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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
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Search results for , issue "Vol 5 No 3 (2018): Volume 5 Number 3 (2018)" : 10 Documents clear
Validasi European System for Cardiac Operative Risk Evaluation (Euroscore) II sebagai Prediktor Lama Perawatan Intensive Care Unit (ICU) pada Pasien Operasi Bedah Jantung (Kelainan Katup dan Kongenital) di RSUP Dr. Sardjito Febrianti, Skolastika Rani; Widyastuti, Yunita; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (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.v5i3.7336

Abstract

Background. Development quality of care, health care resources, and methods to assess the risk of cardiacsurgery are increasing in this era. Cardiac surgery is high risk procedure and require post-operative intensive care. Our objectives were to validating EuroSCORE II as ICU length of stay predictor for post cardiac surgery patient (valvular and congenital heart disease) in Dr. Sardjito General Hospital.Methods. A cohort retrospective study was conducted. Data were collected from the medical records of postoperative cardiac surgery patients in 2006-2016 at Dr. Sardjito General Hospital. EuroSCORE II values were obtained from all subjects. EuroSCORE II model was used to predict prolonged care in the ICU for >48 hours. Discriminative ability was analyzed using receiver operating characteristic (ROC) curve. Calibration were assessed with areas under the receiver operating characteristic curve (AUC) and the Hosmer– emeshow test.Results. In this study the data were obtained from 92 patients post-cardiac surgery in 2006-2016 at Dr. Sardjito General Hospital. Fifteen patients (16.3%) have prolonged ICU stay>48 hours. In this research, the predictive value is underestimate than actual value. EuroSCORE II showed good discrimination ability to predict prolonged ICU stay (AUC=0.711). However, EuroSCORE II showed poor calibration in predicting prolonged ICU stay (Hosmer-Lemeshow: p<0.05).Conclusion. EuroSCORE II showed good discrimination but poor calibration ability. EuroSCORE II can differentiate the outcome of ICU stay between ≤48 hours and >48 hours groups, but it cannot be used for patient risk stratification of prolonged ICU stay.
Efektivitas Informasi Multimedia Video (Video Dan Lisan) untuk Menurunkan Tingkat Kecemasan Praanestesi Umum pada Pasien yang akan Dilakukan Tindakan Operasi Elektif dengan Anestesi Umum Teknik Intubasi Budianti, Nugrahaeni; Pratomo, Bhirowo Yudo; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (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.v5i3.7337

Abstract

Background. Preoperative anxiety is a problem faced by two-thirds patients who would undergo surgery.Anxiety can not be handled properly, will cause adverse pathophysiologic responses. General anesthesiaintubation techniques as one of the anesthetic techniques often lead to an increase in preoperative anxiety. To reduce the level of preoperative anxiety, we can give preoperative information. The health information provided can be well understood by patients and can be used to reduce anxiety situation experienced by the patients. Methods. This studied was Randomized Controlled Trial (RCT). Subjects were patients undergone elective surgery general anesthesia using intubation techniques. The subjects were 110 patients that divided into two groups: the video group and the verbal group. The verbal group received preoperative information verbally, while the video group received preoperative information through a video of general anesthesia intubation technique procedures. The measurement of anxiety level was measured four times, once before the treatment (the level of anxiety/ LA-1) and three times after the treatment, namely when in the ward (LA-2), when in the surgical installation acceptance (LA-3) and when in the operating room prior to general anesthesia intubation techniques (LA-4). The assessment of anxiety used Spielberger State-Trait Anxiety Inventory (STAI) questionnaire of Y-1 form.Results. The percentage of anxiety reduction in video group was bigger than in Verbal group at all measurement times in TK-2 group of 40% video and verbal group 12,7%, in TK-3 video group 41,8% and verbal group 12,7% and at TK-4 video group 41.8% and verbal group 10.9%. Statistically different in the anxiety level between video group and verbal group were obtained in LA-2, LA-3 and LA-4 (p = 0.001, p = 0.001 and p = 0.000).Conclusion. Multimedia video information (video and verbal) is more effective in reducing preanesthesia anxiety levels in patients undergoing elective surgery with general anesthesia of intubation techniques when compared with verbal information.
Perbandingan Insidensi Kultur Apusan Kulit Positif setelah Pemberian Krim Emla® 5% Diikuti Disinfeksi Povidon IODIN 10% Dibandingkan dengan Disinfeksi Povidon IODIN 10% sebelum Anestesia Regional Prihatna, Hendi; Artika, I Gusti Ngurah Rai; Uyun, Yusmein
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (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.v5i3.7338

Abstract

Background. Strategies for reducing pain during needle injection include the provision of eutectic mixture of local anesthesia (EMLA) cream, EMLA contains lidocaine that as in vitro experiment believed to have bacteriostatic and bacteriocid effects, EMLA cream can penetrate into deeper layers of skin, EMLA analgesia can penetrate the skin layer with a thickness of 2 mm after 60 minutes and 3 mm after 120 minutes, in which case it can explain the antibacterial effect of EMLA in the long term. Infection that related to spinal anesthesia is a serious complication which may cause meningitis, paralysis and even death. Many studies showed that the skin puncture site was a potential pathogen source during spinal anesthesia procedure. Therefore, effective skin disinfection before the procedure must be performed. Povidone iodine is the most common antiseptic for skin disinfection before spinal anesthesia procedure and has been already stated in Guidelines of Anesthesiology Practice in Sardjito Hospital, Yogyakarta. The aim of this study is to compare positive skin swab culture incidence among patients who are performed with 5% EMLA and 10 % povidone iodine compared with single 10% povidone iodine for skin disinfection in regional anesthesia procedure.Methods. The design of this study were using single blind randomized controlled clinical trial. Thirty-six patients undergoing regional anesthesia (spinal, epidural, combine spinal epidural) and divided into 2 groups, 5% EMLA + 10% povidone iodine (E) group and single 10% povidone iodine (P) group. Pretreatment was done by examination of skin culture and after disinfection was done re-skincare culture examination. The incidence of positive skin swab cultures were recorded then.Result. The incidence of positive skin swab cultures after administration with EMLA followed by 10% povidone iodine is (11.8%) was less than povidone iodine 10% (22.2%) in skin preparation prior to regional anesthesia procedures. However, there was no significant difference in incidence of positive skin swab cultures between administration 5 % EMLA followed by 10% povidone iodine with single 10% povidone iodine (p> 0,05). There was no side effects of 5% EMLA and 10% povidone iodine usage were found in this study.Conclusion. The positive skin swab cultures incidence after administration of 5% EMLA and povidon iodine 10% were less than a single 10% povidon iodine disinfection (11.8% versus 22.2%, p> 0.05).
Manajemen Peripartum pada Pasien Sindrom Eisenmenger Kurniawaty, Juni
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (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.v5i3.7339

Abstract

Eisenmenger’s syndrome is the most severe form of pulmonary hypertension associated with congenital heart defects. Maternal mortality rates in female patients with Eisenmenger syndrome are still very high (30-50%). The main causes of death are hypovolemia, thromboembolism and preeclampsia. Pregnancy should be avoided in women with Eisenmenger syndrome because of high maternal mortality and a poor prognosis for babies. Epidural has been proven to be preferred for the delivery of labor and cesarean section in pregnant women with Eisenmenger syndrome. A 30-year-old woman with a 32-week pregnancy was diagnosed with Eisenmenger’s syndrome. She was diagnosed with congenital heart disease during antenatal care, she was never diagnosed with congenital heart disease before. Blood pressure examination was obtained 110/75 mmHg, heart rate 82 times per minute, respiratory rate 18-20 times / minute, with oxygen saturation 80-84% using nasal cannula 3 liters / minute. An L4-5 epidural catheter was placed with a catheter tip in L1. Intermittent Epidural Labor Analgesia (ELA) uses ropivacaine 0.0625% + fentanyl 0.125 mcg 5 cc, which is adjusted to the delivery process. During stable hemodynamic delivery with VAS 0. The main goal of handling Eisenmenger’s patients is to minimize pulmonary vascular resistance (PVR), and decrease systemic vascular resistance (SVR) and reduce catecholamine release. To maintain a balance between epidural effects on SVR and PVR, we use a combination of low concentrations of ropivacaine and opioids.
Manajemen Anestesi pada Neonatus dengan Atresia Oesophagus Adi, Danis Woro Kuncoro; Sari, Djayanti; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (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.v5i3.7340

Abstract

A 12-day-old male neonate diagnosed with atresia oesophagus type C was planned to undergo decompression gastrostomy and feeding jejunostomi surgery. The patient’s mother complained that her child always vomit when given breast milk and said the child’s stomach was bloated. Patient was born from G1P1A0 mother with a history of aterm pregnancy, history of routine ANC, birth through normal delivery in midwife with clear amniotic fluid and APGAR SCORE 7/9. Birth weight 2382 grams and body weight is now 2282 grams. Anesthesia management performed under general anesthesia with conscious intubation technique ET No. 2.5 uncuff facilitate with 5mg ketamine. Maintenance anesthesia with O2, air, and sevoflurane. hemodynamics are stable during surgery. The operation lasts for 45 minutes. After the surgery is completed the patient is again treated at the NICU.
Manajemen Anestesi Cedera Vertebra Cervical 4,5 dengan Tindakan Laminektomi Dekompresi Stabilisasi Zaki, Wildan Arsyad; Sudadi; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (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.v5i3.7341

Abstract

Preoperative management of cervical fractures of particular concern include the level of injury, onset of occurrence and cardiorespiratory complications. Then continued the definitive management of laminectomy requiring inline position intubation positions, invasive arterial line monitors and CVC, durante vasoactive drug support in case of hemodynamic decline. Equally important is postoperative intensive care, and treatment of complications of pneumonia, DVT, sepsis due to long immobilization. Treatment of a 54-year-old male patient with a diagnosis of VC IV-V compression fracture, tetraplegi and increased transaminase enzyme. Patients were initially treated in HCU LOC 2 for 10 days with drug support and hemodynamic monitoring, then definitive elective laminectomy, decompression, stabilization. The operation lasted for approximately five hours with bleeding approximately 1200cc, urine output 2.5 cc / kgBW / hour. Post surgery patients treated in ICU with attached tracheostomy, connected with ventilator and vasoactive drug support. During treatment in ICU, hemodynamic monitoring with arterial line, ECG, pulse oximetry, temperature monitor and CVC were performed. Patients are positioned in line mobilization, ureter catheter installed and NGT. Hemodynamic, blood pressure during ICU ranged from syst 100-110 mmHg, diastole blood pressure 50-80 mmHg, pulse 90-110 x / minute and saturation 93-100%. With supportive therapy of ceftriaxone injection, methylprednisolone, fentanyl, mecobalamin, omeprazole, and dobutamine and norepinephrine continue. The patient was treated for 5 days and after stabilizing the patient was returned to the ward.
Penggunaan Ultrasound di Anestesi Obstetri Apsari, Ratih Kumala Fajar; Uyun, Yusmein
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (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.v5i3.7342

Abstract

The incidence of complex medical problems in obstetric populations is is rising, and anesthesia for parturient patients add another problem in this complexity. Ultrasound provides an accurate visualization of the internal anatomical structures that may help assess clinical conditions and improve the safety of therapeutic interventions. Ultrasound procedures in obstetric anesthesia have been used in guiding the neuraxial block, transversus abdominis plane block for post-caesarean section pain control, and vascular access. Ultrasound may also be performed to assess gastric volume, airway evaluation in critical obstetric patients, lung evaluation, transesophageal echocardiography, and intracranial pressure assessment as a surrogate marker of preeclampsia. To succeed in ultrasound guidance techniques, it requires familiarity with relevant cross sectional anatomy. Knowledge of anatomy, without any understanding of its structural formation on ultrasound will hamper the understanding of ‘sonoanatomy’.
Tromboemboli pada Kehamilan Agnesha, Fahmi; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (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.v5i3.7343

Abstract

Thromboembolism is a rare event happen in pregnancy, that if not manage well would be a catastrophic and can cause fatal outcome. Venous thromboembolic event in pregnancy form are deep vein thrombosis and pulmonal thromboembolism. The pathophysiology of thromboembolism explained by Virchow triad that describe the factor contribute are vein stasis, vascular damages and hypercoagulable state. The diagnosis of the new onset thromboembolism can be made by ultrasound examination on proximal vein. Management of thromboembolism in pregnancy is including low molecular weight heparin and unfractioned heparin administration. These treatments can cause neuraxial anesthesia impact on pregnant patient as spinal and epidural hematoma. Thus many guidelines give recommendation for stopping heparin administration before procedure.
Anestesi Spinal pada Seksio Sesaria Wanita dengan Karsinoma Nasofaring Supraptomo; Uyun, Yusmein
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (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.v5i3.7344

Abstract

Introduction. Regional anesthesia and general anesthesia can be performed in patients with nasopharyngeal cancer, although spinal anesthesia is more aggressive lowering the patient’s hemodynamic state, but the likelihood of difficult intubation in these patients becomes a consideration for regional anesthesia. Case. 35-year-old woman, G3P1A1, 37 weeks pregnant in hospital wanted to give birth. Pasr medical history was difficult to swallow with pain and diagnosed with nasopharyngeal carcinoma. Spinal anesthesias was performed with lidocaine 5% dose 75 mg with adjuvant fentanyl 25 ug. Block achieved until dermatome thorakal. The duration of surgery is 60 minutes with systolic between 90-120 mmHg, diastolic between 55-80 mmHg and pulse between 100-112 times / min. Baby born with APGAR score 8-9, weight 3300 gram. Post surgery patients are treated at the Intensive Care Unit, and during treatment the hemodynamic condition is stable. Summary. The technique of spinal block anesthesia with lidocaine 5% 75 mg with adjuvant fentanyl 25 mcg was considered quite satisfactory as anesthesia management in this case. Synergistic effects of local anesthesia and opiod provide great benefits for obtaining adequate anesthesia, thereby reducing the risk of difficult intubation if general anesthesia is performed
Manajemen Anestesi pada Kehamilan Sistemik Lupus Eritematosus Nuryawan, Iwan; Suryono, Bambang; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 5 No 3 (2018): Volume 5 Number 3 (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.v5i3.7345

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune, multisystem disease, which involves complex pathogenetic mechanisms that can occur at all ages, characterized by the presence of direct autoantibodies against the core antigen. Management of lupus in women ideally begins before pregnancy occurs. Adequate analgesia can overcome the response of the organ system due to pain. Regional anesthesia techniques are very popular pharmacological techniques and become the gold standard because they provide optimal analgesia during labor with minimal side effects on the mother and fetus when compared with systemic or inhalation analgesia.

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