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All Journal Jurnal Sehat Indonesia (JUSINDO) Indonesian Health Journal Health & Medical Sciences
Lucky Andriyanto
Universitas Airlangga
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Comparison of Continuous Fentanyl and Levobupivacaine Epidural Anesthesia for Perioperative Pain Following Laparotomy in Children Aged 6– 12 Years Bahtiar Ahmad; Kohar Hari Santosa; Arie Utariani; Lucky Andriyanto
Jurnal Sehat Indonesia (JUSINDO) Vol. 8 No. 1 (2026): Jurnal Sehat Indonesia (JUSINDO)
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/-.v8i1.549

Abstract

Postoperative pain management in pediatric patients is a clinical challenge because uncontrolled pain can trigger systemic inflammatory responses, slow recovery, and increase the risk of postoperative morbidity. Surgical trauma stimulates the release of proinflammatory cytokines such as interleukin-6 (IL-6) and affects hematologic inflammatory parameters, including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). This study aimed to assess differences in the effectiveness of continuous fentanyl administration and epidural levobupivacaine on inflammatory responses and postoperative pain intensity in pediatric patients undergoing laparotomy. This comparative analytical study involved 30 pediatric patients aged 6–12 years who underwent elective laparotomy and were divided into two groups, namely continuous fentanyl (n=15) and epidural levobupivacaine (n=15). The parameters assessed included IL-6, NLR, and PLR levels, as well as pain intensity using the Numerical Rating Scale (NRS), which was measured in the preoperative and postoperative periods. Statistical analysis was conducted to assess differences within and between groups. The baseline characteristics of the subjects were homogeneous (all p>0.05). The median PLR increased from 136.2 (79.5–411.4) to 161.3 (90.6–616.2) (p=0.106), and the median NLR increased from 1.98 (0.98–19.94) to 2.11 (0.80–28.91) (p=0.643), with no significant differences between groups. IL-6 levels increased significantly overall (p=0.018), significantly in the fentanyl group (p=0.028) but not in the levobupivacaine group (p=0.225). NRS scores decreased significantly in both groups (p<0.001), with a greater reduction in the epidural levobupivacaine group in the early postoperative period (ΔNRS −4 vs −3.07±1.10; p=0.030). Both analgesic modalities were effective in reducing postoperative pain. Epidural levobupivacaine provided better early postoperative pain control and showed a more stable inflammatory response profile compared with continuous fentanyl.
The Impact of Recurrent Abdominal Pain on Quality of Life in Children: A Narrative Review Jamilatul Sutjipto; Alpha Athiyyah; Lucky Andriyanto
Health & Medical Sciences Vol. 3 No. 2 (2026): February
Publisher : Indonesian Journal Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47134/phms.v3i2.573

Abstract

This study aims to review and summarize the existing literature on the impact of recurrent abdominal pain on quality of life in children. This study employed a narrative literature review approach. Scientific articles were retrieved from PubMed, Scopus, and ScienceDirect using keywords related to recurrent abdominal pain and quality of life in children. Articles published between 2014 and 2024 and relevant to the topic were reviewed narratively to identify key themes concerning the impact of RAP on children’s quality of life. A total of 10 relevant articles were analyzed in this review. Overall, the literature indicates that children with recurrent abdominal pain experience a lower quality of life compared to healthy children, particularly in the emotional and physical functioning domains. Impairments in school and social functioning were also consistently reported across studies. Psychosocial factors, such as anxiety and depression, frequently emerged as important determinants of reduced quality of life. The reviewed literature demonstrates that recurrent abdominal pain has a multidimensional impact on children’s quality of life. Therefore, the management of RAP should adopt a holistic approach that addresses not only physical aspects but also the psychological and social well-being of the child.
The Platelet-To-Albumin Ratio and the Mean Platelet Volume-To-Albumin Ratio as Predictors of Disease Severity and Mortality in Pediatric Sepsis Patients Okky Hudaya; Lucky Andriyanto; Arie Utariani
Indonesian Health Journal Vol. 5 No. 2 (2026): Indonesian Health Journal
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/ihj.v5i2.898

Abstract

Pediatric sepsis remains a critical emergency condition with high morbidity and mortality rates, particularly in low- and middle-income countries. Early identification of patients at risk of severe outcomes is essential to guide timely interventions. This study aimed to evaluate the prognostic value of Platelet-to-Albumin Ratio (PAR) and Mean Platelet Volume-to-Albumin Ratio (MAR) in predicting disease severity and 7-day mortality among pediatric sepsis patients in the emergency room. A retrospective observational study was conducted on 101 pediatric patients admitted to Dr. Soetomo Hospital, Surabaya, from January 2020 to January 2025. PAR and MAR were measured on days 1, 3, and 5, and severity was assessed using PELOD-2 scores. Statistical analyses included ROC curves, Spearman correlations, and Kruskal–Wallis tests. Results demonstrated that MAR consistently showed superior predictive performance compared to PAR, with AUC values improving from 0.711 on day 1 to 0.905 on day 5, and significant correlations with PELOD-2 scores (p<0.001). PAR showed limited and inconsistent predictive ability. The findings indicate that MAR is a reliable and practical biomarker for early risk stratification and monitoring of pediatric sepsis severity. Future research should validate MAR in multicenter prospective studies and explore its integration with clinical scoring systems for enhanced prognostic accuracy.
Co-Authors Alpha Athiyyah Bahtiar Ahmad Jamilatul Sutjipto Kohar Hari Santosa Okky Hudaya Utariani, Arie