I Made Gede Widnyana
Anesthesiology and Intensive Care Department, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia

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KAJIAN POLA TITIK LAYU TANAMAN PAPRIKA (CAPSICUM ANNUUM L.) DAN KAPASITAS LAPANG PADA BEBERAPA MEDIA TANAM Widnyana, I Made Gede; Sumiyati, S; Tika, I Wayan
Jurnal BETA (Biosistem dan Teknik Pertanian) Vol 5 No 1 (2017): maret
Publisher : Program Studi Teknik Pertanian, Fakultas Teknologi Pertanian, Universitas Udayana, Badung, Bali, Indonesia

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Penelitian ini bertujuan untuk mengetahui pola titik layu tanaman paprika (Capsicum annuum L.) dan kapasitas lapang pada beberapa media tanam yang digunakan. Metode penelitian yang digunakan adalah metode kuantitatif yang terdiri dari tiga perlakuan menggunakan media tanam diantaranya, P1 : media arang sekam, P2 : media tanah campur kompos dengan perbandingan 2 : 1 dan dan P3 : media tanah. Kadar air kapasitas lapang, titik layu sementara dan air tersedia untuk seluruh perlakuan yang diamati mulai minggu ke-2 sampai minggu ke-14, kapasitas lapang pada media arang sekam, tanah campur kompos dan tanah yaitu berturut-turut dari 79,11% sampai 82,06%, 44,10% sampai 46,31%, dan 36,20% sampai 37,41%. Kadar air titik layu sementara pada arang sekam, tanah campur kompos dan media tanah yaitu berturut-turut mengalami penurunan dari 42,99% sampai 25,84%, 13,95% sampai 8,95% dan 14,39% sampai 10,23%. Air tersedia bagi taaman paprika pada media arang sekam, tanah campur kompos dan tanah yaitu berturut-turut mengalami peningkatan 5,20cm sampai 9,65cm, 5,72cm sampai 6,33cm dan 3,43cm sampai 4,86cm. The objective of this study were to determine of wilting point pattern and field capacity in cultivation of sweet pepper (Capsicum annuum L.) in diffferents planting medium. The methodology that used in this study was quantitative method. Three different planting medium were set namely : P1 : rice husk charcoal media , P2: soil and compost mixed media with 2 : 1 ratio and  P3: soil media. The water content of field capacity, temporary wilting point and available water for all treatments were observed start in week 2 to week 14 field capacity on rice husk charcoal, soil and compost mixed and soil media that row from 79.11% to 82,06%, 44.10% to 46.31%, and 36.20% to 37.41%. While the soil mousture of temporary wilting point of rice husk charcoal, soil and compost mixed and soil media is descreased from 42,99% to 25,84%, 13,95% to 8,95% and 14,39% to 10,23%. Available water of sweet paper plants on rice husk charcoal, soil and compost mixed and soil that is row increased from 5,20 cm to 9,65 cm, 5,72 cm to 6,33 cm and 3,43 cm to 4,86 cm.
COST MINIMIZATION ANALYSIS OF HYPNOTIC DRUG: TARGET CONTROLLED INHALATION ANESTHESIA (TCIA) SEVOFLURANE AND TARGET CONTROLLED INFUSION (TCI) PROPOFOL Wiryana, Made; Aribawa, I Gusti Ngurah Mahaalit; Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Hartawan, I Gusti Agung Gede Utara; Sucandra, Made Agus Kresna; Parami, Pontisomaya; Putra, Kadek Agus Heryana; Sutawan, IB Krisna Jaya; Arimbawa, IGNA Putra; Jaya, Ketut Semara; Semarawima, Gede
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
Publisher : BALI MEDICAL JOURNAL

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Background: Cost minimization analysis is a pharmaco-economic study used to compare two or more health interventions that have been shown to have the same effect, similar or equivalent. With limited health insurance budget from the Indonesian National Social Security System implementation in 2015, the quality control and the drug cost are two important things that need to be focused. The application of pharmaco-economic study results in the selection and use of drugs more effectively and efficiently. Objective: To determine cost minimization analysis of hypnotic drug between a target controlled inhalation anesthesia (TCIA) sevoflurane and a target controlled infusion (TCI) propofol in patients underwent a major oncologic surgery in Sanglah General Hospital. Methods: Sixty ASA physical status I-II patients underwent major oncologic surgery were divided into two groups. Group A was using TCIA sevoflurane and group B using TCI propofol. Bispectral index monitor (BIS index) was used to evaluate the depth of anesthesia. The statistical tests used are the Shapiro-Wilk test, Lavene test, Mann- Whitney U test and unpaired t-test (? = 0.05). The data analysis used the Statistical Package for Social Sciences (SPSS) for Windows. Results: In this study, the rate of drug used per unit time in group A was 0.12 ml sevoflurane per minute (± 0.03) and the group B was 7.25 mg propofol per minute (±0.98). Total cost of hypnotic drug in group A was IDR598.43 (IQR 112.47) per minute, in group B was IDR703.27 (IQR 156.73) per minute (p>0.05). Conclusions: There was no statistically significant difference from the analysis of the drug cost minimization hypnotic drug in a major oncologic surgery using TCIA sevoflurane and TCI propofol.
Pemberian Magnesium Sulfat Intravena Meningkatkan Efek Analgesia Pascaoperasi pada Bedah Mayor Menggunakan Anestesi Umum Irawan, Hengki; Subagiartha, I Made; Widnyana, I Made Gede
Jurnal Anestesi Perioperatif Vol 2, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Penatalaksanaan nyeri akut pascaoperasi merupakan tugas penting dokter anestesi. Morfin banyak digunakan untuk mengontrol nyeri pascaoperasi. Tujuan penelitian ini untuk mengetahui pengaruh pemberian MgSO4 intravena selama operasi terhadap efek analgesia dan kebutuhan morfin pascaoperasi. Penelitian ini adalah uji klinik blok tersamar ganda. Tiga puluh enam subjek usia 21–55 tahun dialokasikan ke dalam kelompok A yang diberikan MgSO4 30 mg/kgBB intravena 15 menit dilanjutkan 15 mg/kgBB/jam sampai akhir operasi dan kelompok B diberikan NaCl 0,9% dengan volume sama yang menjalani operasi bedah mayor di RSUP Sanglah Denpasar pada Juni–Agustus 2014. Data hasil penelitian dianalisis dengan Uji Mann-Whitney. Nilai visual analog scale (VAS) diam dan bergerak pada jam ke-4 dan ke-8 pada kelompok Mg berbeda bermakna (p<0,05). Perbedaan konsumsi morfin pascaoperasi pada jam ke-4, ke-8, dan ke-24 berbeda bermakna (p<0,05). Simpulan penelitian ini adalah pemberian MgSO4 intravena selama operasi meningkatkan efek analgesia dan menurunkan kebutuhan morfin pascaoperasi.Kata kunci: Analgesia pascaoperasi, anestesi umum, bedah mayor, magnesium sulfatIntravenous Magnesium Sulphate Administration to Improve Post-operative Analgesia Effect in Major Surgery with General AnesthesiaAbstractRelieving acute post-operative pain is an important role of anesthesiologist. Morphine is frequently used to control moderate to severe post operative pain. The objective of this study is to understand the effect of intravenous MgSO4 administration in improving post-operative analgesia effect. This study was a double-blind randomized block clinical trial. The subjects of this study were patients who underwent major surgeries in Sanglah Hospital during the period of June to August 2014. Thirty six subjects age 21–55 years allocated to group A received intravenous MgSO4 30 mg/kgBW intravenous bolus in 15 minutes followed by 15 mg/kgBW/hour until the surgery is finished and group B received NaCl 0.9% with the same volume. Data were then analyzed using  the Mann-Whitney Test. The stationary and mobile VAS scores in the  4th and 8th hour in Mg group were significantly different (p<0.05). Post-operative morphine consumptions in the 4th, 8th, and 24th hour were significantly different between the Mg and NaCl 0.9% groups (p<0.05). It is concluded that the administration of  intravenous MgSO4 during operation increases analgesia effect and reduces post-operative morphine needKey words: General anesthesia, magnesium sulfate, major surgery, post-operative analgesia DOI: 10.15851/jap.v2n3.335
STABILITAS HEMODINAMIK PADA PEMBERIAN FENTANYL SEBAGAI KOINDUKSI PROPOFOL DIBANDINGKAN DENGAN MIDAZOLAM PADA PEMASANGAN LARYNGEAL MASK AIRWAY Rismantara, I Dewa Gede Tresna; Sinardja, I Ketut; Widnyana, I Made Gede
Medicina Vol 45 No 3 (2014): September 2014
Publisher : Medicina

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Kestabilan hemodinamik pada pemasangan laryngeal mask airway (LMA) dengan propofol sebagaiagen induksi dapat dioptimalkan dengan penambahan agen koinduksi. Tujuan penelitian ini adalahuntuk mengetahui apakah fentanyl sebagai koinduksi dapat memberikan kestabilan hemodinamikdan  kondisi  relaksasi  yang  lebih  baik  dibandingkan  dengan midazolam  pada  pemasangan LMA.Setelah mendapat persetujuan dari bagian etik RSUP Sanglah Denpasar, 42 pasien dengan statusfisik ASA I dan II dilakukan pembiusan umum dengan pemasangan LMA, dipilih secara consecutiverandom sampling. Pasien dibagi menjadi 2 kelompok yaitu kelompok A diberikan midazolam 0.03 mg/kgbb dan kelompok B diberikan  fentanyl 2 mcg/kgbb.  5 menit  setelah koinduksi pasien diinduksidengan menggunakan target control infusion (TCI) propofol efek target 4 mcg/ml hingga tercapai nilaibispectral index (BIS) 40-60. Kondisi hemodinamik dianggap tidak stabil bila terjadi penurunan nilaitekanan arteri  rerata  (TAR)   postinduksi  lebih dari 20% TAR basal. Total dosis propofol dihitungsejak mulai induksi sampai tercapai nilai BIS 40-60 yang tercatat pada mesin TCI. Kondisi relaksasidinilai  dengan  kriteria Young?s. Data  yang  didapat  akan  diolah  dengan  software  SPSS  17.0.karakteristik  sampel  diuji  normalitas  dengan Shapiro-Wilk  dan  homogenitas  dengan  tes  levene.Perbandingan hemodinamik dan total dosis propofol diuji dengan uji t-2-sampel tidak berpasangandan kondisi  relaksasi  saat pemasangan LMA diuji dengan  chi-square  dengan  tingkat kemaknaanP<0,05 Terdapat perbedaan yang tidak bermakna pada penurunan nilai TAR saat pemasangan LMAdibandingkan nilai basal pada kedua kelompok uji yaitu A 13,08%  (SB 2,88%) dan B 14.11%  (SB2.96%) dengan nilai P = 0.216, total dosis propofol yang digunakan secara signifikan lebih sedikit padakelompok A 118.71 mg (SB 13,24 mg) dibandingkan kelompok B 131,61 mg (SB 12.86 mg) dengan P =0,003,  sedangkan  kondisi  relaksasi  yang  dihasilkan  tidak  berbeda  bermakna  dengan P  =  0,739.Simpulan penelitian  ini bahwa  fentanyl  sebagai koinduksi propofol  tidak  lebih baik dibandingkanmidazolam  dalam hal  stabilitas hemodinamik  dan kondisi  relaksasi  pada  pemasangan LMA,  danmenurunkan  dosis  induksi  propofol  lebih  sedikit  dibandingkan  dengan midazolam.  [MEDICINA2014;45:145-150].
ANESTHESIA MANAGEMENT OF ESOPHAGEAL ATRESIA REPAIR SURGERY: A CASE REPORT Putra, Kadek Agus Heryana; Kurniyanta, Putu; Wiryana, Made; Sinardja, Ketut; Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Cindryani, Marilaeta; Kurnia, Prajnaariayi Prawira
Bali Journal of Anesthesiology Vol 2, No 2 (2018)
Publisher : DiscoverSys Inc.

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

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ABSTRACTEsophageal Atresia (EA)is a congenital anomaly commonly found with TracheoesophagealFistula (TEF) of neonates in the first week oflife. This anomaly can cause several complications includingaspiration, reduction in respiration, and other complication from other concomitant congenital anomaly, mostly from heart origin. The treatment for this anomaly is surgery.Intraoperatively, thepatient may develop hypoxia due to lung retraction and hemodynamic instability from bleeding or hypothermia. Anesthesiologists play important role in the management of EA during theperioperative period. Careful examination of the preoperative period must be done to discover any other concomitant anomaly and complication. Good anticipation of any complication during surgery and continuous monitoring post surgery can elevate the prognosis of the patient.
Addiction in Anesthesiology : Sometimes Sh*t Happens Widnyana, I Made Gede; Senapathi, Tjokorda Gde Agung; Lolobali, Marilaeta Cindryani
Bali Journal of Anesthesiology Vol 2, No 1 (2018)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v2i1.59

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Anesthesiology demands a vigilant and controlled cautious person with a good tempered manner and professional character. Those virtues and values were built through thousands of trials, errors, failures, chances and breakdowns. When some individuals could resist and thrive, others may fall and surrender. Anesthesiologists are responsible of patients beneficiary with the utmost point should be considered in patient physical safety and survival. The aim to become a good anesthesiologist who keeps the safety and patient wellbeing sometimes had taken its toll by sacrificing the wellbeing of the anesthesiologists themselves.
CASE REPORT ANESTHETIC MANAGEMENT OF ADRENAL TUMOR RESECTION Widnyana, I Made Gede; Putra, Kadek Agus Heryana; Kurniyanta, Putu; Suarjaya, I Putu Pramana; Suranadi, I Wayan; Hartono, Budi
Bali Journal of Anesthesiology Vol 2, No 2 (2018)
Publisher : DiscoverSys Inc.

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

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ABSTRACTThe adrenal glands are secretory organs that are located above each kidney and produce hormones that play a major role in the metabolic processes. Tumors of the adrenal gland can cause metabolic abnormalities associated with hormonal disorders such as Cushings syndrome, pheochromocytoma, or Conns syndrome. To be able to give a good anesthetic management on resection of the adrenal tumor, it requires adequate preoperative evaluation. However, this will take large resources. Management of anesthesia in adrenal tumor with an unknown hormonal disorder should consider a variety of hormonal abnormalities that may present in the patient so it can be anticipated effectively.Keywords: incidentaloma, adrenalectomy, hormonal disorder, perioperative
CORRELATION BETWEEN PROTEIN INTAKE AND NITROGEN BALANCE OF SURGICAL PATIENTS IN ANESTHESIOLOGY AND INTENSIVE CARE INSTALLATION, SANGLAH GENERAL HOSPITAL, DENPASAR, BALI, INDONESIA Wiryana, Made; Sinardja, I Ketut; Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Panji, Putu Agus Surya; Aryabiantara, I Wayan; Cindryani, Marilaeta
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
Publisher : BALI MEDICAL JOURNAL

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Background: A cell injury from surgical stress in a trauma or a non-trauma case will induce a hyper metabolic response in which the protein degradation increases, the somatic protein synthesis decreases and the amino acid catabolism increases. Thus, the pyper metabolic response contributes to nitrogen loss in urine. This response, without an adequate nutrition, will lead an iatrogenic malnutrition and deterioration. A balance nitrogen formula through urinary urea nitrogen is one of many nutrition evaluation methods. This method aids in evaluating the daily nutrition status and it can be the baseline data for daily intake. Objective: To find a correlation between the protein intake and the nitrogen balance of the surgical patients in anesthesiology and intensive care installation, Sanglah General Hospital, Denpasar, Bali. Methods: Fifty-one surgical patients with trauma and non-trauma cases were observed for their protein intake for 2-3 days continuously. Moreover, they were evaluated for their nitrogen balance based on the urinary urea nitrogen per 24 hours for 2-3 days. For statistical analysis, we utilized Shapiro-Francia, Shapiro-Wilk, Spearman Frank correlation, two-sample t test, and multivariate regression analysis in Strata SE 12.1. Results: The correlation between the protein intake and the nitrogen balance on the first day was ra=0.50 (p<0.05), on the second day ra=0.70 (p<0,05), and on the third day ra=0.740 (p<0,05) Conclusions: There is a correlation between the protein intake and the nitrogen balance of surgical patients in Anesthesiology and Intensive Care Installation Sanglah General Hospital Denpasar.
BLOK INFRAKLAVIKULAR KONTINYU SEBAGAI MANAJEMEN NYERI AKUT PASCAOPERASI EKSTREMITAS ATAS Astuti, Sri; Widnyana, I Made Gede
Medicina Vol 45 No 1 (2014): Januari 2014
Publisher : Medicina

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Seorang laki-laki 39 tahun mengeluh nyeri berat pada tangan kanan setelah kecelakaan lalulintas.Pada pemeriksaan rontgen didapat fraktur dan dislokasi sendi radiocarpal kanan. Tidak ditemukankelainan pada pemeriksaan fisik dan penunjang. Segera dilakukan operasi reduksi terbuka dan eksternal fiksasi, dikelola dengan anestesi blok infraklavikula pemasangan kateter kontinyu denganbantuan USG. Selama operasi dengan anestesi lokal bupivakain 0,5% 10 ml + epinephrine 1/400.000 dan lidokain 2 % + epinephrine 1/400.000 menghasilkan anestesi yang cukup selama operasi.Pascaoperasi dengan analgesia blok kontinyu  infraklavikula bupivakain 0,125 % 4 ml/jam dengan syringe pump. Kateter dipertahankan selama 3 hari, hari keempat dilanjutkan parasetamol oral dan hari kelima pasien pulang tanpa keluhan nyeri. [MEDICINA. 2014;45:47-51].
A PRELIMINARY STUDY ON THE PECTORALIS BLOCK II AS A PART OF MULTIMODAL ANALGESIA FOR INTRA AND POSTOPERATIVE PAIN MANAGEMENT IN MODIFIED RADICAL MASTECTOMY Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Ryalino, Christopher; Junaedi, I Made Darma
Bali Journal of Anesthesiology Vol 2, No 3 (2018)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (503.41 KB) | DOI: 10.15562/bjoa.v2i3.106

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Background: Inadequate acute postoperative pain management is the main risk factor for chronic pain after breast surgery. Pectoralis blocks I and II (pecs block I and II) are novels peripheral nerves block techniques introduced since 2011 by Blanco et al.Methods: Ten patients diagnosed with breast cancer planned for modified radical mastectomy (MRM), from preoperative evaluation patients with a physical status of American Society of Anesthesiologist (ASA) I and II. Anesthesia management under general anesthesia with an endotracheal tube and we performed PECS block II after general anesthesia. We recorded the systolic blood pressure, mean arterial pressure (MAP), and heart rate intraoperatively, and the pain scale at 4th, 6th, 12th, and 24th hours postoperatively.Results: The pain scale at 4th and 6th hours postoperatively were 0.3±0.5 and 0.6±0.5 respectively. The pain scale at resting starts to increase at the 12th and 24th hours (1.2±0.4 and 1.1±0.6). The mean total use of morphine recorded on PCA was 3.3 ± 0.9 (mg). No pecs block II complications were recorded in this study.Conclusion: Pecs block II is a relatively easy, safe, and effective for MRM surgeries. Further larger and double-blinded studies are needed to know its effectiveness compared to other techniques available.