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INDONESIA
Jurnal Komplikasi Anestesi
Published by Universitas Gadjah Mada
ISSN : 23546514     EISSN : 26155818     DOI : https://doi.org/10.22146/jka.v11i2.12773
Core Subject : Health,
Medicine & Pharmacology
JURNAL KOMPLIKASI ANESTESI (e-ISSN 2354-6514) is a scientific and original journal which published as a forum for various scientific articles including research, literature reviews, case reports and recent book reviews. The presence of this journal, it is hoped that it can provide input of knowledge and knowledge in the field of Anesthesiology and Intensive Therapy for medical personnel.
Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine
Articles 10 Documents
 1 
Search results for , issue "Vol 11 No 1 (2023)" : 10 Documents clear
Preliminary Survey in preparation for the implementation of ERAS at Dr Soetomo Hospital Veterini, Anna; Firdaus, Khildan Miftahul; Semedi, Bambang Pujo; Putri, Herdiani Sulistyo; Fitritati, Mariza; Mutiar, Airi
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v11i1.9952

Abstract

Background Medical science has developed rapidly. One of them is ERAS (Enhanced Recovery After Surgery) which is a multidisciplinary team development pathway for perioperative methods that offer a variety of benefits. Some of the advantages of the ERAS method are speeding up the post-operative recovery period, economic benefits, and shortening the Length of Stay (LOS) by minimizing surgical stress so that the patient quickly returns to a normal physiological state. Objective This study aims to analyze the readiness of the team that will support the ERAS application at General Academic Hospital (RSUD) Dr Soetomo. Methods This is an observational analytic study with a cross-sectional design using a questionnaire. Patient baseline data were taken from the examination at the anesthesiology outpatient clinic. Assessment for patient understanding was carried out directly after a brief explanation of ERAS method by the researcher. The patient's level of understanding was assessed by two investigators and rated on a scale of 1 to 5. Primary data and assessment of understanding of doctors and medical personnel were filled in independently by research subjects on online forms and rated on a scale of 1 to 5. Data was collected from March 23 to April 14 2022, at RSUD Dr. Soetomo Surabaya. The analysis results are considered significant if the p-value is less than 0.05. The analysis was carried out using SPSS 19 software. Results Most patients planned to undergo surgery in the field of urology (82.9%), followed by caesarean section (14.6), and almost all patients or their families agreed to surgery using the ERAS method (95.1%). The medical team consists of 110 doctors from 4 areas of expertise, namely specialist doctors and residents in anesthesiology, urology surgery, obstetrics and gynecology, as well as orthopedics and traumatology. The health team consists of 56 personnel, namely anesthesiologists, surgeons, recovery room nurses, nutritionists and pharmacists. The majority (61%) of health workers had heard about ERAS and stated that ERAS was ready to be implemented at RSUD Dr. Soetomo (89%). Most doctors stated that ERAS was ready to be implemented at Dr. Soetomo and its human resources and facilities are considered qualified. Conclusion The ERAS method at RSUD Dr. Soetomo is considered quite ready to start, especially the Obsgyn study program, which is supposed to have an excellent level of understanding of ERAS and is enthusiastic to begin immediately. The patient group can be said to understand and accept the ERAS method well as a perioperative method for handling their cases.
Cost Effectiveness General Anesthesia Combined with Scalp Block Compared to General Anesthesia in Patients Undergoing Removal Tumor Craniotomyin Dr. Sardjito Hospital Wicaksono, Galih Sahid; Sudadi; Uyun, Yusmein
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v11i1.10199

Abstract

Background. Providers of anesthesia services have many opportunities to reduce these costs, of course with the aim of maintaining balance between profit, security and costs. Craniotomy surgery removal of the scalp block tumor is an alternative option that can be combined with general anesthesia. The scalp block itself can blunt stress response in craniotomy and can maintain unwanted hemodynamic instability. Purpose. Find out the cost effectiveness of the scalp block in craniotomy patients removing tumors at Dr. SARDJITO Hospital. Method. Method. Twenty patients ranging in age from 18 - 65 years with intracranial tumors who underwent tumor binding craniotomy at RSUP Dr. SARDJITO is grouped into two treatment groups with general anesthesia and general anesthesia with a combination of scalp blocks, both techniques are calculated using drugs and consumables during the operation. Results. Total cost on the general anesthesia combined scalp block was Rp. 1,347,276 lower Rp. 377,833 compared to general anesthesia Rp. 1,725,109 with a significant difference (p = 0.005). Similarly, the hourly cost of the group in the combined general anesthesia scalp block was Rp. 286,351 Rp. 97,107 lower than general anesthesia Rp. 383,457 with a significant difference (p = 0.038). Conclusion. Combination of general anesthesia and scalp block using 0.5% levobupivacaine more cost effective than general anesthesia and scalp block with placebo in supratentorial tumor patients undergoing tumor removal craniotomy.
Pengaruh Teknik Anestesi Kombinasi Blok Skalp dengan Levobupivacaine 0,5% Terhadap Penggunaan Fentanyl Intravena untuk Mengatasi Nyeri Paska Operasi Kraniotomi Pengangkatan Tumor Di RSUP Dr. Sardjito Akbar, Shonnif; Sudadi; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v11i1.10207

Abstract

Latar Belakang. Pengunaan opioid dosis besar terbukti efektif untuk memblokade stimulasi pada insisi kepala namun memiliki efek yang tidak diinginkan. Blok skalp adalah salah satu pilihan alternatif yang dapat dikombinasikan dengan pembiusan umum. Blok skalp sendiri dapat menumpulkan respon stres pada kraniotomi dan dapat menjaga gejolak hemodinamik yang tidak diinginkan. Blok skalp menurunkan insiden dan skala nyeri paska operasi kraniotomi pengangkatan tumor. Tujuan. Membandingkan jumlah konsumsi fentanyl paska operasi pada pasien yang menjalani operasi kraniotomi pengangkatan tumor dengan teknik pembiusan umum dan teknik pembiusan umum dengan kombinasi blok skalp menggunakan levobupivacaine 0,5%. Metode. Dua puluh orang pasien dengan rentang usia 18-65 tahun dengan tumor intrakranial yang menjalani tindakan operasi kraniotomi pengangkatan tumor di RSUP Dr. Sardjito dikelompokkan menjadi 2 kelompok perlakuan dengan teknik pembiusan umum dengan kombinasi blok skalp menggunakan levobupivacaine 0,5% dan pembiusan umum dengan kombinasi blok skalp menggunakan normal saline. Pasien dievaluasi kebutuhan fentanyl dan skala nyeri 12 jam paska operasi di ICU. Pasien dengan riwayat alergi anestesi lokal, riwayat alergi fentanyl, BMI <18 kg/m2 dan BMI >35 kg/m2 dan durasi operasi >6 jam akan dieksklusi dari pengambilan data. Hasil. Rerata penggunaan fentanyl 12 jam paska operasi pada pasien yang menjalani operasi kraniotomi pengangkatan tumor dengan teknik pembiusan umum dengan kombinasi blok skalp menggunakan levobupivacaine 0,5% sebesar 300,50 mcg dengan standar deviasi 68,65 mcg. Sedangkan pada pasien dengan teknik pembiusan umum dengan kombinasi blok skalp menggunakan normal salin sebesar 408,75 mcg dengan standar deviasi 84,02 mcg. Selisih rerata penggunaan fentanyl paska operasi pengangkatan tumor antara kedua kelompok sebesar 108,25 mcg menunjukkan perbedaan yang bermakna p=0,006 (p<0,05). Kesimpulan. Pembiusan umum dengan kombinasi blok skalp menggunakan levobupivacaine 0,5% terbukti mengurangi kebutuhan fentanyl 12 jam paska operasi kraniotomi pengangkatan tumor dibandingkan pembiusan umum dengan kombinasi blok skalp menggunakan normal salin.
Comparison between the Apfel Score and the Koivuranta Score in Predicting the Occurrence of Postoperative Nausea and Vomiting during General Anesthesia Palupi, Isnafianing; Suwondo, Bambang Suryono
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v11i1.11714

Abstract

Abstract Background: PONV is one of the side effects that often occur after general anesthesia, occurs in the first 24 hours post surgery and occurs in as many as 30-70% of hospitalized patients. PONV greatly avoided by most patients and anesthesiologists. Recent risk score for prediction of PONV has been used as a way to classify patients according to risk prediction and provide prophylaxis in accordance with this classification. For everyday clinical purposes, a simple risk score in easy to do and shows the correlation between the predicted incidence of PONV in patients hospitalized. In the clinical practice known various risk score for prediction of PONV as Apfel scores, Koivuranta scores, Sinclair scores, Palazzo scores, Gan scores, and Scholz scores varying accuracy. Methods: The research design was a cohort study with the total of 80 patients recruited. Ordinal and nominal data was analyzed using chi-square test. P value < 0,05 was declared significant with 95% confidence level. Measurements taken are incidence of PONV between Apfel scores to Koivuranta scores with PONV scores. Results: Incidence of PONV in patients who carried the scoring with Apfel scores higher (80%) than Koivuranta scores, and statistically highly significant differences (p < 0,01). The results said that Apfel scores are more accurate than the Koivuranta scores, indicated by results of PONV scores positive (>1) on the Apfel scores 32 people (80%) and on the Koivuranta scores 12 people (30%), whereas PONV scores negative (≤ 1) on the Apfel scores 8 people (20%) and on the Koivuranta scores 28 people (70%). Conclusions: Apfel scores are more accurate than the Koivuranta scores in predicting the occurrence of PONV in patients with general anesthesia.
Hubungan Antara Tingkat Keparahan dan Jenis Terapi Oksigen Terhadap Kualitas Hidup Penyintas Covid-19 yang Pernah Dirawat Di ICU RSUP Dr Sardjito wandito, Gayuh Utomo; Wisudarti, Calcarina Fitriani Retno; Adiyanto, Bowo
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v11i1.12436

Abstract

Latar Belakang: Proses infeksi COVID-19 dapat meninggalkan gejala sisa, sehingga dapat mempengaruhi kualitas hidup penyintasnya, terutama pada penyintas COVID-19 dengan derajat sedang, berat dan kritis. Pasien yang pernah mendapatkan perawatan di ruangan ICU dengan terapi oksigen beragam, memiliki kualitas hidup yang lebih rendah. Tujuan: Mengetahui hubungan antara tingkat keparahan dan jenis terapi oksigen terhadap kualitas hidup penyintas COVID-19 yang pernah dirawat di ICU RSUP dr Sardjito. Metode Penelitian: Jenis dan rancangan penelitian ini adalah observasional kohort prospektif. Peneliti mengambil data sekunder dari rekam medis pada pasien yang terkonfirmasi COVID-19 derajat sedang, berat, kritis dan mendapatkan terapi oksigen yang pernah dirawat di RSUP Dr. Sardjito Yogyakarta dan kualitas hidup diukur dan menggunakan kuesioner EQ-5D-5L secara langsung pada saat penelitian. Subjek penelitian adalah seluruh penyintas COVID-19 yang pernah dirawat di ICU RSUP dr Sardjito bulan Januari 2020 sampai dengan Desember 2021. Analisis bivariat untuk menganalisis hubungan hubungan antara tingkat keparahan dan jenis terapi oksigen terhadap kualitas hidup adalah uji Kruskal Wallis. Variable yang memiliki p < 0,25 pada uji bivariat dilanjutkan analisis multivariat dengan uji regresi linier berganda. Hasil: Total subjek penelitian yang memenuhi kriteria adalah 56 subjek. Skor EQ-5D-5L pada pasien dengan suplementasi oksigen dengan , nasal kanul 0.82, non-rebreathing mask 0.96, High Flow Nasal Canule 0.53 dan ventilator 0.81 yakni (p=0,115). Skor EQ-5D-5L pada COVID-19 derajat sedang 0.92, derajat berat 0.92, sedangkan derajat kritis, yakni 0,75 (p=0,254). Kesimpulan: Tidak terdapat hubungan antara tingkat keparahan dan jenis terapi oksigen terhadap kualitas hidup penyintas COVID-19 yang pernah dirawat di ICU RSUP dr Sardjito. Kata Kunci: COVID-19, derajat keparahan, terapi oksigen, kualitas hidup
Epidural Volume Extension (EVE) Wijaya, Indriyani; Mahmud
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v11i1.12598

Abstract

Epidural Volume Extension (EVE) technique injects normal saline into the epidural chamber immediately after injection of local anesthesia into the intrathecal (or after subarachnoid/spinal block). Normal saline injection would widen the epidural space thus making the spread of local anesthesia in previous intrathecal injections and the distribution of cerebrospinal fluid to be higher (more cephalad), or it could be said that this EVE technique utilizes the volume effect of normal saline that decreases the volume of intrathecal space. The EVE technique may be useful for reducing the dose of local anesthesia injected intrathecally while still achieve an adequate block height for surgery, as well as for faster recovery of motor blockades. Unfortunately, for the risk of hypotension, the EVE technique does not significantly reduce this risk. Hypotension persists even though the hemodynamics (arterial blood pressure drop mean) is observed to be more stable.
Opioid Intratekal pada Enhanced Recovery After Surgery (Eras) Loho, Irvan Revaldi; Wisudarti, Calcarina Fitriani Retno; Sudadi
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v11i1.12640

Abstract

Enhanced Recovery After Surgery (ERAS) is a multidisciplinary protocol introduced for a faster and more effective recovery from elective surgery. The target of ERAS is early mobilization, early oral intake and a faster length of stay. Preoperative ERAS recommends optimizing the patient's clinical condition, smoking cessation, minimizing fasting and drinking clear, carbohydrate-rich fluids up to 2 hours before surgery, reducing patient anxiety, and PONV prophylaxis. Intraoperatively, ERAS recommends the use of multimodal analgesia, maintenance of normothermia, and goal-directed fluid therapy. Postoperatively, ERAS recommends multimodal analgesia so that patients can mobilize early and eat early. Intrathecal opioid therapy can be an option in achieving the goals of ERAS. Optimal use of opioids is one of the factors that influence effectiveness in patients with the ERAS protocol.
Tatalaksana Komplikasi Prosedur Laparoskopi pada Pasien dengan Komorbid Obesitas Saputra, Dya; Pratomo, Bhirowo Yudo; Sudadi
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v11i1.12663

Abstract

The main problems with laparoscopy are related to cardiopulmonary effects due to pneumoperitoneum, systemic absorption of carbon dioxide, extraperitoneal gas insufflation, venous gas embolism, injury to intra-abdominal structures and position of the patient, especially in laparoscopic cholecystectomy which is a procedure performed in the upper abdominal region.Therefore the author will discuss the complications of anesthesia in laparoscopic procedures and the management that can be done to prevent and treat these complications. Characteristics of the hemodynamic response begins with a decrease in cardiac index after intraperitoneal insufflation of CO2 gas and is followed by recovery. Compression of the abdominal organs as a result of increased intra-abdominal pressure and increased sympathetic may be one of the causes of increased cardiac filling pressure which can also be associated with increased intrathoracic pressure due to pneumoperitoneum. Insufflation of the intraperitoneal space with CO2 gas produces a pneumoperitoneum, a systemic effect of CO2 absorption and a reflex increase in vagal tone that can develop into arrhythmias
Penyakit Paru Obstruktif Kronis (PPOK) dengan Multipel Komorbid Maryani, Nova; Akhmad Yun Jufan; Bowo Adiyanto
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v11i1.12862

Abstract

Background: COPD is a common disease, can prevent and cure, but sometimes its difficult to diagnose and misdiagnose. Hence, patient couldn’t have the correct treatment. Case: A man 76 years old transfer from district hospital with diagnose COPD with multiple comorbid such as CAP, AKI, and CHF cf III needs to hemodialysis. One month before hospitalization, patient complaint dyspnea and become worst in last 1 week. The quality of dyspnea increasing by activity and cough. Cough with white sputum. He has intubated and give treatment for COPD and other comorbids. Patient hospitalize in ICU for 12 days and after that transfer to HCU for further treatment. Discussion: Intubation and weaning process for COPD patient was very challenging. Patient has treatment 12 days in ICU have COPD medical support based on diagnosa and management ventilation with NIV and NRM after autoextubate on day 5. Clinical and imaging evaluation shows us the recovery of pneumonia and pulmo edema that’s help patient to breathing easily even COPD needs more times to resolve. Results: COPD with multiple comorbid disease make the intesivist more difficult to wean and manage the treatment. Keywords: COPD, Cor Pulmonale, ICU
Serial Kasus Tatalaksana Sulit Jalan Napas pada Tumor Tiroid Bayu, Timor Krisna; Widodo, Untung; Sudadi; Wisudarti, Calcarina Fitriani Retno; Farid, Anisa Fadhila
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v11i1.12913

Abstract

This case report studies three patients with difficult airways managed according to the American Society of Anesthesiologists (ASA) algorithm. The first case is a 46-year-old woman with bilateral SNNT who underwent a subtotal thyroidectomy without prior hyperthyroid therapy. The patient, with an ASA physical status II, was intubated using a videolaryngoscope. Postoperatively, the patient was cared for in the ward. The second case is a 58-year-old woman with a retrosternal goiter and comorbid hyperthyroidism and hypertension, who underwent a total thyroidectomy. The patient, with an ASA physical status II, was intubated while conscious. Postoperatively, the patient was admitted to the ICU. The third case is a 60-year-old woman with bilateral SNNT planned for thyroidectomy and permanent tracheostomy. The patient, with an ASA physical status III and comorbid hyperthyroidism, had failed intubation attempts with a videolaryngoscope and fiber optics. The patient could not be intubated, and the family was educated about the condition. This study demonstrates the importance of individualized management in patients with difficult airways, following ASA guidelines for optimal results.

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