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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 358 Documents
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Critical Management of Recurrent Seizure at 16-year-old Primigravida with Atypical Eclampsia HS, Putu Ari Kamanjaya; Gunawan, Febri Jaya
Jurnal Komplikasi Anestesi Vol 13 No 1 (2025)
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.v13i1.14972

Abstract

Background: Atypical eclampsia can complicate the management and pose significant risks to both the mother and fetus. This case report emphasizes the critical management approach for recurrent seizures in a young primigravida. Case: A 16-year-old primigravida presented with sudden onset seizures during her third trimester of pregnancy. Initial assessments showed only a slight elevation of blood pressure and proteinuria, suggesting the presence of atypical eclampsia. Despite initially administering MgSO4, the patient still experienced a postpartum seizure. She was closely monitored and given a maintenance dose of midazolam and dexmedetomidine. After five days of treatment, the patient did not have any further convulsions and remained stable. Discussion: Teenage pregnancies increase the risk of maternal fatalities due to eclampsia. Atypical eclampsia is rare but can occur and requires a specific treatment approach. When therapy with magnesium sulfate is ineffective, midazolam and dexmedetomidine are used as alternative anti-epileptic drugs. Dexmedetomidine has a neuroprotective effect, preventing cerebral ischemia, and is effective in reducing the need for antihypertensive medication and hospitalization. Conclusion: The successful utilization of a combination of midazolam and dexmedetomidine highlights their potential as an effective therapeutic option for refractory seizures and adds to the existing treatment armamentarium for eclampsia.
Core Biopsy of the Mediastinum with Video Assisted Thoracotomy Surgery Approach in Children Without One Lung Ventilation Andre, Phillipus; Erlangga, M. Erias
Jurnal Komplikasi Anestesi Vol 12 No 3 (2025)
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.v12i3.14974

Abstract

Video Assisted Thoracoscopy Surgery (VATS) is a minimally invasive procedure for diagnosing and treating intrathoracic disease. VATS will generate abnormal physiological changes including the presence of artificial pneumothorax so that anesthesia management in these patients requires an understanding those changes. In this case report discuss 4-year-old child, 15 kilograms with mediastinal mass suspected of thymoma underwent planned for core biopsy through VATS without one lung ventilation (OLV) due to equipment limitation. Preoperative he had no breathing problems, stable vital signs (O2 saturation 97-98% free air) with thoracic photographs and CT Scan of the mediastinal mass, and no signs of superior vena cava syndrome. Assessment of anesthesia ASA II, general anesthesia. Induction was performed using spontaneous breathing technique. Intraoperatively there was a period of desaturation up to 92% and increased EtCO2, which managed by increasing the oxygen fraction, PEEP, and increased respiration frequency. Operation lasted for 2 hours, bleeding 60cc. Postoperatively, patient was extubated in the operating room and admitted to intensive care. Pain management was done with ESP block and paracetamol IV. VATS mediastinal biopsy in children with mediastinal masses without OLV can be performed well with good understanding to ensure the safety of the patient.
Can High Flow Nasal Cannula Prevent Intubation in Status Asthmaticus?”: A Case Report Hamdani, Ihsan; Wardana, Artha Wahyu
Jurnal Komplikasi Anestesi Vol 13 No 1 (2025)
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.v13i1.15089

Abstract

Overview of the case: A 29-year-old male with status asthmaticus, the GCS score was 14, the respiratory rate was 30 x/min, SpO2 88% on room air, bilateral lung wheezing, and the blood gas analysis revealed severe respiratory acidosis. Management: Treatment involved High Flow Nasal Cannula (HFNC) oxygenation, salbutamol and ipratropium bromide nebulization, aminophylline drip infusion, and intravenous corticosteroids. Within hours, there was a significant improvement in respiratory parameters and acidosis. Subsequent monitoring in the intensive care unit showed improvement, the patient successfully being weaned off HFNC and transferred to the general ward after six days. This case highlights the efficacy of HFNC in managing severe asthma exacerbation and preventing intubation. Results: The use of HFNC, when combined with standard asthma management, has proven to be a promising option in the non-invasive management of status asthmaticus and can prevent intubation, but should be monitored carefully due to the risk of delayed escalation to respiratory support
Airway Management for Neonates with Beckwith-Wiedemann Syndrome (Bws): Case Report Darmestari, Dara Lalita
Jurnal Komplikasi Anestesi Vol 13 No 1 (2025)
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.v13i1.15137

Abstract

Introduction: Beckwith-Wiedemann syndrome (BWS) is a congenital disorder with abnormalities such as macroglossia and abdominal wall defect. Children with BWS predicted to have difficult airway due to macroglossia in perioperative airway management. Management : 4 days old male neonates with macroglossia on BWS is schedule for umbilical cord hernia revision. Patient was assessed as ASA 3 based on his physical status. First patient was pre-oxygenated and ventilation using size 1 mask, and after ventilation archived, induction started with 4 vol% Sevoflurane followed by intravenous agent Fentanyl 7.5 mcg and Atracurium. The initial intubation attempt with direct laryngoscope failed due to unclear visualization of vocal cord because obstruction of the tongue. The second attempt was made using VL, vocal folds visualized according to Cormack–Lehane grade IIb, and neonate bougie with a kinking, size 3 uncuffed ETT. Postoperatively, patient was extubated before admitted back to the NICU. Conclusion: Macroglossia causes anatomical airway abnormalities in children with BWS. It was predicted that might cause difficult ventilation, intubation and extubation. Airway management with tongue traction and awake tracheal intubation are reported to facilitate the intubation. Other emergency equipment including bougie, FOB, cricothyroidotomy set, and tracheostomy set needs to be ensured before anesthesia administration begins
Blok Saraf Perifer pada Amputasi Bawah Lutut: Telaah Sistematis Krislee, Andre; Suhadi, Andrio; Debora, Charina Geofhany
Jurnal Komplikasi Anestesi Vol 12 No 3 (2025)
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.v12i3.16237

Abstract

Background: Patients who undergo below knee amputation (BKA) surgery are often accompanied with many comorbidities so that BKA surgery with general anesthesia (GA) or spinal or epidural may not be possible. Peripheral nerve block (PNB) is an alternative to this situation. This study aims to investigate the used of PNB in BKA. Methods: We performed a detailed search of PubMed, Scopus, and Web of Science database using the following search terms and their synonyms: “peripheral nerve block”, and “below knee amputation”. Only english articles are included in this study. Data extraction and systhesis were performed according to PRIMA guidelines Results: A total 7 articles were included in this research, see table 1. For the case report and case series, five patients were undergo BKA using sciatic and femoral block combination, one patients using sciatic and lumbar plexus block combination, and five patients using sciatic and adductor canal block combination. One cohort showed that PNB had p=0.04 with adjusted OR 0.75 (0.57 – 0.98) againts GA.
Transform Your Heart Failure Treatment Approach: Conquering Svt and Pneumonia Challenges Utami, Nabilah Puspa; Nugraha, Adriyawan Widya
Jurnal Komplikasi Anestesi Vol 12 No 3 (2025)
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.v12i3.16294

Abstract

In this complex case, an 81-year-old female presented with acute decompensated heart failure (ADHF), pneumonia, and SVT-induced tachyarrhythmia. Upon admission, she received meticulous therapy in the intensive care unit (ICU). The treatment regimen was multifaceted, aiming to address each condition effectively. Fluid balance was closely monitored and maintained. Pharmacological interventions played a crucial role, with digoxin administered initially to manage SVT, alongside medications targeting heart failure including clopidogrel, atorvastatin, spironolactone, candesartan, and furosemide. Antibiotic therapy was initiated promptly following consultation with a pulmonologist, comprising ceftriaxone, levofloxacin, and methylprednisolone for pneumonia management. Additionally, regular nebulizations with salbutamol-ipratropium were administered. By the third day of hospitalization, significant improvement was observed, allowing for the patient's transfer to a general medical ward. This case underscores the importance of a comprehensive therapeutic approach in managing complex medical conditions, such as ADHF exacerbated by SVT and pneumonia, to achieve optimal patient outcomes.
The Effect of Music Listening on Anxiety Levels in Post-Subarachnoid Block Anaesthesia Patients Prandani, Muhammad Yogi; Kurniawaty, Juni; Apsari, Ratih Kumala Fajar
Jurnal Komplikasi Anestesi Vol 13 No 1 (2025)
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.v13i1.18170

Abstract

Background: The patients’ perioperative conditions can affect post-operative anxiety. Subarachnoid block anaesthesia can increase the incidence of post-operative anxiety. Methods to reduce post-operative anxiety are divided into pharmacological, with the administration of sedative drugs, and non-pharmacological, with holistic education, acupuncture, listening to music during surgery, and othersObjective: This study aims to observe the effect of listening to music on the anxiety level of surgical patients undergoing subarachnoid block anesthesia.Methods: This study was a Randomized Controlled Trial (RCT), with an intervention group (n=50) listening to music after subarachnoid block during surgery and a control group (n=50) receiving standard routine anesthetic care. Anxiety assessment using the STAI score and vital signs were performed at 3 different times in both groups.Results: There were no differences in patient characteristics between the two groups. Anxiety measurement in the reception room (X1) showed 37 patients (74%) and 31 patients (62%) with moderate anxiety in the intervention and control groups, respectively (p>0.05). There was no difference in patient anxiety levels between the two groups (p>0.05) in the operating room (X2). Post-operative anxiety measurement in the recovery room (X3) showed 43 patients (86%) with low anxiety in the intervention group, compared to 32 patients (64%) in the control group. Patients who listened to music during surgery had a lower level of post-operative anxiety compared to the control group (p=0.011). Conclusion: Listening to music can reduce post-operative anxiety in patients undergoing surgery with subarachnoid block, compared to patients receiving standard routine care
Early De-resuscitation Strategy using Diuretics Targeting Low Central Venous Pressure in the Management of Septic Shock with Acute Kidney Injury Gabriana, Jessica; George, Yohannes W.H.; Purwowiyoto, Sidhi Laksono
Jurnal Komplikasi Anestesi Vol 12 No 3 (2025)
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.v12i3.22141

Abstract

Septic shock remains a critical condition associated with high morbidity and mortality rates, particularly when complicated by Acute Kidney Injury (AKI). Traditional management strategies have predominantly emphasized fluid resuscitation to restore hemodynamic stability; however, the adverse effects of fluid overload are most pronounced in situations such as septic shock, which predisposes patients to acquired AKI. This case report presents an early de-resuscitation strategy using diuretics to target low central venous pressure (CVP) in a 58-year-old male with Urosepsis-associated AKI. The initial treatment included fluid loading and antibiotics, but his condition worsened, leading to ICU admission. A central venous catheter was placed, and a furosemide infusion was started due to positive fluid balance and high CVP. Over the next few days, the patient's condition improved significantly, with reduced ventilator and vasopressor support and improved renal function. The success of this strategy underscores the importance of re-evaluating fluid resuscitation practices and incorporating de-resuscitation as a key component of patient care.
Analgesia Epidural Thorakal sebagai Tatalaksana Terkini Pankreatitis Akut Cokorda, Padmi
Jurnal Komplikasi Anestesi Vol 12 No 2 (2025)
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.v12i2.23699

Abstract

Acute pancreatitis has high morbidity and mortality rates, especially in moderate to severe conditions. The incidence of this disease reaches 5-30 per 100,000 population per year. The pathophysiology of acute pancreatitis is known to result from microcirculatory dysfunction in the pancreas. Severe abdominal pain is one of the symptoms most frequently complained of by patients, reaching 95%. Complaints of abdominal pain are more severe in the early phase, so multimodal analgesia is needed. Thoracic epidural analgesia is known to provide adequate pain control in 87.5 – 100% of patients. Several experimental studies and clinical data support the use of epidural analgesia in cases of acute pancreatitis. Epidural analgesia provides potential benefit in patients with acute pancreatitis in improving pancreatic perfusion. In thoracic epidural analgesia, sympathetic segmental block occurs which is a way to increase the neural supply to the splanchnic circulation resulting in vasodilation and increased blood flow. This technique is safe to use in patients with acute pancreatitis, but requires adequate hemodynamic monitoring to prevent undesirable events such as hypotension and infection. Key words: pancreatitis, thoracic epidural analgesia, abdominal pain
Bahasa Inggris Sumardi, Fitri Sepviyanti
Jurnal Komplikasi Anestesi Vol 12 No 2 (2025)
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.v12i2.23700

Abstract

Introduction: Thymectomy in patients with myasthenia gravis or mediastinal tumors requires a very careful anesthesia strategy due to neuromuscular sensitivity, risk of airway compression, and possible hemodynamic instability. This systematic literature review summarizes the latest evidence on anesthesia governance, including engineering innovations and their implications for facilities with limited resources.Methodology: Literature searches were conducted through PubMed, Scopus, and Google Scholar using keywords related to "thymectomy", "anesthesia", "mediastinal mass", and "myasthenia gravis". The inclusion criteria include prospective studies, retrospectives, systematic reviews, meta-analyses, and case reports (2019–2025), as well as one 2013 case report. Out of 450 publications, 30 articles met the PRISMA criteria and were analyzed narratively. Results: Comprehensive preoperative evaluation was the main determinant of anesthesia success in patients with neuromuscular and mediastinal mass disorders. Anesthesia techniques without muscle relaxants or with propofol TCI/sevoflurane have been shown to provide better neuromuscular stability. Sugammadex produces a faster and safer reversal than neostigmine. In large mediastinal masses, special strategies such as awake intubation, spontaneous ventilation, double-lumen tube, or ECMO readiness reduce the risk of airway collapse. Minimally invasive techniques (VATS/robotics) show faster recovery and lower complications, especially when combined with advanced respiration monitoring. Discussion & Conclusion: The success of thymectomy anesthesia relies heavily on three pillars: thorough preoperative evaluation, risk-based individualized anesthesia techniques, and rigorous intraoperative monitoring. Innovations such as sugammadex, spontaneous ventilation, and advanced monitoring technology improve safety and speed up recovery. In resource-limited settings, strong clinical skills and teamwork enable effective outcomes with minimal technology.

Page 34 of 36 | Total Record : 358

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