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RACHMAT HIDAYAT
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Journal of Anesthesiology and Clinical Research
Published by HM Publisher
ISSN : -     EISSN : 27459497     DOI : https://doi.org/10.37275/jacr
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience
Journal of Anesthesiology and Clinical Research/JACR that focuses on anesthesiology; pain management; intensive care; emergency medicine; disaster management; pharmacology; physiology; clinical practice research; and palliative medicine.
Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine
Articles 5 Documents
 1 
Search results for , issue "Vol. 1 No. 1 (2020): Journal of Anesthesiology and Clinical Research" : 5 Documents clear
Anesthesia Management in Intramural Uterine Myoma and Obesity Morbid Patients Who Underwent Myomectomy Perlaparatomy RZ Harahap; Rose Mafiana
Journal of Anesthesiology and Clinical Research Vol. 1 No. 1 (2020): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (137.747 KB) | DOI: 10.37275/jacr.v1i1.132

Abstract

Introduction. Obesity is a condition that increases the challenges in the surgical process. Obesity increases the risk of sleep apnea and affects anaesthetics. This case report aims to discuss the management of anaesthesia in a patient with morbid obesity. Case. Female, 26 years old, with intramural uterine myoma and morbid obesity, will undergo myomectomy per laparotomy with ASA II physical status, performed anaesthesia with general anaesthesia intubation technique using the anaesthetic agent Propofol 1-2.5 mg/kg titration until the patient falls asleep, fentanyl 1-2 mcg/kg, then the patient was intubated in a ramped position with sleep non-apnea. After it was confirmed that the ETT was entered, 30 mg of a muscle relaxant (atracurium) was added. The operation lasts 1 hour 30 minutes, with a bleeding 250 cc, hemodynamically stable. Conclusion. Morbid obesity has extraordinary implications for anaesthetic management. Various considerations for patients with morbid obesity are needed starting from the preoperative, intraoperative, to postoperative periods. Regional anaesthesia is preferred because the physiological function of unhealthy obese patients is impaired due to excess body weight. Selection of anaesthetic agent and calculation of drug dose is crucial to know because there is a change in the volume of distribution. The pharmacokinetics of most general anaesthetics are affected by the adipose tissue mass, produce a prolonged drug effect, and less predictable.
Anesthesia Management in Caesarean Section with Preeclampsia and Partial HELLP Syndrome Tiara Wima; Agustina Br. Haloho
Journal of Anesthesiology and Clinical Research Vol. 1 No. 1 (2020): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (130.74 KB) | DOI: 10.37275/jacr.v1i1.133

Abstract

Introduction. Pre-eclampsia is a significant cause of maternal and fetal mortality and morbidity. Pre-eclampsia is characterized by hypertension (blood pressure ≥ 140/90 mmHg), oedema and amount of protein in urine 300 mg in the 24-hour, which appears after 20 weeks of gestation. Pre-eclampsia can cause complications, one of which is HELLP syndrome. This case report discusses the use of anaesthesia in a patient who underwent a cesarean section with indications for pre-eclampsia and partial HELLP syndrome. Case Presentation. A woman, 41 years old, G4P3A0 34 weeks pregnant with pre-eclampsia + syndrome HELLP will undergo emergency cesarean section with ASA IIE physical statusLabouror pain management was carried out using regional spinal anaesthesia technique, using bupivacaine 0.5% hyperbaric agent 12.5 mg. The operation lasted for 1 hour 30 minutes, with 300 ml bleeding, hemodynamically stable. Conclusion. Difficult intubation in emergency cases can be avoided by choosing of neuraxial anaesthesia technique is recommended. It will lead to better uteroplacental perfusion, good analgesia/anaesthesia quality, reducing surgical stress, reducing drugs that enter the uteroplacental circulation, and maternal psychological to be able to see the baby at birth.
Waste Anesthetic Gase: A Forgotten Problems Andi Miarta; Mayang Indah Lestari; Zulkifli
Journal of Anesthesiology and Clinical Research Vol. 1 No. 1 (2020): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (164.476 KB) | DOI: 10.37275/jacr.v1i1.134

Abstract

Waste anesthetic gas (WAG) is a small amount of inhaled anesthetic gas that comes out of the patient’s anesthesia breathing circuit into the envorinment air while the patient is under anesthesia. According to American Occupation Safety and HealthAdministration (OSHA) more than 200.000 healthcare workers especially aneaesthesiologist, surgery nurse, obstetrician and surgeons are at risk of developing work-related disease due to chronic exposure to WAG. Exposure to WAG in short time associated with multiple problems such as headaches, irritability, fatigue, nausea, drowsiness, decrease work efficiency and difficulty with judgment and coordination. While chronic exposure of WAG is associated with genotoxicity, mutagenicity, oxidative stress, fatigue, headache, irritability, nausea, nephrotoxic, neurotoxic, hepatotoxic, immunosuppressive and reproductive toxicological effect. Waste anesthetic gases are known as environmental pollutants and will be released from the OR to the outside environment then the substance will reach the atmosphere damaging ozone layer. Exposure to trace WAG in the perioperative environment cannot be eliminated completely,but it can be controlled. Controlling WAG can be achieve by using scavenging system, proper ventilation, airway management, ideal anesthetic choice, maintaining anesthesia machine and equipment, hospital regulation and routine healthcare workers health status examination.
A Case Report: Diabetic Ketoacidosis in Patient with type 1 Diabetes Mellitus with Complication Septic Shock and AKI Stage III on HD Triggered by Perianal Abscess Muhammad Ikhsan Kartawinata; Yusni Puspita
Journal of Anesthesiology and Clinical Research Vol. 1 No. 1 (2020): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (157.851 KB) | DOI: 10.37275/jacr.v1i1.135

Abstract

Introduction. Diabetic ketoacidosis (DKA) is an acute, life-threatening complication in diabetes mellitus. Infection is a common precipitating cause of diabetic ketoacidosis (DKA) in known diabetic patient, and diabetic ketoacidosis (DKA) often presents as the first symptom of an undiagnosed diabetes. diabetic ketoacidosis (DKA) is diagnosed with combination of hyperglicaemia, acidosis metabolic and ketonuria. Case Presentation. A 27 years old male patient, admitted to Intensive Care Unit with decrease level of consciousness (GCS 3), he was intubated and present with respiratory distress, metabolic acidosis, high glucose level, ketonuria with renal failure as a target organ. Patient known has perianal abscess as a triggered of diabetic ketoacidosis (DKA), turn into septic shock and underwent debridement surgery to source control the infection. The patient was treated in intensive care unit for 9 days, and sent to ward with GCS 15 an no sequelae of organ failure. The treatment of diabetic ketoacidosis (DKA) should include correcting the often substantial hypovolemia, the hyperglycemia, electrolyte imbalance and the triggering factor of diabetic ketoacidosis (DKA). Conclusion. Prompt surgical intervention, antibacterial therapy, rapid restoration of glycemic control are crucial to prevent mortality in diabetes mellitus patients complicated with abscess.
Herbicide Intoxication: Still A Threat in Developing Countries Stevanus Eliansyah Handrawan; Mayang Indah Lestari; Zulkifli
Journal of Anesthesiology and Clinical Research Vol. 1 No. 1 (2020): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (173.13 KB) | DOI: 10.37275/jacr.v1i1.136

Abstract

The critically ill patient has severe respiratory, cardiovascular or neurological disorder often in combination. The critically ill patient needs intensive care unit (ICU) admission and strict monitoring. Intoxication commonly experienced in a critically ill patient in ICU and can complicate management. In developing countries, poisoning of herbicide still common and used for suicide attempts. Herbicides such as paraquat and glyphosate are often used because of their availability. Paraquat and glyphosate have high mortality rate primarily as a suicide attempt agent in developing countries. The primary target for paraquat toxicity is in the lung and can cause lung fibrosis. Severe glyphosate intoxication can cause dehydration, hypotension, pneumonitis, oliguria, loss of consciousness, liver dysfunction, acidosis, hyperkalemia and dysrhythmia. Diagnosis for herbicide intoxication needs a history of herbicide ingestion, physical examination and laboratory examination. Stabilisation and supportive therapy is the only choice, and there is still no specific treatment for herbicide intoxication. The intoxication of herbicide particular critically ill patient because there is still no such specific treatment for these.

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