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Agni Susanti
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Jurnal Neuroanestesi Indonesia
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 8 Documents
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Search results for , issue "Vol 14, No 1 (2025)" : 8 Documents clear
The Role of Basal Cistern as Prognostic Factor in Head Injury Cases Fath, Tri Putra Nuur; Suhendar, Agus; Kania, Nia; Wibowo, Agung Ary; Poerwosusanta, Hery; Abidin, Zainal; Huldani, Huldani
Jurnal Neuroanestesi Indonesia Vol 14, No 1 (2025)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i1.596

Abstract

Background and Objective: Head injury is a medical condition affecting various individuals around the world and is characterized by high mortality and morbidity rates. Several studies have shown that accurate management and appropriate interventions are required to achieve favorable outcomes. In this context, head CT scan has been reported to be the gold standard in diagnostic imaging for patients with head injury. In addition, head CT scan can be used to evaluate basal cistern, which is an area around the brain with a significant role in consciousness due to its close association with the brainstem. Several factors are known to influence prognosis of head injury treatment, including age, gender, severity of head injury, type of bleeding lesion, and the condition of basal cistern, which play a crucial role in the outcome of patients care. Therefore, this study aims to determine the role of basal cistern as a predictor of prognosis in cases of head injury. Subject and Method: The study procedures were carried out using the prospective observational method, and the sample population comprised 67 head injury patients at Ulin Regional General Hospital (RSUD) from February to April in 2024. Based on the inclusion and exclusion criteria, a total of 60 patients were selected as participants, and their primary data were collected. Subsequently, each variable's data was analyzed using SPSS with Chi-square and Spearman correlation tests. Results: Significant differences were observed between various variables, including 1) the type of bleeding lesion and the condition of basal cistern (p-value: 0.004), 2) action (surgery and non-surgery) and prognosis (p-value: 0.017), and 3) prognosis and the condition of basal cistern (p-value: 0.0001). Conclusion: Based on the results, basal cistern could be used as a predictor of prognosis in patients with head injury. In addition, the severity of head injury was closely related to the condition of basal cistern. The more severe head injury, the worse prognosis for patients. The results also showed that the type of bleeding lesion affected the condition of basal cistern
Anesthesia Management in Patients with Moyamoya Disease with Superficial Temporal ArteryMiddle Cerebral Artery Bypass: Case Report Virayanti, Luh Putu Diah; Suarjaya, I Putu Pramana; Ryalino, Christopher; Surya Panji, Putu Agus; Senapathi, Tjokorda Gde Agung
Jurnal Neuroanestesi Indonesia Vol 14, No 1 (2025)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i1.637

Abstract

Moyamoya Disease (MMD) is a rare unknown disease that causes occlusion of the blood vessels of the brain in adults and children. There are several methods of operation that can be used for therapy, such as direct bypass and indirect bypass. Direct bypass is a method to connect the branches of the external carotid artery, usually the superficial temporal artery (STA), to the branching of the internal carotid artery, generally the Middle Cerebral Artery. Its potentially created several problems such as secondary brain injury and changes in hemodynamic. We use general anesthesia based on neuroanesthesia concepts to protect brain perfusion and maintain the patient's hemodynamic stability. In this patient, induction was carried out using remifentanil TCI Minto mode 4-6 ng/ml, Propofol TCI Schneider target effect 46 mcg/ml and Rocuronium 40 mg IV. We also add SCALP Block with Bupivacaine 0.25% volume of 23 ml. Before induction, an arterial line was installed on the right radial artery to determine hemodynamic changes, to protect cerebral perfusion pressure. The patient was stable during the operation and extubated immediately after the surgery. The patient returned to his initial state of consciousness and was admitted to the ICU for 48 hours.
The Use of Ketamine in Traumatic Brain Injury Firdaus, Riyadh; Natanegara, Ahmad Pasha; Sutedja, Anasthasia D.; Kartika, Gloria
Jurnal Neuroanestesi Indonesia Vol 14, No 1 (2025)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i1.633

Abstract

Ketamine, initially developed as an anesthetic agent, has gained significant attention for its potential therapeutic effects in various neurological conditions, particularly in patients with traumatic brain injury (TBI). The use of ketamine is controversial, especially due to concerns that it may increase intracranial pressure in patients with TBI. In this case report, a 29-year-old male with a diagnosis of severe head injury complicated by hemorrhagic shock from multiple traumas presented with decreased consciousness, active bleeding from the extremities, and hemodynamic instability. Rapid Sequence Intubation (RSI) was performed, during procedure which the patient was administered ketamine at a dose of 1 mg/kg, lidocaine 1.5 mg/kg, and rocuronium at 1 mg/kg. Fluid resuscitation with 1000 ml of crystalloid solution and norepinephrine drip 0.1 mcg/kg/min was also initiated. Post-resuscitation, the patient's hemodynamics were monitored and found stable. A literature search revealed systematic reviews from 2020 and studies from 2022 that focused on outcomes related to intracranial pressure and mortality in TBI patients receiving ketamine. The use of ketamine did not demonstrate evidence of harm in patients with traumatic head injury.
Impact of Slow Deep Breathing on Pain in Head Injury Patients: A Systematics Review Kogoya, Neger; Mulyanto, Joko
Jurnal Neuroanestesi Indonesia Vol 14, No 1 (2025)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i1.642

Abstract

Head injury is a global health problem that often resulted from traffic accidents, and has a serious impact on brain and nervous system function. One of the main symptoms of head injury is intense pain, which often affects patients' quality of life. Although pain medications are widely used, non-pharmacological interventions such as the Slow Deep Breathing (SDB) technique have been proposed as an effective alternative to reduce pain in head injury patients. This study was aimed to evaluate the impact of SDB on pain reduction in patients with head injury. This systematic review was conducted using the PRISMA method with journal searches in several databases such as Google Scholar and PubMed. The search focused on studies published between 2020 to 2024. Screened articles had to meet the inclusion criteria involving observational studies on SDB in head injury pain. In this systematic review, information was collected by highlighting key elements, including the population group, type of intervention measures, outcomes observed, and methodological approach chosen. the result of the 425 journals identified, 95 articles were screened, and 4 journals met the criteria for further discussion. The results of the four studies showed that the SDB technique significantly reduced pain intensity in head injury patients. SDB helped lower heart rate, blood pressure, and improve blood oxygenation, all of which contributed to pain reduction. Slow Deep Breathing technique was shown to be effective as a non-pharmacological treatment for managing pain in head injury patients. Despite some limitations in sample size and study design, consistent results support the use of SDB as a complementary therapy in pain management. Future research is needed to inform the maximum therapeutic activity of SDB and explore the potential for combination with other therapies
Inactivated SARSCoV2 Vaccine Inducing Acute Transverse Myelitis and Hypercoagulable State: A Case Report Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 14, No 1 (2025)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i1.631

Abstract

Introduction: Global pandemic of Coronavirus disease 2019 (COVID-19) have been developed with a respiratory infection as main symptom and vaccines had been proven against SARS-CoV-2 infection. We would like to present acute transverse myelitis with hypercoagulable condition case, after receiving the inactive SARS-CoV-2 vaccine (SinoVac). Case Presentation: This is a case from a 20-year-old male with acute onset of flaccid paraplegia, hyporeflexia, loss of sensation below 5th thoracic level, loss of autonomic function, and a positive Babinski sign bilaterally on 7 days after receiving SARS-CoV-2 vaccine. From lumbar puncture examination, we found elevated liquor cerebrospinal protein with mononuclear cell predominantly and elevated d-dimer and also decreased fibrinogen levels from laboratory examination. From Magnetic Resonance Imaging (MRI) showed hyperintensity at the 5th until 9th thoracal level. He improved motoric strength of the lower limb (walking without assistance), numbness and pain, urine and fecal retention after receiving methylprednisolone for 3 days. Conclusion: Acute transverse myelitis with hypercoagulable state was a rare case associated with COVID-19 vaccination, but clinician should be aware for early detection and giving proper treatment.
Dormant No More: The Neurogical Impact of Herpes Simplex Virus Reactivation Following Traumatic Brain Injury Johansyah, Theodorus Kevin Putra; Soetomo, Cindy Thiovany; Tiffany, Tiffany; Maliawan, Sri
Jurnal Neuroanestesi Indonesia Vol 14, No 1 (2025)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i1.659

Abstract

Herpes simplex viruses (HSV), including HSV-1 and HSV-2, are neurotropic viruses capable of establishing lifelong latency in sensory ganglia and reactivating under various triggers, including traumatic brain injury (TBI). TBI induces secondary injury cascades such as neuroinflammation, excitotoxicity, and blood-brain barrier disruption, which create a conducive environment for HSV reactivation. The reactivation of HSV after TBI, particularly HSV-1 and HSV-2, can lead to significant neurological consequences, including encephalitis, cognitive decline, and the development of neurodegenerative diseases like Alzheimers disease and Chronic Traumatic Encephalopathy. Current therapeutic approaches focus on antiviral agents like acyclovir and valacyclovir, which manage acute HSV infection but are less effective in preventing long-term neurological damage. Emerging research highlights the potential of anti-inflammatory and neuroprotective strategies to complement antiviral therapies, aiming to reduce the neuronal damage caused by viral reactivation and inflammation. However, gaps remain in understanding the precise mechanisms linking TBI-induced neuroinflammation to HSV reactivation and its long-term impact on neurological health. This review synthesizes the current literature on the pathophysiology of HSV reactivation following TBI, and their contributions to acute and chronic neurological outcomes
Optical Nerve Sheath Diameter (ONSD) Ultrasonography as Intracranial Non-Invasive Pressure Measurement in PostOperative Patient EDH Evacuation in ICU Saputro, Ramadhan; Adipurna, Resa Putra; Laksono, Buyung Hartiyo
Jurnal Neuroanestesi Indonesia Vol 14, No 1 (2025)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i1.582

Abstract

Intracranial Pressure (ICP) monitoring is an important component in the management of severe Traumatic Brain Injury (TBI) in ICU. Periodic ICP monitoring in patients with severe TBI who were treated in ICU resulted in lower mortality rates than those who were not measured. ICP can be measured by invasive or non-invasive methods. Invasive measurements related to higher cost, while non-invasive tests such as MRI and CT scans are associated with radiation exposure. ONSD ultrasound is an alternative examination that is practical, inexpensive, without radiation, and can be performed bedside. We report a case in the ICU of RSUD Dr. Saiful Anwar Malang, male, 44 years old, had a traffic accident, and was diagnosed with severe TBI with GCS E2V2M4, right frontotemporal 36cc epidural hematoma, cerebral edema, and left posterolateral 4th rib fracture. The patient underwent epidural hematoma surgical evacuation. Postoperatively, the patient was treated in ICU. We performed periodic ONSD ultrasound and with the guidance of these examinations the patient's management could be adjusted. Within 48-hours postoperatively the patient could be extubated and then moved to ward. ONSD ultrasound could be done bedside so that clinicians could quickly and precisely adjusted the management according to the dynamic condition of the patient.
Anesthesia Management for Epilepsy Surgery with Total Intravenous Anesthesia: A Case Report Firdaus, Riyadh; Talitaputri, Clarissa Emiko
Jurnal Neuroanestesi Indonesia Vol 14, No 1 (2025)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i1.649

Abstract

Background: Epilepsy is a neurological disorder characterized by recurrent seizures, affecting many aspects of life. Approximately 3040% of patients do not respond to antiepileptic medications, making surgery a crucial option. While only 1030% of these patients qualify for surgical intervention, procedures like temporal lobectomy are becoming more common. Anesthetic management is essential for intraoperative mapping of the epileptogenic focus. This case report discusses anesthetic strategies in elective epilepsy surgery. Case: A 55-year-old man with recurrent seizures was scheduled to undergo temporal lobectomy with amygdala-hippocampectomy. The patient was classified as American Society of Anesthesiologists (ASA) class 2 without sign of increased intracranial pressure and there was no plan to use intraoperative functional monitoring or intraoperative electroencephalogram by the surgeon, as the epileptogenic focus could be identified through previous functional magnetic resonance imaging (fMRI). The patient underwent general anesthesia with total intravenous anesthesia (TIVA) using a combination of propofol, remifentanil, and rocuronium. Depth of anesthesia was monitored using the Bispectral Index (BIS). There were no significant hemodynamic fluctuations intraoperatively, except for bradycardia during manipulation of the limbic system. The patient was extubated at the end of the operation and there were no seizures during postoperative monitoring. Conclusion: In epilepsy surgery, it is important to understand if intraoperative electrocorticography is planned, the impact of anesthetic drugs on epilepsy, brain protection management, hemodynamics, and early neurological function assessment postoperatively. The use of TIVA, along with adequate monitoring of the depth of anesthesia, is safe and beneficial for assessing neurological function early

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