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All Journal Medula Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine
Bambang Eko Subekti
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Manajemen Anastesi pada Laminektomi pada Cedera Vertebra Servikal V-VI di RSUD Dr. H. Abdul Moeloek, Bandar Lampung Fairuz Nabila Afia; Bambang Eko Subekti
Medula Vol 9 No 4 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v9i4.243

Abstract

Cervical spinal cord injuries can occur directly or inderectly that can cause neurological disorder or death. Cervical injuries occur 2-3% of all cedera events and 8,2% of all cederas that cause of death. Symptoms of cervikal cedera can be partial or loss of limb movements and / or sensation that can be in calssified as complete or incomplete. A 40 year-old man with complaints of weakness and tingling in all four limbs since 3 days before entering the hospital, patient had history of motorcycle accidents. Resuscitation and protection of cervical vertebrae have been carried out, which aim to preventing or minimize other damage to the nervous system after servikal injury , increase the patient's recovery and planning specifically during perioperative, including airway management, induction, general anesthesia, and recovery phase. The purpose of this case report is to find out the anesthetic management in the form of planning, description of clinical problems, identifying the risk factors that cause and providing the best management for patients.
Tatalaksana Anestesi pada Pasien Cedera Otak Traumatik Berat Rani Tiara; Bambang Eko Subekti
Medula Vol 9 No 4 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v9i4.245

Abstract

Anesthetic management in 40-year-old men, body weight 60 kg, height 172 cm. Patient brought to the emergency department due to a traffic accident, fell from a motorcycle. In the emergency department, initial management was management by evaluating the clear airway, breathing with breath rate 20-24x /min, and circulation with blood pressure 90/60 mmHg and pulse rate 64x /min, with patient GCS E3V1M3. Patients diagnosed with intracerebral hemorrhage and subdural hemorrhage who need perform hematoma evacuation with craniotomy procedure, with ASA III in patient physical status. Surgery is performed under general anesthesia, with the specific procedure remaining to stable and maintaining intracranial pressure in optimal condition. Hemodynamics stabilitations by maintaining MAP 70-100 mmHg. The operation held for 2.5 hours, after the operation, the patient was moved to the recovery room and received for further treatment in the surgical care room. Faster management of head injuries, resuscitation with cerebral protection and management of intensive therapy can improve the outcome of patients.
MANAGEMENT OF ECTOPIC PREGNANCY WITH HYPOVOLEMIC SHOCK GRADE III FROM THE SIDE OF ANESTHESIOLOGY eka Cania; Bambang Eko Subekti
Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine Vol. 1 No. 3 (2014): Jurnal Agromedicine
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

Ectopic pregnancy occurs when the conceptus implants outside the normal endometrium. Critical situation can occur if the ectopic pregnancy causes abortion or tubal rupture. About 16% of deaths by severe bleeding (hemorrhagic) in pregnancy is reported to be caused by a ruptured ectopic pregnancy. Hypovolemic shock is a shock that occurs due to a reduction in intravascular plasma volume. This shock, in ruptured ectopic pregnancy case, may occur as a result of hemorrhagic. Mrs. N, 29 years old, was taken to the hospital with complaints of lower abdominal pain accompanied by vaginal bleeding since 2 days before hospital admission. Thepatient had no menstrual periods since 2 months ago and was confirmed pregnant by a pregnancy test. On arriving at the hospital, the patient in a state of compos mentis that confirmed with the Glasgow Coma Scale (GCS) was 15, blood presure was 110/50 mmHg, pulse rate was 120x/min, respiratory rate was 24x/min, temperature was 36,0ºC, which were drasticly change into shock in one hour later. Physical examination found tenderness and rebound tenderness in the suprapubic region (+). Gynecological examination found livide portio, closed Orificium Externum Uteri (OEU), flour (-), fluxus (+), no active vaginal bleeding. In vaginaltoucher found vaginal mucosa palpabled smooth, lower portio palpabled soft, closed OEU, right-left AP palpabled tense, painful shake portio (+), prominent douglas cavity, culdocentesis found blood. Superior and inferior extremities felt cold (+/+), no cyanosis, good turgor, capilary refill time (CRT)>2 seconds. Laboratory examination obtained Hb 5.5 g/dl, hematocrit 15%, leukocytes 24,500/ul. This patient was diagnosed with ruptured ectopic pregnancy with hypovolemic shock grade III and was treated with fluid resucitation then emergency laparotomy. This condition has dubia ad malam prognosis, because it is determined by the accuracyand speed of treatment. [J Agromed Unila 2014; 1(3):202-206]Keywords: fluid resuscitation, hypovolemic shock grade III, ruptured ectopic pregnancy
Pengelolaan Anestesi pada Pasien Neoplasma Ovarium Kistik Berukuran Besar dengan Anemia Tanpa Komplikasi Merry Indah Sari; Bambang Eko Subekti; Eduard Eduard
Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine Vol. 4 No. 1 (2017): Jurnal Agromedicine
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

Pengelolaan anestesi pada pasien neoplasma ovarium membutuhkan persiapan matang karena risiko yang ditimbulkan selama periode perioperatif. Neoplasma Ovarium adalah tumor yang berasal dari jaringan ovarium. Anemia adalah penurunan kadar hemoglobin darah, yang mampu menimbulkan syok volume apabila tidak ditangani dengan tepat sebelum operasi. Ny.D 32 tahun datang dengan keluhan perut yang membesar sejak 8 bulan, dan sejak 7 hari sebelum masuk rumah sakit perut pasien dirasa semakin membesar dan menimbulkan rasa tidak nyaman serta menimbulkan sesak nafas. Pasien dalam keadaan kompos mentis dengan Glasgow Coma Scale (GCS) 15, tekanan darah 110/80mmHg, frekuensi nadi 110x/menit, frekuensi pernapasan 24x/menit, suhu 36,9oC, berat badan 65 kg, tinggi badan 154 cm. Pemeriksaan fisik abdomen diperoleh hasil perut tampak cembung, tegang, nyeri tekan (-), dan teraba massa terfiksir ukuran ± 20cm x 20cm. Pemeriksaan penunjang didapatkan Hb 9,9gr/dl. Dari pemeriksaan USG tampak massa kistik dengan bagian padat di dalamnya, dengan ukuran yang terjangkau probe 18cm x 14cm. Pasien di diagnosa Neoplasma Ovarium Kistik dengan dilakukan operasi Sallfing-Ooforektomi Unilateral per Laparatomi Elektif. Pasca operasi pasien stabil tanpa komplikasi. Kata kunci: anestesia, komplikasi, neoplasma ovarium kistik
Co-Authors Eduard Eduard eka Cania Fairuz Nabila Afia Merry Indah Sari Rani Tiara