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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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Comparison between the Apfel Score and the Koivuranta Score in Predicting the Occurrence of Postoperative Nausea and Vomiting during General Anesthesia Palupi, Isnafianing; Suwondo, Bambang Suryono
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.v11i1.11714

Abstract

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 most patients and anesthesiologists. Recent risk score for prediction of PONV has been used as a way to classify patients according to risk prediction and provide prophylaxis in accordance with this classification. For everyday clinical purposes, a simple risk score in easy to do and shows the correlation between the predicted incidence of PONV in patients hospitalized. In the clinical practice known various risk score for prediction of PONV as Apfel scores, Koivuranta scores, Sinclair scores, Palazzo scores, Gan scores, and Scholz scores varying accuracy. Methods: The research design was a cohort study with the total of 80 patients recruited. Ordinal and nominal data was analyzed using chi-square test. P value < 0,05 was declared significant with 95% confidence level. Measurements taken are incidence of PONV between Apfel scores to Koivuranta scores with PONV scores. Results: Incidence of PONV in patients who carried the scoring with Apfel scores higher (80%) than Koivuranta scores, and statistically highly significant differences (p < 0,01). The results said that Apfel scores are more accurate than the Koivuranta scores, indicated by results of PONV scores positive (>1) on the Apfel scores 32 people (80%) and on the Koivuranta scores 12 people (30%), whereas PONV scores negative (≤ 1) on the Apfel scores 8 people (20%) and on the Koivuranta scores 28 people (70%). Conclusions: Apfel scores are more accurate than the Koivuranta scores in predicting the occurrence of PONV in patients with general anesthesia.
The Blood Glucose Regulation in Intensive Care Unit (ICU) Andriani, Ika Jati Setya; Jufan, Ahmad Yun
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.v10i3.12390

Abstract

Glucose control among ICU patients has been a topic of debate over the past 20 years. Harmful effects posted by uncontrolled hyperglycemia and hypoglycemia among critically-ill patients have been acknowledged widely. Previous researches had proven that a tight glucose control is not only of no benefit, but instead harmful due to the increased risk of developing a significant hypoglycemia. Current guidelines suggest a moderate approach of intravenous insulin therapy initiation towards critically-ill patients with blood glucose level above 180 mg/dL. The most integral factor that underlies the glycemic management of patients in the ICU is the prevention of hypoglycemia. A robust glucose monitoring and insulin protocol strategies need to be implemented in achieving this goal. Keywords: glucose control, hyperglycemia and hypoglycemia, ICU
Hubungan Antara Tingkat Keparahan dan Jenis Terapi Oksigen Terhadap Kualitas Hidup Penyintas Covid-19 yang Pernah Dirawat Di ICU RSUP Dr Sardjito wandito, Gayuh Utomo; Wisudarti, Calcarina Fitriani Retno; Adiyanto, Bowo
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.v11i1.12436

Abstract

Latar Belakang: Proses infeksi COVID-19 dapat meninggalkan gejala sisa, sehingga dapat mempengaruhi kualitas hidup penyintasnya, terutama pada penyintas COVID-19 dengan derajat sedang, berat dan kritis. Pasien yang pernah mendapatkan perawatan di ruangan ICU dengan terapi oksigen beragam, memiliki kualitas hidup yang lebih rendah. Tujuan: Mengetahui hubungan antara tingkat keparahan dan jenis terapi oksigen terhadap kualitas hidup penyintas COVID-19 yang pernah dirawat di ICU RSUP dr Sardjito. Metode Penelitian: Jenis dan rancangan penelitian ini adalah observasional kohort prospektif. Peneliti mengambil data sekunder dari rekam medis pada pasien yang terkonfirmasi COVID-19 derajat sedang, berat, kritis dan mendapatkan terapi oksigen yang pernah dirawat di RSUP Dr. Sardjito Yogyakarta dan kualitas hidup diukur dan menggunakan kuesioner EQ-5D-5L secara langsung pada saat penelitian. Subjek penelitian adalah seluruh penyintas COVID-19 yang pernah dirawat di ICU RSUP dr Sardjito bulan Januari 2020 sampai dengan Desember 2021. Analisis bivariat untuk menganalisis hubungan hubungan antara tingkat keparahan dan jenis terapi oksigen terhadap kualitas hidup adalah uji Kruskal Wallis. Variable yang memiliki p < 0,25 pada uji bivariat dilanjutkan analisis multivariat dengan uji regresi linier berganda. Hasil: Total subjek penelitian yang memenuhi kriteria adalah 56 subjek. Skor EQ-5D-5L pada pasien dengan suplementasi oksigen dengan , nasal kanul 0.82, non-rebreathing mask 0.96, High Flow Nasal Canule 0.53 dan ventilator 0.81 yakni (p=0,115). Skor EQ-5D-5L pada COVID-19 derajat sedang 0.92, derajat berat 0.92, sedangkan derajat kritis, yakni 0,75 (p=0,254). Kesimpulan: Tidak terdapat hubungan antara tingkat keparahan dan jenis terapi oksigen terhadap kualitas hidup penyintas COVID-19 yang pernah dirawat di ICU RSUP dr Sardjito. Kata Kunci: COVID-19, derajat keparahan, terapi oksigen, kualitas hidup
Faktor Risiko yang Mempengaruhi Terjadinya Komplikasi Kardiovaskular Pasca Pembiusan/Sedasi Prosedural pada Pasien Pediatri hendra, hendra hermawan; Widyastuti, Yunita; Djajantisari
Jurnal Komplikasi Anestesi Vol 11 No 2 (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.v11i2.12446

Abstract

Background: The morphology and physiology of neonates and children differ from those of adults. The most common complications encountered involve respiratory issues followed by cardiovascular problems. The predominant cardiovascular complications in the field of pediatric anesthesia are hemodynamic instability followed by cardiac arrest. Perioperative cardiovascular complications are closely related to a history of prematurity under the age of 1 year, ASA physical status ≥3, concomitant cardiovascular or metabolic diseases, emergency surgeries, and surgical procedures. To date, few risk factors related to the cardiovascular system have been identified in pediatric anesthesia. Objective: To identify risk factors influencing the occurrence of post-anesthesia/sedation cardiovascular complications in pediatric patients at Dr. Sardjito Hospital, Yogyakarta. Method: The research design employed in this study was a prospective cohort observation of pediatric patients undergoing anesthesia or procedural sedation at Dr. Sardjito Hospital. Research subject data included demographic characteristics, ASA status, history of concomitant diseases, type of surgery, urgency level, and post-anesthesia complication occurrences. Data normality was tested using the Kolmogorov-Smirnov test, bivariate analysis was conducted using the Fisher test, variables with p-value <0.25 underwent multivariate analysis using logistic regression for categorical data. The results were processed using SPSS version 23.00. Results: A total of 181 subjects were predominantly male patients aged >5 years. Factors influencing post-anesthetic cardiovascular complications included ASA physical status ≥3 (p=0.033) OR 8.96 (95% CI 2.07 – 38.89), emergency procedures (p=0.043) OR 12.63 (95% CI 1.08 – 147.15), age >5 years (p=0.033) OR 5.67 (95% CI 1.15 – 28.1), female gender (p=0.001) OR 7.85 (95% CI 2.23 – 27.71), and type of surgical procedure (p=0.017) OR 16.64 (95% CI 1.63 – 169.05). Conclusion: Age >5 years, female gender, ASA physical status ≥3, emergency procedures, and surgical procedures are risk factors associated with the occurrence of post-anesthetic/sedation cardiovascular complications in pediatric patients.
Hubungan Rasio Bun-Albumin Plasma Terhadap Mortalitas dan Lama Rawat Pasien Covid-19 Di RSUP Dr. Sardjito Primastuti, Githa Rizki; Wisudarti, Calcarina Fitri Retno; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 11 No 2 (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.v11i2.12450

Abstract

Background: The increasing incidence of the COVID-19 pandemic has caused quite high mortality rates and length of stay in developing countries. Early detection is needed to reduce mortality rates. Early detection methods are reported, such as RT-PCR, immunoassay, and CT-scan, but they are expensive. Elevated BUN with decreased albumin is a laboratory condition produced by highly inflammatory states, such as COVID-19. The relationship between the plasma BUN-Albumin ratio in pneumonia sufferers has been proven to predict mortality and length of stay more strongly than the single parameter BUN or albumin. If proven to be relevant, these markers are advantageous because they are widely accessible, simple, and economical. Objective: To determine the relationship between plasma BUN-Albumin ratio on mortality and length of stay for COVID-19 patients at Dr. Sardjito. Methods: The research design used a retrospective cohort observational study method of patients with confirmed COVID-19 at RSUP Dr. Sardjito. Data on BUN and plasma albumin levels at admission were collected to calculate the optimal cut-off using the ROC curve. The relationship between BUN-Albumin ratio levels and mortality was analyzed using the chi-square test method followed by logistic regression in multivariate analysis. Analysis of length of stay using cox-regression survival analysis and is declared significant if it produces p < 0.05. Results: The total research subjects were 1650 patients, with a median age of 56 years. The cut-off value for the BUN-Albumin ratio in predicting mortality was found to be 5.634, with a sensitivity of 65.0% and a specificity of 63.7%. (AUC = 0.689; 95% CI 0.663-0.715; p=0.001). Multivariate analysis showed that an increase in the BUN-Albumin ratio was an independent and significant factor as a predictor of mortality (OR 2.378; 95% CI 1.809 - 3.127) and patient length of stay (HR 0.655; 95% CI 0.574 - 0.748; p<0.001). Age, gender, use of positive pressure oxygenation, hypertension, obesity, COPD, and asthma were not independently associated with mortality. Conclusion: An increase in the BUN-Albumin ratio is independently and significantly associated with an increased risk of mortality and length of stay in COVID-19 patients.
A Case report Myasthenia Gravis Adhinugroho, Sudjati; Sudadi, Sudadi; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 11 No 2 (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.v11i2.12565

Abstract

Myasthenic crisis, defined as respiratory failure requiring mechanical ventilation, occurs in 15 to 20% of patients with myasthenia gravis (MG). Infection (usually pneumonia or viral upper respiratory infection) is the most common precipitant (40%), followed by no obvious cause (30%) and aspiration (10%). As a general rule, 25% of patients are successfully extubated after 1 week, 50% after 2 weeks, and 75% after 1 month. Risk factors for intubation beyond 2 weeks, the point at which tracheostomy is usually performed, include age greater than 50 years, preintubation serum bicarbonate 30 mg/dL or greater, and vital capacity within 6 days of intubation less than 25 mL/kg. Intensive care management of the myasthenic patient should focus on timely intubation, prevention of aspiration with tube feedings, and avoidance of complications, such as atelectasis, that can prolong the duration of crisis. Plasmapheresis leads to short-term improvement of weakness in 75% of patients, and should be performed in all patients unless otherwise contraindicated. Residual weakness leads to functional dependence in 50% of patients at the time of discharge, and one-third will experience two or more episodes of crisis
Luaran Klinis Maternal pada Pasien Obstetri Dengan Covid – 19 yang Menjalani Seksio Sesarea di RSUP Dr. Sardjito Hadiwinoto, Bambang; Apsari, Ratih Kumala Fajar; Sudadi, Sudadi
Jurnal Komplikasi Anestesi Vol 11 No 2 (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.v11i2.12571

Abstract

Background : COVID-19 is a global pandemic with pregnant women is one of the affected populations. Physiological changes in pregnant women, coupled with the pathological conditions of COVID-19, impact maternal outcomes, including the amount of intrapartum hemorrhage, the requirement for mechanical ventilation, and mortality in patients undergoing cesarean section. Objective : To analyze the impact of OCVID – 19 on the maternal outcomes of obstetric patients undergoing cesarean section at Dr. Sardjito General Hospital. Methods : This research employ a retrospective descriptive study. Secondary data were obtained from medical records of COVID – 19 obstetric patient who underwent a cesarean section at Dr. Sardjito General Hospital from January to December 2021. The data were analyze using descriptive data analysis with SPSS software version 26. Results : The study resulting in a total sample size of 89 patients. The median age of the study subjects was 32 years, with a mean body mass index (BMI) of 28.3 kg/m^2. There was 7% incidence of hemorrhage exceeding 1000 cc , mortality rate was 25,8 %, and 20,2% from the population sample need mechanical ventilation pregnant women undergoing cesarean sections with COVID-19 at Dr. Sardjito General Hospital. Conclusion : There was no significant increase in the incidence of hemorrhage exceeding 1000 cc (7% vs. 18.4%), However there was a noticeable rise in mortality rates (25.8% vs. 0.34%, 1.3%) and an increased need for mechanical ventilation (20.2% vs. 0.071%, 0.01%) when compared to descriptive studies conducted on pregnant women undergoing cesarean sections without COVID-19. Keywords : COVID-19 , clinical outcome, cesarean section
Epidural Volume Extension (EVE) Wijaya, Indriyani; Mahmud
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.v11i1.12598

Abstract

Epidural Volume Extension (EVE) technique injects normal saline into the epidural chamber immediately after injection of local anesthesia into the intrathecal (or after subarachnoid/spinal block). Normal saline injection would widen the epidural space thus making the spread of local anesthesia in previous intrathecal injections and the distribution of cerebrospinal fluid to be higher (more cephalad), or it could be said that this EVE technique utilizes the volume effect of normal saline that decreases the volume of intrathecal space. The EVE technique may be useful for reducing the dose of local anesthesia injected intrathecally while still achieve an adequate block height for surgery, as well as for faster recovery of motor blockades. Unfortunately, for the risk of hypotension, the EVE technique does not significantly reduce this risk. Hypotension persists even though the hemodynamics (arterial blood pressure drop mean) is observed to be more stable.
Opioid Intratekal pada Enhanced Recovery After Surgery (Eras) Loho, Irvan Revaldi; Wisudarti, Calcarina Fitriani Retno; Sudadi
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.v11i1.12640

Abstract

Enhanced Recovery After Surgery (ERAS) is a multidisciplinary protocol introduced for a faster and more effective recovery from elective surgery. The target of ERAS is early mobilization, early oral intake and a faster length of stay. Preoperative ERAS recommends optimizing the patient's clinical condition, smoking cessation, minimizing fasting and drinking clear, carbohydrate-rich fluids up to 2 hours before surgery, reducing patient anxiety, and PONV prophylaxis. Intraoperatively, ERAS recommends the use of multimodal analgesia, maintenance of normothermia, and goal-directed fluid therapy. Postoperatively, ERAS recommends multimodal analgesia so that patients can mobilize early and eat early. Intrathecal opioid therapy can be an option in achieving the goals of ERAS. Optimal use of opioids is one of the factors that influence effectiveness in patients with the ERAS protocol.
The Non-Pharmacological Management of Shivering Post-Spinal Anesthesia rade, agrawijaya; Sudadi, Sudadi; Yudo Pratomo, Bhirowo
Jurnal Komplikasi Anestesi Vol 11 No 2 (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.v11i2.12641

Abstract

Shivering is a side effect of hypothermia which includes involuntary movements and contractions of one or more muscle groups that the patient cannot control. Perioperative shivering is a common problem during surgery under spinal anesthesia. Spinal anesthesia can cause shivering in patients because it causes distribution of internal body heat from the core of the body to the environment. Active non-pharmacological treatments for shivering post spinal anesthesia include the use of IV fluid warmed, forced-air warming, and Lower and Upper Body Forced Air Blankets. Key words: shivering, spinal anesthesia, warming of infusion fluids, forced air warming, and forced air blankets of the lower and upper body.

Page 29 of 32 | Total Record : 317

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