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Prihatma Kriswidyatomo
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Departemen Anestesiologi dan Reanimasi Fakultas Kedokteran Universitas Airlangga-RSUD Dr Soetomo Surabaya Gedung Anestesi Baru-RSUD Dr Soetomo Surabaya Jl. Mayjen Prof. Dr. Moestopo No 6-8, Airlangga, Gubeng, Surabaya, 60286, Indonesia
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INDONESIA
Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Published by Universitas Airlangga
ISSN : 27224554     EISSN : 2686021X     DOI : 10.20473/ijar.V2I12020.1-7
Core Subject : Health,
Medicine & Pharmacology
IJAR is a scientific journal published by Department of Anesthesiology and Reanimation, Faculty of Medicine Universitas Airlangga. IJAR is an English language journal. IJAR FOCUSES original research, review article, case report, and correspondence, on anesthesiology; pain management; intensive care; emergency medicine; disaster management; pharmacology; physiology; clinical practice research; and palliative medicine. This journal is a peer-reviewed journal established to improve the understanding of factors involved in anesthesiology and emergency medicine.
Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine
Articles 117 Documents
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Classical Thoracolumbar Interfascial Plane (cTLIP) Block for Perioperative Analgesia Major Spine Surgery: A Case Series Wiliam Yuhono; I Gusti Ngurah Mahaalit Aribawa
Indonesian Journal of Anesthesiology and Reanimation Vol. 8 No. 2 (2026): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

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Abstract

Introduction: Decompression-Stabilization-Fusion (DSF) procedures will continue to increase by 7% more than the aging population. Post spine surgery pain makes the thoracolumbar interfascial plane (TLIP) block an option for multimodal pain management. This block has an efficacy that is comparable to the Erector Spinae Plane Block (ESPB), which is even more selective and better for spinal surgery. Objective: This case series describes the clinical application and perioperative analgesic outcomes of ultrasound-guided classical thoracolumbar interfascial plane (cTLIP) block with dexamethasone in patients undergoing lumbar spine surgery. Case Series: The authors present three cases of lumbar vertebrae fracture at L1 (CV L1) Frankel E with physical status American Society of Anesthesiologists (ASA) physical status II undergoing DSF. All patients underwent general anesthesia (GA-OTT) with a cTLIP block using 20 mL of 0.25% bupivacaine and 2 mg dexamethasone on both sides at level thoracal T12. Patients were extubated and monitored intra- and postoperatively for opioid requirements, numerical pain scale (NRS) at hours 0, 1, 6, 12, 24, and 48, time to first opioid rescue, and length of stay (LOS). The results showed an analgesia duration of 8-9 hours. Opioids were used except during induction and rescue. The opioid requirement within 24 hours postoperative in all three cases appeared to decrease. There was also no Postoperative Nausea and Vomiting (PONV) event, which is associated with the use of the TLIP block. Additionally, the LOS for each patient in this case series was 4 days. Conclusion: With a duration of 8 to 10 hours, the cTLIP block using dexamethasone adjuvant offers excellent pain control during and after the procedure. This leads to a marked decrease in opioid consumption within the first 24 hours, which improves recovery.
Comparison of Effectiveness Between Opioid-Free Anesthesia and Opioid-Based Anesthesia on Postoperative Recovery Dewi Ainur Rohmah; Mayang Indah Lestari; Emma Novita
Indonesian Journal of Anesthesiology and Reanimation Vol. 8 No. 2 (2026): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V8I22026.150-159

Abstract

Introduction: Opioid-Based Anesthesia (OBA) is a common standard; it carries risks like post-operative nausea and vomiting (PONV) and respiratory issues. Opioid-Free Anesthesia (OFA) offers an alternative that may improve recovery quality, but its efficacy relative to OBA requires more evidence. Objective: This systematic review aims to compare the effectiveness between OFA and OBA on post anesthesia recovery outcomes. Methods: This systematic review followed the PRISMA 2020. Article searches were conducted via PubMed, ScienceDirect, SpringerLink, and Wiley using appropriate keywords. Five randomized controlled trials meeting the inclusion criteria were analyzed and assessed for risk of bias using the Cochrane RoB 2 tool. Results: OFA significantly reduced the incidence of PONV across all studies. OFA also demonstrated equivalent or better analgesia quality in the early postoperative period with lower rescue opioid consumption and showed good hemodynamic stability. However, no significant difference was found in the duration of surgery between the two groups. Conclusion: OFA shows potential as a superior anesthetic strategy compared to OBA in aspects of postoperative recovery, particularly in reducing PONV and additional opioid consumption without compromising analgesia quality. The implementation of OFA has the potential to be integrated into Enhanced Recovery After Surgery (ERAS) protocols. Further studies with larger samples and standardized protocols are needed to strengthen these findings.
Association of Pre-Operative Islamic Assistance with Anxiety Reduction Among Surgical Patients: A Pre-Experimental Study Nova Maryani; Miftahulhaq; Ardi Pramono; Muhammad Arif Rizqi; Yosy Budi Setiawan; Hana Maliha Ruhaini; Winny Setyonugroho
Indonesian Journal of Anesthesiology and Reanimation Vol. 8 No. 2 (2026): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V8I22026.100-108

Abstract

Introduction: Preoperative anxiety is a common psychological response among patients undergoing elective surgery and may contribute to adverse physiological and psychological outcomes. Spiritual care has been increasingly explored as a complementary non-pharmacological approach to support patients before surgery. Objective: To examine the association between pre-operative Islamic assistance and changes in anxiety levels among patients undergoing elective surgery. Methods: A quantitative pre-experimental study using a one-group pretest–posttest design was conducted among 56 adult patients undergoing elective surgery who were recruited using purposive sampling. Participants received a structured pre-operative Islamic assistance session consisting of spiritual education, prayer guidance, and dzikr. Anxiety levels were measured before and after the intervention using the Hamilton Anxiety Rating Scale (HARS). Data were analyzed using a paired-sample t-test at a 95% confidence level. Results: Anxiety scores significantly decreased following the intervention (mean difference=1.05, SD=0.22, t(55)=34.7, p<0.001; 95% CI: 0.99–1.11). Lower anxiety scores were observed after the intervention; however, because no control group was included, these findings should be interpreted as an association rather than evidence of a causal effect. Conclusion: Structured pre-operative Islamic assistance may be associated with reduced anxiety among patients undergoing elective surgery. Randomized controlled trials with larger samples are warranted to confirm these findings before broader implementation.
Effects of Thoracic Epidural Anesthesia Combined With Inhalational or Intravenous Anesthesia on Intrapulmonary Shunt During One-Lung Ventilation Korgün Ökmen; Durdu Kahraman Yıldız; Aycan Kurtarangil Doğan
Indonesian Journal of Anesthesiology and Reanimation Vol. 8 No. 2 (2026): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

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Abstract

Introduction: In thoracic surgery, one-lung ventilation (OLV) may increase intrapulmonary shunt and impair oxygenation, and this effect is modulated by anesthetic technique via its influence on hypoxic pulmonary vasoconstriction. Objective: This study aims to compare whether thoracic epidural anesthesia differentially affects intrapulmonary shunt during one-lung ventilation according to the maintenance anesthetic technique. Methods: This retrospective and observational study included 86 patients who underwent OLV during thoracic surgery. Patients were divided into four groups according to the anesthetic protocol: target-controlled infusion (TCI) (22 patients), TCI combined with thoracic epidural anesthesia (TEA) (21 patients), sevoflurane (22 patients), and sevoflurane combined with TEA (21 patients). The primary outcome was the intrapulmonary shunt (Qs/Qt) ratio, measured at T1 (5 minutes after intubation), T2 (20 minutes after initiation of OLV), and T3 (40 minutes after initiation of OLV) using arterial and venous blood gas analyses. Secondary outcomes included arterial oxygen tension (PaO₂) and hemodynamic parameters measured at T1, T2, and T3. Results: The Qs/Qt ratio was higher in all groups at T2 and T3 measurements than at T1 (p<0.001). A statistically significant difference was found between groups in the Qs/Qt ratio at T2 and T3 measurement times (p<0.05). The shunt ratio was highest in the combination of sevoflurane and TEA group at T2 and T3 times and lowest in the TCI group. No statistically significant difference was found between the groups in PaO2 values at T2 and T3 measurement times. (p>0.05) Conclusion: Inhalation and intravenous anesthesia methods increased shunt volume in thoracic surgery patients undergoing OLV. The addition of thoracic epidural anesthesia was associated with higher estimated shunt fractions in both anesthetic techniques.
Comparison of General and Spinal Anesthesia in Cervical Cancer Patients Undergoing Intracavitary Brachytherapy: An Observational Comparative Study Nopian Hidayat; Pratama Ananda; Dino Irawan; Novita Anggraeni; Sony; Patricia Feliani Sitohang
Indonesian Journal of Anesthesiology and Reanimation Vol. 8 No. 2 (2026): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

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Abstract

Introduction: Intracavitary brachytherapy is a fundamental modality in the management of cervical cancer. The procedure often induces significant discomfort due to applicator insertion and patient immobilization, making appropriate anesthetic management essential. General anesthesia (GA) and spinal anesthesia (SA) are commonly applied; however, their relative impact on perioperative outcomes remains a subject of debate. Objective: This study aimed to evaluate and compare the effects of GA and SA in patients with cervical cancer undergoing intracavitary brachytherapy, with particular emphasis on hemodynamic stability, postoperative pain intensity, recovery duration, and anesthesia-related complications. Methods: This observational analytic comparative study was conducted at Arifin Achmad General Hospital, Pekanbaru, Indonesia, following ethical approval. Fifty ASA II cervical cancer patients scheduled for intracavitary brachytherapy were enrolled and allocated into two groups: GA (n=25) and SA (n=25). Intraoperative hemodynamic variables were continuously monitored. Postoperative pain was assessed using the Numeric Rating Scale (NRS) at 0, 2, 4, 6, 12, and 24 hours. Recovery time, rescue analgesia requirement, and perioperative complications were recorded. Data were analyzed using Mann–Whitney U and Chi-square tests, with p<0.05 considered statistically significant. Results: Baseline characteristics were comparable between groups. No significant differences were observed in intraoperative hemodynamic parameters (p=0.930). The SA group demonstrated significantly lower pain scores at 0 hours (mean rank 15.12 vs 35.88; p<0.001) and 6 hours postoperatively (mean rank 19.68 vs 31.32; p=0.002), while no difference was found at 24 hours (p = 0.270). Rescue analgesia was required only in the GA group (16% vs 0%; p = 0.038). Recovery time was significantly shorter in the GA group (mean rank 20.24 vs 30.76; p=0.009). No anesthesia-related complications were observed. Conclusion: Both GA and SA are safe and effective for intracavitary brachytherapy. SA provides superior early postoperative analgesia with reduced need for rescue analgesia, whereas GA offers faster recovery. Anesthetic selection should be tailored to clinical priorities.
Pushing the Limits: Spinal Anesthesia in Children Undergoing Extended Urologic Surgeries Evelyn Tenggara; Khildan Miftahul Firdaus
Indonesian Journal of Anesthesiology and Reanimation Vol. 8 No. 2 (2026): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

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Abstract

Introduction: Spinal Anesthesia (SA) is a promising alternative to General Anesthesia (GA) in pediatric surgery, offering advantages in respiratory safety, hemodynamic stability, and better perioperative pain control. However, it remains underused in routine practice, often due to concerns about its limited duration of block (<90 minutes). Objective: This case report aimed to explore the application of SA in pediatric patients of different ages and to highlight its potential role as an alternative to GA. Case Series: We reported 3 cases of SA used in pediatric patients of different ages who underwent urologic surgeries at Airlangga University Hospital. One child had intermittent asthma, while two were obese. All patients received SA with Bupivacaine, combined with different intravenous adjuvants. Intraoperative hypotension requiring sympathomimetic support occurred in the oldest child. The longest duration of spinal block was 240 minutes, and postoperative pain was mild in all three patients, without the need for rescue analgesia. No Perioperative Respiratory Adverse Events (PRAEs) occurred, and no conversion to GA was required. Discussion: SA in pediatric patients provided good perioperative pain control without the need for airway manipulation, thereby reducing the risk of airway related complications, which is particularly beneficial in patients with high-risk airway. Younger children tended to demonstrate more stable hemodynamic responses during SA due to their immature sympathetic nervous system. The use of intravenous adjuvants in SA prolonged the spinal block duration and improved block quality, while potentially reducing the toxicity of local anesthetic agent used. Conclusion: In these cases, SA was shown to be a safe and beneficial anesthetic technique for pediatric patients undergoing urologic surgery.
Factors Associated with Blood Ordering and Utilization Consistency in Elective Orthopedic Surgery Maulydia Maulydia; Praditta Adhi Makayasa; Prananda Surya Airlangga; Mohammad Zaim Chilmi
Indonesian Journal of Anesthesiology and Reanimation Vol. 8 No. 2 (2026): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

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Abstract

Introduction: Blood transfusion is commonly performed during surgeries, and administering transfusion according to the actual needs helps minimize blood waste. Anesthesiologists determine transfusion timing, volume, and target hemoglobin (Hb) level to minimize unnecessary usage of blood. Objective: This study aims to identify factors associated with the consistency between blood ordering and utilization in elective orthopedic surgeries, resulting in improving transfusion effectiveness, enhancing efficiency and supporting clinical decision making in blood management. Methods: A total of 326 patients who underwent elective orthopedic surgery between January and December 2023 were included. Sex, age, hemoglobin (Hb) level, estimated blood loss (EBL), and American Society of Anesthesiologists (ASA) physical status, were evaluated in relation to the consistency between ordered and utilized blood. Results: Most patients were male (59.5%), aged 21-30 years (24.8%), had Hb levels of 11.0-12.9 g/dL (38.0%), EBL < 15% (51.2%), and an ASA physical status of 2 (66.6%). The consistency of whole blood (WB) utilization was 50%, while packed red cell (PRC) utilization was higher at 82.8%. WB utilization consistency was significantly associated with EBL (p=0.013) and ASA physical status (p=0.014), most patients showed more orders than actual usage in patients with EBL < 15% and patients with ASA physical status of 2. PRC utilization was not significantly associated with any patient characteristics. Conclusion: Sex, age, and Hb levels did not affect the consistency between ordered and utilized blood for either WB or PRC. EBL and ASA scores influenced WB but not PRC utilization, with greater inconsistency seen in cases with EBL <15% and ASA score of 2.

Page 12 of 12 | Total Record : 117

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