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Jurnal Neuroanestesi Indonesia

jni
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Published by Indonesian Society of Neuroanesthesia & Critical Care

ISSN : 20889674 EISSN : 24602302 DOI : https://doi.org/10.24244/jni

Core Subject : Health, Science, Education,

Biochemistry, Genetics & Molecular Biology Education Medicine & Pharmacology Neuroscience Public Health

Editor of the magazine Journal of Neuroanestesi Indonesia receives neuroscientific articles in the form of research reports, case reports, literature review, either clinically or to the biomolecular level, as well as letters to the editor. Manuscript under consideration that may be uploaded is a full text of article which has not been published in other national magazines. The manuscript which has been published in proceedings of scientific meetings is acceptable with written permission from the organizers. Our motto as written in orphanet: www.orpha.net is that medicine in progress, perhaps new knowledge, every patient is unique, perhaps the diagnostic is wrong, so that by reading JNI we will be faced with appropriate knowledge of the above motto. This journal is published every 4 months with 8-10 articles (February, June, October) by Indonesian Society of Neuroanesthesia & Critical Care (INA-SNACC). INA-SNACC is associtation of Neuroanesthesia Consultant Anesthesiology and Critical Care (SpAnKNA) and trainees who are following the NACC education. After becoming a Specialist Anesthesiology (SpAn), a SpAn will take another (two) years for NACC education and training in addition to learning from teachers in Indonesia KNA trainee receive education of teachers/ experts in the field of NACC from Singapore.

Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine

Articles 9 Documents

Search results for , issue "Vol 10, No 2 (2021)" : 9 Documents clear

Perbedaan Nilai The Clinic GBS Severity Evaluation Scale (CGSES) dan Skala Disabilitas Sindroma Guillain-Barre (SDSGB) pada Pasien Sindroma Guillian Barre dengan dan tanpa Imunoterapi Sidabutar, Berliana; Ganiem, Ahmad Rizal; Lailiyya, Nushrotul; Kurniani, Nani; Amalia, Lisda; Sobaryati, Sobaryati
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Latar Belakang dan Tujuan: The Clinical GBS Severity Evaluation Scale (CGSES) dikembangkan untuk penentuan imunoterapi pasien Sindroma Guillian Barre (SGB) secara lebih obyektif. Skala Disabilitas SGB (SDSGB) menggambarkan tingkat keparahan SGB dan dapat digunakan menilai efektifitas pemberian imunoterapi. Tujuan penelitian untuk mengetahui perbedaan penilaian CGSES dan SDSGB pasien SGB dengan dan tanpa imunoterapi dan membandingkan kesesuaian keputusan subyektif dengan CGSES. Subjek dan Metode: Penelitian observasional analitik potong lintang komparatif secara retrospektif pada pasien rawat SGB periode Januari 2015 Maret 2020 di RSUP Dr Hasan Sadikin Bandung. Hasil: Terdapat 92 subjek (35 dengan dan 57 tanpa imunoterapi). Rerata usia 41,5 tahun, dengan pria:wanita (57,6%:42,4%). Tidak didapatkan perbedaan demografi dan pemeriksaan fisik kedua kelompok, kecuali paresis saraf kranial (62,9% vs. 33,3%; p=0,006). Terdapat perbedaan rerata lama perawatan dengan dan tanpa imunoterapi (29,534,4 vs. 11,44,1 hari, p=0,0001). Hasil penilaian CGSES pasien SGB dengan dan tanpa imunoterapi memiliki perbedaan bermakna (p=0,035). Terdapat perbedaan signifikan SDSGB saat masuk dan pulang pasien dengan imunoterapi (p=0,007) dan tanpa imunoterapi (p=0,025). Terdapat ketidaksesuaian keputusan subyektif dengan nilai CGSES (nilai Kappa 0,117; CI95% 0,021-0,213)Simpulan: Terdapat perbedaan skor CGSES dan SDSGB pada kelompok pasien SGB dengan dan tanpa imunoterapi. Terdapat ketidaksesuaian penilaian subyektif keputusan pemberian imunoterapi dengan skoring CGSESDifferences in Value of The Clinic GBS Severity Evaluation Scale (CGSES) and Guillain-Barre Syndrome Disability Scale (GBSDS) in Guillian Barre Syndrome (GBS) Patients with and without ImmunotherapyAbstractBackground and objective: The Clinical GBS Severity Evaluation Scale (CGSES) was developed to determine immunotherapy of GBS patients more objectively. GBS Disability Scale (SDSGB) describes severity of GBS and assesses effectiveness of immunotherapy. Purpose of this study was to measure difference of CGSES and GBSDS in GBS patients with and without immunotherapy and to compare the suitability of subjective decisions with CGSES. Subject and Methods: This is a comparative cross-sectional analytic observational study retrospectively in GBS patients from January 2015-March 2020 hospitalized at Dr Hasan Sadikin Hospital, Bandung. Results: There were 92 subjects (35 with and 57 without immunotherapy). Mean age was 41.5 years, and male:female ratio was 57.6%:42.4%. There were no differences in demographics and physical examination between two groups, except for cranial nerve paresis (62.9% vs. 33.3%; p=0.006). There was a difference in mean length of stay with and without immunotherapy (29.5 34.4 vs. 11.4 4.1 days, p=0.0001). Results of the CGSES assessment with and without immunotherapy had a significant difference (p=0.035). There were significant differences in GBSDS at admission and discharge with (p=0.007) and without immunotherapy (p=0.025). There was a discrepancy between subjective decisions and CGSES value (Kappa value 0.117; 95% CI 0.021-0.213).Conclusion: There were differences in CGSES and GBSDS in group of GBS patients with and without immunotherapy. There was a discrepancy between subjective assessment of decision to give immunotherapy with CGSES scoring.

Penerapan Enhanced Recovery after Surgery (ERAS) pada Bedah Saraf Firdaus, Riyadh; Permana, Affan Priyambodo; Sugianto, Astrid Indrafebrina; Theresia, Sandy
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Enhanced recovery after surgery atau ERAS adalah suatu protokol perawatan perioperasi terstandar multidisiplin pada pasien bedah yang bertujuan untuk meminimalkan stres perioperasi sehingga menghasilkan luaran yang lebih baik. Protokol ERAS tersusun dari berbagai komponen perawatan yang terbukti mendukung pemulihan dan/atau menghindari komplikasi pascaoperasi. Komponen-komponen tersebut mengikutsertakan ahli bedah, ahli anestesi, perawat, farmasi, ahli gizi yang terlibat dalam perawatan pasien sehingga memberikan perbaikan yang lebih baik. Protokol ERAS tersusun dari berbagai komponen perawatan dari mulai praoperasi (konseling, pemberian nutrisi, pengelolaan kebiasaan, trombofilaksis, persiapan daerah operasi dan profilaksis antimikroba), intraoperasi (teknik anestesi, manajemen anestesi, analgesia, manajemen cairan, pengaturan suhu, teknik pembedahan) hingga pascaoperasi (kejadian post-operative nausea and vomiting (PONV), drainase urin, asupan nutrisi, mobilisasi dini). Penerapan ERAS menunjukkan hasil yang baik, dapat diterapkan, dan memberikan keuntungan bagi pasien bedah saraf. Walau demikian, protokol ERAS dalam bedah saraf masih sangat terbatas dan memerlukan penelitian lebih lanjut mengikuti berbagai jenis tindakan/operasi dan keadaan pasien yang berbeda-beda.Implementation of Enhanced Recovery after Surgery (ERAS) in NeurosurgeryAbstractEnhanced recovery after surgery (ERAS) is a multidisciplinary standardized perioperative treatment protocol in surgical patients that aims to minimize perioperative stress and result in better outcomes. The ERAS protocol is composed of various components of care that have been shown to support recovery and/or avoid postoperative complications. These components include surgeons, anesthesiologists, nurses, pharmacists, nutritionists who are involved in patient care to provide better improvements. The ERAS protocol is composed of various components of preoperative care (counseling, nutrition, lifestyle management, thromboprophylaxis, preparation of the surgical area and antimicrobial prophylaxis), intraoperative care (anesthetic technique, anesthesia management, analgesia, fluid management, temperature regulation, surgical technique) and postoperative care (PONV management, urinary drainage, nutritional intake, early mobilization). Implementation of ERAS is applicable and shows good results along with the benefits for patients undergoing neurosurgery. However, ERAS in neurosurgery is still very limited and requires further research following different types of procedures / operations and different patient conditions.

Kombinasi Dexmedetomidine Sevoflurane 0,5 MAC pada Bedah Mikro Reseksi Malformasi Arteri-Vena Tjahyanto, Adhy; Samdani, Ibnu Siena; Harahap, M Sofyan
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Malformasi arterivena (MAV) merupakan kasus yang jarang terjadi, terutama pada usia muda (40 tahun). Usaha untuk menjaga kestabilan hemodinamik dan pencegahan perdarahan masif selama reseksi bedah mikro MAV adalah hal yang harus dikuasai oleh seorang ahli anestesi. Total Intra Venous Anesthesia dengan propofol masih populer untuk mengendalikan tekanan intrakranial karena mudah dititrasi dan agen kerja cepat (baik onset maupun durasi). Penilaian status neurologis umum segera setelah anestesi dihentikan juga termasuk komponen penting dalam pembedahan mikro reseksi MAV otak. Pada kasus ini, dilaporkan seorang wanita berusia 20 tahun yang mengalami penurunan kesadaran dan hemiparesis sinistra mendadak. Hasil angiografi otak menunjukan adanya MAV di lobus frontal dekstra. Tindakan reseksi MAV dilakukan dengan pembedahan mikro. Setelah 5-menit-preoksigenasi dilakukan, induksi anestesi menggunakan propofol, fentanil, rocuronium, dan sevoflurane. Sepuluh detik proses intubasi tidaklah menimbulkan gejolak hemodinamik. Pembedahan berlangsung lancar dengan kombinasi dexmedetomidine-sevoflurane 0,5MAC. Hemodinamik pasien pasca-anestesi stabil dan tanpa lesi neurologis baru.A Combination of Dexmedetomidine Sevoflurane 0.5MAC in Microsurgical Resection of Arteriovenous Malformation: a Case ReportAbstractArterio-venous malformation (AVM) is a rare case, particularly among young patients (40 years old). Maintaining haemodynamic stability and anticipating massive haemorrhage during micro surgery resection of AVM are fundamental for an anaesthetist. Total Intra Venous Anesthesia using propofol is still popular to control intracranial pressure as it is easily titrated and fast acting agent (both in onset and duration). Moreover, general neuruologic evaluation soon after anesthesia terminated is an integral important component of microsurgery of brain MAV. In this case report: a 20-year-old woman suddenly lost her consciousness and left-sided motors strength. Brain angiographic revealed an AVM in right frontal lobe. Microsurgery of brain AVM resection was performed. After 5-minute-preoxygenation, anaesthetic induction was performed by using propofol, fentanyl, rocuronium, and sevoflurane. The surgery went successfully using a combination of dexmedetomidine-sevoflurane 0.5MAC. Post-anaesthesia hemodynamic of this patient was in stable and without new neurologic deficit afterward.

Korelasi antara Stroke dengan Covid-19 Bisri, Dewi Yulianti; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
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Spektrum klinis covid-19 sangat luas, mulai dari gejala minor yang tidak spesifik, seperti demam, batuk kering dan diare, kadang-kadang dikombinasikan dengan pneumonia ringan dan dispnea ringan, hingga pneumonia berat dengan dispnea, takipnea, dan gangguan pertukaran oksigen, menyebabkan disfungsi paru berat, memerlukan ventilasi mekanik, terjadi syok atau kegagalan organ multipel. Bukti awal yang tidak dipublikasikan menunjukkan bahwa pada pasien dengan covid-19 positip terjadi peningkatan risiko stroke iskemik akut. Keluhan neurologik yang sering terjadi adalah sakit kepala, pusing, perubahan pengecapan dan penciuman, lima persen memiliki risiko terjadinya stroke iskemik akut. Coronavirus mempunyai kecenderungan untuk menginvasi susunan sarap pusat (SSP). Perubahan penciuman yang telah dilihat pada covid-19, diposulatkan karena refleks akses dari virus ke otak melalui rute transcribial, walaupun masih perlu dibuktikan untuk severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Satu laporan dari Cina menunjukkan bahwa keluhan neurologis seperti dizziness, sakit kepala, hypogeusia dan hyposmia, sering terjadi (sekitar 36%) pada pasien covid-19. Ensefalopati dan perubahan status mental juga terjadi pada pasien yang telah terinfeksi dengan virus SARS-CoV-2. Penyakit serebrovaskuler lebih sering pada covid-19 yang berat; stroke iskemik akut telah dilaporkan terjadi pada 5,7% pasien dan gangguan kesadaran pada 15% pasien, dan 1% kejadian perdarahan serebral. Kelainan SSP yang memerlukan tindakan pembedahan memerlukan penanganan khusus karena efek teknik dan obat anestesi terhadap SSP, serta perlindungan tenaga kesehatan untuk mencegah transmisi penyakit. Tigapuluh delapan persen pasien covid-19 dengan komplikasi serebrovaskuler meninggal.Correlation between Stroke and Covid-19AbstractThe clinical spectrum of Covid-19 is very broad, ranging from minor no specific symptom, such as fever, dry cough and diarrhea, some time combined with mild pneumonia and mild dyspnoe to severe pneumonia with dyspnoe, tachypnoe and exchange disorders, leading to severe pulmonary dysfunction, necessary ventilation, shock and multiple organ failure. Preliminary unpublished evidence suggest that patient with covid-19 have an increased risk of acute ischemic stroke. Neurologic complaints that oven occurs are headache, dizziness, change in taste and smell. Five percent risk of developing acute ischemic stroke. Coronavirus has a tendency to invade the central nerve system (CNS). The olfactory change that have been seen in covid-19, are attributed to reflex access from the virus to the brain via the transcribial route, although this remain to be proven for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). One report from China showed that neurological complaint, such as dizziness, headaches, hypgeusia and hyposmia, were common (about 36%) in covid-19 patients. Encephalopathy and altered mental status also occurs in patients who have been infected with the SARS-CoV-2 virus. Cerebrovascular disease is more common in severe covid-19; acute ischemic stroke has been reported to occurs in 5.7% of patients and impaired consciousness in 15% of patients, and 1% cerebral hemorrhage was found. CNS disorders that require surgery require special treatment because of the effect of techniques and anesthetics on the CNS, as wll as the protection of health professionals to preventdiseses transmission. Thirty-eight percents of covid-19 patient with cerebrovascular complication died.

Manajemen Anestesi untuk Seksio Sesarea pada Pasien Eklampsia dengan Perdarahan Intrakranial Bangun, Chrismas Gideon; Sudadi, Sudadi; Saleh, Siti Chasnak
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
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Perdarahan intrakranial pada kehamilan adalah penyebab kematian utama pada pasien-pasien dengan eklampsia. Hipertensi, yang berkaitan dengan stroke iskemik dan stroke hemoragik, adalah tampilan utama. Penanganan definitif merupakan terminasi kehamilan dengan seksio sesarea. Namun, tidak tepat untuk memulai persalinan pada ibu yang tidak stabil, sekalipun terdapat gawat janin. Begitu kejang dapat dikendalikan, hipertensi berat ditangani dan hipoksia dikoreksi, persalinan dapat dimulai. Sasaran manajemen anestesia yang pertama yaitu pengendalian kejang, pengendalian tekanan darah, dan pencegahan peningkatan tekanan intrakranial. Anestesi umum merupakan pilihan pada pasien tidak sadar, atau penurunan kesadaran dengan tanda-tanda peningkatan tekanan intrakranial. Anestesia dicapai dengan inhalasi, opioid, relaksasi dan hiperventilasi secara hati-hati. Pada kasus ini seorang ibu 31 tahun, 55 kg, usia kehamilan 36-37 minggu datang ke rumah sakit dengan penurunan kesadaran dan riwayat kejang. Dijumpai sensorium E2M5V2, tekanan darah 180/100mmHg dan proteinuri 3+. Segera diputuskan dilakukan seksio sesarea dengan anestesi umum dan rapid sequence induction dengan fentanyl 50 mcg, propofol 100 mg dan rocuronium 50 mg intravena. Post operasi pasien dirawat di ICU, dilakukan head CT-Scan dan dijumpai perdarahan intrakranial di temporoparietal kanan. Penanganan perdarahan intrakranial diputuskan konservatif. Hari ke-3 pascabedah pasien diekstubasi dan pada hari ke-5 pasien dipindahkan ke ruangan dengan sensorium E3M5V2.Management of Anesthesia for Eclampsia Caesarean Section Patient with Intracranial BleedingAbstractIntracranial haemorrhage in pregnancy is the leading cause of death in eclampsia patients. Hypertension, which is associated with both ischemic and hemorrhagic strokes, is the main feature. Definitive treatment is termination of pregnancy with cesarean section. However, it is not appropriate to start labor in an unstable mother, despite fetal distress. Once seizures can be controlled, severe hypertension is treated and hypoxia is corrected, labor may begin. The first anesthesia management goals are seizure control, blood pressure control, and prevention of increased intracranial pressure. General anesthesia is an option in the unconscious patient, or decreased consciousness with signs of increased intracranial pressure. Anesthesia is achieved with inhalation, opioids, relaxation and hyperventilation techniques carefully. In this case a 31-year-old mother, 55 kg, 36-37 weeks' gestation comes to the hospital with a decrease in consciousness and a history of seizures. Found sensorium E2M5V2, blood pressure 180/100mmHg and proteinuria 3+. Immediately, a cesarean section with general anesthesia and rapid sequence induction with fentanyl 50 mcg, propofol 100 mg and rocuronium 50 mg intravenously were performed. Post surgery the patient was treated in the ICU, head CT-Scan was performed and intracranial hemorrhage in the right temporoparietal was encountered. Management of intracranial hemorrhage was decided conservatively. The 3rd day postoperative the patient was extubated and on the 5th day the patient was transferred with E3M5V2 sensorium.

Pengelolaan Anestesi pada Pasien yang dilakukan Eksisi Tumor Medula Spinalis Servikal 2-3 dengan Ventrikel Ekstra Sistole Maharani, Nurmala Dewi; Rachman, Iwan Abdul; Bisri, Dewi Yulianti; Sudadi, Sudadi; Saleh, Siti Chasnak
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Penyakit yang mengakibatkan kompresi medulla spinalis dapat mengakibatkan iritasi pada sistem saraf otonom. Hiperinervasi saraf simpatis berisiko tinggi pada aritmia ditandai adanya perubahan pada elektrokardiografi, yakni perubahan durasi gelombang P, durasi QRS, depresi segmen ST, interval puncak gelombang T dan ventrikel ekstrasistol. Laki- laki 52 tahun dengan tumor intra-ektramedullar pada area cervikalis 2-3 dengan tetraparesis dan ventrikel ektrasistol dilakukan wide eksisi tumor dan stabilisasi posterior. Pemeriksaan fisik nadi 90 x/menit teraba tidak teratur. Elektrokardiogarfi (EKG) didapatkan hasil irama irreguler 82 x/menit, ventrikel ektrasistol 10 x/menit. Echocardiography menunjukkan disfungsi diastolik grade 3 preserved LV function. Sebelum operasi pasien diberikan terapi ventrikel ektrasistol dengan menggunakan analgetik dan amiodaron 150 mg (10 mL) pada 10 menit pertama, dilanjutkan dengan 360 mg (200 mg) untuk 6 jam selanjutnya, 540 mg untuk 18 jam berikutnya dan analgetik. Induksi anestesi dilakukan dengan midazolam 3 mg, fentanyl 200 mcg, lidokain 60 mg, propofol 100 mg, dan atricurium 30 mg serta intubasi manual in-line. Dilakukan pemasangan arteri line dan kateter vena sentral setelahnya pasien diposisikan prone. Pembedahan berlangsung 6 jam. Pasien dirawat di ICU 2 hari sebelum pindah ruang rawat biasa. Pemberian amiodarone sendiri dapat dipertimbangkan pada ventrikel ekstrasistol maligna yang memerlukan tatalaksana segera dengan pertimbangan hemodinamik pasien dalam keadaan stabil.Anesthesia Management for Cervical 2-3 Spinal Cord Tumor with Ventricles ExtrasystoleAbstractCompression of the spinal cord can cause irritation to the autonomic nervous system. Hyperinervation of sympathetic nerves at high risk for arrhythmias characterized by electrocardiographic results in changes in P-wave duration, QRS duration, ST-segment depression, T-wave peak interval, and ventricular extrasystole. A 52-year-old male with an intra-extramedullar tumor in cervical 2-3, tetraparesis, dysrhythmias, and ventricular extrasystole bigemini. Wide excision of tumor and posterior stabilization would be performed. The pulse was 90x/minute palpable irregularly. Electrocardiography examination revealed irregular rhythm 82 x/minute and ventricular extrasystole 10 x/minute. Echocardiography showed grade 3 diastolic dysfunction with preserved LV function. Before the procedure, the patient was given management for the dysrhythmia and ventricular extrasystole with analgetics and amiodaron 150mg (10ml) in the first 10 minutes followed by 360mg (200mg) for the next 6 hours, 540mg for the next 18 hours and analgetics. General anesthesia carried out with midazolam 3mg, fentanyl 200mcg, lidocaine 60mg, propofol 100mg, and atricurium 30mg, with manual intubation in-line. After arterial line and central venous catheter insertion, the patient was placed in the prone position. Surgery lasted for approximately 6 hours. The patient was treated in the ICU for 2 days before moving to the usual ward. Amiodarone can be considered in ventricular extrasystole requiring immediate treatment with stable hemodynamic.

Hubungan Kadar Gula Darah dan Hematokrit dengan Luaran Pasien Cedera Otak Traumatik Berdasarkan Skor GCS di RSUD Ulin Banjarmasin Riddo, Rasyid; Sikumbang, Kenanga Marwan; Asnawati, Asnawati
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
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Latar Belakang dan Tujuan: Tingkat keparahan dari cedera otak traumatik (COT) dapat dinilai menggunakan Glasgow Coma Scale (GCS). Saat terjadi COT, tubuh mengeluarkan hormon sebagai respons stres fase akut sehingga terjadi peningkatan kadar gula darah reaktif. Selain itu juga memengaruhi pembuluh dan komponen darah sehingga akan memengaruhi hematokrit. Tujuan penelitian ini untuk mengetahui apakah terdapat hubungan antara kadar gula darah dan hematokrit dengan luaran pasien COT berdasarkan skor GCS di RSUD Ulin Banjarmasin. Subjek dan Metode: Penelitian ini bersifat observasional analitik dengan pendekatan cross-sectional. Data diambil secara prospektif dengan metode consecutive sampling. Data yang terkumpul dianalisis hasilnya menggunakan uji korelasi non-parametrik Spearman.Hasil: Sebanyak 45 sampel didapat secara consecutive sampling. Pada hari ke-7, 40 pasien memiliki luaran baik dan 5 pasien memiliki luaran buruk. Analisis menggunakan uji korelasi Spearman menunjukkan terdapat hubungan kadar gula darah dengan luaran pasien COT (p=0,044; r=0,302) tetapi tidak terdapat hubungan antara hematokrit dengan luaran (p=0,958).Simpulan: Terdapat hubungan kadar gula darah dengan luaran pasien COT, tetapi tidak terdapat hubungan hematokrit dengan luaran pasien COT berdasarkan skor GCS.Association of Blood Sugar Levels and Hematocrit with TBI Patient Outcome Based on GCS Score at Ulin General Hospital BanjarmasinAbstractBackground and Objective: Glasgow coma scale (GCS) examination is done to categorize the severity and determine the outcome in TBI. When TBI occurs, the body release hormones in the acute phase of stress response which will occur an increase blood sugar levels. It will also affect hematocrit. The purpose of this study was analyze correlation between blood sugar levels and hematocrit with TBI patients outcome based on GCS score in Ulin General Hospital Banjarmasin. Subject and Method: The design of this study was observational analytic with cross-sectional approach. Data acquired prospectively with consecutive sampling method. The collected data will be analyzed using the Spearman non-parametric trial.Result: Total of 45 samples were obtained by consecutive sampling. On day 7, 40 patients had good outcomes and 5 patients had poor outcomes. Analysis using the Spearman correlation test showed association between blood sugar levels and TBI patients outcome (p=0,044; r=0,302) but no association between hematocit and TBI patients outcome (p=0,958). Conclusion: It was concluded that there is an association between blood sugar levels and TBI patients outcome, but there is no association between hematocrit and TBI patients outcome based on GCS score.

Tatalaksana Anestesi pada Pasien Anak dengan Cystic Craniopharyngioma yang Menjalani Gamma Knife Radiosurgery Widiastuti, Monika -; Halimi, Radian Ahmad; Fuadi, Iwan; Rahardjo, Sri; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Kraniofaringioma merupakan tumor otak jinak dengan karakteristik kistik dan kalsifikasi, yang letaknya dikeliingi oleh stuktur vital sehingga sulit untuk dilakukan reseksi total. Terapi kombinasi dengan Gamma knife radiosurgery (GKRS) merupakan pilihan terapi paling tepat. Prosedur GKRS yang kompleks meliputi banyak tahap dengan durasi 6-10 jam, memerlukan pemberian anestesi pada pasien yang tidak kooperatif. Kasus ini mengenai pasien anak perempuan berusia 4 tahun dengan cystic craniopharyngioma. Pasien dengan keluhan pandangan mata buram, dari pemeriksaan fisik didapatkan papil atrofi bilateral. Hasil magnetic resonance imaging (MRI) menunjukkan massa tumor yang menekan kelenjar hipofise inferior. Pasien menjalani prosedur GKRS selama 6 jam dengan anestesi sedasi sedang menggunakan Propofol 75 mcg/kg/menit. Hemodinamika selama prosedur stabil, tidak terjadi komplikasi. Pemilihan teknik anestesi dapat berupa anestesi umum atau sedasi, tergantung pada kondisi pasien, dokter anestesi, operator, dan fasilitas. Pertimbangan anestesi pada GKRS antara lain prosedur dilakukan di luar kamar operasi, durasi panjang, transportasi ke beberapa tempat seperti radiologi dan cathlab, imobilisasi kepala untuk mencegah pergeseran frame stereotaktik, pasien sendiri di dalam ruang radiasi, prinsip neuroanestesi pediatrik.Anesthetic Management of Pediatric Patient with Cystic Craniopharyngioma Underwent Gamma Knife RadiosurgeryAbstractCraniopharyngioma is a benign tumor characterized by cystic and calcification, surrounded by vital structures therefor it is difficult to perform total tumor resection. Combination with Gamma knife radiosurgery (GKRS) is the best treatment option. The complexities of GKRS consisting of several phases lasts for 6-10 hours. Anesthesia is needed for uncooperative patients. This is a case of a 4-year-old girl with cystic craniopharyngioma. The patient had chief complaint of blurry vision, physical examinations revealed bilateral papil atrophy. Result of MRI showed tumor mass compressing inferior hypophyse. Patient underwent the procedure under moderate sedation with Propofol at 75 mcg/kg/min for 6 hours. Intraoperative hemodynamic condition was stable without adverse events. Choice of anesthesia either general anesthesia or sedation, depends on the condition of patient, considerations from anesthesiologist dan neurosurgeon, dan availability of facilities. Unique considerations for GKRS are; a non-operating room anesthesia, long duration, transportation to other units such as radiology and cathlab, head of the patients need to be immobilized to prevent frame displacement, the patient will be alone in the treatment room, and principles of pediatric anesthesia and neuroanesthesia.

Peran Ferritin pada Stroke Iskemik Akut Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Stroke merupakan defisit neurologis yang terjadi karena jejas fokal akut pada sistem saraf pusat yang semata-mata terjadi karena gangguan vaskuler, termasuk infark serebri maupun perdarahan. Ferritin adalah protein intraselular dan ekstraselular penyimpan zat besi yang penting bagi homeostasis besi dalam tubuh. Ferritin diekspresikan di mikroglia dan makrofag, namun ada juga di dalam neuron. Pada saat terjadi kerusakan sel akibat stroke iskemik, ferritin akan keluar dari sel dan masuk ke dalam serum. Keadaan hipoksia-iskemia pada stroke menginduksi ekspresi dari ferritin pada oligodendrosit dan mikroglia. Saat terjadi stres oksidatif, pembentukan ferritin akan meningkat. Fungsi ferritin pada saat stres oksidatif terjadi, masih kontroversial. Ferritin dalam kondisi tersebut dapat berperan sebagai pembersih (scavenger) dan sebagai donor untuk ion besi bebas. Pasien stroke iskemik dengan lesi yang lebih besar dan defisit neurologis yang lebih berat menunjukkan peningkatan kadar serum ferritin yang lebih tinggi dan kecenderungan terjadinya komplikasi trasformasi perdarahan akan semakin tinggi pula.Role Of Ferritin in Acute Ischemic Stroke: A Literature ReviewAbstractStroke is a neurological deficit that occurs due to acute focal injury to the central nervous system that occurs solely due to vascular disorders, including cerebral infarction or bleeding. Ferritin is an intracellular and extracellular iron storage protein which is essential for iron homeostasis in the body. Ferritin is expressed in microglia and macrophages, and also in neurons. If there is cell damage due to ischemic stroke, ferritin will leave the cells and enter the serum. The hypoxia-ischemic state in stroke induces the expression of ferritin in oligodendrocytes and microglia. When there is oxidative stress, ferritin formation will increase. The function of ferritin in times of oxidative stress is still controversial. Ferritin in this condition can act as a scavenger and as a donor for free iron ions. Ischemic stroke patients with larger lesions and more severe neurological deficits showed higher serum ferritin levels and a higher likelihood of complications of bleeding transformation.

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Agni Susanti

Contact Email jurnalneuroanestesi@gmail.com

Phone +6287722631615

Journal Mail Official jni@inasnacc.org

Editorial Address Jl. Prof. Eijkman No. 38 Bandung 40161, Indonesia Lt 4 Ruang JNI

Location , INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Agni Susanti

Contact Email
jurnalneuroanestesi@gmail.com

Phone
+6287722631615

Journal Mail Official
jni@inasnacc.org

Editorial Address
Jl. Prof. Eijkman No. 38 Bandung 40161, Indonesia Lt 4 Ruang JNI

Location
,

INDONESIA