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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina Bali Journal of Anesthesiology ISM (Intisari Sains Medis) : Jurnal Kedokteran

Kadek Agus Heryana Putra, Kadek Agus

Bagian/SMF Ilmu Anestesi Dan Terapi Intensif RSUP Sanglah, Fakultas Kedokteran Universitas Udayana

Author-ID : 588655

Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Other

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Articles

CASE REPORT ANESTHETIC MANAGEMENT OF ADRENAL TUMOR RESECTION Widnyana, I Made Gede; Putra, Kadek Agus Heryana; Kurniyanta, Putu; Suarjaya, I Putu Pramana; Suranadi, I Wayan; Hartono, Budi
Bali Journal of Anesthesiology Vol 2, No 2 (2018)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v2i2.28

ABSTRACTThe adrenal glands are secretory organs that are located above each kidney and produce hormones that play a major role in the metabolic processes. Tumors of the adrenal gland can cause metabolic abnormalities associated with hormonal disorders such as Cushings syndrome, pheochromocytoma, or Conns syndrome. To be able to give a good anesthetic management on resection of the adrenal tumor, it requires adequate preoperative evaluation. However, this will take large resources. Management of anesthesia in adrenal tumor with an unknown hormonal disorder should consider a variety of hormonal abnormalities that may present in the patient so it can be anticipated effectively.Keywords: incidentaloma, adrenalectomy, hormonal disorder, perioperative

ANESTHESIA MANAGEMENT OF ESOPHAGEAL ATRESIA REPAIR SURGERY: A CASE REPORT Putra, Kadek Agus Heryana; Kurniyanta, Putu; Wiryana, Made; Sinardja, Ketut; Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Cindryani, Marilaeta; Kurnia, Prajnaariayi Prawira
Bali Journal of Anesthesiology Vol 2, No 2 (2018)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v2i2.31

ABSTRACTEsophageal Atresia (EA)is a congenital anomaly commonly found with TracheoesophagealFistula (TEF) of neonates in the first week oflife. This anomaly can cause several complications includingaspiration, reduction in respiration, and other complication from other concomitant congenital anomaly, mostly from heart origin. The treatment for this anomaly is surgery.Intraoperatively, thepatient may develop hypoxia due to lung retraction and hemodynamic instability from bleeding or hypothermia. Anesthesiologists play important role in the management of EA during theperioperative period. Careful examination of the preoperative period must be done to discover any other concomitant anomaly and complication. Good anticipation of any complication during surgery and continuous monitoring post surgery can elevate the prognosis of the patient.

The relationship between nutritional status based on nutritional risk index (NRI) and length of stay of digestive surgery patients Kusuma, Dian Reginalda; Putra, Kadek Agus Heryana; Kurniyanta, I Putu
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

ABSTRACTBackground: Malnutrition is a common concomitant illness that can be found in digestive surgery patients.The risk of malnutrition in digestive surgery patients is often overlooked even though malnutrition has beenknown to be associated with poor postoperative outcomes. The study aimed to analyze the relationship of nutritional status based on the Nutritional Risk Index (NRI) and length of stay of digestive surgery patientsin Sanglah General Hospital. Patients and Methods: The design of this study is an analytical cross-sectional using secondary data fromthe medical record of the digestive surgery patients in Sanglah General Hospital. Data on body weight andserum albumin level were used to identify the preoperative nutritional status of the patients based on NRI. Results: Of the 42 patients involved in this study, 54.8% of patients have poor nutritional status and the remainder 45.2% of patients have good nutritional status. The result of the statistical analysis showed asignificant relationship between nutritional status and length of stay. The result of the logistic regressiontest showed that the prevalence of long hospitalizations (≥11 days) were 5.2 times greater in digestivesurgery patients with poor preoperative nutritional status compared to patients with good nutritionalstatus. Conclusion: This study shows that poor nutritional status is a significant problem for digestive surgery patients and it is one of the factors that contribute to a longer hospital stay.

Perioperative anesthetic management in pediatric with pheochromocytoma tumor resection Thius, Adi Dharma; Kurniyanta, Putu; Putra, Kadek Agus Heryana; Sinardja, I Ketut
Bali Journal of Anesthesiology Vol 3, No 2 (2019)
Publisher : DiscoverSys Inc.

Pheochromocytomas (PCC) is rare neuroendocrine tumors which present as the malignant and familial features. These catecholamine-secreting tumors have triad classical symptoms of headache, sweating, and palpitation primarily due to the release of catecholamines and their metabolites in the body with hypertensive crisis become its predominant clinical symptoms. The excessive release of catecholamines may produce a life-threatening hemodynamic surge during the intraoperativeperiod, therefore preoperative preparation and intraoperative monitoring become an essential point. Nevertheless, postoperative care is also a critical issue in order to further curtail its morbidity and mortality rates.

Cost Minimization Analysis of Hypnotic Drug: Target Controlled Inhalation Anesthesia (TCIA) Sevoflurane and Target Controlled Infusion (TCI) Propofol Wiryana, Made; Aribawa, I Gusti Ngurah Mahaalit; Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Hartawan, I Gusti Agung Gede Utara; Sucandra, Made Agus Kresna; Parami, Pontisomaya; Putra, Kadek Agus Heryana; Sutawan, IB Krisna Jaya; Arimbawa, IGNA Putra; Jaya, Ketut Semara; Semarawima, Gede
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
Publisher : BALI MEDICAL JOURNAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (379.823 KB)

Background: Cost minimization analysis is a pharmaco-economic study used to compare two or more health interventions that have been shown to have the same effect, similar or equivalent. With limited health insurance budget from the Indonesian National Social Security System implementation in 2015, the quality control and the drug cost are two important things that need to be focused. The application of pharmaco-economic study results in the selection and use of drugs more effectively and efficiently. Objective: To determine cost minimization analysis of hypnotic drug between a target controlled inhalation anesthesia (TCIA) sevoflurane and a target controlled infusion (TCI) propofol in patients underwent a major oncologic surgery in Sanglah General Hospital. Methods: Sixty ASA physical status I-II patients underwent major oncologic surgery were divided into two groups. Group A was using TCIA sevoflurane and group B using TCI propofol. Bispectral index monitor (BIS index) was used to evaluate the depth of anesthesia. The statistical tests used are the Shapiro-Wilk test, Lavene test, Mann- Whitney U test and unpaired t-test (? = 0.05). The data analysis used the Statistical Package for Social Sciences (SPSS) for Windows. Results: In this study, the rate of drug used per unit time in group A was 0.12 ml sevoflurane per minute (± 0.03) and the group B was 7.25 mg propofol per minute (±0.98). Total cost of hypnotic drug in group A was IDR598.43 (IQR 112.47) per minute, in group B was IDR703.27 (IQR 156.73) per minute (p>0.05). Conclusions: There was no statistically significant difference from the analysis of the drug cost minimization hypnotic drug in a major oncologic surgery using TCIA sevoflurane and TCI propofol.

PENATALAKSANAAN ANESTESI PADA BAYI DENGAN EMPHYSEMATOUS BULLOSA KONGENITAL Supradnyawati, Ni Made; Kurniyanta, Putu; Heryana Putra, Kadek Agus
Medicina Vol 45 No 2 (2014): Mei 2014
Publisher : Medicina

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (274.238 KB)

Emphysematous bullosakongenital merupakan penyebab distress respirasi yang jarang dijumpai, umumnya pada usia neonatus sampai enam bulan pertama. Insiden dilaporkan sebesar 1:70.000- 1:90.000 kelahiran hidup dan biasanya disertai dengan kelainan kongenital lainnya. Etiologi tidak diketahui, namun diduga terjadi akibat displasi kartilago bronkial. Hiperinflasi dan udara yang terperangkap secara progresif akan menimbulkan ekspansi paru ke sisi yang sehat, mendesak parenkim yang sehat, pergeseran mediastinum, dan mengganggu aliran darah balik vena.Secara klinis ditandai dengan distress napas yang semakin memburuk akibat akumulasi progresif udara pada lobus yang sakit. Kami melaporkan kasus pada bayi perempuan berusia 1 bulan, dengan keluhan sesak napas yang semakin memberat sejak 1 minggu sebelumnya. Diagnosis ditegakkan dari klinis, foto dada, dan computed tomography scan dada. Tindakan torakotomi lobektomi lobus medius telah dilakukan untuk menghilangkan lesi desak ruang sekaligus melindungi jaringan paru fungsional.Penatalaksanaan anestesi menitikberatkan pada saat induksi. Pemberian ventilasi manual secara gentle, menghindari pemberian ventilasi tekanan positif dan penggunaan N2O sampai torakotomi dilakukan untuk mencegahpeningkatan volume lobus yangmengalami emphysematous, serta pemberian analgesi perioperatif yang adekuat.Bila terjadi ekspansi lobus emphysematoussecara tiba-tiba, seorang dokter bedah harus siap melakukan torakotomi dengan segera. Pasien ini menunjukkan perkembangan yang baik dan akhirnya pulang pada hari ke-5 pascaoperasi. [MEDICINA 2014;45:134-8]

A sore throat after endotracheal intubation in Sanglah General Hospital 2017 Sobhana Shanmuganathan; Kadek Agus Heryana Putra; I Made Agus Kresna Sucandra; Putu Kurniyanta
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Cuff volume additionally impacts a postoperative sore throat and dysphagia. The rate of a sore throat has likewise been discovered to be higher in the event of Laryngeal Mask Airway (LMA) than that of endotracheal intubation (ETT).Aim: To know the duration of a sore throat and level of severity of a sore throat after endotracheal intubation among patients of Sanglah General Hospital.Method: This cross sectional study was conducted on patients of Sanglah General Hospital. There were 100 students were participated in this study. They were asked to fill up a self-administered questionnaire. The variables assessed were their duration towards patients who have used anesthetic during surgery.Result: About 54% of 100 patient of Sanglah General Hospital, respectively had a sore throat for 4 to 6 days after endotracheal intubation. However, 28% of patients had a sore throat from day one to day three after the endotracheal intubation method. For the severity of a sore throat over 50% of the patients have experienced pain in eating, drinking, talking and for some people it has given them an enormous side effect towards their daily activity. Though the overall duration and severity of a sore throat among the patient, lasted less than a week and for the severity patient have voted respectively high. Patients with good diet control after the surgery tend to heal faster.

Hubungan antara kadar albumin dengan penyembuhan luka pada pasien pasca bedah di Rumah Sakit Umum Pusat Sanglah Denpasar Ni Luh Gede Apsari Pararesthi; Kadek Agus Heryana Putra; Putu Kurniyanta
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Introduction: Wound healing is influenced by various factors, one of which is nutritional status. Nutritional status itself is often detected by one of the important signs of serum albumin. Albumin is a protein in human plasma that is soluble in water and high in concentration in blood plasma. Low albumin levels as an estimate of the causes of malnutrition and also associated with increased complications and postoperative death. Serum albumin less than 3.5g / dL is recognized by the patient as hypoalbuminemia.Methods: This research was conducted with the aim of analyzing the relationship between albumin levels and wound healing in postoperative patients. This study used a cross sectional observational analytic method by taking secondary data from medical records of postoperative patients (disgestif surgery, neurosurgery, orthopedic surgery, oncology surgery) at Sanglah General Hospital.Result: Of the 60 patients involved in this study, patients with abnormal albumin levels were 36.7% and patients with normal albumin levels were 63.3%. The chi-square test results showed that postoperative patients who had the last abnormal albumin level before surgery 5.1 times more with unrecover wound compared to patients with normal albumin levels (PR = 5.182; 95% CI = 2.181-12.310, p = 0.00001).Conclusion: There is a significant relationship between albumin levels and wound healing.Latar Belakang: Penyembuhan luka dipengaruhi oleh berbagai faktor, salah satunya adalah faktor status nutrisi. Status nutrisi sendiri sering dideteksi oleh salah satu tanda penting yaitu serum albumin. Albumin merupakan protein dalam plasma manusia yang larut dalam air dan tinggi konsentrasinya dalam plasma darah. Kadar albumin yang rendah sebagai perkiraan penyebab malnutrisi dan juga berhubungan dengan peningkatan komplikasi serta kematian postoperasi. Serum albumin yang kurang dari 3.5g/dL diakui pasien tersebut hipoalbuminemia.Metode: Penelitian ini dilaksanakan dengan tujuan untuk menganalisis hubungan kadar albumin dengan penyembuhan luka pada pasien pasca bedah. Penelitian ini menggunakan metode observasional analitik cross sectional dengan mengambil data sekunder dari rekam medis pasien pasca bedah (bedah disgestif, bedah saraf, bedah ortopedi, bedah onkologi) di RSUP Sanglah.Hasil: Dari 60 pasien yang terlibat dalam penelitian ini didapatkan pasien dengan kadar albumin tidak normal sebesar 36.7% dan pasien dengan kadar albumin normal sebanyak 63.3%. Hasil uji chi-square menunjukkan bahwa pasien pasca bedah yang sebelum operasi memilki kadar albumin terakhir tidak normal 5.1 kali lebih banyak mengalami luka tidak sembuh dibanding pasien dengan kadar albumin normal (PR=5.182; 95% CI=2.181-12.310, p=0.00001).Simpulan: Terdapat hubungan yang signifikan antara kadar albumin dengan penyembuhan luka.

Co-Authors Damayanti, Elok Gede Semarawima, Gede I Gusti Agung Gede Utara Hartawan I Gusti Ngurah Mahaalit Aribawa I Ketut Sinardja I Made Agus Kresna Sucandra I Made Gede Widnyana I Wayan Suranadi Ida Bagus Krisna Jaya Sutawan IGNA Putra Arimbawa, IGNA Putra Ketut Semara Jaya, Ketut Semara Kurnia, Prajnaariayi Prawira Kusuma, Dian Reginalda Made Agus Kresna Sucandra, Made Agus Kresna Made Wiryana Marilaeta Cindryani, Marilaeta Ni Luh Gede Apsari Pararesthi Ni Made Supradnyawati, Ni Made Pontisomaya Parami Putu Kurniyanta Putu Pramana Suarjaya Sobhana Shanmuganathan Thius, Adi Dharma Tjokorda Gde Agung Senapathi

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