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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 363 Documents
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Anesthesia Management and Complications of Reperfusion Syndrome After Thrombectomy in Acute Ischemic Stroke: A Case Report I Gede Catur Wira Natanagara; Ida Bagus Krisna Jaya Sutawan; Putu Herdita Sudiantara
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.83013

Abstract

Background: Acute ischemic stroke (AIS) caused by cerebral vascular occlusion requires rapid reperfusion to prevent irreversible neuronal damage. Mechanical thrombectomy is currently the standard of care alongside intravenous thrombolysis for appropriately selected patients with AIS, as supported by randomized clinical trials and stroke guidelines. However, despite its clinical benefits, thrombectomy presents significant anesthesiological challenges, particularly regarding the prevention of post-procedural neurological complications, such as reperfusion syndrome.Case: A 64-year-old man with heart disease and diabetes mellitus underwent mechanical thrombectomy for AIS under general anesthesia with close monitoring of blood pressure, ventilation, and hemodynamic status. Following successful recanalization, the patient developed persistent aphasia with suspected cerebral edema. Reperfusion syndrome was considered based on the temporal relationship between restored cerebral blood flow and neurological deterioration, while other possible causes were evaluated clinically.Discussion: Reperfusion syndrome is a recognized but uncommon complication after successful cerebral recanalization. Intensive care unit (ICU) management included close neurological observation, hemodynamic stabilization, blood pressure control, optimization of oxygenation and ventilation, targeted temperature management at 35–36°C for 24 hours, and antioxidant therapy with N-acetylcysteine 200 mg every 8 hours. These interventions were applied as individualized supportive strategies rather than established standard treatment.Conclusion: This case highlights the importance of individualized anesthetic management, strict physiological control, early recognition of post-thrombectomy neurological deterioration, and multidisciplinary ICU care to minimize secondary brain injury. 
Intraoperative Raw EEG Monitoring for Anesthetic Depth Assessment in Scoliosis Correction Surgery: A Case Report Maha Swardwipayana Putra Thedja; Ida Bagus Krisna Jaya Sutawan
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.82818

Abstract

Background: General anesthesia aims to provide adequate hypnosis, analgesia, amnesia, and muscle relaxation. Conventional intraoperative monitoring mainly relies on hemodynamic parameters, which do not directly reflect brain function—the primary target organ of anesthesia. This limitation may lead to excessively light or deep anesthesia, increasing the risk of intraoperative awareness, hemodynamic instability, and postoperative neurocognitive disorders. In prolonged and highly stimulating procedures such as scoliosis correction surgery, accurate assessment of anesthetic depth is crucial. Electroencephalography (EEG) offers real-time insight into cortical activity and may improve anesthetic depth monitoring.Case: We report a 17-year-old female with adolescent idiopathic scoliosis (Lenke 3AN, Risser stage 5) who underwent spinal deformity correction under intraoperative monitoring. General anesthesia was maintained with propofol and remifentanil. Raw EEG monitoring using dual channels (CP3–Fpz and CP4–Fpz) was applied throughout the procedure. During induction, incision, spinal rotation/translation, and closure, EEG consistently demonstrated symmetric, dominant frontal alpha activity, corresponding with stable anesthetic depth. Anesthetic titration was guided by EEG patterns without reliance on processed EEG indices. The surgery was completed uneventfully, and the patient recovered without neurological complications.Discussion: EEG waveforms change in a dose-dependent manner with anesthetic agents. Dominant frontal alpha activity (alpha anteriorization) is associated with adequate hypnotic depth under propofol anesthesia, whereas excessive slowing or burst suppression may indicate overly deep anesthesia. Raw EEG monitoring provides direct neurophysiological information and may be more sensitive than processed indices such as the Bispectral Index, particularly in surgeries requiring intraoperative neurophysiological monitoring.Conclusion: Intraoperative raw EEG monitoring is a valuable adjunct for assessing anesthetic depth in long-duration scoliosis correction surgery. Maintaining dominant alpha activity may help prevent anesthetic overdose while preserving neurological stability.
Comparison of the Effects of Continuous Infusion of Fentanyl 0.7 mcg/kgBW/hour versus Lidocaine 1.5 mg/kgBW/hour on Post-Anesthesia Recovery Quality Using QoR-40 Scoring in Laparotomy Surgery Sherwin Sherwin; Rr Sinta Irina; Andriamuri Primaputra Lubis
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.83599

Abstract

Background: Postoperative recovery quality is a critical measure of anesthetic effectiveness, particularly in major surgeries such as laparotomy. Both fentanyl and lidocaine are used in multimodal analgesia, but their comparative efficacy on recovery quality remains underexplored.Objectives: To evaluate and compare the impact of continuous intravenous infusions of fentanyl as well as lidocaine on the quality of postoperative recovery in laparotomy patients undergoing general anesthesia, utilizing the quality of recovery-40 (QoR-40) score as the evaluation instrument.Methods: This double-blind randomized controlled trial (RCT) included 40 patients undergoing laparotomy at Adam Malik Hospital, Medan. Subjects were randomly allocated to receive either fentanyl (0.7 mcg/kg/h) or lidocaine (1.5 mg/kg/h) infusion postoperatively. QoR-40 scores were assessed 24 hours post-surgery. Pain scores and rescue analgesia requirements were also evaluated.Results: Subjects in the fentanyl group had substantially higher QoR-40 scores (173.35 ± 41.764) than those in the lidocaine group (148.95 ± 25.362; p = 0.0001). Fentanyl was superior in comfort and pain control. Rescue analgesia was needed less frequently and later in the fentanyl group (p = 0.0001).Conclusion: Fentanyl infusion substantially improved postoperative recovery quality more effectively than lidocaine in patients undergoing laparotomy, particularly in pain management and comfort.

Page 37 of 37 | Total Record : 363

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