Jurnal Komplikasi Anestesi
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.
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358 Documents
<![CDATA[The Use of Surgical Apgar Score as a Predictor of Postoperative ICU Admission ]]>
<![CDATA[Nugroho, Stefanus Danan]]>;
<![CDATA[Jufan, Akhmad Yun]]>;
<![CDATA[Fajar Apsari, Ratih Kumala]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v13i1.25449
<![CDATA[Background: Postoperative Intensive Care Unit (ICU) care can improve outcomes in high-risk surgical patients. The Surgical Apgar Score (SAS) was developed to predict postoperative morbidity and mortality; however, its ability to predict ICU admission remains unclearObjective: To evaluate the utility of the SAS as a predictor of postoperative ICU admission.Methods: This prospective cohort study included 314 surgical patients at Dr. Sardjito General Hospital between June and July 2025. Data on demographics, preoperative status, intraoperative variables (including the SAS), ICU admission, and postoperative mortality were analyzed using both bivariate and multivariate methods.Results: Lower SAS scores were significantly associated with an increased risk of postoperative ICU admission in multivariate analysis, particularly in SAS categories 0–2 (OR 326.45; p = 0.016) and 5–6 (OR 47.39; p = 0.037). The ROC curve of SAS for predicting postoperative ICU admission yielded an AUC of 0.701 (p = 0.001; 95% CI: 0.62–0.78) with a cut-off value of 6.5. Neurosurgical and vascular thoracic procedures, cardiovascular comorbidities, intraoperative vasopressor use, and surgical duration greater than 2 hours were also strong predictors of postoperative ICU admission. The postoperative mortality rate was 3.5%, mainly associated with surgical duration exceeding 6 hours (predictive factor) and other types of surgery (protective factor). The SAS, with clinical factors such as procedure type, comorbidities, and surgical duration, may help guide the decision for postoperative ICU admissionConclusion: The SAS is a useful tool for predicting postoperative ICU requirements.]]>
<![CDATA[PROTEINURIA SEBAGAI PREDIKTOR GAGAL GINJAL AKUT PADA PASIEN INTENSIVE CARE UNIT RSUP DR. SARDJITO ]]>
<![CDATA[Ihsan, Ismail]]>;
<![CDATA[Retno Wisudarti, Calcarina Fitriani]]>;
<![CDATA[Jufan, Ahmad Yun]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 12 No 3 (2025) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v12i3.25676
<![CDATA[Background: Acute kidney injury (AKI) accounts for 32–77% of mortality in intensive care unit (ICU) patients in Indonesia and increases the risk of death up to eightfold at Dr. Sardjito General Hospital. Patient outcomes are greatly influenced by early detection, but diagnosis still relies on serum creatinine, which only increases after severe kidney damage. Proteinuria has the potential to be an early predictor of AKI with simple, inexpensive, and rarely studied tests.Objective: To assess proteinuria as a predictor of AKI in ICU patients at Dr. Sardjito General Hospital, Yogyakarta.Subject and Methods: This prospective cohort study involved ICU patients who met the inclusion and exclusion criteria and were grouped based on proteinuria status. Data analysis was performed univariately (descriptive tables), bivariately (Chi-square/Fisher's Exact and Mann-Whitney tests), and multivariate (logistic regression) for variables with p < 0.25 at the bivariate stage. Model validation was performed using receiver operating characteristic (ROC) curve analysis to assess discriminatory ability and Hosmer–Lemeshow testing for model calibration.Result: Of the 187 patients screened, 151 patients met the criteria (median age 52 years; 47.7% male). Proteinuria was found in 51.7% of patients, with a AKI incidence of 10.6%. Bivariate analysis showed a significant association between proteinuria and AKI (19.2% vs. 1.4%; RR 14.04; p<0.001).]]>
<![CDATA[The Relationship Between the Time Elapsed from the Incident to Medical Management and the Outcome of Traumatic Brain Injury Patients Undergoing Craniotomy ]]>
<![CDATA[Agung Nugroho, Fauzi]]>;
<![CDATA[Adiyanto, Bowo]]>;
<![CDATA[Sudadi, Sudadi]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 12 No 3 (2025) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v12i3.27389
<![CDATA[Backgrround: Traumatic brain injury (TBI) is one of the leading causes of global morbidity and mortality, with treatment outcomes influenced by several factors, including treatment timing. Objective: This study aims to analyze the relationship between the duration from injury to initial medical management and the duration from injury to craniotomy surgery on the outcomes of TBI patients at RSUP Dr. Sardjito Yogyakarta, using the Glasgow Outcome Scale Extended (GOSE) as an assessment tool and Length of Stay (LOS).Subject and Method: This is a prospective observational study conducted on TBI patients treated at RSUP Dr. Sardjito from May to October 2024. Data were collected from the patients' electronic medical records who underwent craniotomy procedures. The analysis was performed using regression tests to evaluate the impact of the duration between the incident and initial medical management, as well as the duration until craniotomy, on patient outcomes.Result: Among 71 included patients, the median age was 19 years (Q1: 7; Q3: 57), and 71.8% were male. Most patients (52.1%) presented with a GCS score of 13–15. GOSE outcomes showed good recovery in 28.2%, mild disability in 26.8%, slight disability in 9.9%, moderate disability in 21.1%, severe disability in 5.6%, and death in 8.4%, with a median length of stay of 10 days.]]>
<![CDATA[Perioperatif Operasi pada Fetus ]]>
<![CDATA[Raksawardana, Yusuf]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 12 No 3 (2025) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v12i3.27659
<![CDATA[Anesthetic risk is inversely proportional to age, with neonates having a higher risk of mortality and morbidity compared to adults. Understanding these differences is essential for appropriate perioperative evaluation, preparation, planning, and anesthetic management in neonatal and fetal surgery. Advances in prenatal diagnostic techniques have improved the accuracy of fetal anomaly detection, enabling timely surgical intervention when indicated. Fetal surgery includes minimally invasive procedures, open fetal surgery, and ex utero intrapartum treatment (EXIT) procedures. Surgical intervention is considered when congenital abnormalities threaten fetal survival or lead to severe postnatal morbidity.]]>
<![CDATA[Thoracic Segmental Spinal Anesthesia ]]>
<![CDATA[Simanjuntak, Alvina]]>;
<![CDATA[Sudadi, Sudadi]]>; Mahmud
<![CDATA[ Jurnal Komplikasi Anestesi Vol 12 No 3 (2025) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v12i3.27699
<![CDATA[Thoracic segmental spinal anesthesia (TSSA) is a regional anesthesia technique that is increasingly used as an alternative to general anesthesia, especially for high-risk patients undergoing abdominal and thoracic surgeries. TSSA offers significant benefits, including better hemodynamic stability and a reduction in postoperative side effects such as nausea, vomiting, and respiratory depression. This technique also provides more optimal pain control and facilitates faster recovery, particularly in terms of postoperative mobilization and gastrointestinal function recovery. However, the use of TSSA requires a deep understanding of the relevant anatomy, physiology, and pharmacology to avoid complications such as iatrogenic injury or excessive spread of anesthesia. With the right understanding, TSSA can reduce the need for large volumes of local anesthetics, accelerate recovery, and deliver better outcomes in various surgical procedures. Further development of practice guidelines and research related to TSSA is also necessary to maximize its benefits in improving anesthesia safety and effectiveness in high-risk patients.]]>
<![CDATA[Management of Failed Spinal Anesthesia ]]>
<![CDATA[Hastuti, Wiji]]>;
<![CDATA[Fajar Apsari, Ratih Kumala]]>;
<![CDATA[Sudadi, Sudadi]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v13i1.27741
<![CDATA[The management of failed spinal anesthesia is a significant challenge in surgical procedures. Spinal anesthesia failure can occur either partially or totally, often leading to conversion to general anesthesia, which adds clinical risks and potential complications. The aim of this study is to evaluate the factors contributing to spinal anesthesia failure and identify effective management strategies. The study found that factors such as patient positioning, anesthesiologist experience, the number of attempts, and patient BMI significantly influenced spinal block success. Total spinal anesthesia failure often requires conversion to general anesthesia, whereas partial failures can be managed with adjuvant medications or repeated procedures. Understanding the management of failed spinal anesthesia is essential for providing safe and effective care]]>
<![CDATA[Transesophageal Echocardiography–Derived Renal Resistive Index after Cardiopulmonary Bypass: A Novel Hemodynamic Marker of Postoperative Renal Vulnerability ]]>
<![CDATA[Parna, Dian Raseka]]>;
<![CDATA[Kurniawaty, Juni]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v13i1.27983
<![CDATA[Acute kidney injury (AKI) remains a frequent and clinically significant complication following cardiopulmonary bypass (CPB), often developing despite apparently stable systemic hemodynamics. Conventional renal monitoring relies on delayed biochemical markers that fail to capture early disturbances in renal microcirculation. The renal resistive index (RRI) has emerged as a dynamic indicator of renal vascular resistance and microcirculatory stress, but its perioperative application has been limited by the practicality of transabdominal ultrasonography. Transesophageal echocardiography (TEE), routinely used during cardiac surgery, offers a unique opportunity for real-time assessment of renal hemodynamics during and immediately after CPB. This literature review synthesizes current evidence on the feasibility, physiological basis, and clinical relevance of TEE-derived RRI measurement in the post-CPB setting. The reviewed studies suggest that elevated RRI values reflect a complex interaction of renal vascular resistance, venous congestion, altered pulsatility, and inflammatory endothelial dysfunction rather than isolated reductions in renal blood flow. Importantly, RRI elevation frequently precedes changes in serum creatinine or urine output and has been associated with an increased risk of postoperative renal dysfunction, even in patients without overt hypotension or low cardiac output. TEE-derived RRI therefore represents a promising, underutilized hemodynamic marker for early identification of postoperative renal vulnerability and may support more proactive, organ-protective hemodynamic management strategies following cardiopulmonary bypass]]>
<![CDATA[Risk Factors Associated with Morbidity and Mortality after Cervical Spine Injury at Dr Sardjito General Hospital ]]>
<![CDATA[Nashiruddin, Nashiruddin]]>;
<![CDATA[Fajar Apsari, Ratih Kumala]]>;
<![CDATA[Jufan, Akhmad Yun]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v13i1.28419
<![CDATA[Background: Cervical injury is a form of spinal cord trauma with high morbidity and mortality rates, especially in developing countries. Identifying risk factors is essential for prevention strategies, management, and improved patient outcomesObjective: This study aims to observe the effect of listening to music on the anxiety level of surgical patients undergoing subarachnoid block anesthesia. To analyze risk factors of cervical injury related to morbidity and mortality, and to present the demographic profile of cervical injury cases at Dr Sardjito General HospitalMethods: This study employed a retrospective case-control design involving 127 patients with cervical injury treated at Dr Sardjito General Hospital, Yogyakarta, from January 1, 2022, to December 31, 2024. Data were collected from medical records and analyzed using bivariate analysis (Fisher’s exact test). A p-value <0.05 was considered statistically significant.Results: The majority of patients were male (88.2%) with an average age of 50.57 years. The most common trauma mechanisms were falls from height (45.7%) and traffic accidents (44.9%). Severe disability as morbidity was experienced by 41.7% of patients, while mortality reached 31.5%. Risk factor analysis for morbidity did not find any variables significantly associated with clinical outcomes (P>0.05). Length of stay (LOS) was significantly associated with morbidity (p=0.001). Significant risk factors for mortality included respiratory comorbidity (OR 4.50; p=0.004)Conclusion: ASIA score, prolonged ventilator use, and tracheostomy were identified as risk factors for mortality in cervical injury patients at Dr Sardjito General Hospital. No statistically significant risk factors were found to be associated with morbidity]]>
<![CDATA[Comparing Sniffing Position Between Inflatable Vs Fixed Pillow for Glottic Visualization during Laryngoscopy ]]>
<![CDATA[Adiyanto, Bowo]]>;
<![CDATA[Ikhwandi, Arif]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 1 (2025) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v13i1.28464
<![CDATA[Background: Effective glottic visualization is crucial for successful tracheal intubation and reducing complications during airway management. The sniffing position is commonly used, with various pillow types employed to optimize the alignment of the airway axes. We performed a study to evaluate the effectiveness of an inflatable intubation pillow for glottic visualization, intubation time, and first-attempt intubation success.Objective: We performed a study to evaluate the effectiveness of an inflatable intubation pillow for glottic visualization, intubation time, and first-attempt intubation success.Methods: A randomized controlled trial was conducted with 222 patients undergoing general anesthesia and endotracheal intubation at Dr. Sardjito General Hospital, Yogyakarta. Patients were randomly assigned to two groups: Group I (inflatable pillow) and Group S (fixed pillow). The primary outcome was glottic visualization, assessed using the Cormack–Lehane score, while secondary outcomes included intubation time and the number of intubation attempts. Multivariate analyses adjusted for potential confounders such as BMI, sex, and age.Results: The inflatable pillow group showed a higher proportion of grade 1 glottic visualization (64%) compared to the fixed pillow group (55%), but this difference was not statistically significant after adjusting for confounders. The inflatable pillow group demonstrated a significantly shorter intubation time (35 seconds) compared to the fixed pillowConclusion: The use of an inflatable pillow in the sniffing position significantly reduced intubation time, improving procedural efficiency. However, it did not show a significant improvement in glottic visualization or first-attempt intubation success after adjusting for confounding factors. BMI was the primary determinant of glottic visualization]]>
<![CDATA[Opioid-free Anesthesia Technique in Laparoscopic Hysterectomy: A Case Report ]]>
<![CDATA[Islami Monika, Tesha]]>;
<![CDATA[Sukmapradipta, Michael]]>;
<![CDATA[Jasmine, Nabila]]>;
<![CDATA[Antonius, Jonathan]]>;
<![CDATA[Sulistio, Maria Edith]]>
<![CDATA[ Jurnal Komplikasi Anestesi Vol 13 No 2 (2026) ]]>
Publisher : <![CDATA[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 ]]>
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DOI: 10.22146/jka.v13i2.14681
<![CDATA[Background: The use of opioid-free anesthesia techniques is increasingly recognized in efforts to reduce the risk of opioid-related postoperative side effects. Case: This case report describes the use of opioid-free anesthesia technique in laparoscopic hysterectomy in a 50-year-old woman with multiple myomas. The patient had a history of fentanyl allergy and was classified as ASA I. Anesthesia induction was performed with a combination of dexmedetomidine, ketamine, and rocuronium, maintained with sevoflurane, rocuronium, and lidocaine. The patient did not experience any complications during postoperative monitoring.Discussion: This case highlights that an opioid-free anesthesia approach can be safely implemented in patients with opioid allergies. The combination of dexmedetomidine, ketamine, and lidocaine provides adequate analgesia and hemodynamic stability, supporting its role as an effective alternative to opioid-based anesthesia Conclusion: This anesthesia technique demonstrates good pain control without the use of opioids and minimizes opioid-related side effects]]>
