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Prihatma Kriswidyatomo
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Departemen Anestesiologi dan Reanimasi Fakultas Kedokteran Universitas Airlangga-RSUD Dr Soetomo Surabaya Gedung Anestesi Baru-RSUD Dr Soetomo Surabaya Jl. Mayjen Prof. Dr. Moestopo No 6-8, Airlangga, Gubeng, Surabaya, 60286, Indonesia
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Kota surabaya,
Jawa timur
INDONESIA
Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Published by Universitas Airlangga
ISSN : 27224554     EISSN : 2686021X     DOI : 10.20473/ijar.V2I12020.1-7
Core Subject : Health,
Medicine & Pharmacology
IJAR is a scientific journal published by Department of Anesthesiology and Reanimation, Faculty of Medicine Universitas Airlangga. IJAR is an English language journal. IJAR FOCUSES original research, review article, case report, and correspondence, on anesthesiology; pain management; intensive care; emergency medicine; disaster management; pharmacology; physiology; clinical practice research; and palliative medicine. This journal is a peer-reviewed journal established to improve the understanding of factors involved in anesthesiology and emergency medicine.
Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine
Articles 9 Documents
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Search results for , issue "Vol. 4 No. 2 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)" : 9 Documents clear
Severe Preeclamptic Patients in The Resuscitation Room of Dr. Soetomo General Academic Hospital Surabaya: A Retrospective Study Neissya Nastiti Firmanto; Maulydia; Pungky Mulawardhana; Mariza Fitriati
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 2 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V4I22022.62-71

Abstract

Introduction: Preeclampsia is the leading cause of maternal and fetal death. This is an urgency in maternal health, especially in developing countries such as Indonesia. Patients with severe preeclampsia who had critical conditions tend to be admitted to the resuscitation room for assistance from more skilled personnel and more sophisticated technology. Objective: This study aims to determine the complications, treatments, and outcomes of severe preeclampsia patients managed in the resuscitation room at Dr. Soetomo General Academic Hospital from January 1st, 2018 – December 31th 2019. Methods and Materials: The method used in this study was retrospective descriptive using medical records and analyzed using Microsoft Excel. Eighty-one samples met the inclusion criteria. Results: The majority of patients were aged 20-35 years (65.43%) and had completed senior high school (88.89%). Most patients were having stage 2 obesity (44.44%) and multigravida (41.97%). A history of preeclampsia and hypertension was not found in the majority of patients. Most patients are diagnosed with late-onset preeclampsia (69.14%). The majority of patients were referred from secondary health facilities (96.30%). The most common complication was pulmonary edema(53.09%). The majority of patients had 2 complications (43.17%) with the most common combinations being eclampsia and HELPP syndrome (13.58%). Intubation is given to the majority of patients (70.37%) and most often in patients with eclampsia (56.14%). Termination of pregnancy by cesarean section is carried out in the majority of patients (72.84%). There were no cases of maternal death in this study. Most of the fetal born had prematurity (70.11%), low birth weight (60%), and asphyxia as assessed by the first minute APGAR score (72.97%) and fifth minute APGAR score (54.05%). Conclusion: The majority of preeclampsia patients with complications in the resuscitation room at Dr. Soetomo General Academic Hospital Surabaya from January 1st 2018-December 31rd 2019 had good maternal outcomes but not the fetal outcome.
Airway Foreign Bodies in Patients that Underwent Bronchoscopies with General Anesthesia in Dr. Soetomo General Academic Hospital Surabaya Annisa Maya Sabrina; Maulydia; Rizka Fathoni Perdana; Mariza Fitriati
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 2 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V4I22022.72-79

Abstract

Introduction: Airway foreign body (AFBs) is the most common emergency for ENT-HN (Ear, Nose, Throat-Head Neck) that requires immediate treatment. The gold standard management for AFBs is a bronchoscopy performed under general anesthesia (GA). Objective: This study aims to determine the profile of AFBs patients who underwent bronchoscopies with GA at Dr. Soetomo General Hospital Surabaya from January 2018 – December 2019. Methods and Materials: This is a descriptive, retrospective study that uses data from medical records. Microsoft Excel was used to analyze the data. 22 patients met the inclusion criteria. Results: The most common ages were 11 to 20-year-olds (73%), 55% were female, and 45% were male. The patients were from outside (73%) and inside (27%) Surabaya. As much as 67% of the sampled patients had coughs and 23% were symptomless. The foreign bodies found were pins (67%), clipboard nails (14%), and nuts (9%). These AFBs were located in the left main bronchus (45%), trachea (32%), and right main bronchus (18%), and in 5% of these cases, the AFBs could not be located. The duration between the event and the bronchoscopy was mostly less than 1 day (54%), 2 days (32%), and 3 days (14%). Most cases (90%) were without AFBs complications, but some had obstruction (5%), and hemoptysis (5%). Most patients also had an uncomplicated bronchoscopy (81%), however, some suffered lesions (14%) and bleeding (5%). A majority of the patients were also ASA I (68%), and the remainder were classified as ASA II (18%), and III (14%). The premedication drugs administered were fentanyl (41%), and a combination of fentanyl and midazolam (41%). Meanwhile, the most frequently maintained anesthetic agent was Isoflurane+O2 (27%). Most patients also did not have any comorbid factors (85%), but some had anemia (5%), obstruction (5%), as well as obesity followed by sputum retention and hypernatremia (5%). Conclusion: Most AFB patients who underwent bronchoscopy under GA were 11-20 years old, female, and had a cough as a clinical symptom. Most AFBs were pins at the left main bronchus. The duration between the incident and the bronchoscopy was less than 1 day. There were also mostly no complications of AFBs and bronchoscopies. The most common physical status in patients was ASA I, with fentanyl only or fentanyl and midazolam as a premedication drug. The most common agent used to maintain the anesthesia was a combination of isoflurane and O2. Most patients also had no comorbid factors for GA.
Anemia Profile in Pediatric Patients at Pediatric Intensive Care Unit (PICU) of Dr. Soetomo General Academic Hospital Sarah Ayu Larasati; Arina Setyaningtyas; Elizeus Hanindito; Mia Ratwita Andarsini
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 2 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V4I22022.80-86

Abstract

Introduction: Anemia often occurs in critically ill children and is associated with increased morbidity and mortality in women and children and impaired cognitive and behavioral development in children. Objective: This study aims to understand the profile and characteristics of anemia patients in the critical care population. Materials and Methods: This is a retrospective, descriptive study of the patient's medical records. Data were collected by the total sampling technique. Results: Among 203 patients, 52% were anemic at admission to the Pediatric Intensive Care Unit (PICU), while 45% were anemic at discharge. Anemia tends to be more common in older age and male individuals with their chief complaints being respiratory symptoms, higher mean Red Cell Distribution Width (RDW) levels, and poorer nutritional status. There were 84 patients (41%) who received Packed Red-Cells (PRC) transfusions, among them there were 54 patients (51%) who were anemic at PICU admission. Of the 84 patients who received PRC transfusions during their PICU stay and 43 patients (47%) were anemic on PICU discharge. Conclusion: Anemia is quite common in critically ill children and is dominated by male patients aged under 5 years. Anemia also mostly happens in patients with higher organ dysfunction scores and poorer nutritional status than nonanemic patients. Half of the patients with anemia at the PICU also received PRC blood transfusion.
Low-Dose Ketamine as Perioperative Analgesia in Caesarean Sections in Remote Areas with Limited Medical Supplies Yoppie Prim Avidar; Agustina Salinding; Hamzah; Akhyar Nur Uhud; Maulydia
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 2 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V4I22022.87-97

Abstract

Introduction: Cesarean section is the most common surgical procedure performed in the world and its postoperative pain is still a major issue in several countries. In a low-resource setting, this management poses a challenge for anesthesiologists. Ketamine is the most used anesthetic drug in the world due to its easy access and proven benefits. Objective: This research aims to analyze the effectiveness of low-dose ketamine as postoperative analgesia in cesarean sections conducted in areas with limited medical supplies. Materials and Methods: A Randomized Controlled Trial (RCT) was done from August 2020 to January 2021 with consenting pregnant patients who had undergone cesarean section. The sampled population was randomized to receive either ketamine intravenously or a placebo before the Subarachnoid Block (SAB). Low dose ketamine was divided into three groups 0.15 mg/kg, 0.25 mg/kg, and 0.5 mg/kg. The outcome was divided into primary outcome (pain score after 1-hour post-operation, 2 hours post-operation, 24 hours post-operation, and 48 hours post-operation) and secondary outcome (Apgar Score in the first minute and 5 minutes, hypotension after SAB, sedative effect during operation, postoperative nausea vomiting, time to receive opioid postoperative as rescue analgesia and total opioid uses). Results and Discussion: This study screened 105 patients and recruited 90 patients that were randomized into two groups consisting of 45 patients that received either low-dose ketamine or a placebo. The groups administered ketamine showed a lower pain score in 1 hour (p-value = 0.0037) and 2 hours post-operation (p-value = 0.0037). They also showed that it could prolong the administration of fentanyl (p-value = 0.0003) and lower total fentanyl used (p-value = 0.0008). The groups administered ketamine showed that there was a sedation effect (p-value = 0.0001) that depended on the dosage used. Conclusion: Intravenous ketamine with low doses can reduce pain scores at 1 hour to 2 hours post-operation and shows the need to reduce opioid requirements.
Early Tracheostomy in Prolonged Mechanical Ventilation Due to Severe Head Injury to Prevent Ventilator-Associated Pneumonia (VAP) Pratama Ananda; Sony
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 2 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V4I22022.115-119

Abstract

Introduction: Early tracheostomy needs to be considered if a ventilator is expected to be used for an extended period of time. Early tracheostomy is recommended since it improves respiratory function, reduces the risk of ventilator-associated pneumonia (VAP), improves patients’ comfort level, cleanses secretions in the throat, reduces laryngeal ulceration, improves mobilization, and speech efforts, and allows treatment outside the intensive care unit (ICU). Case Report: Four cases of severe head injury with an early tracheostomy, which illustrate the prevention of VAP, were reported. In these four cases, early tracheostomy was performed (£ 4 days) considering the initial critical GCS, the location of the lesion, and that mechanical ventilation was expected to be used for an extended period of time. During treatment, no VAP signs were detected, evidenced by Clinical Pulmonary Infection Score (CPIS), Rontgen thorax, and sputum culture examinations. Based on a meta-analysis study, early tracheostomy reduces mortality due to VAP by up to 50% and reduces the length of stay in ICU compared to delayed/late tracheostomy (> 10 days) or prolonged intubation (> 14 days). Conclusion: In the study cases, early tracheostomy (<4 days) was found to be associated with reduced ventilation time and shortened ICU and hospital stays without an increased risk of VAP. VAP prevention efforts are carried out by applying early tracheostomy and VAP bundle as well. Early tracheostomy offers more benefits than prolonged intubation or delayed/late tracheostomy.
Anesthetic Management of A Patient with Henoch-Schonlein Purpura for Caesarean Section Indriyani Wijaya
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 2 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V4I22022.107-114

Abstract

Introduction: Henoch-Schonlein Purpura or Immunoglobulin-A vasculitis is a systemic vasculitis caused by immune complexes that attack small blood vessels. The classic symptoms of Henoch-Schonlein Purpura include erythema purpura,  arthralgia, gastrointestinal complaints, and renal involvement. Some cases show that pregnancy itself could be the trigger for its recurrence and lead to early delivery. Case report: A 33-year-old patient, G2P1A0 and 35 weeks and 4 days pregnant complained of diarrhea 8 days before hospital admission (8-15 times per day). The patient was diagnosed with Henoch-Schonlein Purpura 3 years ago. Upon monitoring in the ward, the fetus was found to be in a compromised condition and an emergency cesarean section was needed. The patient was assessed as having an ASA II physical status and was anesthetized with regional anesthesia epidural in the sitting position, with a median approach, puncture at L3-L4 level, and with 12 ml of Bupivacaine 0.5% isobaric. Postoperative care was continued in the ward. Discussion: As long as there are no contraindications, a neuraxial block could be performed on parturient patients with Henoch-Schonlein Purpura who would undergo a cesarean section. Neuraxial block, namely epidural block, has the added advantage of being a postoperative analgesic and helps to avoid the use of Non-Steroidal Anti Inflammatory Drugs (NSAIDs) in Henoch-Schonlein Purpura patients who often have renal complications. Conclusion: Caesarean Section with  Henoch-Schonlein Purpura disease has been reported with Epidural Block Anesthesia without complications.
Anesthesia and Analgesia Management Profile for Airway Surgeries at Dr. Soetomo General Academic Hospital Surabaya Agustina Salinding; Widiartha Wahyudi; Arya Pradipta
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 2 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V4I22022.98-106

Abstract

Introduction: Ear, Nose, and Throat (ENT) surgeries are commonly performed and very often require the surgeon and anesthesiologist to share the same workspace. Over the years, ENT surgery techniques have evolved from conventional methods to computer-assisted intraoperative navigation. In contrast to the past, a minimally invasive approach to paranasal sinus and petrous bone surgery is now preferred. Bleeding, postoperative nausea, and vomiting are complications often encountered in ENT surgery. In addition, pain management during surgery and patient comfort after a surgical procedure is a challenge for anesthesiologists. Therefore, the choice of anesthetic drugs is important. Objective: This study aims to determine the action profile, anesthetic management, and pain management in ENT surgery at Dr. Soetomo General Academic Hospital Surabaya. Materials and Methods: This is a retrospective descriptive study. A total of 177 patients underwent airway surgery. Data were obtained from the Medical Records of the Integrated Surgery Center of Dr. Soetomo General Academic Hospital recorded from January to December 2021. Results and Discussion: Most of the patients were in the age group of 45 - 65 years (40.1%) and a majority were men (65.5%). Most patients who were ≥ 20 years old had a normal nutritional status (54.2%). The most frequent diagnosis was laryngeal cancer (23%), with micro laryngeal surgery being the most frequently performed (35.8%). Most surgeries also needed less than 60 minutes followed by 60 to 119 minutes (27.1%). The most frequently used induction agents were a combination of propofol, fentanyl, and rocuronium (39.5%), with isoflurane as the most frequent inhalation agent (91.3%). Metamizole (70.1%) was the most postoperative analgesic. Conclusion: In general, intravenous agents were used for anesthesia induction. A combination of different induction agents brings synergistic benefits.
Front Matter IJAR Vol 4 (2) July 2022
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 2 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V4I22022.%p

Abstract

Back Matter IJAR Vol 4 (2) July 2022
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 2 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V4I22022.%p

Abstract

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