Jurnal Anestesiologi dan Terapi Intensif
type: channel
description: Jurnal Anestesiologi dan Terapi Intensif (JATI) (e-ISSN : 3090-3580) is a peer-reviewed, open-access journal published three times a year (April, August, and December) by the Department of Anesthesiology and Intensive Care, Faculty of Medicine, Udayana University, in collaboration with the Bali Chapter of Indonesian Society of Anesthesiology and Intensive Therapy (PERDATIN). The journal aims to disseminate high-quality scientific work in the fields of anesthesiology, intensive care medicine, pain management, perioperative medicine, and basic clinical sciences. All submissions are reviewed through a double-blind peer-review process. JATI welcomes original research articles, reviews, selected case reports, and editorials from clinicians, researchers, and scholars in related fields.
publisher: Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)
language: en
publication name: Jurnal Anestesiologi dan Terapi Intensif
issn: 3090-3580
copyright: Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY 4.0) that allows others to share, use, distribute, and reproduce the work in any medium, provided the original author and source are properly credited.
items: Integrasi Pendekatan Multimodal dalam Praktik Anestesiologi dan Terapi Intensif
items: Dexmedetomidine as Adjuvant in Scalp Nerve Block for Craniotomy: A Double-Blind Randomized Clinical Trial
items: Anesthetic Approach to Placenta Previa with Associated Bladder Rupture: A Case Report
items: Dexmedetomidine pada Blok Torakolumbar Interfasial Plane Modifikasi: Tinjauan Naratif
items: Renal Resistive Index in Early Detection of AKI after Neurosurgery: A Case Series
items: Effectiveness of Dexmedetomidine Compared to Midazolam for Sedation in Mechanically Ventilated Patients: A Narrative Review
items: Peran Gabapentinoid dalam Strategi Analgesia Preemptif pada Mastektomi Radikal Termodifikasi: Tinjauan Naratif
items: Transformasi ICU Modern: Teknologi, Humanisasi, dan Perawatan Individual dalam Era Perawatan Kritis
items: Albumin Use and Its Association with Nutritional Status in the Intensive Care Unit : A Narrative Review
items: External Oblique Intercostal Plane Block (EOIPB) sebagai Tambahan Analgesia Multimodal Pasca Laparoskopi Kolesistektomi: Tinjauan Naratif
items: Managemen Anestesi pada Congenital Diapragmatic Hernia dengan Ventrikel Septal Defek dan Atrium Septal Defek pada Pasien Pediatrik : Laporan Kasus
items: Awake Intubation in Patient with Superoanterior Mediastinal Mass and Superior Vena Cava Syndrome (SVCS): A Case Report
items: Hubungan MAP dan CVP terhadap PEEP dan Perubahan Stroke Volume pada Pasien Ventilasi Mekanik Invasif: Studi Observasional Analitik
items: Fibrinolytic and Anticoagulant Therapy in COVID-19 Associated Pulmonary Embolism: A Case Report
items: Comparison Between Opioid Free Anesthesia and Opioid Based Anesthesia in Laparoscopic Hysterectomy: A Systematic Review
items: Perkembangan Terkini dalam Painless Labour: Tinjauan Naratif
items: Manajemen Anestesi pada Pasien Pediatri dengan Double Inlet Left Ventricle Yang Menjalani Bidirectional Cavo-Pulmonary Shunt: Laporan Kasus
items: Manajemen Anestesi pada Pasien Pasca Transplantasi Ginjal yang menjalani Operasi Seksio Sesaria: Laporan Kasus
items: Korelasi Pulsatile Index dan Optic Nerve Sheath Diameter terhadap Tekanan Intrakranial Pasien Preeklamsia: Studi Analitik Observasional
items: Menumbuhkan Budaya Riset di Bidang Anestesi Melalui Integrasi Kecerdasan Buatan dan Peran Strategis Open Journal System
items: Efektivitas Blok Ilioingunal Dalam Menurunkan Penggunaan Opioid Dan Skor Nyeri Pada Seksio Sesarea: Studi Acak Terkontrol
items: Efektivitas dan Risiko Pemberian Antibiotik Profilaksis Ceftriaxone pada Pasien Cedera Otak Akut: Tinjauan Naratif
items: Graded Epidural Anesthesia with Real-Time Hemodynamic Monitoring for Cesarean Delivery in Severe Mitral Stenosis: A Case Report
items: Efektivitas dan Keamanan Deksmedetomidine Nebulisasi Dibandingkan Rute Intravena sebagai Premedikasi Anestesi: Tinjauan Naratif
items: Low-Flow Anesthesia Management in Pediatric Laparoscopic Choledochal Cyst Excision and Hepaticojejunostomy: A Case Report
items: Comparison of IL-6 Levels After Ibuprofen–Paracetamol– Dexamethasone in Percutaneous Nephrolithotomy Patients: an Analytic Observational Study

Integrasi Pendekatan Multimodal dalam Praktik Anestesiologi dan Terapi Intensif
type: item
description: Praktik anestesiologi dan terapi intensif mengalami pergeseran paradigma dari penggunaan terapi tunggal menuju strategi multimodal yang terstruktur dan saling melengkapi. Bukti ilmiah menunjukkan bahwa multimodal analgesia pada pembedahan mayor meningkatkan kontrol nyeri, menurunkan konsumsi opioid, serta mempercepat pemulihan pascaoperasi. Temuan ini menegaskan bahwa pendekatan multimodal merupakan elemen utama dalam manajemen perioperatif modern yang berfokus pada luaran klinis yang lebih baik. Pendekatan ini sejalan dengan konsep personalized anesthesia, di mana pilihan obat, teknik anestesi, dan strategi analgesia disesuaikan dengan karakteristik, komorbiditas, serta risiko individual pasien. Pada populasi berisiko tinggi, personalisasi multimodal menjadi faktor kritis dalam menjaga stabilitas perioperatif. Pemahaman baru mengenai respons stres perioperatif semakin menguatkan urgensi pendekatan multimodal. Peningkatan sitokin proinflamasi dan biomarker stres telah dikaitkan dengan komplikasi neurologis pascaoperasi, sehingga mengatur respons biologis berlebihan menjadi bagian penting dari keberhasilan terapi. Agen farmakologis seperti dexmedetomidine, dengan efek sedasi, analgesia, dan stabilitas hemodinamik, memberikan nilai tambah melalui penurunan kebutuhan opioid dan anestetik volatil, serta peningkatan kualitas pemulihan. Teknik anestesi regional berbasis ultrasonografi juga berperan sentral dalam multimodal perioperatif karena meningkatkan presisi tindakan, mengurangi risiko komplikasi, dan memberikan analgesia superior. Meskipun terdapat kekhawatiran mengenai kompleksitas protokol dan ketersediaan sumber daya, bukti menunjukkan bahwa strategi multimodal dan personalisasi terapi memberikan hasil klinis yang lebih baik serta efisiensi sistem yang lebih tinggi. Dengan komitmen terhadap praktik berbasis bukti dan pelayanan yang berpusat pada pasien, integrasi multimodal akan menjadi fondasi penting bagi peningkatan mutu dan keselamatan dalam anestesiologi dan…
subject: Editorial
  topic: section
subject: Anesthesiology
  topic: keywords
subject: Multimodal analgesia
  topic: keywords
subject: Perioperative
  topic: keywords
creator: Aryawangsa Anak Agung Ngurah
rights: Copyright (c) 2025 Aryawangsa Anak Agung Ngurah (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-12-01
publication date: 2025-12-01
starting page: 93
ending page: 94
doi: 10.24843/087fc824

Dexmedetomidine as Adjuvant in Scalp Nerve Block for Craniotomy: A Double-Blind Randomized Clinical Trial
type: item
description: Introduction: Scalp nerve block (SNB) is an effective adjunct for attenuating hemodynamic responses and reducing postoperative pain in craniotomy. Dexmedetomidine (DEX), with its analgesic and anti-inflammatory properties, may enhance the quality of SNB. This study evaluated the effects of adding DEX to SNB on hemodynamic stability, postoperative pain, inflammatory response, and analgesic duration in craniotomy patients. Methods: A double-blind, parallel-group randomized clinical trial was conducted on 36 adult patients undergoing elective craniotomy (July–September 2025) at a tertiary hospital Denpasar. Participants received SNB using 0.375% ropivacaine (20 mL) with or without DEX 1 µg/kg under standardized general anesthesia. Outcomes included mean arterial pressure (MAP), Visual Analog Scale (VAS) scores at 12 and 24 hours, neutrophil-to-lymphocyte ratio (ΔNLR), and time to first rescue analgesic (TTFAR). Statistical analyses used mixed ANOVA and Mann–Whitney U tests. Ethical approval number was 2159/UN14.2.2.VII.14/LT/2025. Results: MAP was significantly lower in the DEX group at 10 minutes (Δ = 4.89 mmHg; 95% CI 1.62–8.16), 20 minutes (Δ = 4.83; 95% CI 1.57–8.10), 30 minutes (Δ = 3.67; 95% CI 0.40–6.94), and upon PACU arrival (Δ = 3.72; 95% CI 0.45–6.99) (all p < 0.05). Median VAS scores were significantly lower with DEX at 12 hours (1.50 vs 3.00; p < 0.001) and 24 hours (1.00 vs 2.00; p < 0.001). ΔNLR was reduced in the DEX group (−0.56 vs 3.08; p = 0.004). TTFAR was markedly prolonged (554 vs 257 minutes; p < 0.001). No adverse events were reported. Conclusion: Dexmedetomidine added to scalp nerve block enhances hemodynamic stability, reduces postoperative pain for up to 24 hours, suppresses early systemic inflammation, and prolongs analgesic duration in craniotomy without observed complications. DEX–SNB represents a beneficial component of multimodal analgesia in neuroanesthesia and may support enhanced recovery pathways
subject: Original Articles
  topic: section
subject: Craniotomy
  topic: keywords
subject: Dexmedetomidine
  topic: keywords
subject: Hemodynamic Stability
  topic: keywords
subject: Inflamation
  topic: keywords
subject: Postoperative pain
  topic: keywords
subject: Scalp Block
  topic: keywords
creator: Putu Eka Nantha Kusuma
creator: I Putu Pramana Suarjaya
creator: Pontisomaya Parami
creator: IGAG Utara Hartawan
creator: I Gusti Ngurah Mahaalit
creator: I Putu Kurniyanta
creator: Ida Bagus Krisna Jaya Sutawan
creator: Putu Herdita Sudiantara
creator: I Made Gede Widnyana
creator: Tjokorda Gde Agung Senapathi
rights: Copyright (c) 2025 Putu Eka Nantha Kusuma, I Putu Pramana Suarjaya, Pontisomaya Parami, IGAG Utara Hartawan, I Gusti Ngurah Mahaalit Aribawa, I Putu Kurniyanta, Ida Bagus Krisna Jaya Sutawan, Putu Herdita Sudiantara, I Made Gede Widnyana, Tjokorda Gde Agung Senapathi (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-12-01
publication date: 2025-12-01
starting page: 102
ending page: 111
doi: 10.24843/q23wyc88

Anesthetic Approach to Placenta Previa with Associated Bladder Rupture: A Case Report
type: item
description: This case report outlines the anesthetic management of total placenta previa with high-risk features of placenta accreta spectrum (PAS) complicated by bladder rupture, representing a rare but clinically significant form of invasive placentation. A 29-year-old G2P1001 at 35+3 weeks’ gestation presented with recurrent antepartum bleeding and ultrasonographic features consistent with PAS, including grade III lacunae, bridging vessels, severe myometrial thinning, and a Placenta Accreta Indeks (PAI) score of 6. Spinal anesthesia was initiated for delivery, followed by a controlled conversion to general anesthesia to facilitate hysterectomy, two-layer bladder repair, ureteral reconstruction, and Double-J stent placement. Hemodynamic stability was maintaned using tranexamic acid, colloid co-loading, invasive arterial monitoring, and norepinephrine titration. An estimated blood loss of 2,300 mL was managed with targeted transfusion, resulting in favourable maternal recovery and neonatal outcomes (Apgar 7 and 9). This case underscores the importance of early PAS recognition, structured anesthetic planning, and coordinated multidisciplinary care, supporting the benefit of a staged neuraxial-to-general anesthesia strategy in complex PAS with urologic involvement.
subject: Case Report or Case Series
  topic: section
subject: Anesthetic Management
  topic: keywords
subject: Bladder Rupture
  topic: keywords
subject: Caesarean Hysterectomy
  topic: keywords
subject: Placenta Accreta Spectrum
  topic: keywords
subject: Placenta Previa
  topic: keywords
creator: Made Bagus Cahya Maha Putra
creator: IGAG Utara Hartawan
creator: Dewa Ayu Mas Shintya Dewi
rights: Copyright (c) 2025 Made Bagus Cahya Maha Putra, IGAG Utara Hartawan, DA Mas Shintya Dewi (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-12-01
publication date: 2025-12-01
starting page: 163
ending page: 167
doi: 10.24843/nqk01d22

Dexmedetomidine pada Blok Torakolumbar Interfasial Plane Modifikasi: Tinjauan Naratif
type: item
description: Nyeri pascaoperasi merupakan tantangan klinis utama pada pasien yang menjalani bedah tulang belakang lumbal. Pendekatan analgesia multimodal semakin berkembang, dan blok interfasial torakolumbal (Thoracolumbar Interfascial Plane/TLIP) menjadi salah satu teknik yang efektif dalam mengurangi nyeri dengan risiko minimal terhadap fungsi motorik. Modifikasi teknik TLIP, terutama dengan penambahan adjuvan seperti dexmedetomidine, menawarkan potensi peningkatan durasi dan kualitas analgesia. Tinjauan naratif ini bertujuan merangkum bukti terkini mengenai efektivitas, mekanisme, dan keamanan penggunaan dexmedetomidine sebagai adjuvan pada TLIP modifikasi untuk bedah lumbal. Pencarian literatur dilakukan melalui basis data PubMed, Scopus, dan Google Scholar dengan menggunakan kata kunci “modified TLIP block”, “dexmedetomidine”, “lumbar spine surgery”, dan “postoperative analgesia” untuk artikel berbahasa Inggris atau Indonesia yang diterbitkan antara tahun 2013 hingga 2024. Hasil sintesis menunjukkan bahwa penambahan dexmedetomidine (0,5–1 µg/kg) pada anestesi lokal dapat memperpanjang durasi analgesia hingga 6–8 jam, menurunkan skor nyeri pascaoperasi, serta mengurangi konsumsi opioid tanpa menimbulkan efek samping berat, seperti bradikardia atau hipotensi yang signifikan. Efek analgesik ini terkait dengan aktivasi reseptor α₂-adrenergik di perifer dan spinal yang menghambat transmisi nyeri. Tinjauan ini membahas secara komprehensif dasar fisiologi dan farmakologi kombinasi TLIP–dexmedetomidine, perbandingan dengan blok interfasial lain, bukti klinis terkini, serta arah penelitian yang diperlukan untuk penerapan optimal dalam praktik anestesiologi modern.
subject: Review Articles
  topic: section
subject: Analgesia pascaoperasi
  topic: keywords
subject: Bedah tulang belakang
  topic: keywords
subject: Blok TLIP
  topic: keywords
subject: Blok torakolumbar interfasial
  topic: keywords
subject: Dexmedetomidine
  topic: keywords
creator: I Putu Eka Ariyasa
creator: I Made Gede Widnyana
creator: I Made Agus Kresna Sucandra
rights: Copyright (c) 2025 I Putu Eka Ariyasa, I Made Gede Widnyana, I Made Agus Kresna Sucandra (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-12-01
publication date: 2025-12-01
starting page: 112
ending page: 117
doi: 10.24843/s4tbj786

Renal Resistive Index in Early Detection of AKI after Neurosurgery: A Case Series
type: item
description: Postoperative acute kidney injury (AKI) is a frequent yet underrecognized complication in neurosurgical patients, often contributing to increased morbidity and mortality. Brain injury can trigger systemic effects, including sympathetic overactivation, inflammatory responses, and hemodynamic instability, all of which predispose patients to renal dysfunction. The Renal Resistive Index (RRI), obtained by Doppler ultrasonography, reflects intrarenal vascular resistance and has emerged as a promising early marker of AKI. This case series describes three patients undergoing decompressive craniectomy for intracranial hemorrhage who had normal preoperative renal function and subsequently developed stage 1 AKI according to Kidney Disease; Improving Global Outcome (KDIGO) guideline within 24 hours postoperatively. In each case, an elevated RRI (>0.7) measured during the early postoperative period preceded the rise in serum creatinine and the reduction in urine output. The consistent pattern across these patients highlights the potential utility of RRI as a noninvasive, bedside predictor of postoperative AKI in neurosurgical populations. The findings support the clinical relevance of integrating RRI into perioperative monitoring, particularly in high-risk patients where early detection of renal dysfunction may guide timely interventions to optimize hemodynamic stability and prevent further injury. Further prospective studies with larger cohorts are warranted to validate these observations and establish standardized thresholds for practice.
subject: Case Report or Case Series
  topic: section
subject: Acute Kidney Injury
  topic: keywords
subject: Intracranial hemorrhage
  topic: keywords
subject: Neurosurgery
  topic: keywords
subject: Postoperative care
  topic: keywords
subject: Renal resistive index
  topic: keywords
creator: Aldy Sethiono
creator: Pontisomaya Parami
creator: I Made Wirga Wirgunatha
rights: Copyright (c) 2025 Aldy Sethiono, Pontisomaya Parami, I Made Wirga Wirgunatha (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-12-01
publication date: 2025-12-01
starting page: 157
ending page: 162
doi: 10.24843/t6eqx794

Effectiveness of Dexmedetomidine Compared to Midazolam for Sedation in Mechanically Ventilated Patients: A Narrative Review
type: item
description: Delirium is a common and clinically significant neuropsychiatric complication in mechanically ventilated adult ICU patients, contributing to prolonged hospitalization, increased morbidity, and long-term cognitive impairment. The choice of sedative agent plays a pivotal role in preventing delirium, with dexmedetomidine and midazolam representing the most commonly used drugs with contrasting mechanisms. This narrative review evaluates the clinical efficacy, safety profile, neurocognitive outcomes, and cost-effectiveness of dexmedetomidine compared with midazolam in mechanically ventilated ICU patients. Literature was searched through PubMed, Scopus, ScienceDirect, Cochrane Library, and Google Scholar for studies published between 2020 and 2025 using the keywords dexmedetomidine, midazolam, sedation, mechanical ventilation, delirium, and intensive care units. Seventeen peer-reviewed publications were included and analyzed narratively. Dexmedetomidine consistently reduced the incidence and duration of delirium (RR 0.55–0.65; 95% CI 0.4–0.8), shortened mechanical ventilation by 0.7–1.5 days, and facilitated earlier extubation compared to midazolam. Its α₂-adrenergic agonism at the locus coeruleus produces a sleep-like, cooperative sedation, with mild, dose-dependent bradycardia as the most frequent adverse effect. Despite higher acquisition cost, economic analyses reported average savings of US$ 450–700 (≈ IDR 7–10 million) per patient through reduced ICU stay and delirium-related complications. Overall, dexmedetomidine demonstrates superior efficacy and safety compared with midazolam for ICU sedation, providing both clinical and economic advantages. Integration into light-sedation and delirium-prevention bundles may improve ICU outcomes, particularly in resource-limited settings.
subject: Review Articles
  topic: section
subject: Delirium
  topic: keywords
subject: Dexmedetomidine
  topic: keywords
subject: Intensive care unit
  topic: keywords
subject: Mechanical Ventilation
  topic: keywords
subject: Midazolam
  topic: keywords
creator: Guntur Mu Ammar Haithami
creator: Putu Agus Surya Panji
creator: Ida Bagus Krisna Jaya Sutawan
creator: Christopher Ryalino
rights: Copyright (c) 2025 Guntur Mu Ammar Haithami, Putu Agus Surya Panji, Ida Bagus Krisna Jaya Sutawan, Christopher Ryalino (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-12-01
publication date: 2025-12-01
starting page: 138
ending page: 143
doi: 10.24843/359b8m36

Peran Gabapentinoid dalam Strategi Analgesia Preemptif pada Mastektomi Radikal Termodifikasi: Tinjauan Naratif
type: item
description: Nyeri pascaoperasi tetap menjadi tantangan utama pada pasien kanker payudara yang menjalani prosedur Modified Radical Mastectomy (MRM), dengan prevalensi nyeri sedang hingga berat mencapai hampir 70%. Salah satu pendekatan yang menjanjikan adalah penggunaan analgesia preemptif dengan agen gabapentinoid, seperti pregabalin dan gabapentin, yang bekerja menghambat sensitisasi sentral serta menurunkan konsumsi opioid. Tinjauan naratif ini bertujuan mengevaluasi efektivitas kedua agen tersebut dalam mengurangi nyeri pasca-MRM, memperpanjang durasi bebas nyeri, dan menekan kebutuhan analgesik tambahan. Penelusuran literatur dilakukan melalui basis data PubMed, Scopus, ScienceDirect, dan Google Scholar dengan kata kunci “pregabalin”, “gabapentin”, “preemptive analgesia”, “modified radical mastectomy”, dan “postoperative pain”, mencakup publikasi berbahasa Inggris dan Indonesia periode 2013–2024. Hasil sintesis menunjukkan bahwa pregabalin dan gabapentin secara konsisten menurunkan skor nyeri Visual Analog Scale (VAS), memperpanjang waktu hingga permintaan analgesik pertama, dan mengurangi total konsumsi opioid pascaoperasi. Pregabalin dosis 150 mg menunjukkan efektivitas yang setara atau lebih baik dibandingkan gabapentin 900 mg, dengan onset kerja lebih cepat dan profil efek samping yang lebih ringan. Secara keseluruhan, gabapentinoid terbukti efektif dan aman sebagai bagian dari strategi analgesia multimodal pasca MRM, dengan pregabalin menunjukkan keunggulan farmakokinetik dan tolerabilitas yang lebih baik. Penelitian berskala besar dengan populasi homogen masih diperlukan untuk memperkuat rekomendasi klinis berbasis bukti.
subject: Review Articles
  topic: section
subject: Gabapentin
  topic: keywords
subject: Gabapentinoid
  topic: keywords
subject: Mastektomi radikal modifikasi
  topic: keywords
subject: Nyeri pascaoperasi
  topic: keywords
subject: Pregabalin
  topic: keywords
creator: Yolanda Jenny Pratana
creator: I Gusti Agung Made Wibisana Kurniajaya
creator: Nyoman Bendhesa Wirananggala
rights: Copyright (c) 2025 Yolanda Jenny Pratana, IGA Made Wibisana Kurniajaya, Nyoman Bendhesa Wirananggala (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-12-01
publication date: 2025-12-01
starting page: 131
ending page: 137
doi: 10.24843/ztnjkq21

Transformasi ICU Modern: Teknologi, Humanisasi, dan Perawatan Individual dalam Era Perawatan Kritis
type: item
description: Transformasi ICU modern ditandai oleh kemajuan teknologi, pendekatan humanistik, dan perawatan individual yang terintegrasi. Penerapan ICU Liberation Bundle (ABCDEF) terbukti mengurangi durasi rawat, delirium, dan meningkatkan survival jangka panjang. Inovasi seperti kecerdasan buatan, tele-ICU, serta pemantauan hemodinamik lanjutan memperkuat deteksi dini dan intervensi tepat waktu. Strategi manajemen cairan berbasis responsivitas dinamis dan ventilasi protektif semakin diutamakan. Penggunaan ECMO dan imunoterapi untuk sepsis menunjukkan perkembangan signifikan. Meski demikian, tantangan seperti burnout tenaga kesehatan dan rehabilitasi pasca-ICU masih perlu diatasi. Kolaborasi dan inovasi terus menjadi kunci dalam membentuk ICU masa depan yang lebih adaptif dan berpusat pada pasien.
subject: Editorial
  topic: section
subject: Artificial Intelligence
  topic: keywords
subject: Telemedicine
  topic: keywords
subject: Critical care
  topic: keywords
subject: Fluid responsiveness
  topic: keywords
creator: I Made Prema Putra
rights: Copyright (c) 2025 I Made Prema Putra (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-08-08
publication date: 2025-08-08
starting page: 36
ending page: 37
doi: 10.24843/JATI.2025.v01.i02.p01

Albumin Use and Its Association with Nutritional Status in the Intensive Care Unit : A Narrative Review
type: item
description: Introduction: Albumin is the major protein in blood plasma that plays a pivotal role in the regulation of oncotic pressure and nutritional status, particularly in critically ill patients. Hypoalbuminemia is frequently observed in ICU patients and is associated with increased morbidity and mortality. This narrative review aims to assess the role and efficacy of albumin supplementation, administered both orally and intravenously, in supporting the nutritional status and prognosis of critically ill patients. Methods: A literature search was conducted across the PubMed, Google Scholar, ScienceDirect, and ProQuest databases utilizing the keywords: "albumin", "critical illness", "nutrition", and "ICU". Articles included were those published within the last 10 years, available in English and Indonesian, and comprised review articles, clinical trials, and clinical practice guidelines. The selection process was performed through the screening of titles, abstracts, and subsequent full-text reviews. A total of 23 articles were included in this review. Results: The literature indicates that albumin supplementation contributes to hemodynamic stability, a reduction in nosocomial infections, and improved prognosis in patients with conditions such as sepsis, ARDS, hepatic and renal dysfunction, and in post-operative states. Supplementation with snakehead fish (Channa striata) extract has also been reported to increase albumin levels. Accurate nutritional assessment, using tools like the Nutrition Focused Physical Exam (NFPE), Subjective Global Assessment (SGA), and biomarkers such as Total Lymphocyte Count (TLC) and Neutrophil to Lymphocyte Ratio (NLR) are essential for determining the nutritional status of critically ill patients. Specific recommendations from the ESPEN consensus and various hepatology and nephrology associations exist concerning the application of albumin in specific clinical conditions. Conclusion: Albumin supplementation holds significant potential in supportin…
subject: Review Articles
  topic: section
subject: albumin
  topic: keywords
subject: critical ill
  topic: keywords
subject: Hipoalbuminemia
  topic: keywords
subject: Intensive Care Unit
  topic: keywords
subject: Nutritional Status
  topic: keywords
creator: Putu Eka Nantha Kusuma
creator: Jeremy Jonathan
creator: Putu Agus Surya Panji
rights: Copyright (c) 2025 Putu Eka Nantha Kusuma, Jeremy Jonathan, Putu Agus Surya Panji (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-08-08
publication date: 2025-08-08
starting page: 85
ending page: 92
doi: 10.24843/JATI.2025.v01.i02.p08

External Oblique Intercostal Plane Block (EOIPB) sebagai Tambahan Analgesia Multimodal Pasca Laparoskopi Kolesistektomi: Tinjauan Naratif
type: item
description: Pendahuluan: Nyeri pascaoperasi, terutama setelah kolesistektomi laparoskopi, adalah masalah signifikan yang meningkatkan morbiditas dan memperpanjang masa rawat inap. Penanganan nyeri sering kali melibatkan opioid sistemik yang memiliki efek samping merugikan. Oleh karena itu, pendekatan analgesia alternatif yang minim opioid sangat dibutuhkan. Tinjauan naratif ini bertujuan mengevaluasi efektivitas External Oblique Intercostal Plane Block (EOIPB) sebagai tambahan analgesia multimodal pasca kolesistektomi laparoskopi, berfokus pada kualitas analgesia, pemulihan pasien, dan respons inflamasi sistemik. Metode: Tinjauan naratif ini didasarkan pada penelusuran literatur terstruktur dari PubMed, Scopus, ScienceDirect, Cochrane Library, dan Google Scholar. Pencarian menggunakan kombinasi kata kunci seperti "external oblique intercostal plane block", "laparoscopic cholecystectomy", "postoperative pain", "quality of recovery", "neutrophil to lymphocyte ratio", dan "platelet to lymphocyte ratio". Publikasi dibatasi pada tahun 2019–2024, berbahasa Inggris atau Indonesia. Kriteria inklusi meliputi studi primer peer-reviewed (RCT, kohort, observasional) yang mengevaluasi EOIPB atau blok interfasial sebanding, serta melaporkan skor nyeri pascaoperasi, konsumsi opioid, skor quality of recovery (QoR-15), dan/atau nilai neutrophil to lymphocyte ratio (NLR) / platelet to lymphocyte ratio (PLR). Hasil: EOIPB secara konsisten memperpanjang durasi analgesia, menurunkan intensitas nyeri dengan skor visual analog scale (VAS), dan mengurangi konsumsi opioid pascaoperasi secara signifikan. Studi juga menunjukkan profil keamanan EOIPB yang baik dengan insiden efek samping minimal. Bupivakain, agen anestesi lokal yang umum digunakan, tidak hanya memblok transmisi nyeri tetapi juga menunjukkan sifat anti-inflamasi. Meskipun demikian, terdapat heterogenitas dalam teknik dan jenis anestesi yang digunakan antar studi. Kesimpulan: EOIPB adalah teknik blok interfasial yang efektif dan aman untuk …
subject: Review Articles
  topic: section
subject: External Oblique Intercostal Plane Block
  topic: keywords
subject: Laparoscopic surgery
  topic: keywords
subject: Visual Analog Scale (VAS)
  topic: keywords
subject: quality of recovery 15
  topic: keywords
subject: Neutrophil to lymphocyte ratio
  topic: keywords
creator: David Rendra Mahardika
creator: Made Agus Kresna Sucandra
creator: Tjokorda Gde Agung Senapathi
rights: Copyright (c) 2025 David Rendra Mahardika, Made Agus Kresna Sucandra, Tjokorda Gde Agung Senapathi (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-08-08
publication date: 2025-08-08
starting page: 72
ending page: 84
doi: 10.24843/JATI.2025.v01.i02.p07

Managemen Anestesi pada Congenital Diapragmatic Hernia dengan Ventrikel Septal Defek dan Atrium Septal Defek pada Pasien Pediatrik : Laporan Kasus
type: item
description: Congenital diaphragmatic hernia (CDH) merupakan kelainan kongenital pada diafragma yang terjadi pada pediatri. Insiden terjadinya hernia tipe Borchdalek lebih sering terjadi pada sisi kiri dari pada sisi kanan. Penyulit lain pada CDH adalah hipoplasia paru, hipertensi paru dan kelainan pada jantung. Pada kasus ini kami mendiskusikan bayi 12 hari dengan kelainan CDH sisi kanan dengan kelainan jantung berupa ventrikel septal defek (VSD) dan atrium septal defek (ASD) yang dilakukan operasi laparotomi hernia. Manajemen anestesi pada pasien ini menggunakan inhalasi sevoflurane, fentanil, volume tidal rendah, obat inotropik dengan kondisi hemodinamik yang stabil selama pembedahan. Kami melaporkan management anestesi dengan sevoflurane yang dikombinasi dengan volume tidal rendah dan inotropik dobutamine pada operasi congenital diaphragmatic herdia dengan VSD dan ASD membantu dalam keberhasilan intraoperatif. Setelah operasi, pasien dilakukan perawatan di NICU untuk perawatan secara ketat.
subject: Case Report or Case Series
  topic: section
subject: Congenital Hernia Diaphragmatica
  topic: keywords
subject: asd
  topic: keywords
subject: vsd
  topic: keywords
subject: dobutamine
  topic: keywords
subject: Sevoflurane
  topic: keywords
creator: Mauritius Septa
creator: Adinda Putra Pradhana
creator: I Putu Kurniyanta
creator: Ketut Wibawa Nada
creator: Novandi Kurniawan
creator: Tjokorda Gde Agung Senapathi
rights: Copyright (c) 2025 Mauritius Septa Kristiawan, Adinda Putra Pradhana, I Putu Kurniyanta, Ketut Wibawa Nada, Novandi Kurniawan, Tjokorda Gde Agung Senapathi (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-08-08
publication date: 2025-08-08
starting page: 64
ending page: 71
doi: 10.24843/JATI.2025.v01.i02.p06

Awake Intubation in Patient with Superoanterior Mediastinal Mass and Superior Vena Cava Syndrome (SVCS): A Case Report
type: item
description: Superior vena cava syndrome (SVCS) with airway compression is challenging in anesthesia management. We report the case of a 69-year-old man with a superoanterior mediastinal mass and grade 3 SVCS who underwent Video-Assisted Thoracoscopic Surgery (VATS) with awake intubation using a double lumen tube (DLT) and videolaryngoscope. Awake intubation was chosen as the safest anesthesia technique where patients still breathe spontaneously without experiencing the effects of deep sedation. The combination of 4% lidocaine nebulization, oropharyngeal lidocaine spray, and dexmedetomidine infusion (0.5 μg/kg bolus over 10 minutes followed by 0.3-0.6 μg/kg/hour during surgery) in this patient, successfully maintained spontaneous ventilation without hemodynamic complications. The use of nebulized lidocaine, lidocaine spray, and dexmedetomidine as intubation facilities showed excellent effectiveness by maintaining the patient's spontaneous breathing, increasing the pain threshold, suppressing the nausea-vomiting reflex, and providing comfort in the form of mild sedation during awake intubation. This approach emphasizes the importance of topical anesthesia and selective sedation in high-risk patients with airway difficulties.
subject: Case Report or Case Series
  topic: section
subject: awake intubation
  topic: keywords
subject: deksmedetomidine
  topic: keywords
subject: mediastinal mass
  topic: keywords
subject: lidocaine
  topic: keywords
subject: superior vena cava syndrome
  topic: keywords
creator: Ery Oktadiputra
creator: I Putu Fajar Narakusuma
creator: Tjokorda Gde Agung Senapathi
rights: Copyright (c) 2025 Ery Oktadiputra, I Putu Fajar Narakusuma, Tjokorda Gde Agung Senapathi (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-08-08
publication date: 2025-08-08
starting page: 57
ending page: 63
doi: 10.24843/JATI.2025.v01.i02.p05

Hubungan MAP dan CVP terhadap PEEP dan Perubahan Stroke Volume pada Pasien Ventilasi Mekanik Invasif: Studi Observasional Analitik
type: item
description: Pendahuluan: Penggunaan parameter statis seperti mean arterial pressure (MAP) dan central venous pressure (CVP) sering kali tidak cukup akurat untuk memprediksi fluid responsiveness, sehingga diperlukan parameter dinamis yang lebih praktis dan dapat diandalkan. Penelitian ini bertujuan untuk mengevaluasi korelasi antara perubahan MAP dan CVP akibat perubahan positive end expiratory pressure (PEEP) dengan perubahan stroke volume (SV) sebagai prediktor kecukupan cairan pada pasien ICU dengan ventilasi mekanik. Pasien dan Metode: Penelitian ini merupakan studi observasional analitik. Subjek penelitian adalah pasien berusia 18–65 tahun yang menjalani ventilasi mekanik. Setelah mendapatkan persetujuan etik dan informed consent, dilakukan pengukuran MAP dan CVP pada PEEP 5 dan 15 cmH₂O. Selanjutnya, SV diukur menggunakan ekokardiografi transtorakal dan setelah manuver passive leg raising (PLR). Fluid responsiveness didefinisikan sebagai peningkatan SV ≥10% setelah PLR. Analisis korelasi dilakukan untuk menilai hubungan antara perubahan MAP dan CVP akibat PEEP dengan perubahan SV akibat PLR, serta analisis kurva ROC untuk menentukan nilai ambang diagnostik. Hasil: Sebanyak 28 pasien memenuhi kriteria inklusi dan dianalisis dalam penelitian ini. Hasil analisis menunjukkan bahwa tidak ditemukan korelasi yang signifikan antara perubahan MAP akibat PEEP dengan perubahan SV akibat PLR (r = -0,233; p = 0,232). Sebaliknya, ditemukan korelasi kuat antara perubahan CVP akibat PEEP dengan perubahan SV akibat PLR (r = 0,751; p < 0,001). Analisis kurva ROC memperlihatkan area under curve (AUC) sebesar 0,872 untuk perubahan CVP, dengan nilai ambang optimal 3,25 cmH₂O yang memberikan sensitivitas 71,4% dan spesifisitas 78,6% dalam memprediksi fluid responsiveness. Kesimpulan: Perubahan CVP akibat peningkatan PEEP memiliki korelasi kuat dengan fluid responsiveness dan dapat digunakan sebagai parameter dinamis untuk menilai kecukupan cairan pada pasien ICU dengan ventilasi mekanik.
subject: Original Articles
  topic: section
subject: mean arterial pressure
  topic: keywords
subject: central venous pressure
  topic: keywords
subject: positive end-expiratory pressure
  topic: keywords
subject: fluid responsiveness
  topic: keywords
subject: ventilasi mekanik
  topic: keywords
creator: Win Muliadi
creator: Cynthia Dewi Sinardja
creator: I Made Subargiartha
rights: Copyright (c) 2025 Win Muliadi, Cynthia Dewi Sinardja, I Made Subargiartha (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-08-08
publication date: 2025-08-08
starting page: 38
ending page: 42
doi: 10.24843/JATI.2025.v01.i02.p02

Fibrinolytic and Anticoagulant Therapy in COVID-19 Associated Pulmonary Embolism: A Case Report
type: item
description: Pulmonary thromboembolism is a complication that can occur in coronavirus disease-2019 (COVID-19). Efforts to prevent and therapy for thromboembolism have been a challenge to this date. The side effects of fibrinolytic, anticoagulant, and platelet anti-aggregation therapies, such as hemorrhage, are some of the causes of morbidity and mortality that must be addressed immediately. In this case, the patient received prophylaxis with the anticoagulant enoxaparin and platelet anti-aggregation agents with aspirin and clopidogrel. The COVID-19 patient presented a complication of pulmonary thromboembolism that was established using a computed tomography pulmonary angiography (CTPA) performed on his third day of care (day 14 of onset treatment) due to the patient’s clinical aggravation of pulmonary manifestation. After fibrinolytic therapy had been given, the patient’s clinical condition improved. However, on the 7th day after the provision of recombinant tissue plasminogen activator (r-TPA), the patient experienced a side effect of hemorrhage, and management was undertaken to address these issues by transfusions of blood components, such as cryoprecipitates, thrombocyte concentrate, fresh frozen plasma, and packed red cell. Thromboembolism occurring in COVID-19 patients is based on the Virchow triad concept, comprising endothelial injury, static blood flow, and hypercoagulation. The principle of prevention and management of thromboembolism refers to this concept. Currently, further studies are required to treat thromboembolism and the side effects of fibrinolytic and anticoagulant therapies on COVID-19 patients.
subject: Case Report or Case Series
  topic: section
subject: anticoagulant
  topic: keywords
subject: Covid 19
  topic: keywords
subject: Fibrinolytic
  topic: keywords
subject: hemorrage
  topic: keywords
subject: thromboembolism
  topic: keywords
creator: Putu Eka Nantha Kusuma
creator: I Made Prema Putra
creator: I Gusti Ngurah Mahaalit Aribawa
rights: Copyright (c) 2025 Putu Eka Nantha Kusuma, I Made Prema Putra, I Gusti Ngurah Mahaalit Aribawa (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-08-08
publication date: 2025-08-08
starting page: 50
ending page: 562025-08-08
doi: 10.24843/JATI.2025.v01.i02.p04

Comparison Between Opioid Free Anesthesia and Opioid Based Anesthesia in Laparoscopic Hysterectomy: A Systematic Review
type: item
description: Introduction: In Gynecology field, laparoscopy surgery is used for many procedures that were traditionally performed via laparotomy. Hysterectomy associated with postoperative pain, which greatly affected postoperative recovery and patient satisfaction. Combinations of opiod base analgesia (OBA) and opioid free analgesia (OFA) agents are combined with local or regional anesthesic techniques whenever possible. Methods: A systematic search of relevant databases was conducted to identify case control studies comparing OBA and OFA post hysterectomy procedure. Inclusion criteria encompassed studies reporting Visual Analog Scale (VAS) and Numeric Rating Scale (NRS) as an outcome measure. Quality assessment and data extraction were performed independently by author. Results: The systematic review identified a total of four case-control studies meeting the inclusion criteria with total of 357 patients undergone hysterectomy procedure. The sample sizes varied across the studies, with the smallest study including 30 patients and the largest study including 157 patients. The outcomes were assessed using VAS and NRS scores. The results consistently showed that either OBA or OFA administration giving similar outcome on pain scale. Conclusion: All studies concluded whether OBA or OFA administration peri or postoperative given similar or not significantly different of pain scoring outcomes. Although OFA would give a better result to maintain post operative nausea and vomitting (PONV) and reducing opiod-related adverse events that happen postoperatively.
subject: Original Articles
  topic: section
subject: Hysterectomy
  topic: keywords
subject: opioid-free anesthesia
  topic: keywords
subject: general anesthesia
  topic: keywords
subject: opioid based anesthesia
  topic: keywords
subject: pain score
  topic: keywords
creator: Ode Mahesa Putra
creator: I Ngurah Arya Wicaksana
rights: Copyright (c) 2025 Ode Mahesa Putra, I Ngurah Arya Wicaksana (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-08-08
publication date: 2025-08-08
starting page: 43
ending page: 49
doi: 10.24843/JATI.2025.v01.i02.p03

Perkembangan Terkini dalam Painless Labour: Tinjauan Naratif
type: item
description: Pendahuluan: Persalinan merupakan proses fisiologis yang sering kali disertai dengan nyeri hebat, yang dapat menyebabkan stres fisik dan psikologis pada ibu. Manajemen nyeri yang tidak optimal dapat berkontribusi terhadap peningkatan angka morbiditas dan mortalitas ibu serta mempengaruhi kesejahteraan neonatal. Oleh karena itu, pemilihan metode analgesia yang efektif dan aman menjadi perhatian utama dalam praktik obstetri modern. Metode: Tinjauan naratif ini didasarkan pada penelusuran literatur terstruktur dari PubMed, Scopus, ScienceDirect, Cochrane Library, dan Google Scholar. Pencarian menggunakan kombinasi kata kunci seperti "painless labour", "labour analgesia", "obstetric analgesia", "pain management in labour", "epidural analgesia", “non-pharmacological pain relief in labour” dan "neuraxial analgesia". Publikasi dibatasi pada tahun 2018–2022, berbahasa Inggris atau Indonesia. Kriteria inklusi meliputi studi primer peer-reviewed (RCT, kohort, observasional) yang mengevaluasi painless labour atau labour analgesia, serta melaporkan skor nyeri pasca melahirkan, dan kepuasan persalinan. Hasil: Kajian ini adalah untuk mengevaluasi berbagai metode manajemen nyeri persalinan, baik melalui pendekatan farmakologis maupun non-farmakologis, serta menyoroti keunggulan dan keterbatasan masing-masing pendekatan. Metode farmakologis seperti anestesi epidural, analgesia intravena, dan blok saraf telah terbukti efektif dalam mengurangi intensitas nyeri, sementara pendekatan non-farmakologis seperti teknik pernapasan, hidroterapi, akupunktur, dan stimulasi listrik saraf transkutan (TENS) juga memberikan manfaat tambahan dalam meningkatkan kenyamanan ibu selama persalinan. Kajian ini menekankan pentingnya pendekatan multidisiplin dalam manajemen nyeri persalinan guna memastikan pengalaman persalinan yang lebih aman, nyaman, dan sesuai dengan kebutuhan individual pasien. Kesimpulan: Pemilihan metode yang tepat harus mempertimbangkan kondisi medis ibu, preferensi pasien, serta ke…
subject: Review Articles
  topic: section
subject: painless labour
  topic: keywords
subject: manajemen nyeri persalinan
  topic: keywords
subject: Epidural Anesthesia
  topic: keywords
subject: non-pharmalogical pain relief in labour
  topic: keywords
subject: neuroaxial block
  topic: keywords
creator: Acuyta Ganakin
creator: Jeremy Jonathan
creator: I Made Gede Widnyana
rights: Copyright (c) 2025 Acuyta Ganakin, Jeremy Jonathan, I Made Gede Widnyana (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-09-03
publication date: 2025-09-03
starting page: 25
ending page: 35
doi: 10.24843/JATI.2025.v01.i01.p06

Manajemen Anestesi pada Pasien Pediatri dengan Double Inlet Left Ventricle Yang Menjalani Bidirectional Cavo-Pulmonary Shunt: Laporan Kasus
type: item
description: Istilah single ventricle (jantung univentrikular) digunakan untuk menggambarkan kelainan jantung dengan satu rongga ventrikel yang efektif. Kelainan jantung ini meliputi ventrikel tunggal, ventrikel umum, double inlet left ventricle (DILV), dan koneksi atrioventrikular univentrikular. Double Inlet Left Ventricle (DILV) merupakan kelainan jantung kongenital langka dengan anatomi ventrikel tunggal, di mana kedua atrium mengalir ke ventrikel kiri. dan merupakan variasi penyakit jantung bawaan fungsional univentrikular yang bersifat sianotik Variasi ini secara keseluruhan mencakup ≤2% dari semua kelainan jantung bawaan (congenital heart defects/CHDs). Harapan kelangsungan hidup pasien dengan kelainan ini tanpa koreksi bedah adalah sekitar 14 tahun. Untuk mengatasi kondisi ini, diperlukan pemisahan total antara sirkulasi pulmonal dan sistemik melalui prosedur Fontan yang berlangsung dalam tiga tahap. Tujuan prosedur Fontan adalah untuk mengalihkan aliran darah balik sistemik langsung ke arteri pulmonal tanpa melewati ruang jantung kanan. Langkah pembedahan awal adalah prosedur Bidirectional Cavopulmonary Shunt (BCPS) sebagai tahap pertama untuk sirkulasi Fontan. Manajemen anestesi pada pasien DILV yang menjalani Bidirectional Cavopulmonary Shunt (BCPS) memerlukan keseimbangan hemodinamik presisi untuk mempertahankan aliran darah sistemik (Qs) dan aliran darah pulmonal (Qp), berbagai pemantauan invasif, dan kesiapan menghadapi komplikasi hemodinamik perioperatif. Komplikasi low cardiac output syndrome (LCOS) dan gangguan metabolik pasca BCPS menegaskan pentingnya pendekatan multidisiplin pada kasus ini. Optimalisasi ventilasi, penggunaan vasodilator pulmonal, dan inotropik dini menjadi kunci dalam tata laksana. Pada laporan kasus ini dipaparkan manajemen perioperatif pasien anak laki-laki usia 1 tahun dengan kelainan jantung bawaan DILV, VSD, ASD dan PLSVC yang menjalani operasi BCPS. Pasien diketahui memiliki kelainan jantung bawaan sejak lahir, namun tidak pernah menunj…
subject: Case Report or Case Series
  topic: section
subject: bcps
  topic: keywords
subject: cardiothoracic anethesia
  topic: keywords
subject: low cardiac output syndrome
  topic: keywords
creator: Aditya Wangsa
creator: IGAE Parasanti Sidemen
creator: Ketut Wibawa Nada
rights: Copyright (c) 2025 Aditya Wangsa, Parasanti Sidemen, Ketut Wibawa Nada (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-09-03
publication date: 2025-09-03
starting page: 19
ending page: 24
doi: 10.24843/JATI.2025.v01.i01.p04

Manajemen Anestesi pada Pasien Pasca Transplantasi Ginjal yang menjalani Operasi Seksio Sesaria: Laporan Kasus
type: item
description: Wanita dengan riwayat pasca transplantasi ginjal harus menjalani persiapan yang matang untuk menjalani proses kehamilan. Manajemen perioperatif pada pasien wanita hamil dengan pasca transplantasi ginjal juga dibutuhkan kerjasama tim yang meliputi ahli nefrologi, obstetri, dan anestesiologi & terapi intensif. Evaluasi meliputi pemeriksaan preanestesi rutin yang difokuskan kepada efek pemberian obat-obatan imunosupresif pasca transplantasi ginjal dan penyakit komorbidnya. Durante operasi juga harus mempertimbangkan teknik anestesi yang digunakan, interaksi obat dan teknik anestesi yang digunakan terhadap obat-obatan imunosupresi, serta resiko infeksi. Perawatan pasca operasi di ruang terapi intensif dibutuhkan untuk memonitoring status preload pasien, fungsi ginjal, dan juga pencegahan infeksi. Pemahaman mengenai perubahan fisiologi yang terjadi pada wanita hamil dengan pasca transplantasi ginjal akan memberikan outcome yang lebih baik.
subject: Case Report or Case Series
  topic: section
subject: anestesi
  topic: keywords
subject: hamil
  topic: keywords
subject: seksio sesaria
  topic: keywords
subject: transplantasi ginjal
  topic: keywords
creator: Tjahya Aryasa
creator: I Made Prema Putra
creator: Made Wiryana
rights: Copyright (c) 2025 Tjahya Aryasa, I Made Prema Putra (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-09-03
publication date: 2025-09-03
starting page: 15
ending page: 18
doi: 10.24843/JATI.2025.v01.i01.p05

Korelasi Pulsatile Index dan Optic Nerve Sheath Diameter terhadap Tekanan Intrakranial Pasien Preeklamsia: Studi Analitik Observasional
type: item
description: Pendahuluan: Peningkatan tekanan intrakranial (TIK) menjadi pertimbangan penting dalam penanganan pasien preeklamsia. Manifestasi klinis peningkatan TIK pada preeklamsia sulit untuk dideteksi secara klinis, dan pemeriksaan baku emasnya memiliki keterbatasan. Adapun modalitas non-invasif yang memiliki potensi sebagai pengukuran TIK yaitu pulsatile index (PI) dengan transcranial doppler (TCD) dan optic nerve sheath diameter (ONSD). Penelitian ini bertujuan untuk mengetahui korelasi pulsatile index dengan ONSD terkait nilai TIK. Pasien dan Metode: Penelitian ini merupakan penelitian analitik observasional potong lintang, melibatkan 29 subjek yang terbagi menjadi preeklamsia ringan (PER), preeklamsia dengan gejala berat tanpa gejala neurologis (PEB) dan PEB dengan gejala neurologis (PEBn). Hasil: Pada ketiga kelompok tidak ditemukan adanya perbedaan variasi data demografis. Prevalensi peningkatan TIK menurut ONSD dan pulsatile index (PI) berturut-turut adalah 31% dan 20,7%. Perbedaan nilai rerata ONSD ketiga kelompok secara statistik tidak bermakna (p = 0,134), namun setelah dilakukan analisis Post-hoc, didapatkan perbedaan bermakna antara PER dan PEBn (CI -2,58-0,01 mm, p = 0,048). Rerata PI pada ketiga kelompok tidak berbeda bermakna (p = 0,866). Korelasi tekanan arteri rerata (TAR) baik terhadap ONSD (p =0,054) dan PI (p = 0,403) tidak ditemukan bermakna. Pada studi ini didapatkan korelasi positif sedang antara TCD terhadap ONSD pada pasien dengan preeklamsia (r = 0,657, p = 0,001). Kesimpulan: Pengukuran PI berpotensi untuk menjadi metode pengukuran TIK non-invasif selain ONSD. Studi lebih lanjut diperlukan untuk membandingkan antara pengukuran baku emas dengan TCD dan ONSD pada populasi preeklamsia.
subject: Original Articles
  topic: section
subject: peningkatan TIK
  topic: keywords
subject: preeklamsia
  topic: keywords
subject: ONSD
  topic: keywords
subject: PI
  topic: keywords
subject: TCD
  topic: keywords
creator: Mark Christsatya Bolla
creator: Jeremy Jonathan
creator: I Made Gede Widnyana
rights: Copyright (c) 2025 Mark Christsatya Bolla, Jeremy Jonathan, I Made Gede Widnyana (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-09-03
publication date: 2025-09-03
starting page: 9
ending page: 14
doi: 10.24843/JATI.2025.v01.i01.p03

Menumbuhkan Budaya Riset di Bidang Anestesi Melalui Integrasi Kecerdasan Buatan dan Peran Strategis Open Journal System
type: item
description: Artikel editorial ini menyoroti pentingnya penguatan budaya riset di bidang anestesiologi dan terapi intensif melalui pemanfaatan teknologi, khususnya kecerdasan buatan (AI), serta peran strategis sistem penerbitan ilmiah berbasis Open Journal System (OJS). Integrasi AI dalam praktik klinik dan riset memberikan peluang besar untuk personalisasi terapi dan efisiensi sistem kesehatan. Jurnal ini hadir sebagai wadah kolaboratif dan inklusif untuk mendukung riset primer, mendemokratisasi akses ilmu, serta mendorong kapasitas akademik para klinisi dan peneliti di Indonesia dan Asia Tenggara.
subject: Editorial
  topic: section
subject: Budaya Riset Anestesi
  topic: keywords
subject: kecerdasan buatan dalam anestesi
  topic: keywords
subject: Open Journal System
  topic: keywords
subject: Translasi Teknologi Ke praktik klinik
  topic: keywords
subject: Publikasi Ilmiah Kedokteran
  topic: keywords
creator: Putu Herdita Sudiantara
rights: Copyright (c) 2025 P H Sudiantara (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-09-03
publication date: 2025-09-03
starting page: 1
ending page: 2
doi: 10.24843/JATI.2025.v01.i01.p01

Efektivitas Blok Ilioingunal Dalam Menurunkan Penggunaan Opioid Dan Skor Nyeri Pada Seksio Sesarea: Studi Acak Terkontrol
type: item
description: Pendahuluan: Nyeri pascaoperasi seksio sesarea merupakan nyeri berat yang dapat mengganggu aktifitas ibu dan hubungan ikatan pertama kali antara ibu dan bayi. Tatalaksana nyeri hanya berfokus pada opioid dapat menyebabkan efek samping seperti mual, muntah, sedasi, dan depresi napas yang mengganggu ikatan ibu dan bayi. Saraf ilioinguinal menginervasi bagian abdomen bawah yang terlibat dalam insisi Pfannenstiel saat tindakan seksio sesarea sehingga blok ilioinguinal berpotensi mengatasi kedua permasalahan nyeri tersebut diatas pada pascaoperasi seksio sesarea. Pasien dan Metode: Penelitian ini merupakan penelitian true experimental dengan rancangan yang digunakan adalah single blind randomized controlled trial yang membagi 70 subyek penelitian kedalam dua kelompok, yaitu kelompok blok ilioinguinal pascaoperasi seksio sesarea dan kelompok kontrol. Kedua kelompok juga diberikan patient controlled analgesia morfin Kemudian dilakukan evaluasi skala nyeri NRS pada jam ke-0, 3, 6, 12, dan 24 selama 24 jam pertama, penggunaan total morfin dalam 24 jam, dan kenaikan nilai NLR dan PLR yang terjadi. Keseluruhan data kemudian dibandingkan untuk melihat keberhasilan blok ilioinguinal dalam menangani nyeri pascaoperasi seksio sesarea. Hasil: Penelitian ini menunjukkan bahwa kelompok blok ilioinguinal memiliki skor nyeri NRS pascaoperasi seksio sesarea yang lebih rendah dibandingkan kelompok kontrol, dan secara statistik bermakna (p < 0,001). Untuk penilaian konsumsi morfin dalam 24 jam, kelompok blok juga menggunakan morfin dalam jumlah yang lebih sedikit yaitu sebesar 4 mg dibandingkan kelompok kontrol yang hingga 22 mg dan bermakna secara statistik (p < 0,001). Kenaikan nilai NLR dan PLR juga terlihat lebih rendah pada kelompok blok dan bermakna secara statistik (p < 0,001). Kesimpulan: Blok ilioinguinal mampu memberikan penanganan nyeri yang baik selama 24 jam pertama pascaoperasi seksio sesarea dengan mengurangi kebutuhan penggunaan morfin secara signifikan. Selain itu blok il…
subject: Original Articles
  topic: section
subject: blok ilioinguinal
  topic: keywords
subject: patient controlled analgesia
  topic: keywords
subject: seksio sesaria
  topic: keywords
subject: abdominal blok
  topic: keywords
creator: Andi Irawan
creator: Pontisomaya Parami
creator: Made Wiryana
rights: Copyright (c) 2025 Andi Irawan (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-09-08
publication date: 2025-09-08
starting page: 3
ending page: 8
doi: 10.24843/JATI.2025.v01.i01.p02

Efektivitas dan Risiko Pemberian Antibiotik Profilaksis Ceftriaxone pada Pasien Cedera Otak Akut: Tinjauan Naratif
type: item
description: Cedera otak akut merupakan salah satu penyebab utama mortalitas dan morbiditas pada pasien trauma dan sering disertai komplikasi infeksi nosokomial seperti ventilator-associated pneumonia (VAP) dan meningitis. Penggunaan antibiotik profilaksis, termasuk ceftriaxone, banyak diterapkan untuk mencegah komplikasi tersebut karena spektrum kerjanya yang luas dan kemampuannya menembus sistem saraf pusat. Namun, efektivitas dan dampak terhadap resistensi antimikroba masih menjadi perdebatan, terutama dalam konteks praktik intensif dan bedah saraf. Tinjauan naratif ini bertujuan untuk menilai efektivitas, keamanan, dan implikasi klinis pemberian ceftriaxone sebagai antibiotik profilaksis pada pasien cedera otak akut. Berdasarkan hasil uji klinis acak dan kajian sistematis, ceftriaxone menunjukkan penurunan kejadian VAP dini sebesar 14% dibandingkan 32% pada kelompok kontrol, tetapi tidak menunjukkan manfaat signifikan terhadap pencegahan meningitis atau infeksi luka operasi. Beberapa studi juga melaporkan peningkatan risiko resistensi bakteri akibat pemberian berkepanjangan. Hasil sintesis ini menegaskan pentingnya pendekatan selektif dalam pemberian antibiotik profilaksis dengan mempertimbangkan risiko infeksi dan prinsip antimicrobial stewardship. Pesan utama dari tinjauan ini adalah perlunya kebijakan penggunaan antibiotik yang lebih rasional dan penelitian prospektif untuk menentukan populasi pasien yang paling diuntungkan serta durasi optimal pemberian profilaksis.
subject: Review Articles
  topic: section
subject: Antibiotik profilaksis
  topic: keywords
subject: Cedera otak akut
  topic: keywords
subject: Ceftriaxone
  topic: keywords
subject: Pneumonia terkait ventilator
  topic: keywords
subject: Resistensi antimikroba
  topic: keywords
creator: Mora Lesmana Pita
creator: I Wayan Suranadi
creator: I Ketut Wibawa Nada
rights: Copyright (c) 2025 Mora Lesmana Pita, I Wayan Suranadi, I Ketut Wibawa Nada (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-12-01
publication date: 2025-12-01
starting page: 126
ending page: 130
doi: 10.24843/ygnrw562

Graded Epidural Anesthesia with Real-Time Hemodynamic Monitoring for Cesarean Delivery in Severe Mitral Stenosis: A Case Report
type: item
description: This case report highlights the successful management of a high-risk obstetric patient with severe rheumatic mitral stenosis (MS) and acute decompensated heart failure (ADHF) using graded epidural anesthesia guided by real-time hemodynamic monitoring. A 34-year-old woman, in her second pregnancy following a previous abortion, presented at 34 weeks and 5 days of gestation with progressive dyspnea and orthopnea. Echocardiography confirmed severe MS accompanied by pulmonary hypertension and preserved left ventricular systolic function. After multidisciplinary optimization, an elective cesarean delivery was performed under graded epidural anesthesia with incremental dosing of lidocaine and ropivacaine. Beat-to-beat cardiac output monitoring using the MostCare™ PRAM (Pressure Recording Analytical Method) system guided vasopressor titration with phenylephrine, maintaining hemodynamic stability. The patient remained hemodynamically stable throughout the intraoperative and postoperative periods, with no pulmonary edema or arrhythmias, and was discharged on postoperative day four. This case demonstrates that graded epidural anesthesia, when combined with advanced hemodynamic monitoring and collaborative care, represents a safe and effective alternative to general anesthesia in parturients with severe valvular heart disease.
subject: Case Report or Case Series
  topic: section
subject: Caesarian Section
  topic: keywords
subject: Graded Epidural Anesthesia
  topic: keywords
subject: Hemodynamic Monitoring
  topic: keywords
subject: Mitral Stenosis
  topic: keywords
subject: Rheumatoid heart disease
  topic: keywords
creator: Stephanie Kurniady
creator: Tjahya Ariyasa EM
creator: Adinda Putra Pradana
rights: Copyright (c) 2025 Stephanie Kurniady, Tjahya Ariyasa EM, Adinda Putra Pradana (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-12-01
publication date: 2025-12-01
starting page: 150
ending page: 156
doi: 10.24843/fefrfk17

Efektivitas dan Keamanan Deksmedetomidine Nebulisasi Dibandingkan Rute Intravena sebagai Premedikasi Anestesi: Tinjauan Naratif
type: item
description: Laringoskopi dan intubasi trakea merupakan prosedur rutin anestesi yang sering memicu respons hemodinamik berupa peningkatan tekanan darah dan denyut jantung, yang dapat berisiko pada pasien dengan komorbiditas kardiovaskular atau serebrovaskular. Deksmedetomidine, agonis reseptor α2 adrenergik selektif, terbukti efektif dalam menekan respon tersebut melalui efek simpatolitik dan sedatif. Namun, pemberian intravena sering menyebabkan efek samping berupa hipotensi dan bradikardia. Tinjauan naratif ini bertujuan membandingkan efektivitas dan profil keamanan deksmedetomidine nebulisasi dengan rute intravena sebagai agen premedikasi untuk mengontrol respon hemodinamik selama laringoskopi dan intubasi. Berdasarkan hasil sintesis, deksmedetomidine nebulisasi mampu menurunkan lonjakan tekanan darah dan denyut jantung secara efektif dengan insidensi hipotensi dan bradikardi yang lebih rendah dibandingkan pemberian intravena, serta mengurangi kebutuhan obat induksi anestesi tanpa menimbulkan komplikasi serius. Dengan demikian, deksmedetomidine nebulisasi berpotensi menjadi alternatif premedikasi yang efektif dan lebih aman untuk stabilisasi hemodinamik selama anestesi, meskipun masih diperlukan uji klinis multisenter berskala besar untuk memperkuat bukti dan menentukan dosis optimal.
subject: Review Articles
  topic: section
subject: Bradikardia
  topic: keywords
subject: Dexmedetomidine
  topic: keywords
subject: Hipotensi
  topic: keywords
subject: Laringoskopi
  topic: keywords
subject: Nebulisasi
  topic: keywords
subject: Respon Hemodinamik
  topic: keywords
creator: Ida Katarina
creator: I Putu Fajar Narakusuma
creator: Made Septyana Parama Adi
rights: Copyright (c) 2025 Ida Katarina, I Putu Fajar Narakusuma, Made Septyana Parama Adi (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-12-01
publication date: 2025-12-01
starting page: 118
ending page: 125
doi: 10.24843/93296c76

Low-Flow Anesthesia Management in Pediatric Laparoscopic Choledochal Cyst Excision and Hepaticojejunostomy: A Case Report
type: item
description: Laparoscopic surgery offers significant benefits in pediatric populations but presents anesthetic challenges, especially during prolonged procedures. This case report describes the anesthetic management of an 11-year-old boy who underwent nearly 12 hours of laparoscopic choledochal cyst excision, Roux-en-Y hepaticojejunostomy, and cholecystectomy. Low-flow anesthesia using sevoflurane was administered via a Dräger Perseus A500, enabling precise control of anesthetic delivery, oxygenation, and ventilation. Throughout the procedure, inspired oxygen fraction (FiO₂) was maintained above 30%, and end-tidal CO₂ (EtCO₂) remained stable around 35 mmHg. Volatile agent consumption was reduced, with age-adjusted MAC (xMAC) consistently between 0.85 and 0.90. Intraoperative hemodynamics and postoperative recovery were stable, with no immediate complications. This case highlights the safety, efficiency, and cost-effectiveness of low-flow anesthesia in complex pediatric laparoscopic surgery when guided by advanced monitoring systems and supports its broader adoption in resource-limited healthcare settings.
subject: Case Report or Case Series
  topic: section
subject: Choledochal cyst
  topic: keywords
subject: Laparoscopic surgery
  topic: keywords
subject: Low-flow anesthesia
  topic: keywords
subject: Pediatric anesthesia
  topic: keywords
subject: Sevoflurane
  topic: keywords
creator: Togi Stanislaus Patrick
creator: I Gusti Ngurah Mahaalit Aribawa
creator: Marilaeta Cindryani Ra Ratumasa
creator: Anak Agung Gde Adistaya
rights: Copyright (c) 2025 Togi Stanislaus Patrick, I Gusti Ngurah Mahaalit Aribawa, Marilaeta Cindryani Ra Ratumasa, A A Gde Adistaya (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-12-01
publication date: 2025-12-01
starting page: 144
ending page: 149
doi: 10.24843/xqsck350

Comparison of IL-6 Levels After Ibuprofen–Paracetamol– Dexamethasone in Percutaneous Nephrolithotomy Patients: an Analytic Observational Study
type: item
description: Introduction: Percutaneous Nephrolithotomy (PCNL) is the therapeutic procedure of choice for kidney stones. IL-6 secretion is stimulated during a secondary inflammatory response due to tissue injury or infection. Proper administration of analgesics can reduce morbidity rates, reduce treatment days, and reduce financing. Patients and Methods: An analytical observational study with a cross-sectional design at Purwokerto tertiary hospital in the period from December 2024 to January 2025 in patients undergoing PCNL procedures and receiving ibuprofen, paracetamol, and dexamethasone therapy, which met the inclusion and exclusion criteria. The observational group (15 patients each) was: Group A 1000 mg paracetamol and 400 mg ibuprofen and 5 mg dexamethasone; Group B 1000 mg paracetamol and 400 mg ibuprofen. IL-6 levels were measured before and 2 hours after the PCNL procedure. IL-6 levels were measured by ELISA (enzyme-linked immunosorbent assay). Comparative analysis of pre- or post-PCNL IL-6 levels by type of analgesic using unpaired t-test, while the comparison of changes in IL-6 levels was analyzed with the Mann-Whitney test. To determine whether the data distribution was normal, we used the Shapiro-Wilk test. The analysis used SPSS version 25. Results: Pre- and post-PCNL IL-6 levels were significantly lower in Group A compared to Group B (p < 0.05). However, changes in IL-6 levels were not statistically significant (p = 0.787). Effect size analysis indicated only a small and clinically negligible difference. Conclusion: There was no significant difference in IL-6 levels post-PCNL between the two observation groups.
subject: Original Articles
  topic: section
subject: Dexametasone
  topic: keywords
subject: Ibuprofen
  topic: keywords
subject: IL6
  topic: keywords
subject: Paracetamol
  topic: keywords
subject: PCNL
  topic: keywords
creator: Fakhriyadi Rozi
rights: Copyright (c) 2025 Fakhriyadi Rozi (Author) https://creativecommons.org/licenses/by/4.0
date: 2025-12-01
publication date: 2025-12-01
starting page: 95
ending page: 101
doi: 10.24843/5xdehe52