster, adequate pain control will facilitate early mobilization and prevent side effects related to prolonged immobilization. Adductor canal block is a good modality as an adequate analgetic, the use of ACB can reduce use of rescue analgetic, reduce the incidence of PONV and support early mobilization.Conclusion: ACB in ACLR can facilitate adequate analgesia, does not require other rescue analgetics, reduce the incidence of PONV, and improve the ambulation as well as avoid other complications.

Page 30 of 35 | Total Record : 341

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