This document contains the biography and career history of Dr. I Putu Pramana Suarjaya. It details his education including medical school and residency training. It lists his work experience, including positions at various hospitals. It also outlines his professional memberships.

1. Nama : dr. I Putu Pramana Suarjaya, SpAn, KMN, KNA
Tempat/Tanggal Lahir : Denpasar, 8 Juni 1969
Alamat : Jalan Tukad Yeh Penet 11A, Renon, Denpasar
Istri : dr. Ni Made Puspa Dewi Astawa
Anak-anak : I Putu Krisna Murti
Made Kartika Dewi
Nyoman Ira Sayani Saraswati
I Ketut
Agama : Hindu
Riwayat Pendidikan
SD 3 Saraswati Denpasar 1976-1982
SMP N 3 Denpasar 1982-1985
SMAN 1 Denpasar 1985-1988
Fakultas Kedokteran Universitas Udayana Denpasar 1988-1995
Pendidikan Dokter Spesialis Anestesi 1999-2003
Fakultas Kedokteran Universitas Padjadjaran, Bandung
Pendidikan Magister Kesehatan 2001-2003
Fakultas Kedokteran Universitas Padjadjaran, Bandung
7. Pendidikan Konsultan NeuroAnesthesia dan Neuro Critical Care 2009-2012
Kolegium Anestesiologi dan Terapi Intensif, Fakultas Kedokteran
Universitas Padjadjaran, Bandung

2. Pendidikan Tambahan
Dalam Negeri
ESPEN LLL (Bali, 2012)
LuarNegeri
Asia Pasific Parenteral Nutrition Workshop (Kuala Lumpur 2010)
Medical Observership di Department of Anesthesiology and Intensive Care, Tan Tock
Seng Hospital, Singapore (Singapore 2011)
Pengalaman Kerja
Dokter di kapal MV. Illiria, (1996)
Dokter PTT di Puskesmas Ubud I, Gianyar Bali (1996-1999)
Dokter Asisten di Bagian Anestesiologi RS Sanglah, Denpasar Bali (1999)
Dokter Spesialis Anestesi RS Zainul Abidin, Banda Aceh (2004)
Dokter Spesialis Anestesi RS Korpri Puri Raharja Denpasar (2004- sekarang)
Dokter Spesialis Anestesi RS Sanglah Denpasar (2004-sekarang)
Keanggotaan Profesi
Ikatan Dokter Spesialis Anestesiologi Indonesia ( IDSAI) Bali
Indonesian Society of Anesthesiology for Pain Management (ISAPM)
Perhimpunan Manajemen Nyeri Indonesia (PMNI)
Indonesian Society of Neuro Anesthesia and Critical Care ( ISNACC)
Asian Society of Neuro Anesthesia and Critical Care (ASNACC)
Anggota IDI Wilayah Bali
Anggota IDI Denpasar
Anggota PKDGI

3.  I Putu Pramana Suarjaya
 IGN Mahaalit Aribawa
Department of Anesthesiology and Intensive Care
Sanglah General Hospital
Denpasar

4. 1. Pulse
2. Blood
pressure
3. Temperature
4. Respiratory
rate
11/12/2015BROS 4
Pain:
The Fifth
Vital Sign™
*by now health care professional asses patient for
pain every time we check for other vital sign
June 2005

5. Anesthesiology-Based APS
•Introduced in US, 1988
Nurse-Based APS
•Introduced in Sweden, 1991

6. • ANESTHESIA RESIDENT BASE
Developed in teaching
hospital
Non teaching -Private
Hospital

7. Despite of advanced knowledge & techniques in
acute pain management
MORE than 50% patients do not
receive adequate postoperative
pain relief
Filos,KS: lehman, KA, Eur Surg Des 2002

8. 1.Confusion about who is responsible for
postoperative pain management ?
2.Inadequate knowledge of analgesics
(opioid & non-opioid analgesics).
3.Administration of analgesic is too late,
when the patient complain of pain.
4.Using single modality and similar to
every surgery.

9. • ANXIETY AND PAIN
1.PATIENT BARRIERS :
• ATTITUDE : UNWILLINGNESS TO RAISE THE
PRIORITY OF PAIN
• LACK OF ASSESMENT AND DOCUMENTATION
• LACK OF KNOWLEDGE ABOUT PAIN AND PAIN
KILLER
2. PROFESSIONAL BARRIERS

10. •ACCOUNTABILITY  WHO??
•LOCAL POLICIES  RULES AND
REGULATION??
•LOCAL RESOURCES
•GLOBAL BARRIERS AND NATIONAL
POLICIES
3. ORGANISATIONAL BARRIERS

11. IV kontinyu : syringe
pump
Oral analgesia
Epidural analgesia :
intermitten dan
kontinyu
Intratekal opioid MULTIMODAL Bolus IV
Patch percutaneus
Peripheral Nerve Block
: continuous
Patient Controlled
Analgesia
( PCA) : IV and
Epidural

12. 12

13. 13

15. 15
PERBANDINGAN PCA IV : IM : BOLUS IV

16. • PATIENT’S REQUEST PAIN FREE  HIGHER
SOCIAL CLASS
1. PATIENT BARRIERS
SOME BARRIERS RESOLVE

17. •SURGEON LACK OF PAIN AWARENESS
BUT WILLING TO SET PAIN FREE FOR
PATIENT CONSULT TO ANESTHETIS
•ASSESMENT AND DOCUMENTATION
START AS PART OF MED RECORD
•NURSE GET CONTINUING PAIN UP GRADE
SESSION
2. PROFESIONAL BARRIERS :

18. • ANESTHETIS RESPONSIBLE FOR PAIN MANAGEMENT, MIN 3 DAYS
ACCOUNTABILITY  WHO?
• DEVELOPMENT AND IMPLEMENTATION OF SOP
•SET UP PAIN MANAGEMENT TEAM INCL NURSE & GP ON DUTY
•ANESTHETIS CONSULTANT VISITE DAILY & READY 24 H
LOCAL POLICIES  RULES AND REGULATION

19. •MEDICAL STAFF TRAINING @ 1 MONTH
•PAIN MANAGEMENT EQUIPMENT SUPPLY:
•SYRINGE PUMP  BY HOSPITAL
•PERIPHERAL BLOCK CATHETER
•PATIENT CONTROLLED ANALGESIA MACHINE : 11 PCA
MACHINE IN BROS HOSPITAL (BY ANESTHETIS)
•USG (BY ANESTHETIS)
LOCAL RESOURCES
GLOBAL BARRIERS AND NATIONAL POLICIES 
COMMON PROBLEM

20. 0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
JAN FEB MRT APR MEI JUN JUL AUG SEP OKT
PCA
EPIDURAL
SYRINGE PUMP

21. SYRINGE PUMP,
63.29%
PCA, 18.50%
EPIDURAL, 5.78%
BOLUS IV / ORAL,
11%
PERIPHERAL
BLOCK, 2%
SYRINGE PUMP
PCA
EPIDURAL
BOLUS IV / ORAL
PERIPHERAL BLOCK

22.  BARRIERS TO APS NOT YET CLEARED  JCI ACRREDITATION
ENCOURAGE
• WIDE PATIENT VARIETY
• PATIENT LESS DEMANDING
1. PATIENT BARRIER
• OPERATOR STILL UNWILLINGNES TO TREAT PAIN
• ASSESMENT & DOCUMENTATION ONLY DONE BY
ANESTHETIST AND NURSE, SURGEON DO NOT
2. PROFESIONAL BARRIER

23. • SOP
•  IF VAS <5 SURGEON RESPONSIBLE FOR PAIN
MANAGEMENT POST OP
•  IF VAS ≥ 5 ANESTHETIST RESPONSIBLE
• RULES DAN REGULATION NOT WELL ESTABLISHED YET
• LACK OF HOSPITAL UNDERSTANDING OF PAIN
MANAGEMENT MODALITY  BANNED NEW TECHNIQUE
BY MANAGEMENT
• EQUIPMENT SUPPLY FOR PAIN MANAGEMENT
ORGANISATIONAL BARRIERS

26. STARTING MAY 2012, DRIP NOT
USED ANYMORE JCI
SISTEMIC IV :
1. SYRINGE PUMP
2. PCA

38. THANK YOU
11/12/2015 38

40. BULAN PEMAKAIAN PCA TOTAL PASIEN
OPERASI
PERSENTASE
PEMAKAIAN
JANUARI 11 108 10.18
FEBRUARI 14 108 12.96
MARET 15 161 9.3
APRIL 19 133 14.28
MEI 24 175 13.71
JUNI 21 172 12.20
JULI 19 133 14.29
AGUSTUS 37 147 25.17
SEPTEMBER 48 158 30.38
OKTOBER 64 160 40
TOTAL 272 1455 18.69

41. BULAN PEMAKAIAN
EPIDURAL
TOTAL PASIEN
OPERASI
PERSENTASE
PEMAKAIAN
JANUARI 6 108 5.55
FEBRUARI 5 108 4.63
MARET 8 161 4.96
APRIL 10 133 7.51
MEI 9 175 5.14
JUNI 8 172 4.65
JULI 7 133 5.26
AGUSTUS 11 147 7.48
SEPTEMBER 12 158 7.59
OKTOBER 9 160 5.62
TOTAL 85 1455 5.84

42. BULAN PEMAKA
IAN S.P.
PCA EPIDURA
L
ORAL-
BOLUS
IV
BLOK
PERIFER
TOTAL
PASIEN
OPERASI
PERSENT
ASE
PEMAKA
IAN SP
JANUARI 87 11 6 10 4 108 82.07
FEBRUA
RI
74 14 5 11 4 108 68.51
MARET 116 15 8 19 3 161 72.04
APRIL 87 19 10 15 2 133 65.41
MEI 119 24 9 20 2 175 68
JUNI 122 21 8 18 3 172 70.93
JULI 93 19 7 12 2 133 69.92
AGUSTU
S
82 37 11 14 3 147 55.78
SEPTEM
BER
80 48 12 15 3 158 50.63