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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 317 Documents
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Sepsis-Akut Kidney Injury pada Urosepsis Palu, Raphael Putra; Aditianingsih, Dita; Sudarsono
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (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.v5i2.7328

Abstract

Sepsis is a life-threatening condition caused by a dysregulated immune response to infection. Sepsis mortality increases with acute kidney injury and patients with acute kidney injury worsen with sepsis. It is interesting to note that most of the clinical trials on sepsis treatment that derived from the results of translational researches are a failure. This is because of the complexity of human sepsis in comparison with animal models and the improper matching of the animal models to the individual patient. It is possible that the main mechanism of sepsis induction in each patient with the variety causes of sepsis might be different. Immune response to sepsis depends on genetic background, route of immune activation and organisms. Urosepsis is type of infection that cause AKI and septic shock. Specific treatment of sepsis induced acute kidney injury in individual patient according to the specific immune response characteristic might be a more proper strategy. Report the case of a female aged 50 years, entered into RSCM with primary complaints of unconsciousness, and diangnosed with acute kidney injury et causa urosepsis. Complications acute kidney injury, inbalance electrolite and pneumonia were arised. Monitoring macrocirculation, tissue perfusion parameters, antibiotic and intermitten hemodialisis were performed in patient to recover.
Penggunaan Teknik Blok Perifer Angkle pada Pasien Papo Digiti 4,5 Pedis Sinistra Triputra, Audhiaz Marthsyal; Mahmud; Artika, I Gusti Ngurah Rai
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (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.v5i2.7329

Abstract

A 75 yearl old woman diagnosed gangrenous 4th – 5th left digiti pedis e.c susp. PAPO went to surgery with amputation of the 4th and 5th left digiti pedis with a peripheral nerve block anesthesia techniques. Preoperative physical status been classified with ASA II, with warfarin therapy has been discontinued since 4 days ago and replaced with UF heparin for one day therapy. The operation takes approximately less than one hour with hemodynamically stable, patients had no complaints of pain to post-surgery. Heparin therapy then continued one day after surgery
Neurophysiology Intraoperative Monitoring (Niom) pada Operasi Deformitiy Correction at Adolesent Scoliosis Herlambang, Panji; Sudadi; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (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.v5i2.7330

Abstract

The use of neurophysiological intraoperative monitoring (NIOM) during spinal orthopaedic and neurosurgical procedures provides a challenge to the attending anaesthesiologist. Since all anaesthetic agents affect synaptic function, the choice of agent will be determined by the type of surgery and the NIOM modality employed. Had been performed surgery for scoliosis correction of spinal abnormalities in children aged 15 years with using of sensory and motoric NIOM. The surgery going under general anesthesia with the installation monitor invasive arterial line and central venous pressure during surgery for hemodynamic monitoring. Drugs used during anesthesia using balanced anesthesia technique with a combination of opioids, propofol and sevoflurane as inhalation. Muscle relaxants given intermittently for operator leisure and ventilation controls. Postoperative hospitalization in ICU with the aim of assessing the function of the respiratory and neurological of the patients and pain management.
Perbandingan Daya Guna Kombinasi Ondansetron 4mg dan Dexamethasone 8mg dengan Granisetron 3mg dalam Mencegah Mual Muntah pada Pasien Berisiko Tinggi Pascaoperasi Traktus Gastrointestinal Mahardieni, Karlina; Wisudarti, Calcarina Fitriani Retno; Sari, Djayanti
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (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.v5i2.7331

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 patients and anesthesiologists. Objective. To compare the efficacy of ondansetron 4mg IV-dexamethasone 8mg IV combination with granisetron 3mg IV for preventing of postoperative nausea and vomiting (PONV) in high risk patient in gastrointestinal tract operation. Methods. The research design was randomized control trial (RCT) study with the total of 80 patients, aged 18-60 years old, physical status ASA I and II who underdue gastrointestinal tract operation recruited. Data analysis is done by determined PONV score, side effect, rescue antiemetic needed, incidence and severity of PONV, fentanyl and neostigmine added, fluid status and duration of operation. Results. Incidence PONV of ondansetron-dexamethasone group is 12,5%. Incidence PONV of granisetron group is 10%. There was no significant difference of incidence PONV between these groups. In this study there was no side effect between these groups. Conclusions. Efficacy of ondansetron 4mg IV-dexamethasone 8mg IV combination with granisetron 3mg IV for preventing of postoperative nausea and vomiting (PONV) in high risk patient in gastrointestinal tract operation was no significant difference.
Efek Pemberian Ketamin Dosis 0,5 Mg/Kgbb Terhadap Onset Blokade Neuromuskular Oleh Atrakurium Al-Hilal, Said Rival; Sarosa H, Pandit; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (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.v5i2.7332

Abstract

Background. Atracurium is a nondepolarizing muscle relaxant agent. The onset of this drug is slower than succinylcholine thus limiting its use. Various attempts had been made to accelerate the onset of the nondepolarizing muscle relaxants. Various reports suggest that ketamine is associated with a better intubation conditions. Aims. The aim of this study was to determine the effect of ketamine 0.5 mg.kg-1 on neuromuscular blockade onset of atracurium. Method. The method was a Randomized Controlled Trial (RCT) with double blinding. Eighty adult patients aged 18-65 years with physical status according to class I and II of ASA classification who were undergoing elective surgery under general anesthesia in November 2016 up to January 2017, patients who met the inclusion and exclusion criteria were randomly divided into two groups: K (Ketamine ) and group S (Saline Control). Group K was given ketamine 0.5 mg.kg-1 while the S was given Saline. Eight patients were otherwise drop out because of tool’s error. The Onset of atracurium was measured by using a Train of Four. Result. The results of this study were the onset of neuromuscular blockade by atracurium in the ketamine group significantly faster (160.500 ± 58.956 seconds vs 288.750 ± 135.038 seconds; p = 0.001). Hemodynamic 8 changes (∆MAP : 6,500±7,965 mmHg vs 10,750±14,655 mmHg & ∆pulse rate : 3,737±11,700 x/minute vs 4,333±12,254 x/min) was not statistically significant (p = 0.123 and p = 0.831). Conclusion: The administration of ketamine 0.5 mgkg-1 accelerate the onset of neuromuscular blockade of atracurium.
Hubungan antara Lama CPB dan Aortic Cross Clamp dengan Mortalitas dan Lama Rawat di ICU pada Pasien Pascaoperasi Katup Jantung di RSUP Dr. Sardjito Anggraini, Diana; Widodo, Untung; Pratomo, Bhirowo Yudo
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (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.v5i2.7333

Abstract

Background: CPB (cardiopulmonary bypass) results a non physiologic circulation and AOX (aortic cross clamp) causes a hypoxic condition of myocard. The length of CPB and AOX are probably factors that influence the ICU outcome after valvular heart surgery. Objective: To determine whether CPB and AOX time have significant effect on postoperative ICU length of stay (LOS) and ICU mortality. Methods: Data were collected from hospital medical record from period 2010 until 2016. After inclusion and exclusion 57 patients were analyzed for mortality and LOS in ICU. Results: Among 57 patients, 9 (15%) had ICU stay > 3 days, the mean+SD CPB was 119,2+32,5 min, AOX 92,7+27,7 min, while 7 (12,3%) had mortality in ICU, the mean+SD CPB was 113,7+37,3 min, AOX 79,3+36 min. Statistically showed that there were no correlation between duration of CPB and AOX with LOS and mortality in ICU, but we found that increased LOS in patient with comorbid (CHF+other) (p=0,019 OR 7,7 CI 95% 1,39-42,66) while ICU mortality increased with value of APACHE II (p=0,015 OR 1,69 CI 95% 1,11-2,58). Conclusion: There were no correlation of CPB and AOX time against ICU LOS and in mortality ICU, but preoperative factor (CHF+other) and postoperative factor (APACHE II score) respectively have a factor correlation.
Falls Protocol Wibowo, Catur Prasetyo; Jufan, Akhmad Yun; Wisudarti, Calcarina Fitriani Retno
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (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.v5i2.7334

Abstract

Fluid therapy in the emergency case, especially shock is usefull for the patient, but it can be detrimental if we give it too much. There is so many type of shock, and fluid therapy is not the answer for all type of shock. FALLS-protocol (Fluid Administration Limited by Lung Sonography) was designed so that there is guidance for fluid therapy on shock patient. FALLS-protocol follows weil’s classification of shock. It uses simple equipment (ultrasonography) and microconvex probe that can be used to assess heart, lung, and vascular. Right now, the ultrasonography is so well known in the emergency setting.
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).

Page 14 of 32 | Total Record : 317

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