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All Journal Medula Pendas : Jurnah Ilmiah Pendidikan Dasar PEDAGOGIK : JURNAL PENDIDIKAN Journal of English Language and Pedagogy Wahana Dedikasi : Jurnal PkM Ilmu Kependidikan Jurnal Pengabdian Mandiri MULTIPLE: Journal of Global and Multidisciplinary Argopuro: Jurnal Multidisiplin Ilmu Bahasa Causa: Jurnal Hukum dan Kewarganegaraan Jurnal Kajian Islam dan Sosial Keagamaan Journal Economic Excellence Ibnu Sina Aliansi: Jurnal Hukum, Pendidikan dan Sosial Humaniora Argopuro : Jurnal Multidisiplin Ilmu Bahasa E-Jurnal Akuntansi
IMAM GHOZALI
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Religion Humanities Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Public Health Social Sciences Other

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Journal : Medula

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Single-Shot Anestesi Spinal Segmental Thoracic Atau Thoracic Spinal Anesthesia (TSA) Untuk Operasi Embolectomy Pada Pasien Dengan Acute Limb Ischemia (ALI) Stadium IIB : Laporan Kasus Imam Ghozali; Tasrif Hamdi; Rizki Arisandi; Alda Putri Rahmadilla
Medula Vol 12 No 4 (2022): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v12i4.530

Abstract

General anesthesia is the most widely used anesthetic and is the standard for most surgeries. However, general anesthesia has several disadvantages, including side effects of the drugs used, longer recovery time, and inadequate pain control. Therefore, the use of regional anesthesia is an alternative option to reduce the adverse effects of general anesthesia, one of which is spinal segmental thoracic anesthesia. In this case report, a 52-year-old woman that diagnosed with Stage IIb Acute Limb Ischemia (ALI) underwent embolectomy under thoracic spinal segmental anesthesia. The patient presented with ASA III physical status with type II DM, CHF, CAD3VD and increased coagulation factors. Thoracic spinal anesthesia with a paramedian approach at the level of the T10-11 vertebrae using a regimen of levobupivacaine 5 mg and bupivacaine 2.5 mg. The adjuvants used were dexmedetomidine 5 mcg, ketamine 15 mg, and fentanyl 25 mg. During the operation there were no hemodynamic fluctuations. Post-operative monitoring of the patient's condition was stable, pain control was good, and there were no complaints of headache, nausea, and vomiting. Segmental thoracic spinal anesthesia has several advantages such as the need for lower anesthetic doses, safer than lumbar spinal anesthesia, good pain control, faster recovery, and avoiding the side effects of general anesthesia. Therefore, this anesthetic technique can be an effective alternative choice for general anesthesia
Segmental Thoracic Spinal Anesthesia (TSA) for Open Reduction with Internal Fixation (ORIF) Surgery in Right Humeral Fracture Patients: A Case Report Imam Ghozali; Natalia Danayati
Medula Vol 13 No 6 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i6.830

Abstract

General anesthesia is used in most surgeries, but there has disadvantages, such as drug side effects and a long recovery. Spinal anesthesia such as TSA is starting to get attention and become an alternative option to reduce adverse effects and more effective. This case report, a 33-year-old woman diagnosed complete closed fracture of the 1/3 proximal right humerus underwent Open Reduction and Internal Fixation (ORIF) surgery with segmental thoracic Spinal Anesthesia (TSA). The patient presented with ASA II with mild electrolyte imbalance. Thoracic spinal anesthesia with a paramedian approach at the level of T4-5 vertebrae using a regimen levobupivacaine 5 mg. The adjuvants used were dexmedetomidine 5 mcg, ketamine 5 mg, and fentanyl 25 mcg. Intraoperative and postoperative monitoring of the patient's condition was stable, pain control was good, and no postoperative complications such as headache, nausea and vomiting. Thoracic segmental spinal anesthesia has several advantages such as the need for lower doses of anesthetic drugs and relatively safer than lumbar spinal anesthesia, good pain control, faster recovery, and can avoid the side effects of general anesthesia, so that TSA can be an alternative technical choice for anesthesia.
A Case Report of Modified Radical Mastectomy (MRM) In A 59-Year-Old Female Patient With Comorbid Bronchiectasis Using Thoracic Segmental Spinal Anesthesia (TSA) Imam Ghozali; Hario Tri Hendroko; Dansen Rudyanto; Marcella Dena Fernanda
Medula Vol 13 No 6 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i6.831

Abstract

Breast cancer is a disease with the highest incidence of malignancy in Indonesia and the world. Epidemiological studies have shown that cancer affects billions of women each year. The incidence of breast cancer increases with age. In the elderly, the possibility of co-morbidities which are comorbid major medical problems makes anesthetic management decisions more complicated and perioperative care more challenging. Increasing age and comorbidities are the most important risk factors for postoperative complications. TSA was performed on a 59-year-old female patient with comorbid bronchiectasis who received MRM. The level of needle insertion was between T5-T6, premedication in the form of 0.5 mg alprazolam tablets, initiation of TSA with 1 ml of 0.5% hyperbaric bupivacaine and 20 mcg of fentanyl. The level of sensory block achieved was between T1-T7. TSA resolved without complications. The patient remained comfortable during the operation and there was no significant change in the patient's hemodynamics, airway and breathing. There were no postoperative complications. Thoracal segmental spinal anesthesia (TSA) is a safe alternative in performing modified radical mastectomy (MRM) and other breast surgeries because it has highly selective spinal block capabilities, ensures better control during induction and surgical processes, stability of the respiratory system and cardiovascular, and reduces the need for local anesthetics and has a lower risk of toxicity.
Co-Authors Alda Putri Rahmadilla Ali Fahmi ALINE RIZKY OKTAVIARI SATRIANINGSIH Amelia Nur Anindya Khalisha Nurdiati Asfar Muniir, Asfar Budiarto, Chris Louis Cantik Putri Aditya, Mega Daffa Fittaktahta Putra Dansen Rudyanto Deva Setyawan Dwi Oktariani Egi Putri Grandena Endah Nur Tjendani Evan Aswitiya Listanto Faiza Ayrul Fandra Firmansyah Galuh Juniarto Hario Tri Hendroko Hikmah Hikmah Indah Rachma Intan Maiyuni Ismunandar Jayawarsa, A.A. Ketut Khairunnisa Fiqri M. Azriel Yaqi Akbar Marcella Dena Fernanda Mastri Dihita Sagala Nabilla, Arfi Sintya Naida Nasywa Cahyarani Naila Putri Susanto Nany Safrianty Nastiti, Astrid Ayu Natalia Danayati Niken Ayu Nisrina Fairuz Burhani Nuraini Isnawati Nurmila Sari Djau Regaria Tindarika Rizki Arisandi Rudian, Rudian Sabila Ilma Irjayana Siti Halidjah Sri Suprapti Tasrif Hamdi Tri Widayati Vania Indri Gunawan Vicky Chandra Vilda Ghasya Yery Silaban, Chiristianly Zahro, Khalifatus Zakarias Aria Widyatama Putra Zaky Fadli, Ahmad Zerahya Kenanya