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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 317 Documents
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Angka Kematian Terkait Anestesi RSUP Dr. Sardjito 2017-2021 Gunawan, Fanny; Sudadi; Mahmud
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8344

Abstract

Background: Anesthesia service is a complex part of health care and has the potential to be dangerous. Anesthesia services can be improved by knowing the death rate related to anesthesia. This study aims to determine the death rate related to anesthesia in RSUP Dr. Sardjito. Methods: A retrospective review of the patient database under anesthesia from January 2017 to May 2021 was carried out by taking data from the medical record installation of RSUP Dr. Sardjito. Data on patients who died related to anesthesia were determined by 3 anesthesiologists. We assessed the patient's preoperative, intraoperative, and postoperative variables such as age, sex, ASA physical status, anesthetic technique, type of surgery, size of surgery, and patient comorbidities associated with anesthesia-related death and place of death. Results: There were 39,965 patients undergoing anesthesia. Thirty patients died related to anesthesia. Characteristics of patients who died related to anesthesia in January 2017 to May 2021 at Dr. Sardjito was a patient with male gender (n=14 (46.6%)), ASA III physical status (n=20 (66.7%)), type of emergency surgery (n=12 (40%)), general anesthetic technique (n=25 (83.3%)), and underwent major surgery (n=25 (83.3%)). The mean age of patients who died related to anesthesia was 46.53 with a standard deviation SD of ±26.31. There were 9 patients (30%) who died with comorbid hypertension. There were twenty six patients (86.6%) died outside the operating room. Conclusion: The death rate related to anesthesia within 24 hours at RSUP Dr. Sardjito is 7.5 per 10,000 anesthetic actions.
Identifikasi Faktor Risiko Kematian di ICU RSUP Dr. Sardjito Ardiansyah, Firman; Widyastuti, Yunita; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8345

Abstract

Background: ICU is one of patients care unit that is costly and have limited capacity. Thus, time spending, man resources and tools should be allocated wisely based on the needs of the patients that would be admitted to ICU. One of the means that can be used to increase care quality of the ICU is creating a risk prediction system to assess and analyze risk factors that associated with mortality in ICU. This system makes comparative assessment and intensive care evaluation can be done. For the first step, we need to identify risk factors that affect mortality in ICU, that can be used as a new scoring models. Methods: This study based on 356 patients that admitted to ICU RSUP dr. Sardjito from 1 January to 31 December 2019. In this cohort retrospective study, variables will be tested with regression logistics test, with univariable and multivariable approach. From this test, we achieved variables that identified as risk factors of mortality in ICU. Those identified variable undergo assessment of strength as a predictor with Area Under The Curve (AUC) method. If we find that, the discrimination strength is quite strong, we continue the test with calibration test using Hosmer-Lemeshow to achieve compoarative value within observed and expected mortality. The whole statistic process use SPSS application version 26.0. Results: Factors that identified as risk factors for mortality in the ICU Dr.Sardjito Hospital were intraoperative use of vasopressor/inotropic drugs drugs, respiratory failure, GCS (Glasgow Coma Scale) decrease, kidney failure and intraoperative PRC transfusion with p < 0.005 in both univariable and multivariable tests. The AUC for mortality prediction in this study was 0.896 (95% CI; 85,3-94%). This value is classified as strong as a predictor factors, so it is continued to the calibration test with Hosmer-Lemeshow test and showed a p value of 0.53 (p > 0.05) which means that this risk prediction factors has a good fit between the observed and the expected. Conclusion: The intraoperative use of vasopressor/inotropic drugs, respiratory failure, GCS decrease, kidney failure and intraoperative PRC transfusion are predictive factors for mortality in the ICU Dr.Sardjito Hospital. The discrimination ability of these factors is strong and also have a good fit in predicting the incidence of mortality in the ICU Dr.Sardjito Hospital.
Pengaruh Fisioterapi Terhadap Parameter Hemodinamik pada Pasien Kritis Di ICU RSUP Dr. Sardjito Hanafi, Irham; Sari, Djayanti; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8346

Abstract

Background: Critically ill patients undergoing treatment in the ICU experience long-term immobilization. Giving physiotherapy to patients is a recommendation to mobilize critically ill patients early to prevent complications. Monitoring vital signs is important to ensure that physiotherapy is safe and that the patient is protected from the adverse effects of physiotherapy. The recording of hemodynamic changes has never been done in Dr. Sardjito General Hospital. Objective: To determine the effect of passive motion physiotherapy on hemodynamic parameters in critically ill patients admitted to the ICU. Method: This study used a quasi-experimental interventional design. Patients who entered the inclusion criteria were patients who were treated in the ICU and aged over 18 years in June and July 2021. Hemodynamic data were taken from bedside monitors and ICON devices. Results: The number of research subjects was 32 patients. Passive motion physiotherapy resulted in a lower SVV value (10.84 ± 6.19; p = 0.014) than at baseline (12.91 ± 6.19) and after rest (12.25 ± 5.21). Other parameters, HR, RR, SBP, DBP, MAP, SV, SI, CO, CI, SVR, and DO2 did not produce statistically significant changes. Conclusion: Passive motion physiotherapy has no effect on hemodynamic parameters in critically ill patients admitted to the ICU Dr. Sardjito General Hospital. Passive motion physiotherapy resulted in lower SVV compared to baseline and resting conditions.
Manajemen pada Pasien Sindroma Guillain-Barré Di ICU RSUP Dr. Sardjito Jufan, Akhmad Yun; Sudadi; Sunantara, I Gusti Ngurah Putu Mandela
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8347

Abstract

Guillain-Barré syndrome (GBS) is an autoimmune disorder that affects the peripheral nervous system. Most patients with GBS are clinically characterized by tetraplegia with or without sensory disturbances. In GBS this is due to a hyperreactive immune response including release of antiganglioside antibodies, formation of antibody-dependent immune complexes, and increased macrophages leading to axonal demyelination and degeneration. Severe cases of GBS may present with progressive clinical signs involving respiratory muscle and requiring mechanical ventilation and treatment in an intensive care unit (ICU). We reported a 26-year-old woman with type 2 respiratory failure with suspicion of GBS who was being treated in the ICU of RSUP Dr. Sardjito and undergone plasma exchange as immunomodulator therapy. The patient was treated for 9 days in the ICU of RSUP Dr. Sardjito with the outcome of the patient discharged from ICU to the ward.
Manajemen Sulit Jalan Napas pada Pasien Pediatrik dengan Sindrom Bosman-Arhinia Mikroftalmia Mahmud; Widodo, Untung; Loru, Martha Yuanita
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8348

Abstract

A 12-months-old boy with Bosman-Arhinia Microphthalmia Syndrome (BAMS) will undergo surgery to replace a nasopharyngeal duct catheter after nasal reconstruction. Patients with ASA physical status 2 with BAMS and prediction of difficult airway. Patient with a history of 2 months ago went on tracheostomy surgery, facilitated by general anesthesia using the Supraglotic Airway Device (SAD) or Laringeal Mask Airway (LMA). After 3 weeks, the tracheostomy cannula was removed and the tracheostomy wound was closed. We used crash induction but found difficulty in ventilation with a facemask or with the LMA so that management was immediately carried out according to the difficult airway algorithm and intubation was successful
Manajemen Intraoperative Nausea and Vomiting (IONV) pada Pasien Seksio Sesarea dengan Anestesi Spinal Apsari, Ratih Kumala Fajar; Jufan, Akhmad Yun; Sari, Dhanty Dwita
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8350

Abstract

Background: Spinal anesthesia is the most commonly used anesthesia for caesarean section with it being safely, quickly and easy to administer. Current literature indicates a high incidence of intraoperative nausea and vomiting (IONV) during caesarean section under spinal anesthesia up to 80% likely to suffer from nausea and vomiting because of the pregnancy itself. This is applicable not only to the first 3 months of pregnancy but also to the last trimester due to the reduced tone of the esophagogastric junction and an increased intraabdominal pressure. During abdominal surgery under regional anesthesia, nausea may happen due to several contributing factors such as sympathetic blocks followed by parasympathetic dominance with hypotension which is the most important cause of nausea after spinal anesthesia, decreased perfusion of central nervous system, anxiety, and sudden abdominal movements during surgery
Rapid Sequence Spinal pada Seksio Sesarea Emergensi Adiyanto, Bowo; Widodo, Untung; Wibowo, Arif Setyo
Jurnal Komplikasi Anestesi Vol 8 No 2 (2021): Volume 8 Number 2 (2021)
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.v8i2.8355

Abstract

Obstetric emergencies are a challenge both for the obstetrician and the anesthesiologist. The incidence of caesarean sections as per the National Family Health Survey published in 2015–16 was 17.2%. In 7.6% of cases, the decision to conduct a caesarean section was taken after the onset of labour pain. Caesarean sections are classified depending on the urgency into four categories. The target decision to delivery interval for category 1 caesarean section is less than 30 min. The management of these emergencies involves a rapid assessment with minimal investigations. Although general anaesthesia is considered to have higher morbidity and mortality, category 1 caesarean sections may still warrant this technique. Rapid sequence spinal anaesthesia is replacing general anaesthesia for category 1 SC emergency. In category 2 and 3 caesarean sections, spinal anaesthesia still remains the technique of choice
Rapid Sequence Intubation pada Pasien Hamil Ektopik dengan COVID-19 Ringan yang Menjalani Laparotomi Histerektomi Wisudarti, Calcarina Fitriani Retno; Adiyanto, Bowo; Naomi, Diah Anis
Jurnal Komplikasi Anestesi Vol 8 No 2 (2021): Volume 8 Number 2 (2021)
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.v8i2.8356

Abstract

Female patient aged 27 years was diagnosed with ectopic pregnancy in ampulla vateri, grade II hemorrhagic shock resolved, G2P1A0 8 weeks 5 days pregnant, mild COVID-19, underwent exploratory laparotomy and hysterectomy. The patient did not have any complaints of fever, cough, shortness of breath, and anosmia. The patient was diagnosed with mild COVID-19 because of a positive SARS-CoV-2 Qualitative PCR swab and no pneumonia. The operation was carried out in a special operation room for airborne infection patients with a HEPA filter machine installed. General anesthesia intubation using the RSI technique. No difficult airway was found in the patient. No Sellick maneuver was performed. Patient was intubated with a direct laryngoscope. The ETT position was confirmed by capnograph. After the operation, the patient was extubated deeply, then returned to the ward. There was no perioperative complication in this patient.
Manajemen Perioperatif pada Pasien Varises Esofagus yang Menjalani Endoskopi Sari, Djayanti; Widodo, Untung; Mi’raj, Geza Getar
Jurnal Komplikasi Anestesi Vol 8 No 2 (2021): Volume 8 Number 2 (2021)
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.v8i2.8357

Abstract

Esophageal varices are a condition in which there is distension of the submucosal veins that project into the esophageal lumen in patients with portal hypertension. Endoscopic examination is needed in cases of esophageal variceal bleeding to confirm a diagnosis, assess varicose veins and plan their management. We report a 12-year-old patient with grade 3 esophageal varices who underwent an endoscopy procedure. Management of anesthesia in esophageal varices patients undergoing endoscopy needs to pay attention to the depth of anesthesia and to keep the patient’s airway secure to avoid hypoxemia.
Manajemen Post-Dural Puncture Headache Menggunakan Teknik Blok Ganglion Sphenopalatina Wisudarti, Calcarina Fitriani Retno; Mahmud; Gupta, Adista Yugadhyaksa
Jurnal Komplikasi Anestesi Vol 8 No 2 (2021): Volume 8 Number 2 (2021)
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.v8i2.8358

Abstract

Post Dural Puncture Headache (PDPH) is a complication that can occur and be bothersome in patients undergoing neuraxial anesthesia. PDPH management includes conservative management such as hydration, caffeine, and oral analgesics to other invasive measures such as the Epidural Blood Patch (EBP). Sphenopalatine Ganglion Block (SPGB) is a technique to treat various kinds of headaches. The results showed that the SPGB technique improved PDPH symptoms although the data were not significant in some cases. We report a post-subarachnoid block patient who complained of PDPH symptoms. The patient's risk factor is the female gender. In this patient, an SPGB procedure was performed. Symptoms of PDPH were relieved after 17 days post-subarachnoid block procedure.

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