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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.
Arjuna Subject : -
Articles 493 Documents
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ANALISIS HUBUNGAN EARLY WARNING SCORE (EWS) DENGAN KEJADIAN IN HOSPITAL CARDIAC ARREST (IHCA) : STUDI RETROSPEKTIF DI RS PENDIDIKAN UTAMA Listiarini, Dian Ayu; Yulianti, Suryani; Alfaruq, Ahmad Umar; Safira, Alya
Jurnal Anestesi Perioperatif Vol 13, No 2 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n2.4062

Abstract

Henti jantung saat masih menjadi penyebab utama kematian di dunia. Kejadian in-hospital cardiac arrest (IHCA) perlu dideteksi sedini mungkin oleh tenaga kesehatan agar dapat segera dilakukan penaganan. Salah satu instrumen yang digunakan untuk mendeteksi perubahan klinis pasien ialah early warning sign (EWS). Nilai EWS yang tinggi dikaitkan dengan peningkatan risiko terjadinya IHCA. Penelitian ini bertujuan untuk menganalisis hubungan antara EWS dan kejadian IHCA di RS Islam Sultan Agung Semarang. Penelitian ini merupakan studi retrospektif dengan desain cross sectional menggunakan data sekunder dari rekam medis pasien di RS Islam Sultan Agung Semarang periode Mei–Juli 2023. Sebanyak 110 subjek pada penelitian ini diperoleh melalui metode non probability sampling dengan teknik consecutive sampling. Analisis data dilakukan menggunakan uji spearman untuk menilai hubungan dan keeratan antar variabel. Hasil penelitian menunjukan bahwa pasien dengan EWS risiko tinggi (skor>7) memiliki hubungan yang signifikan terhadap kejadian IHCA (p<0,001) dengan keeratan sedang (r=0,638). Temuan ini menunjukan bahwa pasien dengan skor EWS>7 berisiko tinggi mengalami IHCA. 
Blokade Peribulbar dengan Adjuvan Fentanil: Efek Hemodinamik dan Analgetik pada Vitrektomi Yadi, Dedi Fitri; Nadya, Siti Fairuz; Halimi, Radian Ahmad; Tavianto, Doddy; Pradian, Erwin; Fuadi, Iwan
Jurnal Anestesi Perioperatif Vol 13, No 2 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n2.4413

Abstract

Operasi vitrektomi membutuhkan analgesia adekuat dan stabilitas hemodinamik, terutama pada pasien usia lanjut dengan komorbiditas. Ropivakain adalah anestesi lokal yang umum digunakan untuk blokade peribulbar, namun kualitas bloknya dapat ditingkatkan dengan penambahan opioid seperti fentanil. Studi ini merupakan penelitian pertama yang membandingkan efektivitas ropivakain 0,75% dengan kombinasi ropivakain 0,75% dan fentanil 3 μg/mL pada tekanan darah dan kualitas analgesia pada operasi vitrektomi. Desain penelitian ini adalah single blind randomized controlled trial yang melibatkan 54 pasien yang menjalani vitrektomi. Penelitian dibagi menjadi dua kelompok yang masing-masing terdiri 27 pasien: kelompok R yang menerima ropivakain 0,75% dan kelompok RF yang menerima ropivakain 0,75% dan fentanil 3 μg/ml. Tekanan darah sistolik, diastolik, MAP, serta kualitas analgesia (NRS) diukur pada tiga waktu yaitu sebelum, selama dan setelah operasi. Analisis statistik menggunakan uji t tidak berpasangan, Mann Whitney dan Chi-Square. Hasil penelitian menunjukkan bahwa tidak terdapat perbedaan bermakna dalam perubahan tekanan darah sistolik, diastolik, dan MAP antara kedua kelompok (p>0,05). Kualitas analgesia yang dinilai menggunakan NRS juga tidak menunjukkan perbedaan signifikan (p>0,05). Kesimpulan penelitian ini adalah kombinasi ropivakain 0,75 % dan fentanil 3 mcg/ml memberikan hasil yang sebanding dengan ropivakain 0,75 % saja dalam hal stabilitas hemodinamik dan kualitas analgesia pada operasi vitrektomi.
Faktor Risiko Komorbid pada Mortalitas Sepsis Pramono, Ardi; Maryani, Nova; Wardhani, Ufita Dauma Ummi Nusuka; Ramadhan, Muhammad Tahfiz; Afaki, Sajida Fihrisa
Jurnal Anestesi Perioperatif Vol 13, No 2 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n2.4426

Abstract

Sepsis merupakan disfungsi organ yang disebabkan oleh respons berlebihan tubuh terhadap infeksi dan dapat mengancam jiwa. Secara global, insiden sepsis di rumah sakit mencapai 189 kasus per 100.000 orang per tahun dengan tingkat moralitas 26,7%. Salah satu faktor yang dapat memengaruhi luaran pasien adalah komorbiditas. Penelitian observasional analitik dengan desain potong lintang dilakukan untuk menilai faktor risiko komorbid yang berhubungan dengan kematian pasien sepsis di Rumah Sakit PKU Muhammadiyah Gamping pada tahun 2022–2023. Berdasarkan data rekam medik diperoleh 55 subjek dengan sepsis, baik yang meninggal maupun hidup, dengan komorbid meliputi gangguan paru, gangguan jantung, gangguan ginjal, gangguan saraf, dan diabetes mellitus. Analisis menggunakan uji chi-square menunjukkan bahwa dari lima faktor komorbid yang dianalisis, dua faktor berhubungan signifikan dengan mortalitas, yaitu gangguan paru dan gangguan ginjal (p<0,05).
Manajemen Anestesi Perioperatif Operasi Bypass Jantung pada Pasien dengan Fraksi Ejeksi 26 % dan Regurgitasi Aorta Berat Tanpomas, Irvan; Boom, Cindy Elfira
Jurnal Anestesi Perioperatif Vol 13, No 2 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n2.4452

Abstract

Penyakit jantung koroner (PJK) merupakan kondisi ketika suplai darah ke miokardium tidak optimal akibat pengerasan dan penyempitan arteri koroner, dan menjadi penyebab 26,4% kematian di Indonesia. Regurgitasi aorta adalah aliran balik darah pada fase diastole dari aorta ke ventrikel kiri yang terjadi akibat kegagalan koaptasi katup aorta, baik karena kelainan pada daun katup aorta maupun akar aorta. Kondisi ini menyebabkan beban volume berlebih pada atrium dan ventrikel kiri, meningkatkan tekanan ventrikel kiri, menimbulkan disfungsi ventrikel, serta mengurangi perfusi koroner. Laporan kasus ini membahas manajemen anestesi pada pasien laki-laki berusia 65 tahun dengan PJK dan regurgitasi aorta berat yang menjalani operasi bypass arteri koroner dan penggantian katup aorta di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita pada Maret 2025. Pasien dengan fraksi ejeksi rendah dan regurgitasi aorta memerlukan strategi anestesi yang cermat karena berisiko mengalami penurunan curah jantung, berkurangnya perfusi sistemik, serta perburukan kondisi hemodinamik. Operasi berlangsung selama 5,5 jam, pasien dipindahkan ke unit perawatan intensif, dilakukan ekstubasi 24 jam pascaoperasi, dan dirawat selama 4 hari di ruang intensif. 
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.

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