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Jurnal Anestesi Perioperatif
Published by Universitas Padjadjaran
ISSN : 23377909     EISSN : 23388463     DOI : 10.15851/jap
Core Subject : Health, Education,
Education Health Professions
Jurnal Anestesi Perioperatif (JAP)/Perioperative Anesthesia Journal is to publish peer-reviewed original articles in clinical research relevant to anesthesia, critical care, case report, and others. This journal is published every 4 months with 9 articles (April, August, and December) by Department of Anesthesiology and Intensive Care Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung.
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Search results for , issue "Vol 13, No 3 (2025)" : 9 Documents clear
Hemodynamic Effects of Phenylephrine 100 µg versus Ephedrine 5 mg During Propofol-Induced General Anesthesia: A Randomized Study Sibarani, Nicholas Hamonangan; Lubis, Andriamuri Primaputra; Bangun, Chrismas Gideon; Yunanda, Yuki
Jurnal Anestesi Perioperatif Vol 13, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n3.4454

Abstract

Background: Propofol is widely used for induction of general anesthesia; however, it frequently associated hypotension due to vasodilation and myocardial depression. Vasopressors such as phenylephrine and ephedrine are commonly administered to counteract this effect, but evidence comparing their hemodynamic efficacy during induction remains limited.Methods: This randomized double-blind clinical trial included 80 patients undergoing elective surgery under general anesthesia. Patients were randomly allocated into two groups to receive either phenylephrine 100 µg or ephedrine 5 mg at the time of propofol induction. Demographic characteristics (sex, age, body mass index, and ASA physical status) were recorded. Hemodynamic parameters, including systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate, were measured after premedication and 30 seconds following propofol administration.Results: Baseline characteristics were comparable between the two groups. At 30 seconds after induction, there were no statistically significant differences in systolic blood pressure, diastolic blood pressure, mean arterial pressure, or heart rate between the phenylephrine and ephedrine groups. Both vasopressors effectively maintained hemodynamic stability during propofol induction.Discussion: The findings suggest that phenylephrine and ephedrine have similar hemodynamic profiles when administered during propofol induction. Despite their differing pharmacological mechanisms, both agents were equally effective in preventing early hypotension without significant differences in heart rate or blood pressure responses.Conclusion: Phenylephrine 100 µg and ephedrine 5 mg demonstrated comparable efficacy in maintaining hemodynamic stability during propofol-induced general anesthesia, with no significant difference in their ability to prevent hypotension.
Comparison between Local Infiltration Combination of 1% 200 mg Lidocaine and 10 mg Dexametason with 0.75% 150 mg Ropivacaine on Degree of Pain in Post-Caesarian Operative Wounds Simamora, Veronica; Bangun, Chrismas Gideon; Hamdi, Tasrif; Harahap, Juliandi
Jurnal Anestesi Perioperatif Vol 13, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n3.3673

Abstract

Introduction: Local anesthetic wound infiltration reduces postoperative pain, promotes early mobilization, and shortens hospital stay after cesarean section. Lidocaine is widely used, and the addition of dexamethasone may prolong its analgesic effect. Ropivacaine provides longer-lasting analgesia but is more expensive and less accessible in many hospitals. This study aimed to compare the analgesic effects of local wound infiltration using 0.75% ropivacaine 150 mg versus 1% lidocaine 200 mg combined with 10 mg dexamethasone on postoperative pain following cesarean section.Methods: This randomized, double-masked, controlled clinical trial involved 38 patients undergoing cesarean section under spinal anesthesia. Participants were randomly allocated using a computer-generated sequence to receive wound infiltration with either 1% lidocaine (200 mg) plus dexamethasone (10 mg) or 0.75% ropivacaine (150 mg). Patients and outcome assessors were blinded to group allocation. Postoperative pain intensity was assessed using the Numeric Rating Scale (NRS) at rest and during passive movement at 2, 6, 12, and 24 hours after surgery.Results: The ropivacaine group had significantly lower NRS scores at rest and during passive movement at 2, 6, and 12 hours postoperatively compared with the lidocaine–dexamethasone group (p < 0.05). At 24 hours after surgery, no significant difference in pain intensity was observed between groups (p>0.05).Conclusion: Local wound infiltration with 0.75% ropivacaine 150 mg provided superior analgesia during the first 12 hours after cesarean section compared with lidocaine combined with dexamethasone. The lidocaine–dexamethasone combination remains a practical alternative where ropivacaine is unavailable.
Efek Analgesia Pemberian Lidokain 2,64% Teralkalinisasi dalam Alkohol 70% Secara Topikal Sebelum Flebotomi Huka, Joel Apriyanto Fejacreyo; Angkejaya, Ony Wibriyono; Tuahuns, Achmad; Devi, Cokorda Istri Arintha; Hataul, Is Ikhsan; Lilihata, Jilientasia
Jurnal Anestesi Perioperatif Vol 13, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n3.4054

Abstract

Background: Phlebotomy is an essential procedure in healthcare, but it often causes pain due to its invasive nature. Although lidocaine is effective as a local anesthetic, the injectable formulation and low pH may induce pain before the anesthetic effect begins. Therefore, alkalinized lidocaine administered topically is considered a potential alternative to reduce pain and accelerate anesthetic onset. This study is essential to evaluate the effectiveness of this approach. This research aimed to assess the effect of 2.64% alkalinized lidocaine in 70% alcohol, applied topically, on phlebotomy pain levels, measured using the Numeric Rating Scale (NRS).Methods: This study employed a single-masked randomized controlled trial (RCT) with a posttest-only control group design. Samples were obtained via simple random sampling, yielding 20 paired samples from 135 eligible participants. On the first day, participants underwent phlebotomy after the application of alkalinized lidocaine, and on the tenth day, phlebotomy was repeated using 70% alcohol as the control. Pain was measured using the NRS and analyzed using the Wilcoxon test.Results: NRS scores in the control group were significantly higher than those in the experimental group, with a p-value of 0.001.Discussion: Alkalinized lidocaine effectively reduced phlebotomy pain, likely due to an increased non-ionic fraction that enhances tissue penetration and accelerates anesthetic onset. These findings align with existing literature, although generalization remains limited by the small sample size and single-masked design.Conclusion: Topically applied 2.64% alkalinized lidocaine in 70% alcohol is effective in reducing pain associated with phlebotomy.
Red Cell Distribution Width to Albumin Ratio versus Red Cell Distribution Width to Platelet Ratio as Predictors of 28-Day Mortality in Sepsis Patients Admitted to the Intensive Care Unit Ningsih, Diana Fitria; Pison, Osmond Muftilov; Suwarman, Suwarman; Maskoen, Tinni T.; Oktaliansah, Ezra; Aditya, Ricky
Jurnal Anestesi Perioperatif Vol 13, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n3.4638

Abstract

Background: Sepsis is a leading cause of mortality in the Intensive Care Unit (ICU). Early identification of high-risk patients requires simple and accessible prognostic biomarkers. The Red Cell Distribution Width to Albumin Ratio (RAR) and Red Cell Distribution Width to Platelet Ratio (RPR) have been proposed as potential biomarkers.Methods: This prospective cohort study was conducted in the ICU of Dr. Hasan Sadikin General Hospital, Bandung, from July to September 2025, involving 71 subjects who met the Sepsis-3 criteria. RAR and RPR values were calculated from blood tests within the first 24 hours of ICU admission. The primary outcome was 28-day mortality. Statistical analysis used the Receiver Operating Characteristic (ROC) curve to determine the cut-off value, sensitivity, specificity, and Area Under the Curve (AUC). The AUC comparison between RAR and RPR was analyzed using the DeLong test.Results: A total of 41 patients (57.7%) experienced 28-day mortality. The optimal cut-off value for RAR was 5.7404 (Sensitivity 85.4%; Specificity 73.3%) with an AUC of 89.3% (95% CI: 79.8–95.4%). The optimal cut-off value for RPR was 0.0627 (Sensitivity 75.6%; Specificity 76.7%) with an AUC of 74.7% (95% CI: 63.0–84.3%). RAR had a significantly better discriminatory value than RPR (p=0.026).Discussion: The RAR value is a better predictor of 28-day mortality than the RPR value in septic patients treated in the ICU.Conclusion: RAR can be considered a simple and effective prognostic tool for the early risk stratification of septic patients.
Peritonsillar Block as a Treatment for Post-Tonsillectomy Pain in Pediatric Patients with a History of OSA Merry, Merry; Adi, Made Septyana Parama
Jurnal Anestesi Perioperatif Vol 13, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n3.4159

Abstract

Background: Postoperative pain remains one of the most common and distressing complaints following tonsillectomy in children. Among the various strategies explored, regional anesthesia techniques have gained attention for their ability to provide targeted analgesia with minimal systemic side effects. Our objective is to evaluate the effectiveness of ropivacaine and dexamethasone in controlling postoperative pain in children undergoing tonsillectomy, with a focus on its potential to improve recovery outcomes and patient satisfaction.Case: This case involved an 8-year-old male patient who exhibited classic symptoms of OSA, who underwent tonsillectomy procedure. In the anesthetic management, the patient received premedication with midazolam, ondansetron, and intravenous paracetamol. Induction was achieved using propofol, fentanyl, and atracurium, while anesthesia maintenance was provided with Sevoflurane. Prior to extubation, bilateral injections of ropivacaine and dexamethasone were administered in the peritonsillar fossae. Postoperative pain assessments indicated mild pain, with no occurrence of nausea or vomiting. The patient was discharged one day after surgery with manageable pain.Discussion: This case highlights the potential benefit of pre-extubation peritonsillar infiltration with 0.2% ropivacaine (3 mL) and dexamethasone for postoperative pain control. This multimodal, opioid-sparing approach may reduce central sensitization, minimize opioid-related adverse effects, and improve postoperative recovery. Although recent evidence suggests ropivacaine provides superior analgesia at 24 hours compared with bupivacaine, variability in pain timing underscores the need for further research on optimal administration strategies.Conclusion: This case highlights the effectiveness of ropivacaine and dexamethasone in controlling postoperative pain in children.
KORELASI NILAI OPTICAL NERVE SHEATH DIAMETER DENGAN LENGTH OF STAY ICU PADA PASIEN PASCABEDAH OTAK DI RSUP HASAN SADIKIN BANDUNG Wardana, Artha Wahyu; Sudjud, Reza Widianto; Aditya, Ricky
Jurnal Anestesi Perioperatif Vol 13, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n3.3986

Abstract

Background: Elevated intracranial pressure (ICP) is a common complication after craniotomy, often causing decreased consciousness, ventilator dependence, and prolonged ICU stay. Invasive ICP monitoring carries risks, while non-invasive methods such as optic nerve sheath diameter (ONSD) measurement via ultrasonography offer a promising alternative. This study aimed to examine the correlation between ONSD and ICU length of stay (LOS) in post-craniotomy patients.Methods: A prospective observational study was conducted at the ICU of Dr. Hasan Sadikin General Hospital, Bandung, from February to April 2024. Post-craniotomy patients admitted to the ICU were included. ONSD was measured 12–24 hours after ICU admission. Data collected included ONSD, demographics, preoperative clinical status, and ICU records. The relationship between ONSD and ICU LOS was analyzed using Pearson correlation and multivariable analysis.Results: Thirty-three patients were included (mean age 48.2 years; 60.6% male). Median preoperative GCS was 10.8, and 54.5% were ASA III/IV. ONSD correlated positively with ICU LOS (r = 0.636, p < 0.001). Multivariable analysis showed that ONSD ≥ 5.0 mm was independently associated with prolonged ICU stay (≥7 days) after adjusting for GCS and postoperative complications.Discussion: A larger ONSD, reflecting higher ICP, was moderately associated with longer ICU stay, suggesting that non-invasive ONSD measurement can serve as a useful marker for resource utilization. However, further studies with larger cohorts are needed to validate its predictive role.Conclusion: ONSD measurement is a reliable non-invasive parameter that shows a significant correlation with ICU length of stay in post-craniotomy patients.
Korelasi Penggunaan Metode ERACS terhadap Kualitas Hidup Ibu dan Anak di Rumah Sakit Bina Sehat Efendi, Erfan; Sisdayani, Alfina Galuh Hannie; Safitri, Athiyah Naura
Jurnal Anestesi Perioperatif Vol 13, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n3.3830

Abstract

Background: The Caesarean section (CS) rate has increased every year. However, this increase is not entirely due to medical indication. This phenomenon may put bot mothers and newborns at risk of short- and long-term complications associated with CS. Enhanced recovery after caesarean surgery (ERACS) is CS approach that incorporates preoperative, intraoperative, and postoperative. This study compared maternal and neonatal outcomes between ERACS and conventional caesarean delivery.Methods: A retrospective cohort study was conducted using medical records of caesarean deliveries at Bina Sehat Hospital, Jember (Sep tember2022–Aug 2023). Fifty ERACS and fifty conventional cases were included. Outcomes were early ambulation (≤12 h), length of stay (≤2 days), and good APGAR score (7–10) at 1 and 5 minutes. Data were analyzed using chi-square test.Results: Early ambulation (≤12 h) occurred in 38/50 ERACS VS 18/50 conventional cases. Leng of stay ≤2 days occurred in 40/50 ERACS vs 15/50 conventional cases. Good APGAR score in first minute 38/50 ERACS vs 37/50 conventional cases and in fifth minute 48/50 ERACS vs 49/50 conventional cases. The relationship between postoperative ambulation and length of stay is significant.Discussion: Preoperative, intraoperative, and postoperative modifications can accelerate patient mobilization after caesarean section. In addition, early ambulation improves various body functions related to metabolism. Theses factor has direct impact on postoperative ambulation and shorter length of stay.Conclusion: ERACS was associated with higher rate of early postoperative mobilization and shorter hospital length of stay compared with conventional caesarean delivery.
Perbedaan Frekuensi PVA (Patient Ventilator Asynchrony) Pada Beberapa Level Sedasi Pasien Kritis Ridwan, Romi; Suwarman, Suwarman; Kestriani, Nurita Dian Kestriani Dian
Jurnal Anestesi Perioperatif Vol 13, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n3.3987

Abstract

Background: Patient–ventilator asynchrony (PVA) is a frequent but often underrecognized phenomenon in mechanically ventilated patients, associated with adverse outcomes. Sedation depth is a modifiable factor affecting PVA, yet data from resource-limited ICUs remain scarce. This study aimed to evaluate PVA prevalence and its association with sedation depth and mechanical ventilation duration.Methods: A cross-sectional observational study included 60 adult ICU patients on mechanical ventilation. Ventilator waveform recordings were analyzed over 30-minute periods, totaling 41,372 breaths. PVA events were identified, classified, and quantified. Sedation depth was categorized as fully awake, light sedation, or deep sedation. Associations between sedation depth, PVA frequency, and mechanical ventilation duration were assessed using statistical tests.Results: A total of 2,539 PVA events were detected, yielding an overall asynchrony rate of 6.1%. Ineffective effort was most common (58%), followed by double triggering (17.2%) and flow asynchrony (15.3%). Mean PVA values increased significantly with deeper sedation (p<0.05). A weak but statistically significant positive correlation existed between average PVA and duration of mechanical ventilation (r=0.306, p<0.05).Discussion: PVA is prevalent in mechanically ventilated ICU patients, with ineffective effort predominating. Deeper sedation levels are associated with higher PVA frequency, which correlates with prolonged ventilation. These findings emphasize the need for careful sedation management and routine ventilator waveform monitoring to improve patient–ventilator interaction.Conclusion: Patient–ventilator asynchrony is common and significantly associated with sedation depth and ventilation duration. Optimized sedation and vigilant waveform monitoring may enhance synchrony and reduce ventilation time
Prognostic Value of Alactic Base Excess for 28 Day Mortality in Sepsis Patients: A Retrospective Prognostic Accuracy Study in an Intensive Care Unit Sulistiono, Paulus; Sudjud, Reza Widianto; Budipratama, Dhany
Jurnal Anestesi Perioperatif Vol 13, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n3.4591

Abstract

Introduction: Prognostication in sepsis is challenging. Serum lactate is widely used but cannot separate non-lactate contributions to metabolic acidosis. Alactic Base Excess (ABE) provides a more complete assessment of acid–base status. This study assessed ABE’s value in predicting 28-day mortality in sepsis patients.Methods: A retrospective study included 109 adult sepsis patients meeting Sepsis-3 criteria with arterial blood gas analysis within 24 hours of ICU admission. ABE was calculated from base excess and lactate. Prognostic performance was evaluated using ROC analysis, and association with mortality was assessed using odds ratios (OR).Results: Of 109 patients, 59 (54.1%) died within 28 days. Non-survivors had more negative median ABE than survivors (-7.04 vs. -0.15; p<0.001). Optimal ABE cut-off was ≤ -4.1. Patients with ABE ≤-4.1 had a higher risk of mortality (OR 38.6; 95% CI: 13.2–112.9; p<0.001).Discussion: ABE showed strong prognostic performance, reflecting non-lactate metabolic acidosis not captured by lactate alone. As it is derived from routine arterial blood gas analysis, ABE is practical for early risk stratification in critically ill sepsis patients.Conclusion: ABE demonstrates excellent prognostic value for 28-day mortality in ICU sepsis patients. An ABE ≤-4.1 is linked to significantly higher mortality and may serve as a readily available biomarker for early risk assessment and timely clinical decisions.

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