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Perioperative Application of 2% Lidocaine Dewi, Fitri Hapsari; Nugroho, Andy; Muttaqin, Fandi Ahmad
Journal of Anaesthesia and Pain Vol 3, No 2 (2022): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.003.02.01

Perioperative intravenous lidocaine (IVL) can help minimize opioid-related side effects that impede the postoperative recovery process. Neurological side effects were averaged at an 8 mg/kg dose, and cardiotoxicity side effects were reported at plasma values greater than 21 g/ml. Approximately 90% of lidocaine is converted to monoethylglycinexylidide (MEGX) in the liver via oxidative demethylation (dealkylation). Analysis of MEGX concentrations after lidocaine administration can be a method used to evaluate liver function. Perioperative intravenous lidocaine lowers discomfort, nausea, the duration of ileus, the need for opioids, and the length of time spent in the hospital after surgery. During injection, low blood concentrations can result in these symptoms, which may last for several hours or days after termination. Postoperative problems, such as pain and organ failure, can be caused by anti-inflammatory and pro-inflammatory components. Analgesic, anti-inflammatory, and anti-hyperalgesic are just some of the other effects of lidocaine. It also decreases the volume of the airways and the rate of breathing, prolongs the duration of exhalation, reduces the respiratory rate and tidal volume, also causes vasoconstriction at low concentrations and vasodilation at high concentrations. In clinical applications, lidocaine can prevent propofol injection pain, improve postoperative recovery, and play a role in various surgical procedures. Perioperative IVL application is proven to provide more benefits in various surgeries compared to other available anesthetic options. Very few studies have systematically analyzed the occurrence of side effects, and the quality of evidence is low.

BIMBINGAN TEKNIS DIGITAL MARKETING SEBAGAI UPAYA DALAM MENINGKATKAN PENJUALAN IKM/UMKM DI KABUPATEN TANGERANG DI TENGAH PANDEMI COVID 19 Sudaryana, Yayan; Sarwani, Sarwani; Subur, Herjanto; Aulia, Risyda; Nurhasanah, Nunung; Nugroho, Andy; Sujarwadi, Rani
Abdi Laksana : Jurnal Pengabdian Kepada Masyarakat Vol 2 No 1 (2021): Abdi Laksana : Jurnal Pengabdian Kepada Masyarakat
Publisher : LPPM Universitas Pamulang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32493/al-jpkm.v2i1.8770

Penjualan adalah ilmu dan seni mempengaruhi pribadi yang dilakukan oleh penjualan untuk mengajak orang lain agar bersedia membeli barang atau jasa yang ditawarkan. Tujuan dari bimbingan teknis adalah untuk meningkatkan pengetahuan dan keterampilan IKM/UMKM dalam menyikapi perkembangan teknologi dan informasi yang dikenal sebagai revolusi industri 4.0 yang tidak dapat dipungkiri lagi secara perlahan beralih kearah digital baik dibidang industri maupun perdagangan. Sebagai acuan bagi pelaku usaha dalam melakukan transaksi melalui digital marketing yaitu 1). UU no. 7 tahun 2014 tentang Perdagangan, bahwa perdagangan melalui sistem elektronik adalah perdagangan yang transaksinya dilakukan melalui serangkaian perangkat dan prosedur elektronik, dimana setiap pelaku usaha wajib menyediakan data dan/atau informasi secara lengkap dan benar. 2). UU No. 8 Tahun 1999 tentang Perlindungan Konsumen, antara lain bahwa pelaku usaha dalam menawarkan barang dan/atau jasa yang ditujukan untuk diperdagangkan dilarang menawarkan, mempromosikan, mengiklankan atau membuat pernyataan yang tidak benar atau menyesatkan mengenai tawaran potongan harga atau hadiah menarik yang ditawarkan. 3). UU No.11 Tahun 2008 tentang Informasi dan Transaksi Elektronik (ITE) sebagaimana telah diubah oleh UU No. 19 Tahun 2016 tentang Perubahan atas UU No. 11 Tahun 2008 tentang Informasi dan Transaksi Elektronik (ITE) antara lain bahwa Setiap orang dengan sengaja, dan tanpa hak menyebarkan beritra bohong dan menyesatkan yang mengakibatkan kerugian konsumen dalam transaksi elektronik dikenai sanksi pidana penjara maksimum 6 tahun dan/atau denda maksimum1 milyar rupiah. Berdasarkan survey pendahuluan oleh Tim Pengabdian Kepada Masyarakat (PKM) ke lokasi dan melakukan wawancara, observasi, dan Fokus Group Diskusi (FGD) dengan Dinas Perindustrian dan Perdagangan Kabupaten Tangerang Provinsi Banten dan beberapa pelaku bisnis yang tergolong IKM/UMKM, bahwa pada umumnya kegiatan penjualan produk masih dilakukan secara offline melalui pihak ke tiga namun demikian terdapat beberapa IKM/UMKM telah melakukan kegiatan penjualan melalui digital marketing terutama untuk pasar dalam negeri. Yang akan datang para IKM/UMKM mengharapkan untuk mampu menjangkau pasar luar negeri (ekspor).

Perioperative Application of 2% Lidocaine Dewi, Fitri Hapsari; Nugroho, Andy; Muttaqin, Fandi Ahmad
Journal of Anaesthesia and Pain Vol. 3 No. 2 (2022): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.003.02.01

Perioperative intravenous lidocaine (IVL) can help minimize opioid-related side effects that impede the postoperative recovery process. Neurological side effects were averaged at an 8 mg/kg dose, and cardiotoxicity side effects were reported at plasma values greater than 21 g/ml. Approximately 90% of lidocaine is converted to monoethylglycinexylidide (MEGX) in the liver via oxidative demethylation (dealkylation). Analysis of MEGX concentrations after lidocaine administration can be a method used to evaluate liver function. Perioperative intravenous lidocaine lowers discomfort, nausea, the duration of ileus, the need for opioids, and the length of time spent in the hospital after surgery. During injection, low blood concentrations can result in these symptoms, which may last for several hours or days after termination. Postoperative problems, such as pain and organ failure, can be caused by anti-inflammatory and pro-inflammatory components. Analgesic, anti-inflammatory, and anti-hyperalgesic are just some of the other effects of lidocaine. It also decreases the volume of the airways and the rate of breathing, prolongs the duration of exhalation, reduces the respiratory rate and tidal volume, also causes vasoconstriction at low concentrations and vasodilation at high concentrations. In clinical applications, lidocaine can prevent propofol injection pain, improve postoperative recovery, and play a role in various surgical procedures. Perioperative IVL application is proven to provide more benefits in various surgeries compared to other available anesthetic options. Very few studies have systematically analyzed the occurrence of side effects, and the quality of evidence is low.Â

Phenytoin Administration Following Early Postoperative Seizure After Brain Tumor Surgery Nugroho, Andy; Bisri, Dewi Yulianti; Rachman, Iwan Abdul
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 3 (2025): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.73402

Background: Early postoperative seizures (EPS), defined as seizures occurring within seven days following brain surgery, are a common and serious complication, particularly in patients with high-grade gliomas. EPS can prolong hospitalization, impair neurological recovery, and increase the risk of further brain injury. The optimal prophylactic strategy for seizure prevention remains controversial, especially in settings where access to second-generation antiepileptic drugs is limited.Case: A 53-year-old female presented with progressive headaches and was diagnosed with a supratentorial intra-axial tumour consistent with high-grade glioma. She underwent subtotal tumour resection. Four hours postoperatively, the patient developed two episodes of generalized seizures. Immediate management included intravenous administration of midazolam, endotracheal intubation, and phenytoin administration. Diagnostic evaluations excluded metabolic or infectious causes. Near-infrared spectroscopy (NIRS) monitoring indicated stable cerebral oxygenation throughout the postoperative course. The patient experienced no further seizures and demonstrated full neurological recovery. Oral phenytoin was continued for 21 days.Discussion: EPS are associated with multiple risk factors, including tumour location, size, and incomplete resection. In this case, the tumour’s frontal and parietal lobe involvement, large volume, and subtotal excision likely contributed to seizure onset. Phenytoin, despite being a first-generation antiepileptic drug, proved effective in managing EPS and preventing recurrence in the absence of levetiracetam. NIRS served as a useful non-invasive adjunct to monitor cerebral oxygenation after a seizure.Conclusion: Effective early recognition and treatment of EPS are critical in preventing secondary neurological complications. In resource-limited settings, phenytoin remains a viable monotherapy for seizure control post-craniotomy. Individualized, protocol-driven management strategies, supported by neuromonitoring tools such as NIRS, can optimize outcomes in brain tumor surgery.

Safe and Effective Perioperative Management in Patients with Atrial Septal Defect and Pulmonary Contusion: A Case Study with Supraclavicular Block RTH Supraptomo, RTH Supraptomo; Nugroho, Andy; Baihaqi Siddik, Muhammad
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.78083

Introduction: Peripheral nerve blocks are a safe and effective anesthetic option for patients with congenital heart disease, offering significant advantages over general anesthesia by minimizing cardiovascular and pulmonary risks. The supraclavicular brachial plexus block, in particular, provides excellent anesthesia for upper limb surgery with fewer intraoperative and postoperative complications, faster recovery, and improved pain control 2.Case : A 67-year-old woman with a large secundum ASD, severe pulmonary hypertension, right ventricular dysfunction, and bilateral lung contusions on the 10th day is scheduled for ORIF of a distal radius fracture. Given her high cardiopulmonary risk, regional anesthesia via ultrasound and Nerve Stimulator supraclavicular block using Levobupivacaine 0.375 % 20 ml was chosen to minimize hemodynamic instability and avoid complications from general anesthesia. The procedure is supported by intensive monitoring in the High Care Unit after the operation is complete, reflecting a careful, individualized approach for this high-risk geriatric patient.Discussion : Anesthetic management in patients with left-to-right shunt congenital heart disease requires preservation of hemodynamic stability and careful control of pulmonary and systemic vascular resistance. General anesthesia and mechanical ventilation may disturb the Qp:Qs balance and increase cardiopulmonary risk, particularly in the presence of pulmonary contusion, which predisposes to ventilator-induced lung injury and hypoxemia. In this case, ultrasound-guided supraclavicular brachial plexus block was selected to preserve spontaneous ventilation, maintain stable hemodynamics, and minimize pulmonary stress while providing effective surgical anesthesia.Conclusion Supraclavicular brachial plexus block may be a method to consider in patients with congenital heart disease and pulmonary contusion in patients with surgery below the shoulder.Keywords: Adult Congenital Heart Disease, Pulmonary Contusion, Radius fracture, Supraclavicular block

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