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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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Hubungan Thoracic Fluid Content Cardiometry dengan Lung Ultrasound Score untuk Menilai Lung Water pada Pasien Pascaoperasi Mayor di ICU Pradana, Gilar Rizki Aji; Jufan, Akhmad Yun; Wisudarti, Calcarina Fitriani Retno
Jurnal Komplikasi Anestesi Vol 9 No 1 (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.v9i1.8519

Abstract

Background: Perioperative fluid management in patients undergoing major surgery is important. Excessive administration of fluid can cause atrial natriuretic peptide release and iatrogenic glycocalyx/vascular endothelial junction dysfunction which can cause intravascular fluid shifting to the extravascular space. This fluid shifting can occur in the pulmonary interstitial space. Lung Ultrasound Score (LUS) score and Thoracic Fluid Content (TFC) examination with ICON is considered suitable to assess Extravascular Lung Water (EVLW). Objective: To determine the correlation between the LUS score with TFC using ICON in post-operative major patients in the ICU. Methods: A prospective observational research design with a cross-sectional study design. The sample size was 30 adult post-major surgery patients who were treated in the ICU of Dr. Sardjito. The LUS score was obtained from an ultrasound examination of the lungs and TFC was assessed with the ICON device. LUS examination was performed at 3-4 and 7-8 intercostal space between the parasternal-mid clavicular line, and on the lateral side at the level of the mid-axillary line. Correlation analysis was conducted to determine the degree of correlation between LUS score and TFC. Results: The sample of this study was 30 patients. Mean age 46.40±12.30 years, P/F ratio 411,21±77,64, AaDO2 121,20±53,4, LUS score 3.30±2.58, and TFC 24.56±10.30. Fluid balance during operation 194,2±756,65. The Spearman correlation test between LUS score and TFC showed a positive and significant correlation between LUS score and TFC, p<0.001 and r=0.703. The Spearman correlation test for LUS score and P/F ratios, LUS score and AaDO2, LUS score and fluid balance in the operating room showed no significant relationship (p>0.05). Conclusions: The correlation between LUS score and TFC values in postmajor surgery patients treated in the ICU was statistically significant (p<0.001) and the correlation was positive (r=0.703).
Manajemen Intensif Peripartum pada Pasien COVID-19 Apsari, Ratih Kumala Fajar; Wisudarti, Calcarina Fitriani Retno; Negara, Adista Yugadhyaksa Gupta
Jurnal Komplikasi Anestesi Vol 9 No 1 (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.v9i1.8521

Abstract

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus. Pregnant women in the third trimester and after delivery are at risk for severe COVID19. Intensive management of pregnant women with COVID-19 consists of a variety of steps. Key points of intensive management include fluid management, steroids, thromboprophylaxis, antibiotics, monoclonal antibodies, and ventilation management. Laboratory, radiological, and clinical examination monitoring should be carried out as needed. In pregnant women with severe COVID-19, there are critical targets that must be achieved. Patient management must be adjusted to achieve these targets. This case report discusses a 23-year-old woman who was 30 weeks pregnant who experienced severe COVID-19 and eventually died. There is much to be learned about the intensive management of pregnant women with COVID19 from this case.
Konsiderasi Anestesi pada Pasien Seksio Sesarea dengan COVID-19 Wisudarti, Calcarina Fitriani Retno; Jufan, Akhmad Yun; Trijayanti, Christiana
Jurnal Komplikasi Anestesi Vol 9 No 1 (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.v9i1.8522

Abstract

COVID-19 infection in pregnant patients can lead to premature labor. The most common method of delivery is by caesarean section. There are many aspects that must be considered in carrying out anesthesia for COVID-19 patients, including physiological changes that occur due to pregnancy and the effects of COVID-19 infection which can aggravate the condition of pregnant patients. Maintaining adequate oxygenation in the blood, choosing the right anesthetic agent, considering its effect on the fetus, and mechanical ventilation management related to ARDS caused by COVID-19 infection are the main things that should be of concern in anesthesia management
Manajemen Akhir Hayat Pasien Sakit Kritis Di ICU COVID-19 Adiyanto, Bowo; Widodo, Untung; Hernawan, Agung Diky
Jurnal Komplikasi Anestesi Vol 9 No 1 (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.v9i1.8654

Abstract

End-of-life condition was showed with symptoms of brain-stem death and functional impairment of breathing effort that persisted at fifth day of care. Physician explained to patient’s family about end-of-life condition, prognose, probability, and a desicion making that would had to make. Family decided to accept this condition, wish to continue medication but not to resuscitate if patient’s condition became worst. A chaplain gave spiritual care, end-of-life counceling, and praying to patient. Unfortunately, there was no intensive communication among medical teams about end-of-life condition. Patient care was underwent until the time of death with permitted family at patient’s bedside, not gave cardiopulmonal resuscitation as family’s wishes and pronaounced death in front of family.
Anesthesia in Renal Transplant Kurniawaty, Juni; Ancilla, Cornelia; Arovah, Novita Intan
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.v10i3.8769

Abstract

Background: Transplantation provides near-normal life and excellent rehabilitation compared to dialysis and is the preferred method of treating end-stage renal disease (ESRD) patients. Methods: We conducted a retrospective analysis of anesthesia management from 20 cases of live renal transplants carried out between August 2017 and April 2019 at Dr. Sardjito Central General Hospital, Yogyakarta. The subjects ' preoperative patient status, anesthesia management, and postoperative care were assessed. Results: Most patients had preoperative anemia, normal serum potassium, serum creatinine, and average ejection fraction. Anesthesia management began 24 hours before surgery, in which the patients were hospitalized, had peripheral IV access and fluid maintenance, and hemodialysis, followed by premedication 1 hour before surgery. Before surgery, anesthesia induction and intubation were done, followed by maintenance of anesthesia and intraoperative monitoring. Postoperative care consisted of the administration of analgesia and management of complications. Conclusion: Optimization of preoperative status, proper anesthesia management, and good postoperative care are keys to a successful renal transplant program.
A case series Percutaneus Dilatasional Tracheostomy (PDT) in Cerebrovascular Disease Helen Yudi Irianto, Helen Yudi; Wisudarti, Calcarina Fitriani Retno
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.v10i3.8778

Abstract

ABSTRAK Penyakit jaringan otak sering kali membutuhkan manajemen proteksi jalan nafas. Intubasi dan PDT merupakan opsi dari prosedur guna mempertahankan patensi jalan nafas. PDT dapat menurunkan resiko pneumonia dan mempermudah penyapihan bentilator. PDT dilakukan di ruang ICU dan dilakukan anesthesiologist senior dan terdapat 12 kasus yang dikumpulkan serta dicatat kemudian dibagi menjadi 2 kelompok grup yakni dilakukan PDT awal (kurang dari 7 hari setelah intubasi ) dan PDT ahir ( lebih dari 7 hari setelah intubasi). Terdapat 3 set PDT yang dilakukan sterilisasi ulang oleh tim CSSD RSUD Ciawi yang kemudian di Analisa usap instrument oleh tim BLKK dari Jakarta. Semua manajemen PDT dilakukan secara berhasil tanpa adanya komplikasi, hasil lauran pasien pada kedua grup tidak berbeda jauh. Jumlah hari yang dibutuhkan untuk penyapihan ventilator, evaluasi kultur sputum dan instrumen PDT dicatat dan di tampilkan. Penelitian lebih lanjut dibutuhkan untuk melihat keuntungan PDT dan waktu terbaik prosedur dilakukan. Penggunaan set PDT berulang yang disterilisasi menggunakan cairan dekonek dan di suhu dingin dapat memnghindari dari infeksi bakteri. Kata kunci : VaskularisasI otak, penyakit, PDT, komplikasi, luaran
Preliminary Survey in preparation for the implementation of ERAS at Dr Soetomo Hospital Veterini, Anna; Firdaus, Khildan Miftahul; Semedi, Bambang Pujo; Putri, Herdiani Sulistyo; Fitritati, Mariza; Mutiar, Airi
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
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.v11i1.9952

Abstract

Background Medical science has developed rapidly. One of them is ERAS (Enhanced Recovery After Surgery) which is a multidisciplinary team development pathway for perioperative methods that offer a variety of benefits. Some of the advantages of the ERAS method are speeding up the post-operative recovery period, economic benefits, and shortening the Length of Stay (LOS) by minimizing surgical stress so that the patient quickly returns to a normal physiological state. Objective This study aims to analyze the readiness of the team that will support the ERAS application at General Academic Hospital (RSUD) Dr Soetomo. Methods This is an observational analytic study with a cross-sectional design using a questionnaire. Patient baseline data were taken from the examination at the anesthesiology outpatient clinic. Assessment for patient understanding was carried out directly after a brief explanation of ERAS method by the researcher. The patient's level of understanding was assessed by two investigators and rated on a scale of 1 to 5. Primary data and assessment of understanding of doctors and medical personnel were filled in independently by research subjects on online forms and rated on a scale of 1 to 5. Data was collected from March 23 to April 14 2022, at RSUD Dr. Soetomo Surabaya. The analysis results are considered significant if the p-value is less than 0.05. The analysis was carried out using SPSS 19 software. Results Most patients planned to undergo surgery in the field of urology (82.9%), followed by caesarean section (14.6), and almost all patients or their families agreed to surgery using the ERAS method (95.1%). The medical team consists of 110 doctors from 4 areas of expertise, namely specialist doctors and residents in anesthesiology, urology surgery, obstetrics and gynecology, as well as orthopedics and traumatology. The health team consists of 56 personnel, namely anesthesiologists, surgeons, recovery room nurses, nutritionists and pharmacists. The majority (61%) of health workers had heard about ERAS and stated that ERAS was ready to be implemented at RSUD Dr. Soetomo (89%). Most doctors stated that ERAS was ready to be implemented at Dr. Soetomo and its human resources and facilities are considered qualified. Conclusion The ERAS method at RSUD Dr. Soetomo is considered quite ready to start, especially the Obsgyn study program, which is supposed to have an excellent level of understanding of ERAS and is enthusiastic to begin immediately. The patient group can be said to understand and accept the ERAS method well as a perioperative method for handling their cases.
Cost Effectiveness General Anesthesia Combined with Scalp Block Compared to General Anesthesia in Patients Undergoing Removal Tumor Craniotomyin Dr. Sardjito Hospital Wicaksono, Galih Sahid; Sudadi; Uyun, Yusmein
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
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.v11i1.10199

Abstract

Background. Providers of anesthesia services have many opportunities to reduce these costs, of course with the aim of maintaining balance between profit, security and costs. Craniotomy surgery removal of the scalp block tumor is an alternative option that can be combined with general anesthesia. The scalp block itself can blunt stress response in craniotomy and can maintain unwanted hemodynamic instability. Purpose. Find out the cost effectiveness of the scalp block in craniotomy patients removing tumors at Dr. SARDJITO Hospital. Method. Method. Twenty patients ranging in age from 18 - 65 years with intracranial tumors who underwent tumor binding craniotomy at RSUP Dr. SARDJITO is grouped into two treatment groups with general anesthesia and general anesthesia with a combination of scalp blocks, both techniques are calculated using drugs and consumables during the operation. Results. Total cost on the general anesthesia combined scalp block was Rp. 1,347,276 lower Rp. 377,833 compared to general anesthesia Rp. 1,725,109 with a significant difference (p = 0.005). Similarly, the hourly cost of the group in the combined general anesthesia scalp block was Rp. 286,351 Rp. 97,107 lower than general anesthesia Rp. 383,457 with a significant difference (p = 0.038). Conclusion. Combination of general anesthesia and scalp block using 0.5% levobupivacaine more cost effective than general anesthesia and scalp block with placebo in supratentorial tumor patients undergoing tumor removal craniotomy.
Pengaruh Teknik Anestesi Kombinasi Blok Skalp dengan Levobupivacaine 0,5% Terhadap Penggunaan Fentanyl Intravena untuk Mengatasi Nyeri Paska Operasi Kraniotomi Pengangkatan Tumor Di RSUP Dr. Sardjito Akbar, Shonnif; Sudadi; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023)
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.v11i1.10207

Abstract

Latar Belakang. Pengunaan opioid dosis besar terbukti efektif untuk memblokade stimulasi pada insisi kepala namun memiliki efek yang tidak diinginkan. Blok skalp adalah salah satu pilihan alternatif yang dapat dikombinasikan dengan pembiusan umum. Blok skalp sendiri dapat menumpulkan respon stres pada kraniotomi dan dapat menjaga gejolak hemodinamik yang tidak diinginkan. Blok skalp menurunkan insiden dan skala nyeri paska operasi kraniotomi pengangkatan tumor. Tujuan. Membandingkan jumlah konsumsi fentanyl paska operasi pada pasien yang menjalani operasi kraniotomi pengangkatan tumor dengan teknik pembiusan umum dan teknik pembiusan umum dengan kombinasi blok skalp menggunakan levobupivacaine 0,5%. Metode. Dua puluh orang pasien dengan rentang usia 18-65 tahun dengan tumor intrakranial yang menjalani tindakan operasi kraniotomi pengangkatan tumor di RSUP Dr. Sardjito dikelompokkan menjadi 2 kelompok perlakuan dengan teknik pembiusan umum dengan kombinasi blok skalp menggunakan levobupivacaine 0,5% dan pembiusan umum dengan kombinasi blok skalp menggunakan normal saline. Pasien dievaluasi kebutuhan fentanyl dan skala nyeri 12 jam paska operasi di ICU. Pasien dengan riwayat alergi anestesi lokal, riwayat alergi fentanyl, BMI <18 kg/m2 dan BMI >35 kg/m2 dan durasi operasi >6 jam akan dieksklusi dari pengambilan data. Hasil. Rerata penggunaan fentanyl 12 jam paska operasi pada pasien yang menjalani operasi kraniotomi pengangkatan tumor dengan teknik pembiusan umum dengan kombinasi blok skalp menggunakan levobupivacaine 0,5% sebesar 300,50 mcg dengan standar deviasi 68,65 mcg. Sedangkan pada pasien dengan teknik pembiusan umum dengan kombinasi blok skalp menggunakan normal salin sebesar 408,75 mcg dengan standar deviasi 84,02 mcg. Selisih rerata penggunaan fentanyl paska operasi pengangkatan tumor antara kedua kelompok sebesar 108,25 mcg menunjukkan perbedaan yang bermakna p=0,006 (p<0,05). Kesimpulan. Pembiusan umum dengan kombinasi blok skalp menggunakan levobupivacaine 0,5% terbukti mengurangi kebutuhan fentanyl 12 jam paska operasi kraniotomi pengangkatan tumor dibandingkan pembiusan umum dengan kombinasi blok skalp menggunakan normal salin.
Kidney Transplantaion Purwoko, Purwoko; Saputra, Wahyu Yas
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.v10i3.10963

Abstract

Chronic Kidney Disease (CKD) is a global public health problem where there is a decrease in kidney function which is marked by a decrease Glomerular Filtration Rate (GFR) slowly over a period of time. The incidence of CKD is increasing rapidly and is expected to become the 5th most common cause of death worldwide by 2040. Kidney transplantation from a living donor is the treatment of choice for most patients with End-Stage Renal Disease (ESRD). However, the absence of specific regulations related to kidney transplantation and guidelines for implementing regulations has become one of the obstacles in the development of kidney transplantation in Indonesia. In addition, a thorough evaluation of potential living donors requires a lot of resources. Early triage of an unsuitable donor will help maximize benefits, minimize risks, and manage expectations for both donors and recipients, and their families. Past and current medical history, family history, and general medical assessment are important to explore the possibility of previously undiagnosed diseases in potential donors. Pre-operative care and preparation as well as types of surgery and anesthesia should also be carried out by a team with adequate expertise, and in an environment where the donor is cared for on a regular basis.

Page 28 of 32 | Total Record : 317

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