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INDONESIA
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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Perbedaan Pengaruh Pemberian Propofol Dan Etomidat Terhadap Agregasi Trombosit Tabahhati, Sri; Budiono, Uripno; Harahap, Mohammad Sofyan
JAI (Jurnal Anestesiologi Indonesia) Vol 3, No 1 (2011): 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.v3i1.68420

Abstract

Latar belakang penelitian: Perdarahan perioperatif merupakan masalah yang sering dihadapi dalam setiap operasi. Penggunaan obat anestesi induksi dikatakan mempunyai pengaruh dalam agregasi trombosit.Tujuan: Untuk mengetahui perbedaan pengaruh pemberian propofol dan etomidat terhadap agregasi trombosit.Metode:Merupakan penelitian eksperimental pada 40 pasien yang menjalani anestesi umum. Penderita dibagi 2 kelompok (n=20), kelompok I menggunakan propofol dan kelompok II menggunakan etomidat, yang diberi sejak awal induksi dengan besar pemberian propofol 2,5 mg/kg intravena, etomidat 0,3 mg/kg intravena bersama O2 : N2O = 50% : 50%. Masing-masing kelompok akan diambil spesimen sebelum induksi dan 5 menit setelah induksi. Semua spesimen dibawa ke Laboratorium Patologi Klinik untuk dilakukan pemeriksaan Tes Agregasi Trombosit. Uji statistik menggunakan Paired T-Test dan Independent T-Test (dengan derajat kemaknaan <0.05).Hasil: Karakteristik data penderita maupun data variabel yang akan dibandingkan terdistribusi normal. Pada penelitian ini didapatkan perbedaan persen agregasi maksimal trombosit yang bermakna sebelum dan sesudah pemberian propofol (p=0,001) dan tidak bermakna untuk sebelum dan sesudah pemberian etomidat (p=0,089). Pada kelompok propofol didapatkan rerata persen agregasi maksimal trombosit 66,07±8,28 dan etomidat 56,29+18,04 dan menunjukkan perbedaan yang bermakna antara keduanya (p=0,053).Kesimpulan: Propofol secara bermakna menurunkan persen agregasi maksimal trombosit, dibandingkan etomidat.
Literature Review: Palliative Care in Intensive Care Units Akhsaniati, Novi Dwi; Adiyanto, Bowo
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.v0i0.62195

Abstract

Palliative care is defined as care with an approach that improves the quality of life of patients and their families in dealing with problems associated with life-threatening illnesses. As many as 75% of patients treated in the intensive care unit experience unpleasant symptoms. Various studies have shown that palliative care can reduce symptoms caused by invasive procedures in intensive care units and can provide end-of-life care. Thus, assisting patients proactively, decision-making with families, prospects for continued care planning and possible scenarios for end-of-life decisions are essential in intensive care units (ICUs). The integration of palliative care is an important part of comprehensive critical patient care. Critical care providers are often asked to provide pain relief to critically ill patients, hold family meetings to clarify the goals of care, deliver bad news, or provide end-of-life care and care for critically ill patients while providing support to their loved ones. Most ICU patients who are unable to make decisions rely on their families or carers for clinical decision making. Decision making for cardiopulmonary resuscitation, cessation of life-sustaining treatment (LST), and provision of artificial nutrition and hydration should be based on the patient's willingness to discontinue LST, with the involvement of family members and the multidisciplinary team, ensuring that decisions are aligned with the patient's values and goals. The application of palliative care in ICU care can relieve symptoms experienced by patients and can reduce unnecessary invasive procedures. In its application, decision making in palliative care must be based on ethical principles and involve the patient's family, and the decisions made must also be in line with the wishes and values of the patient. The application of palliative care focuses on good symptom management to reduce patient suffering.
A 23-Year-Old Woman with Cerebellopontine Tumor Angle Sectio Caesaria Trans-peritoneal Profunda Surgery Over Oligohydramnios Indication Paramita, Dina; Putera, Try Buana Tunggal
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.v0i0.53487

Abstract

Background: Primary tumor are rarely found in pregnancy. Treatment for intracranial tumors in pregnant woman is a challenge for anesthesiologists, obstetricians and neurosurgeons. A large size cerebellopontine angle (CPA) tumor can suppress the brain stem structure and cause death if not treated immediately. This makes the way we treat patients, when the delivery time and the surgical intervention we choose to be quite difficult.Case: A 23 years-old female patient using general anesthesia (GA) to accommodate profunda trans-peritoneal cesarean section (SCTP) in a 36 weeks pregnancy age, G1P0A0, ASA IIIE with CPA tumor and oligohydramnions.Disscussion: Brain tumor usually grow rapidly during pregnancy due to fluid retention, increased blood volume, and hormonal changes. There is no specific guidelines that explain the treatment of intracranial tumor in pregnancy. This patient suffers from CPA tumor and oligohydramnions so SCTP is required. We use GA for SCTP because it is safe for patients with intracranial tumor.Conclusion: Female G1P0A0, 23 years old, 36 weeks pregnancy age with CPA tumor was consulted by Obstetricians to Anesthesiologists to do SCTP with GA.
The Comparison between Preoperative Maltodextrine and Sugar Water Administration on Random Blood Glucose Levels in Enhanced Recovery After Cesarean Surgery (ERACS) Patients Wicaksono, Satrio Adi; Pudjonarko, Dwi; Riwanto, Ignatius
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.v0i0.65043

Abstract

Background: Oral carbohydrate administration reduces post-operative insulin resistance and improves post-operative recovery. Sugar water and maltodextrin are oral carbohydrates that can be given to enhanced recovery after caesarean surgery (ERACS) patients.Objective: To compare the effect between pre-operative maltodextrin treatment and sugar water treatment on random blood glucose (RBG) levels in enhanced recovery after caesarean section (ERACS) patients.Methods: A randomized control study with pre-test and post-test design was used on 48 patients who underwent ERACS surgery at Dr. Kariadi hospital Semarang Indonesia and met the inclusion and exclusion criteria. Study subjects were divided into two groups: a pre-operative maltodextrin treatment group (n=24) and a pre-operative sugar water control group (n=24). RBG levels were checked with point-of-care testing (POCT) at soon before surgery and at 2 hours after surgery. Mann-Whitney test was used to analyse the difference of RBG levels between group with Maltodextrin and group with sugar water. Wilcoxon test was used to analyse the difference of RBG levels before surgery (pre-operative RBG) and 2 hours after surgery (post-operative RBG). The p value of <0.05 was considered as statistically significant.Result: There were significant lower RBG levels in group with pre-operative maltodextrin treatment compared to group with pre-operative sugar water at soon before surgery (pre-operative) (83.5 ± 9.73 vs 96.2 ± 12.99 mg/dL, p=0.003) and at 2 hours post-operative (101.7 ± 15.81 vs 118.9 ± 28.38, p=0.035) in ERACS patients.Conclusion: If confirmed by further studies, pre-operative maltodextrin administration might provide better outcome in reducing post-operative catabolic status by reducing post-operative insulin resistance and improving RBG levels before and after ERACS compared to sugar water control.
Naja Kaouthia Snake Bite: Case Report Ahmad, Bahtiar; Rehatta, Nancy Margarita
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.v0i0.59758

Abstract

Background: Snakebites prevalent globally, pose a severe threat, especially in resource-limited regions. The impact is substantial, affecting millions annually, with a significant number of fatalities.Case: A 37-year-old man experienced deterioration leading to cardiac arrest after being bitten by a Naja Kaouthia snake. Adequate management in the intensive care unit (ICU), including antivenom administration, restored the patient's condition to return of spontaneous circulation (ROSC).Discussion: Snake venom causes various symptoms, from tissue damage to breathing and heart issues. Treating with antivenom, specifically from horses, can neutralize the venom's effects, as shown in studies. This treatment is effective for Naja Kaouthia bite.Conclusion: Quick treatment with antivenom partially neutralized the venom, showing how important antivenom is for treating snakebites.
Bronchial Toilets in Sepsis Patients Treated in The Intensive Care Unit (ICU): A review On Indications and Complications Lubis, Andriamuri Primaputra; Irina, Rr Sinta; Karim, T. Abdul
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.v0i0.56989

Abstract

The respiratory system is very important for human life. Its performance determines the quality of life. Physical exercise helps patients suffering from various diseases to build physical fitness, improve respiratory mechanisms, and reduce secretions. It is important to choose the right technique for such patients, using fitness and strength training, breathing exercises, bronchial cleansing. Bronchial clearing aims to remove respiratory tract secretions that contribute to recurrent inflammation and respiratory distress. This is based on the position which facilitates the removal of dense secretions due to the influence of gravity. Pharmacological measures to reduce the secretions in the respiratory tract and facilitate coughing, should be administered prior to drainage. Tracheo-bronchial toilet is a method used to clear mucus and secretions from the airways. The benefits of a tracheo-bronchial toilet include preventing infections such as pneumonia and improving drainage of secretions. Methods used in tracheo-bronchial toilets include temporary naso-tracheal intubation with small tubes, percussion, positioning, and coughing. A tracheotomy can also be performed for lung clearance. Toilet bronchoscopy is a potentially therapeutic intervention to aspirate retained secretions in the endotracheal tube and airway and restore atelectasis. 
Anesthesia in Awake Craniotomy Patients Akim, Mhd; Bisono, Luwih; Hamdi, Tasrif; Sitepu, John Frans; Harahap, Awi Tifani Mayandisa
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.v0i0.65478

Abstract

Background: Awake craniotomy is a neurosurgical procedure performed while the patient is conscious and cooperative, commonly used to remove brain tumors or epileptic foci located close to brain regions that control in real-time critical functions such as speech, movement, or vision.Case: A 26-year-old male presented to Haji Adam Malik Hospital, Medan with progressive blurred vision in both eyes and headaches over three months diagnosed with secondary headache due to intracranial space-occupying lesions (SOL) (thalamic glioma). The patient was referred to a neurosurgical colleague for further treatment in the form of a craniotomy. The craniotomy was performed using awake anesthesia techniques for the excision of diffuse glioma in the thalamic region. The awake anesthesia technique involved intravenous premedication with 0.25 mg atropine sulfate, 5 mg dexamethasone, 50 mg phenytoin, 2.5 mg diazepam, 100 mcg fentanyl, and dexmedetomidine administered at 20 mcg/hour to achieve the desired sedation level. Prior to incision, infiltration was performed in the area to be incised using 0.75% ropivacaine 20 ml mixed with 2% lidocaine 4 ml, and before the burr hole was made in the cranium, 50 mcg fentanyl was administered intravenously. The surgery proceeded according to protocol, and the patient was transferred to the recovery room.Discussion: Awake craniotomy requires clear communication for brain mapping, making severe aphasia and respiratory disorders like sleep apnea contraindications. Dexmedetomidine is favored for sedation due to its minimal respiratory effects. Local analgesia with ropivacaine and lidocaine ensures pain control and hemodynamic stability, reducing opioid use. The lack of bispectral index monitoring to assess sedation depth is a noted limitation.Conclusion: Considering the benefits and challenges associated with awake surgery, the use of this method should be considered on an individual case basis to ensure surgical success and patient safety.
Management of Adult-Onset Still's Disease Patients in Intensive Care Unit: a Case Report Andriani, Ika Jati Setya; Rakhmatjati, Pradana Bayu; Wisudarti, Calcarina Fitriani Retno; Widodo, Untung
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.v0i0.65781

Abstract

Background: Adult-onset Still's disease (AOSD) is a rare inflammatory disorder characterized by the classic triad of fever, arthritis, and evanescent rash. AOSD is a multi-systemic disorder with unclear etiology. Glucocorticoids are the first line treatment for AOSD, and disease-modifying anti-rheumatic drugs (DMARDs) are often used in some patients with a poor response to glucocorticoids. Parenchymal lung involvement in AOSD is rare (only 5% of AOSD), one of them is acute respiratory distress syndrome (ARDS), where ARDS is the most severe complication. Management of such conditions in the intensive care unit (ICU) is crucial.Case: A 25-year-old woman came with unresolved fever for one week which was preceded by joint pain and reddish spots on the skin. The patient was diagnosed as AOSD complicated with ARDS due to pneumonia which kept the patient in the ICU for 24 days.Discussion: AOSD is a multigenic auto-inflammatory disorder involving the innate and adaptive immune systems. Based on Yamaguchi's criteria, the patient was diagnosed with AOSD where there was a high fever that lasted more than a week, arthritis, salmon rash, leucocytosis, sore throat, splenomegaly, alanine aminotransferase (ALT) abnormalities, and negative antinuclear antibodies (ANA) test. The first-line therapy given was methylprednisolone, doses were tapered gradually. As the patient didn't respond to therapy, she was then given immunosuppressive therapies such as cyclosporine, hydroxychloroquine and underwent therapeutic plasma exchange (TPE). The patients responded to treatments and showed good laboratory results.Conclusion: This case report describes a patient with AOSD that was diagnosed based on clinical manifestations and Yamaguchi criteria. The patient improved clinically with high dose administration of corticosteroids, immunosuppressive agents, and TPE. Making a correct diagnosis and starting an appropriate treatment as soon as feasible is crucial in this case as the patient suffers complications.
Comparison of The Effectiveness of Use Antiseptic Povidone Iodine 10% And Octenidine Hydrochloride 0.1% in The Action of Neuroaxial Blocks in Patients Who Will Surgery in Haji Adam Malik General Hospital Medan Handayani, Bejo Utomo; Bisono, Luwih; Wijaya, Dadik Wahyu; Amelia, Rina
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.v0i0.62613

Abstract

Background: Antiseptics or germicides are chemical compounds used to kill or inhibit the growth of microorganisms on living tissue such as the surface of the skin and mucous membranes.Objective: To determine the comparative effectiveness of povidone iodine 10% antiseptic compared to octenidine hydrochloride 0.1% in neuraxial blockade in patients undergoing surgery at Haji Adam Malik General Hospital, Medan.Methods: This study is an experimental study of the two-group pre-test - post-test study type. This design is a design that groups patients into certain groups that receive different treatments based on group division. There are two groups, with each group containing 10 samples.Result: In group A (povidone iodine 10%), the average value of bacterial growth before aseptic action was 192.20±117.54, and after aseptic action, no bacterial growth was found with a P Value of 0.005. In group B (octenidine hydrochloride 0.1%) before aseptic action was performed, the average bacterial growth value was 212.20 ± 107.21, and after aseptic action, no bacterial growth was found with a P Value of 0.004.Conclusion: There was no significant difference in the bacterial profile after aseptic with povidone iodine 10% and octenidine hydrochloride 0.1%.
Nutrition Therapy in Post-Hartmann’s Procedure Patients in The Intensive Care Unit Palupi, Isnafianing; Adiyanto, Bowo; Wisudarti, Calcarina Fitriani Retno
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 2 (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.v0i0.67337

Abstract

Background: The Hartmann procedure is a surgical procedure for treating colorectal cancer that is widely used in emergencies because it is fast and has a minimal risk of anastomotic leakage. This procedure is usually performed on rectosigmoid cancer. Colorectal cancer patients who undergo gastrointestinal surgery are considered at risk of malnutrition, so adequate nutritional therapy is needed.Case: We report a 51-year-old male patient who came to the intensive care unit (ICU) with an unconscious condition, was intubated, received Norepinephrine support, and had a reddish black product in the nasogastric tube (NGT). The patient was referred with a diagnosis of post-operative Hartmann’s procedure day-3 (D-3) for indications of high obstructive ileus due to rectosigmoid tumor, septic shock, acute kidney injury (AKI), and peptic ulcer. During treatment in the ICU, the patient received antibiotic therapy (Meropenem and Metronidazole), proton pump inhibitors (PPIs), and parenteral nutrition via a central venous catheter (CVC).Discussion: Parenteral nutrition was given from the beginning of admission to the ICU because oral and enteral nutrition could not be provided due to gastrointestinal bleeding (peptic ulcer). Moreover, the patient was considered at risk of malnutrition with evidence of critical illness more than 48 hours post-gastrointestinal surgery due to cancer. Also, there was a post-operative fasting period, usually for several hours to 1-2 days, depending on the patient's condition.Conclusion: Nutritional therapy, as part of the management of critically ill patients, should be given at the right time, in the most effective way, and in appropriate doses for each individual to avoid malnutrition during treatment.

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