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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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Articles 502 Documents
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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.
Association of Neuropathic Pain with Anxiety Severity in Cancer Patients: A Cross-Sectional Analytic Study Alfebrino, Alfebrino; Zainumi, Cut Meliza; Ihsan, Muhammad
Jurnal Anestesi Perioperatif Vol 14, No 1 (2026)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v14n1.4706

Abstract

Background: Pain and anxiety are highly prevalent interrelated symptoms in cancer patients; however, the relationship between specific pain mechanisms and anxiety severity remains insufficiently characterized. This study aimed to examine the association between mechanism-based pain classification and anxiety levels in cancer patients. Methods: A cross-sectional study was conducted among 103 cancer patients attending a tertiary pain clinic. Pain mechanisms were classified using the PainDETECT Questionnaire (PDQ) into nociceptive, unclear/mixed, or neuropathic categories. Anxiety severity was assessed using the Generalized Anxiety Disorder-7 (GAD-7) scale. Associations were analyzed using correlation tests, the Kruskal–Wallis test, and Fisher’s exact test, with p<0.05 considered statistically significant. Results: Neuropathic pain was the predominant mechanism (57.3%). Anxiety severity differed significantly across pain types (p=0.004), with patients experiencing neuropathic pain demonstrating higher mean GAD-7 scores (12.98) compared with unclear/mixed (11.82) and nociceptive pain (11.50) (p=0.009). Moderate-to-severe anxiety was present in 98.3% of patients with neuropathic pain. Younger age was weakly but significantly correlated with higher anxiety levels (r=–0.224; p=0.024). Discussion: The findings suggest that neuropathic pain contributes to a heavier psychological burden than other pain types. Younger age was also identified as a vulnerability factor for anxiety, potentially due to greater psychosocial impact in this age group. Conclusion: Pain mechanisms are significant predictors of anxiety in cancer patients, with neuropathic pain associated with greater psychological vulnerability. Younger patients also exhibit higher anxiety levels. These findings emphasize the clinical necessity of integrating psychological screening with mechanism-based pain assessment.
Perbandingan Nilai Diskriminasi Modified NUTRIC Score dan Skor APACHE II Terhadap Mortalitas 28 Hari Pada Pasien Sepsis Yang Dirawat Di ICU Mulyawan, Dadang; Pradian, Erwin; Zulfariansyah, Ardi
Jurnal Anestesi Perioperatif Vol 14, No 1 (2026)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v14n1.4027

Abstract

Introduction: Sepsis with malnutrition increases complications and mortality in ICU patients. The modified Nutrition Risk in Critically Ill (mNUTRIC) score assesses nutritional risk and predicts mortality, whereas APACHE II does not account for nutritional status. This study compared mNUTRIC and APACHE II for predicting 28–day mortality in ICU patients with sepsis. Methods: This prospective observational study was conducted from February to April 2024. Sepsis patients admitted during the study period were included. Discriminatory performance for predicting 28–day mortality was evaluated using the area under the receiver operating characteristic curve (AUROC). Comparison between scoring systems was performed using DeLong’s non–parametric test.Results: A total of 39 ICU patients were included. The mean mNUTRIC score was 4.44±2.23, and the mean APACHE II score was 17.59±5.28. The AUROC value was 0.825 for the mNUTRIC score and 0.789 for the APACHE II score. DeLong’s test showed that the mNUTRIC score had significantly better discrimination for predicting 28–day mortality than the APACHE II score (p=0.011).Discussion: mNUTRIC integrates nutritional and chronic health factors, capturing patients’ physiological reserve more comprehensively than APACHE II. Early identification of high–risk patients may guide targeted interventions and ICU resource allocation.Conclusion: The mNUTRIC score demonstrated superior discriminatory ability compared to the APACHE II score in predicting mortality among sepsis patients in the ICU. Incorporating nutritional risk assessment may improve mortality prediction and clinical decision–making in critically ill sepsis patients.
Correlation of Postoperative Cerebral Oxygen Saturation and Duration of Intensive Care Unit Stay Following Heart Valve Surgery Putri, Deby Yuliananda Rosa; Irina, Rr. Sinta; Tanjung, Qadri Fauzi
Jurnal Anestesi Perioperatif Vol 14, No 1 (2026)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v14n1.4034

Abstract

Background: Postoperative neurological complications and prolonged recovery are key concerns in heart valve surgery, and monitoring regional cerebral oxygen saturation (rScO₂) using Near–Infrared Spectroscopy (NIRS) offers a non–invasive way to assess cerebral oxygenation. This study aimed to evaluate the relationship between perioperative rScO₂ and ICU length of stay and its potential clinical significance.Methods: A cross–sectional, observational, analytic study was conducted in 48 patients undergoing heart valve surgery at Haji Adam Malik General Hospital, Medan. Regional cerebral oxygen saturation was measured at three time points: preoperative (T0), immediately postoperative (T1), and 8 hours post–extubation (T2).Results: Spearman correlation analysis revealed a significant negative relationship between right rScO₂ at T1 and ICU length of stay (r=–0.406; p=0.034), and similarly, left rScO₂ at T1 (r=–0.343; p=0.017), indicating that lower postoperative cerebral oxygenation correlates with longer ICU stays, emphasizing its potential clinical relevance.Discussion: These findings suggest that the immediate postoperative period may represent a critical window in which cerebral oxygenation reflects hemodynamic stability and early recovery trajectory. However, interpretation should be cautious due to the cross–sectional design, small sample size, and lack of adjustment for potential confounders, limiting causal inference.Conclusion: Lower immediate postoperative rScO₂ is associated with prolonged ICU length of stay, suggesting its potential role as an early indicator of recovery trajectory, although causal interpretation remains limited.
Tingkat Kepuasan Pasien Terhadap Pelayanan Anestesi Berdasarkan Rekomendasi American Society of Anesthesiologist di Rsup Dr. Hasan Sadikin Bandung Sitanggang, Ruli Herman; Tullah, Anay; Budipratama, Dhany
Jurnal Anestesi Perioperatif Vol 14, No 1 (2026)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v14n1.4597

Abstract

Background: Anesthesia services are an important component of patient–centered healthcare systems. Patient satisfaction is a key indicator of anesthesia service quality. The American Society of Anesthesiologists (ASA) recommendation questionnaire has been developed to assess patient satisfaction comprehensively.Methods: This descriptive study was conducted at Dr. Hasan Sadikin General Hospital, Bandung, from December to March 2025. A total of 384 patients aged 18–60 years who underwent general or regional anesthesia and met the inclusion criteria were included. Data were collected using a validated and reliable Indonesian version of the full ASA questionnaire. The assessed domains included provision of information and consent, attention and interpersonal relationships, and management of pain and postoperative nausea and vomiting (PONV).Results: The mean patient satisfaction level was 78.11%. Most patients reported being satisfied to very satisfied with anesthesia services. The highest satisfaction was observed in informed consent (78.8%) and overall anesthesia services (79.74%).Discussion: These findings suggest that anesthesia services were generally well perceived, particularly in communication and consent processes. Effective perioperative pain and PONV management likely contributed to positive evaluations. However, satisfaction levels below 80% indicate the need for continuous quality improvement, especially in enhancing interpersonal communication and individualized care.Conclusion: Patients rated anesthesia services as good. The ASA questionnaire is a useful tool for ongoing evaluation and quality improvement of anesthesia care.
Effect of Transversus Abdominis Plane Block with Dexmedetomidine and Clonidine on Numerical Rating Scale and Interleukin–6 Heryadi, Mohamad Ismu; Purnomo, Heri Dwi; Arianto, Ardana Tri
Jurnal Anestesi Perioperatif Vol 14, No 1 (2026)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v14n1.4000

Abstract

Background: The use of adjuvants like dexmedetomidine and clonidine in Tranversus Abdominis Plane (TAP) blocks can enhance analgesic effects. This study aimed to compare the impact of these adjuvants on TAP blocks by measuring postoperative pain using the numerical rating scale (NRS) and interleukin-6 (IL-6) levels.Methods: This study was conducted from January to April 2024 at the Central Surgical Installation of Dr. Moewardi using a double-masked randomized controlled trial design. The study involved 30 patients undergoing cesarean section, divided into two groups: Group A (15 received a TAP block with dexmedetomidine 0.5 mcg/kgBB) and Group B (15 received a TAP block with clonidine 0.5 mcg/kgBB).Results: Independent tests revealed significant differences in NRS and IL-6 levels between the groups (p<0.001), indicating that dexmedetomidine is superior at preventing NRS and IL-6 elevation.Discussion: Conventional epidural opioids effectively manage pain but cause significant side effects and serious risks, including delayed respiratory depression in mothers and adverse effects on breastfed infants, necessitating alternative approaches. TAP block with dexmedetomidine and clonidine adjuvants demonstrated significant effectiveness in reducing postoperative pain, with dexmedetomidine proving superior in prolonging analgesia duration, decreasing rescue medication requirements, and reducing opioid consumption through its anti-inflammatory effects.Conclusion: These findings highlight the positive effects of dexmedetomidine in reducing postoperative inflammation and pain. The results provide grounds for considering dexmedetomidine as an adjuvant in TAP blocks to enhance effective postoperative pain management.
Superior Vena Cava Obstruction After Pediatric Cardiac Surgery: A Case Series Synthana, Meta Restu; Wisudarti, Calcarina Fitriani Retno; Kurniawaty, Juni; Deviatika, Fiandila Elvana
Jurnal Anestesi Perioperatif Vol 14, No 1 (2026)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v14n1.4510

Abstract

Background: Superior vena cava (SVC) obstruction is a rare but potentially life–threatening complication following pediatric cardiac surgery, particularly in patients with congenital heart disease. Mechanical factors related to central venous catheterization and underlying venous anomalies may increase the risk of this condition.Case: We reported a case series of three pediatric patients who developed postoperative SVC obstruction following corrective cardiac surgery and were managed in the intensive care unit (ICU). All patients underwent insertion of a central venous catheter (CVC) via the internal jugular vein for perioperative hemodynamic support. Postoperatively, all patients developed clinical manifestations consistent with SVC obstruction, including facial and upper extremity edema, venous congestion, hemodynamic instability, and reduced urine output. Vascular ultrasonography confirmed partial to severe SVC obstruction in all cases. Two patients had associated anatomical variations, including a persistent left SCV, which may have contributed to altered venous drainage. Management strategies included CVC repositioning or removal, anticoagulation therapy, and surgical release of the obstruction when indicated. These interventions resulted in clinical and hemodynamic improvement in all affected patients.Discussion: This case series highlights the importance of recognizing mechanical and anatomical risk factors for SVC obstruction in pediatric cardiac surgery, including catheter size, tip position, and congenital venous anomalies.Conclusion: careful selection of CVC size, optimal tip placement, and ultrasound guidance for catheter positioning and postoperative assessment may help prevent this serious complication. Early diagnosis and timely intervention are essential to reduce morbidity and improve outcomes in this vulnerable population.
Mortality Outcomes Associated with Blood Group O Versus Non-O in Patients Undergoing Coronary Artery Bypass Grafting Oktaliansah, Ezra; Maskoen, Tinni T.; Oey, Bernadeth; Suwarman, Suwarman; Pradian, Erwin; Zulfariansyah, Ardi
Jurnal Anestesi Perioperatif Vol 14, No 1 (2026)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v14n1.4640

Abstract

Background: Coronary artery bypass grafting (CABG) carries an operative mortality of 1–7%. Von Willebrand factor (vWF) levels are approximately 30% lower in individuals with blood group O compared to non–O groups, potentially influencing post–CABG mortality. This study aimed to compare mortality between blood group O and non–O in adult patients after on–pump CABG in the ICU.Methods: A retrospective cohort study was conducted using secondary data from medical records of adult patients (>18 years) who underwent elective on–pump CABG in the ICU at Dr. Hasan Sadikin General Hospital, Bandung. A sample of 64 patients was required, with a 28–day follow–up post–CABG. Data were analyzed using unpaired t–tests, Mann–Whitney tests, Chi–square, and Fisher’s exact tests, with significance set at p<0.05, using SPSS version 26.0.Results: A total of 129 patients were included, comprising 64 patients with blood group O and 65 with non–O blood groups. Mortality in blood group O patients was 10.9% (7/64), compared with 29.2% (19/65) in non–O patients, a significant difference (p=0.010). Non–O blood group patients had nearly three times higher risk of mortality compared to those with blood group O.Discussion: The observed mortality differences are related to variations in vWF and factor VIII levels among blood groups. Lower vWF levels in blood group O may provide a protective effect against macro–thrombosis in coronary grafts, whereas higher factor VIII levels in non–O groups increase the risk of microvascular thrombosis and secondary myocardial ischemia after on–pump CABG.Conclusion: Adult patients undergoing on–pump CABG with non–O blood groups experience significantly higher mortality compared to those with blood group O. Blood group may be associated with postoperative mortality. However, its role as an independent prognostic factor requires further investigation.

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