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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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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.
Analgesia Multimodal Pascaoperatif pada Pasien Pediatrik Widyastuti, Yunita; Sari, Djayanti; Rizki, Gilar
Jurnal Komplikasi Anestesi Vol 6 No 2 (2019): Volume 6 Number 2 (2019)
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.v6i2.7346

Abstract

Acute pain can be found in patient undergoing surgery. Postoperative pain scale is variable from mild to moderate-severe. There are difficulties in assessing pain scale in pediatric, not like adult, pediatric patient can’t say what they feel. Management of postoperative pain, especially in moderate-severe scale needs a multimodal approach to overcome it. The aim of multimodal strategy is to optimize analgetic effect and reduce the adverse effect of the drugs.
Hubungan antara Kadar Prokalsitonin Serum dan Skor SOFA sebagai Parameter Tingkat Keparahan Disfungsi Organ Pasien Sepsis yang Dirawat di ICU RSUP Dr. Sardjito Setiandari, Kristina; Wisudarti, Calcarina Fitriani Retno; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 6 No 2 (2019): Volume 6 Number 2 (2019)
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.v6i2.7347

Abstract

Background: Sepsis causes an increase in procalcitonin level by increased secretion of proinflammatory ytokines, increased expression of CD 14 and CD 16, decrease of neutrophil phagocytic activity, suppression of blast transformation from T cells and neutrophil malfunctions. Procalcitonin secretion increase with increasing the severity of sepsis. The severity of sepsis is determined by the severity of organ dysfunction. The more severe the sepsis the more severe the organ dysfunction occurs and the higher the procalcitonin secretion.Objective: The purpose of this study was to determine if there is a relationship between procalcitonin levels and SOFA score as a severity parameter of organ dysfunction in septic patients treated in ICU Dr Sardjito Hospital.Methods: The study design was prospective observational cohort study. A total of 29 septic patients, age above 18 years old treated in ICU Dr Sardjito Hospital Yogyakarta were included in this study. Procalcitonin serum was measured and the SOFA score were calculated at the day of admission or at the day the diagnosis of sepsis was made (Day-0), within 24 hours (Day-1), at Day-3 and at day-5. Spearman correlation was used to analize the correlation between procalcitonin levels and SOFA score.Result: The overall mean of SOFA score was 10.3+3.9 while overall mean of procalcitonin level was 59.2+58.7 ng/ml. Significant positive correlation was found between overall procalcitonin level and SOFA score (r=0.663; p<0.05). The significant positive correlation was also found at Day-0 (r= 0.601; p<0.05), Day-1 (r=0.675; p<0.05), Day-3 (r=0.754; p<0.05) and Day-5 (r=0.718; p<0.05).Conclusion: There is a significant strong positive correlation between procalcitonin levels and SOFA score as a severity parameter of organ dysfunction in septic patients treated in ICU Dr Sardjito Hospital.
Pengaruh Posisi Elevasi Head Of Bed 300 Dibandingkan dengan Elevasi Head Of Bed 600 terhadap Peningkatan PaO2 dan Rasio PaO2/FiO2 pada Pasien dengan Ventilasi Mekanik di ICU RSUP Dr. Sardjito Anindita, Triatma; Wisudarti, Calcarina Fitriani Retno; Rahardjo, Sri
Jurnal Komplikasi Anestesi Vol 10 No 3 (2022)
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.v10i3.7349

Abstract

Background: Mechanical ventilation is the frequent reason of admitting patients to the Intensive Care Unit(ICU). Mechanical ventilation was used in resuscitating critical patient with lung disorder where the lung fails to oxygenite arterial blood. Patients with mechanical ventilation are more prone to immobilization because of the decrease of consciousness. Some researches had showed that the position change of patients with several conditions including mechanical ventilation increased the lung function thus resulting better blood oxygenation.Objectives: To compare the benefits of positioning patients with 600 HOB elevation to 300 HOB elevation by evaluating the PaO2 and PaO2/FiO2 ratio.Methods: This research was done with clinical trial using One Group Pretest Posttest. Patients was positioned first in the standard position (supine), elevation position Head of Bed (HOB) 300 and HOB 600. Then we measured the hemodynamic parameters, blood pressure, heart rate, respiratory parameters, peripheral O2 saturation and Blood Gas Analysis.Results: We obtained 21 subjects in this research 10 males and 11 females. We found significant increaseof PaO2 with elevation HOB of 600 compared to 300 (192.2 vs 160.7, p<0,05). The PaO2/FiO2 ratio showedsignificant increase in the HOB 600 (382.3 vs 322.2, p<0,05). The hemodynamic and respiratory parameters, we found that mean MAP, tidal volume, PIP and compliance in position of HOB elevation 600 were highercompared to the HOB elevation of 300 while the heart rate, resistance and PH were lower. But those differences were not statistically significant with p>0.05.Conclusion: The elevation head of bed 600 increase the PaO2 and PaO2/FiO2 ratio compared to the elevation head of bed 300 in patients with mechanical ventilation in ICU of RSUP Dr. Sardjito.

Page 15 of 32 | Total Record : 317

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