Jurnal Komplikasi Anestesi
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.
Articles
10 Documents
Search results for
, issue
"Vol 13 No 1 (2025)"
:
10 Documents
clear
<![CDATA[Intraoperative Anaphylaxis Reaction Due to Suspected Anesthesia Agent ]]>
<![CDATA[Sukmono, Raden Besthadi]]>;
<![CDATA[Febri, Rafli Nur]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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.v13i1.14971
<![CDATA[Background: Intraoperative anaphylaxis is a life-threatening condition that may present atypically without cutaneous or respiratory manifestations, making early diagnosis challenging. Case Presentation: A 24-year-old male (ASA II) with sinus bradycardia and three previous uneventful general anesthetics underwent left auricular mass extirpation under general anesthesia. Approximately 90 minutes after induction, the patient developed sudden tachycardia despite minimal surgical stimulation. No additional epinephrine infiltration had been administered. Body temperature was normal and sevoflurane MAC was 0.7. Initial management included a 200 mL crystalloid fluid challenge, fentanyl 2 µg/kg IV bolus, and reduction of sevoflurane MAC to 0.5; however, tachycardia persisted and severe hypotension ensued (from 100/60 mmHg to 50/30 mmHg). No rash, bronchospasm, or fever was observed. Suspected intraoperative anaphylaxis was treated with epinephrine 0.1 mg IV (two doses), 500 mL crystalloid bolus, and supine positioning. Tachycardia resolved after the first epinephrine dose, and blood pressure improved after the second dose. Conclusion: This case highlights that intraoperative anaphylaxis can occur without skin or airway manifestations, consistent with World Allergy Organization (WAO) criteria. Prompt recognition and early epinephrine administration are crucial to improving patient outcomes]]>
<![CDATA[Critical Management of Recurrent Seizure at 16-year-old Primigravida with Atypical Eclampsia ]]>
<![CDATA[HS, Putu Ari Kamanjaya]]>;
<![CDATA[Gunawan, Febri Jaya]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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.v13i1.14972
<![CDATA[Background: Atypical eclampsia can complicate the management and pose significant risks to both the mother and fetus. This case report emphasizes the critical management approach for recurrent seizures in a young primigravida. Case: A 16-year-old primigravida presented with sudden onset seizures during her third trimester of pregnancy. Initial assessments showed only a slight elevation of blood pressure and proteinuria, suggesting the presence of atypical eclampsia. Despite initially administering MgSO4, the patient still experienced a postpartum seizure. She was closely monitored and given a maintenance dose of midazolam and dexmedetomidine. After five days of treatment, the patient did not have any further convulsions and remained stable. Discussion: Teenage pregnancies increase the risk of maternal fatalities due to eclampsia. Atypical eclampsia is rare but can occur and requires a specific treatment approach. When therapy with magnesium sulfate is ineffective, midazolam and dexmedetomidine are used as alternative anti-epileptic drugs. Dexmedetomidine has a neuroprotective effect, preventing cerebral ischemia, and is effective in reducing the need for antihypertensive medication and hospitalization. Conclusion: The successful utilization of a combination of midazolam and dexmedetomidine highlights their potential as an effective therapeutic option for refractory seizures and adds to the existing treatment armamentarium for eclampsia.]]>
<![CDATA[Can High Flow Nasal Cannula Prevent Intubation in Status Asthmaticus?”: A Case Report ]]>
<![CDATA[Hamdani, Ihsan]]>;
<![CDATA[Wardana, Artha Wahyu]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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.v13i1.15089
<![CDATA[Overview of the case: A 29-year-old male with status asthmaticus, the GCS score was 14, the respiratory rate was 30 x/min, SpO2 88% on room air, bilateral lung wheezing, and the blood gas analysis revealed severe respiratory acidosis. Management: Treatment involved High Flow Nasal Cannula (HFNC) oxygenation, salbutamol and ipratropium bromide nebulization, aminophylline drip infusion, and intravenous corticosteroids. Within hours, there was a significant improvement in respiratory parameters and acidosis. Subsequent monitoring in the intensive care unit showed improvement, the patient successfully being weaned off HFNC and transferred to the general ward after six days. This case highlights the efficacy of HFNC in managing severe asthma exacerbation and preventing intubation. Results: The use of HFNC, when combined with standard asthma management, has proven to be a promising option in the non-invasive management of status asthmaticus and can prevent intubation, but should be monitored carefully due to the risk of delayed escalation to respiratory support]]>
<![CDATA[Airway Management for Neonates with Beckwith-Wiedemann Syndrome (Bws): Case Report ]]>
<![CDATA[Darmestari, Dara Lalita]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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.v13i1.15137
<![CDATA[Introduction: Beckwith-Wiedemann syndrome (BWS) is a congenital disorder with abnormalities such as macroglossia and abdominal wall defect. Children with BWS predicted to have difficult airway due to macroglossia in perioperative airway management. Management : 4 days old male neonates with macroglossia on BWS is schedule for umbilical cord hernia revision. Patient was assessed as ASA 3 based on his physical status. First patient was pre-oxygenated and ventilation using size 1 mask, and after ventilation archived, induction started with 4 vol% Sevoflurane followed by intravenous agent Fentanyl 7.5 mcg and Atracurium. The initial intubation attempt with direct laryngoscope failed due to unclear visualization of vocal cord because obstruction of the tongue. The second attempt was made using VL, vocal folds visualized according to Cormack–Lehane grade IIb, and neonate bougie with a kinking, size 3 uncuffed ETT. Postoperatively, patient was extubated before admitted back to the NICU. Conclusion: Macroglossia causes anatomical airway abnormalities in children with BWS. It was predicted that might cause difficult ventilation, intubation and extubation. Airway management with tongue traction and awake tracheal intubation are reported to facilitate the intubation. Other emergency equipment including bougie, FOB, cricothyroidotomy set, and tracheostomy set needs to be ensured before anesthesia administration begins]]>
<![CDATA[The Effect of Music Listening on Anxiety Levels in Post-Subarachnoid Block Anaesthesia Patients ]]>
<![CDATA[Prandani, Muhammad Yogi]]>;
<![CDATA[Kurniawaty, Juni]]>;
<![CDATA[Apsari, Ratih Kumala Fajar]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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.v13i1.18170
<![CDATA[Background: The patients’ perioperative conditions can affect post-operative anxiety. Subarachnoid block anaesthesia can increase the incidence of post-operative anxiety. Methods to reduce post-operative anxiety are divided into pharmacological, with the administration of sedative drugs, and non-pharmacological, with holistic education, acupuncture, listening to music during surgery, and othersObjective: This study aims to observe the effect of listening to music on the anxiety level of surgical patients undergoing subarachnoid block anesthesia.Methods: This study was a Randomized Controlled Trial (RCT), with an intervention group (n=50) listening to music after subarachnoid block during surgery and a control group (n=50) receiving standard routine anesthetic care. Anxiety assessment using the STAI score and vital signs were performed at 3 different times in both groups.Results: There were no differences in patient characteristics between the two groups. Anxiety measurement in the reception room (X1) showed 37 patients (74%) and 31 patients (62%) with moderate anxiety in the intervention and control groups, respectively (p>0.05). There was no difference in patient anxiety levels between the two groups (p>0.05) in the operating room (X2). Post-operative anxiety measurement in the recovery room (X3) showed 43 patients (86%) with low anxiety in the intervention group, compared to 32 patients (64%) in the control group. Patients who listened to music during surgery had a lower level of post-operative anxiety compared to the control group (p=0.011). Conclusion: Listening to music can reduce post-operative anxiety in patients undergoing surgery with subarachnoid block, compared to patients receiving standard routine care]]>
<![CDATA[The Use of Surgical Apgar Score as a Predictor of Postoperative ICU Admission ]]>
<![CDATA[Nugroho, Stefanus Danan]]>;
<![CDATA[Jufan, Akhmad Yun]]>;
<![CDATA[Fajar Apsari, Ratih Kumala]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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.v13i1.25449
<![CDATA[Background: Postoperative Intensive Care Unit (ICU) care can improve outcomes in high-risk surgical patients. The Surgical Apgar Score (SAS) was developed to predict postoperative morbidity and mortality; however, its ability to predict ICU admission remains unclearObjective: To evaluate the utility of the SAS as a predictor of postoperative ICU admission.Methods: This prospective cohort study included 314 surgical patients at Dr. Sardjito General Hospital between June and July 2025. Data on demographics, preoperative status, intraoperative variables (including the SAS), ICU admission, and postoperative mortality were analyzed using both bivariate and multivariate methods.Results: Lower SAS scores were significantly associated with an increased risk of postoperative ICU admission in multivariate analysis, particularly in SAS categories 0–2 (OR 326.45; p = 0.016) and 5–6 (OR 47.39; p = 0.037). The ROC curve of SAS for predicting postoperative ICU admission yielded an AUC of 0.701 (p = 0.001; 95% CI: 0.62–0.78) with a cut-off value of 6.5. Neurosurgical and vascular thoracic procedures, cardiovascular comorbidities, intraoperative vasopressor use, and surgical duration greater than 2 hours were also strong predictors of postoperative ICU admission. The postoperative mortality rate was 3.5%, mainly associated with surgical duration exceeding 6 hours (predictive factor) and other types of surgery (protective factor). The SAS, with clinical factors such as procedure type, comorbidities, and surgical duration, may help guide the decision for postoperative ICU admissionConclusion: The SAS is a useful tool for predicting postoperative ICU requirements.]]>
<![CDATA[Management of Failed Spinal Anesthesia ]]>
<![CDATA[Hastuti, Wiji]]>;
<![CDATA[Fajar Apsari, Ratih Kumala]]>;
<![CDATA[Sudadi, Sudadi]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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.v13i1.27741
<![CDATA[The management of failed spinal anesthesia is a significant challenge in surgical procedures. Spinal anesthesia failure can occur either partially or totally, often leading to conversion to general anesthesia, which adds clinical risks and potential complications. The aim of this study is to evaluate the factors contributing to spinal anesthesia failure and identify effective management strategies. The study found that factors such as patient positioning, anesthesiologist experience, the number of attempts, and patient BMI significantly influenced spinal block success. Total spinal anesthesia failure often requires conversion to general anesthesia, whereas partial failures can be managed with adjuvant medications or repeated procedures. Understanding the management of failed spinal anesthesia is essential for providing safe and effective care]]>
<![CDATA[Transesophageal Echocardiography–Derived Renal Resistive Index after Cardiopulmonary Bypass: A Novel Hemodynamic Marker of Postoperative Renal Vulnerability ]]>
<![CDATA[Parna, Dian Raseka]]>;
<![CDATA[Kurniawaty, Juni]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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.v13i1.27983
<![CDATA[Acute kidney injury (AKI) remains a frequent and clinically significant complication following cardiopulmonary bypass (CPB), often developing despite apparently stable systemic hemodynamics. Conventional renal monitoring relies on delayed biochemical markers that fail to capture early disturbances in renal microcirculation. The renal resistive index (RRI) has emerged as a dynamic indicator of renal vascular resistance and microcirculatory stress, but its perioperative application has been limited by the practicality of transabdominal ultrasonography. Transesophageal echocardiography (TEE), routinely used during cardiac surgery, offers a unique opportunity for real-time assessment of renal hemodynamics during and immediately after CPB. This literature review synthesizes current evidence on the feasibility, physiological basis, and clinical relevance of TEE-derived RRI measurement in the post-CPB setting. The reviewed studies suggest that elevated RRI values reflect a complex interaction of renal vascular resistance, venous congestion, altered pulsatility, and inflammatory endothelial dysfunction rather than isolated reductions in renal blood flow. Importantly, RRI elevation frequently precedes changes in serum creatinine or urine output and has been associated with an increased risk of postoperative renal dysfunction, even in patients without overt hypotension or low cardiac output. TEE-derived RRI therefore represents a promising, underutilized hemodynamic marker for early identification of postoperative renal vulnerability and may support more proactive, organ-protective hemodynamic management strategies following cardiopulmonary bypass]]>
<![CDATA[Risk Factors Associated with Morbidity and Mortality after Cervical Spine Injury at Dr Sardjito General Hospital ]]>
<![CDATA[Nashiruddin, Nashiruddin]]>;
<![CDATA[Fajar Apsari, Ratih Kumala]]>;
<![CDATA[Jufan, Akhmad Yun]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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.v13i1.28419
<![CDATA[Background: Cervical injury is a form of spinal cord trauma with high morbidity and mortality rates, especially in developing countries. Identifying risk factors is essential for prevention strategies, management, and improved patient outcomesObjective: This study aims to observe the effect of listening to music on the anxiety level of surgical patients undergoing subarachnoid block anesthesia. To analyze risk factors of cervical injury related to morbidity and mortality, and to present the demographic profile of cervical injury cases at Dr Sardjito General HospitalMethods: This study employed a retrospective case-control design involving 127 patients with cervical injury treated at Dr Sardjito General Hospital, Yogyakarta, from January 1, 2022, to December 31, 2024. Data were collected from medical records and analyzed using bivariate analysis (Fisher’s exact test). A p-value <0.05 was considered statistically significant.Results: The majority of patients were male (88.2%) with an average age of 50.57 years. The most common trauma mechanisms were falls from height (45.7%) and traffic accidents (44.9%). Severe disability as morbidity was experienced by 41.7% of patients, while mortality reached 31.5%. Risk factor analysis for morbidity did not find any variables significantly associated with clinical outcomes (P>0.05). Length of stay (LOS) was significantly associated with morbidity (p=0.001). Significant risk factors for mortality included respiratory comorbidity (OR 4.50; p=0.004)Conclusion: ASIA score, prolonged ventilator use, and tracheostomy were identified as risk factors for mortality in cervical injury patients at Dr Sardjito General Hospital. No statistically significant risk factors were found to be associated with morbidity]]>
<![CDATA[Comparing Sniffing Position Between Inflatable Vs Fixed Pillow for Glottic Visualization during Laryngoscopy ]]>
<![CDATA[Adiyanto, Bowo]]>;
<![CDATA[Ikhwandi, Arif]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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.v13i1.28464
<![CDATA[Background: Effective glottic visualization is crucial for successful tracheal intubation and reducing complications during airway management. The sniffing position is commonly used, with various pillow types employed to optimize the alignment of the airway axes. We performed a study to evaluate the effectiveness of an inflatable intubation pillow for glottic visualization, intubation time, and first-attempt intubation success.Objective: We performed a study to evaluate the effectiveness of an inflatable intubation pillow for glottic visualization, intubation time, and first-attempt intubation success.Methods: A randomized controlled trial was conducted with 222 patients undergoing general anesthesia and endotracheal intubation at Dr. Sardjito General Hospital, Yogyakarta. Patients were randomly assigned to two groups: Group I (inflatable pillow) and Group S (fixed pillow). The primary outcome was glottic visualization, assessed using the Cormack–Lehane score, while secondary outcomes included intubation time and the number of intubation attempts. Multivariate analyses adjusted for potential confounders such as BMI, sex, and age.Results: The inflatable pillow group showed a higher proportion of grade 1 glottic visualization (64%) compared to the fixed pillow group (55%), but this difference was not statistically significant after adjusting for confounders. The inflatable pillow group demonstrated a significantly shorter intubation time (35 seconds) compared to the fixed pillowConclusion: The use of an inflatable pillow in the sniffing position significantly reduced intubation time, improving procedural efficiency. However, it did not show a significant improvement in glottic visualization or first-attempt intubation success after adjusting for confounding factors. BMI was the primary determinant of glottic visualization]]>
