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All Journal Indonesian Journal of Anesthesiology and Reanimation (IJAR) Journal of Anaesthesia and Pain
Vitraludyono, Rudy
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Health Professions Medicine & Pharmacology

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Dexmedetomidine as an Ambulatory Sedation Agent for Abdominal MRI in Patients with Suspected Pheochromocytoma Iradat, Prataganta; Vitraludyono, Rudy; Yupono, Karmini
Journal of Anaesthesia and Pain Vol 5, No 1 (2024): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.01.04

Abstract

Background: Pheochromocytoma is a vascular tumor of chromaffin tissue, most commonly at the adrenal medulla, that produces and secretes norepinephrine and epinephrine and is a tumor that secretes catecholamines. Magnetic resonance imaging (MRI) is often used to provide clinical data and remains challenging in pediatrics. We present anesthesia management for abdominal MRI in pediatric patients with suspected pheochromocytoma.Case: A 12-year-old child weighing 25 kg with a diagnosis of suspected pheochromocytoma will have an abdominal MRI for diagnosis with sedation. Intravenous sedation technique using dexmedetomidine loading dose 50 μg for 10 minutes and continued maintenance of dexmedetomidine dose 17.5 μg/hour. Durante's MRI showed stable hemodynamics. Post-MRI of the abdomen, monitoring, and evaluation were carried out in the conscious recovery room and found no complications.Conclusion: The use of dexmedetomidine as a sedation agent in patients with suspected pheochromocytoma generally shows stable hemodynamics in the absence of signs of catecholamine spikes.
Management of Anesthesia in Pediatric Patients with Bronchoscopy Late Onset Foreign Body Aspiration Sintani, Rinni; Vitraludyono, Rudy
Indonesian Journal of Anesthesiology and Reanimation Vol. 7 No. 2 (2025): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V7I22025.116-127

Abstract

Introduction: Aspiration of foreign bodies in the airways is a severe and fatal condition if it occurs in children, because the risk of life-threatening obstruction is higher. Bronchoscopy is the main choice of procedure for treating foreign body aspiration, either with rigid bronchoscopy or flexible bronchoscopy. Anesthesia techniques are used with comprehensive anesthesia considerations, such as premedication, induction of anesthesia, maintenance of anesthesia, and monitoring. Objective: To evaluate the management of anesthesia in a pediatric patient with foreign body aspiration in late-onset settings. Case report: We report a case of anesthesia management in a child who aspirated a foreign body (peanuts) three days before being delivered to the hospital and undergoing a rigid bronchoscopy procedure. The patient experienced respiratory failure, and atelectasis was found in the right lower lobe of the lung upon arrival at the Emergency Unit (ER) due to the late onset of the case, so a secure airway must be performed before rigid bronchoscopy. Post-treatment care is carried out by observation and monitoring in the Intensive Care Unit (ICU) with complications of pneumonia. After three days of ICU treatment, the patient was transferred to the High Care Unit (HCU) in improved condition. The patient was discharged after three days of treatment in the low care Unit. Conclusion: Rigid bronchoscopy is the best modality for extracting foreign bodies in the pediatric airway. Delayed onset effects from foreign body aspiration in the respiratory tract cause greater complications after bronchoscopy. Pneumonia is the most common complication. Comprehensive anesthesia evaluation and preparation are the keys to the success of this procedure.
Dexmedetomidine as an Ambulatory Sedation Agent for Abdominal MRI in Patients with Suspected Pheochromocytoma Iradat, Prataganta; Vitraludyono, Rudy; Yupono, Karmini
Journal of Anaesthesia and Pain Vol. 5 No. 1 (2024): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.01.04

Abstract

Background: Pheochromocytoma is a vascular tumor of chromaffin tissue, most commonly at the adrenal medulla, that produces and secretes norepinephrine and epinephrine and is a tumor that secretes catecholamines. Magnetic resonance imaging (MRI) is often used to provide clinical data and remains challenging in pediatrics. We present anesthesia management for abdominal MRI in pediatric patients with suspected pheochromocytoma.Case: A 12-year-old child weighing 25 kg with a diagnosis of suspected pheochromocytoma will have an abdominal MRI for diagnosis with sedation. Intravenous sedation technique using dexmedetomidine loading dose 50 μg for 10 minutes and continued maintenance of dexmedetomidine dose 17.5 μg/hour. Durante's MRI showed stable hemodynamics. Post-MRI of the abdomen, monitoring, and evaluation were carried out in the conscious recovery room and found no complications.Conclusion: The use of dexmedetomidine as a sedation agent in patients with suspected pheochromocytoma generally shows stable hemodynamics in the absence of signs of catecholamine spikes.
Co-Authors Iradat, Prataganta Karmini Yupono Sintani, Rinni