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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 9 Documents
 1 
Search results for , issue "Vol 5 No 1 (2017): Volume 5 Number 1 (2018)" : 9 Documents clear
Hipoalbuminemia: Pengaruhnya pada Farmakokinetika Agen-Agen Anestesi Wardhana, Ardyan Prima; Widyastuti, Yunita; Mahmud
Jurnal Komplikasi Anestesi Vol 5 No 1 (2017): Volume 5 Number 1 (2018)
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.v5i1.7314

Abstract

Hypoalbuminemia is a condition in which the serum albumin contentration less than 3.5 mg / dL. Albumin serves as a binding protein and carrier of various substances including drugs. This manuscript discusses the effect of plasma albumin levels on pharmacokinetics changes of anesthetic agents. Inhalation and mostly intravenous anesthetic agents are lipophilic and highly protein binding. The albumin concentration is directly proportional to the blood/gas partition coefficient. For the intravenous agent, the unbound drug concentration gradient between plasma and tissue will be increased under conditions of hypoalbuminemia. The changes in volume distribution and elimination half-life occur, but unbound drug concentration in steady conditions does not depend on the amount of drug binding to proteins. Bolus administration of anesthetic agents generally does not require dose adjustment under hypoalbuminemia. It differs in continuous administration. There are few clinical studies of anesthetic agents in patients with hypoalbuminemia. Generally, clinical studies are conducted in patients with cirrhosis, which can be accompanied by hypoalbuminemia. One study was able to demonstrate a change in clinical effects seen in the administration of infusion propofol as well as repeated injections compared with bolus during induction.
Perbandingan Efektivitas Penambahan Tramadol 0,125 Mg/Kgbb/Jam dengan Tramadol Bolus Intermitten 50mg Per 6 Jam pada Pasien yang Mendapatkan Fentanil 1 Μg/Kgbb/ Jam untuk Penanganan Nyeri Pasca Operasi Noegroho, Wahyu; Uyun, Yusmein; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 5 No 1 (2017): Volume 5 Number 1 (2018)
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.v5i1.7315

Abstract

Background : The effectiveness of tramadol and fentanyl as multimodal pain theraphy after surgery. Objective : The aim of this study is to compare the effectiveness of the addition of a continuous drip of tramadol is 0,125mg/kgbw /hour on a continuous fentanyl 1 ug/kg/h after the addition of bolus tramadol 50mg given every 6 hours in patients with fentanyl 1 ug/kgbw/hour as analgesia post operation. Methods : Thirty two patients who underwent surgery (oncology, gynecology and laminectomy) under general anesthesia were enrolled.. Samples were randomly divided into 2 groups TB and TK, each group contained 16 patients. In TK group got tramadol 0,125mg/kgbw/hour on a continuous fentanyl 1μg/kgbw/hour. TB group got Bolus tramadol 50 mg per 6 hours on a continuous fentanyl 1μg/kgbw/hour. Results : No significant clinical difference between VAS score TK Group and TB Group on minute 0, hour 6th and hour 12th (p > 0.05, p<0.05). Frequencies of additional fentanyl rescue at first 6 hour in TB group was 6 patients (37.5%), (VAS 4, 3 patients),(VAS 5, 2 patients), in TK group was 3 patients (18.8%), (VAS 4, 1 Patient), (VAS 5, 1 patient), (VAS 6, 1 patient). Additional of fentanyl rescue at second 6 hours in TB Group were 2 patients (12.5%), (VAS 4, 2 patients), in TK Group was 3 patients (18,8%), (VAS 4 , 2 patients) , (VAS 5, 1 patient). Conclusion : The addition of tramadol 0.125 mg/kgbw/h give the same effectiveness in clinical analgesia than tramadol intermittent bolus of 50 mg/6 hours in patients who received fentanyl 1 ug/kgbw/h for the treatment of postoperative pain
Perbandingan Daya Guna Profilaksis Pethidine 0,5 Mg/KgBB, Tramadol 1 Mg/KgBB dan Ketamin 1 Mg/KgBB untuk Mencegah Shivering Pasca Operasi Laparaskopi dengan Anestesi Umum Iqbal, Muhammad; Sarosa, Pandit; Sari, Djayanti
Jurnal Komplikasi Anestesi Vol 5 No 1 (2017): Volume 5 Number 1 (2018)
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.v5i1.7316

Abstract

Background: Post anaesthesia shivering is a autonom mechanism compensation against fall body temperature to increased heat body production. Hypothermia during operation is primary cause post anaesthetic shivering. Shivering can increased cardiac activity, intraocular pressure, intracranial pressure and create postoperative discomfort condition. Objective: The aim of this study is compare effectivity of pethidin 0,5 mg/kg, tramadol 1 mg/kg and ketamin 0,5 mg/kg as a prophylactic drug of shivering after laparascopy surgery with general anesthesia. Methods: This study is double blind randomized controlled trial. The subject were 193 patient, male or female with age 18-60, physical status of ASA I and II, who undergo of laparascopy surgery with general anesthesia. Subject were divided into three group. Group P with pethidin 0,5 mg/kg, group T with tramadol 1 mg/kg, group K with ketamin 0,5 mg/kg, drug were diluted with 10 mL normal saline. Prophylactic drugs given when superficial skin closure. Results: Is done measurement systolic blood pressure, diastolic blood pressure, heart rate and body temperature. Measurement done before procedure anaesthesia, during anesthesia and at the recovery room. Conclusion : Shivering assessment began after terminating inhalation anaesthesia agen.
Hubungan antara Kesesuaian Terapi Antibiotik Empiris dengan Mortalitas Rumah Sakit pada Pasien Hospital Acquired Pneumonia yang Dirawat Di ICU RSUP Dr. Sardjito Yogyakarta Nasution, Rusdi Anwar; Wisudarti, Calcarina Fitriani Retno; Sudadi
Jurnal Komplikasi Anestesi Vol 5 No 1 (2017): Volume 5 Number 1 (2018)
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.v5i1.7319

Abstract

Objective: To determine the association between appropriateness of empirical antibiotic therapy and hospital mortality in patients with hospital acquired pneumonia (HAP) admitted to ICU. Design: Retrospective cohort observational study Methods: Data were collected from patient’s medical record. The inclusion criteria were ICU’s patients aged 18 years old or older who diagnosed HAP within period of June 1, 2015 to December 31, 2016. Patients with HIV-positive were excluded and those without culture result were dropped out. The empiric antibiotic therapy was considered appropriate when all significant bacteria were susceptible or intermediate to at least one of the antibiotics. Variables determined were association between mortality and appropriateness of empirical antibiotic therapy, age, gender, ICU length of stay, duration of mechanical ventilation (MV), type of case (surgical or medical), and APACHE II scores (within the first 24 hours after ICU admission). Results: Eighty one patients were enrolled. Three patients were excluded and 9 patients were dropped because no bacterial cultures were reported. Sputum cultures were obtained from 59 patients while blood cultures were drawn from 10 patients. The sputum cultures were positive in 44 patients and negative in 15 patients, while all blood culture were negative. No differences in hospital mortality were related to age (p=0,345), gender (p=1,000), length of stay in ICU (p=0,059), duration on MV (p=0,09), type of case (p=0,199), and APACHE II score (p=0,331). No significant association was found between appropriateness of empirical antibiotic therapy and hospital mortality (p=1,000). The most common prescribed empiric antibiotics were ceftazidime (n=30), ciprofloxacin (n=21, and levofloxacin (n=19). The most common bacteria were Acinetobacter baumannii (n=13), Klebsiella pneumoniae (n=9), Pseudomonas aeruginosa (n=7), and Streptococcus viridans (n=7), which most of them were multi drug resistant (MDR). Conclusion: No association was found between appropriateness of empirical antibiotic therapy with hospital mortality in patients with hospital acquired pneumonia (HAP) admitted to ICU.
Manajemen Preoperatif Kehamilan Ektopik Terganggu dengan Syok Hipovolemia Budianti, Nugrahaeni; Rahardjo, Sri; Uyun, Yusmein
Jurnal Komplikasi Anestesi Vol 5 No 1 (2017): Volume 5 Number 1 (2018)
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.v5i1.7320

Abstract

Had been reported a case of preoperative management for a woman 36 years old, G1P0A0, pregnant 11 weeks with ruptured ectopic pregnancy and run into hypovolemia shock. We assessed physic status patient as ASA (American Society of Anesthesia) 4E (emergency) with hypovolemia shock et causa internal bleeding and patient had been done relaparotomy. Patient had been refered from RSUD Wonosari and when she came to RSUP Sardjito, she feel pain and pale suspicious hypovolemia shock with internal bleeding then had been done laparatomy emergency surgery, dextra salphingectomy et causa ruptured ectopic pregnancy in IGD operation room for 2 hours and then she was observated in resusitation room for 6 hours and then she was transported to PACU. When in PACU, her condition compos mentis, she feel pain and the hemodynamic is blood pressure 90/ 60 mmHg, pulse 165 times/ minutes, respiration rate 32 times/ minutes on NRM 8 liters/ minutes, spO2 99 – 100 %, temperature 36,8 °C and VAS 3 – 4. In abdominal assessment, we found decreased of peristaltic, distended (+), tenderness (+), wound dressing blood seeped (-) and capilarry refill over 2 second and also radialis artery was not detected. We did evaluation to know internal bleeding, we did positive challange test with kristaloid 20 cc/ kg BB in 15 minutes and then in USG, we found free liquid intraabdomen and we planned emergency laparatomy in IGD operation room. Anesthetic technique that we used was general anesthesia. After surgery, patient was transported to ICU in sedation condition and was intubated.
Gagal Spinal pada Pasien Operasi Amputasi Transfemoral dengan Debridemen dan Penatalaksanaannya Maryani, Nova; Artika, I Gusti Ngurah Rai; Sudadi
Jurnal Komplikasi Anestesi Vol 5 No 1 (2017): Volume 5 Number 1 (2018)
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.v5i1.7321

Abstract

A man 64 years old had a traffic accident 12 hours ago, resulting in crush injury on regio left femur and cruris. This man has fasted and for 8 hours and was planned to undergo debridement and transfemoral amputation surgery by orthopedics. The hemodynamic profile of this patient preoperative: stable with HB 8.4, had two colfs of PRC blood transfusion. Vital sign BP 110/55, HR 110x/minute, RR 22x/minute, SpO2 97%. The anesthesia technique planned for the surgery is spinal block anasthesia. Fluid preloading RL 500 ml, intravenous analgesics fentanyl 25 mcq, sitting position, spinal anesthesia L4-L5, CSF (+), blood (-), agent: bupivacaine 0,5 % hyperbaric 15 mg + fentanyl 25 mcq, aspiration (+) barbotage until 4cc. Thus, supine position after spinal anesthesia. Pin Prick result, Sensoric test (-), Motoric Bromage 0, evaluated until 10 minutes, just parasthesia. Pin prick, result sensoric test no sensoric. Block declared failed, conversion to General Anesthesia LMA. Operation held for 2 hours, post-operative patient transfers to High Unit Care.
Komplikasi Regional Anestesi pada Pediatrik Sari, Djayanti
Jurnal Komplikasi Anestesi Vol 5 No 1 (2017): Volume 5 Number 1 (2018)
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.v5i1.7322

Abstract

Seperti pada dewasa, teknik regional anestesi pada pediatrik kini makin popular digunakan oleh ahli anestesikarena keuntungannya. Namun demikian selalu ada risiko dan kemungkinan timbulnya komplikasi dari setiap tindakan yang dilakukan, termasuk tindakan anestesi regional pada pediatrik. Insidensi komplikasi anestesi regional pada pediatrik tidak banyak, dan kalaupun terjadi komplikasi adalah minor. Komplikasi bisa diakibatkan dari identifikasi ruang saraf, alat, obat, teknis tindakan anestesi regionalnya dan komplikasi lainnya.Walaupun tidak banyak kejadian komplikasi regional anestesi yang dilaporkan pada pediatrik, dan bukanlah komplikasi yang fatal, teknik regional anestesi pada pediatrik harus dilakukan dengan lebih hatihati, pertimbangan risiko dan keuntungannya untuk menghindari terjadinya komplikasi, terlebih karena kebanyakan komplikasi dapat dihindari dengan mempelajari teknik yang benar, menggunakan peralatan yang sesuai, dan sangat menerapkan prinsip keamanan pada pasien dengan baik.
Brain Protection pada Traumatik Brain Injury Sudadi
Jurnal Komplikasi Anestesi Vol 5 No 1 (2017): Volume 5 Number 1 (2018)
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.v5i1.7323

Abstract

Trauma is the leading cause of death in children and people under 45 years old, and brain trauma is theleading cause of death in 25% of cases. Brain trauma can be classified as both primary and secondary injury.Primary brain injury is a direct result on the head causing both anatomical and physiological damage.Secondary brain injury is the result of hypotension, hypoxia, acidosis, edema, or other advanced factors thatcause damage to brain tissue. Brain protection as prevention and improvement of neuronal damage causedby abnormalities of cerebral metabolism, histopathological or neurological functioning that occurs afterhypoxia or ischemic conditions. The key elements in brain protection that must be achieved are loweringoxygen demand, increasing oxygen supply and halting intracellular pathological processes.
Prinsip Proteksi Sel Otot Jantung dalam Mesin Pintas Jantung Paru pada Prosedur Pembedahan Jantung Terbuka Indrasutanto, Teddy Ferdinand; Boom, Cindy Elfira
Jurnal Komplikasi Anestesi Vol 5 No 1 (2017): Volume 5 Number 1 (2018)
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.v5i1.7324

Abstract

Cardiovascular disease is still the leading cause of global death. At 2004, there are 17.1 million deaths caused by cardiovascular disease which is 29% of total overall death in the world. Coronary artery bypass graft (CABG) surgery is still the gold standard to treat cardiovascular disease. CABG surgery could be done using cardiopulmonary bypass machine so the heart could be stopped from beating for the entire procedure. Cardiopulmonary bypass and CABG procedure itself could cause myocardial injury. There should be a good understanding about cardiovascular physiology before using cardiopulmonary bypass, especially at myocardial protection strategy. The goal of myocardial protection during heart surgery is to avoid injury that is caused by cardiopulmonary bypass machine and ischemia. Cardioplegia is the main factor to help obtain the target of myocardial protection. Cardioplegia could induce cardiac arrest and give nutrition to the myocard at the same time. There are other strategies that could be used to obtain myocardial protection, like hypothermia technique, anesthesia preconditioning using volatile anesthesia and intravenous anesthesia agent. There are a lot of studies on myocardial protection right now, and the future strategies are focused on molecular physiology of the myocard.

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