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The Role of Anesthetic Techniques and Drugs in Laparotomy Cases of Postoperative Ileus Puspita, Eka Ari; Nugroho, Yudhistiro Andri; Rahmasena, Naomi; Jamil, Ahmad Mochtar; Haniifah, Ulaa; Anas, Muhammad; Rahmah, Laila
MAGNA MEDICA Berkala Ilmiah Kedokteran dan Kesehatan Vol 11, No 1 (2024): February
Publisher : Universitas Muhammadiyah Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26714/magnamed.11.1.2024.97-107

Abstract

Background: Ileus occurs when there is a non-mechanical decrease or stoppage of the flow of intestinal contents. The cause of ileus has yet to be clearly defined. Various factors influence the risk for an ileus, each affecting a small part of the complex neuroimmune system. The patient will present with bloating and abdominal distension. Plain abdominal films and computed tomography (CT) scans of the abdomen are usually the first diagnostic imaging obtained. The most important principle for treating ileus is treating the underlying cause. Treating the infection, electrolyte abnormalities, and decreasing opiate use can all potentially decrease the durability of an ileus. Anesthesia procedures must be performed to treat patients preoperatively, during surgery, and postoperatively. Enhanced recovery protocols, regional anesthesia, opioid-sparing analgesics, and laparoscopy have all improved the number of postoperative ileus cases.Case Presentation: The following is a 67-year-old male patient who presents with abdominal pain with a scale of 4 out of 10, diagnosed with ileus, which was planned for laparotomy surgery by general anesthesia with supine position.Conclusion:We conclude that anesthetic procedures are critical in ileus patients in performing laparotomy operations, both in selecting anesthetic techniques, anesthetic drugs, and supporting scores (Aldrete score). Before induction, anesthesiologists must carefully assess preoperative and monitor postoperative 
Pulsed Radiofrequency on Sphenopalatine Ganglion as the Interventional Pain Management in Cluster Headache Secondary to Sphenoid Meningioma Rahmasena, Naomi; Koeshardiandi, Mirza; Mudianto, Fajar Tri
Indonesian Journal of Anesthesiology and Reanimation Vol. 6 No. 1 (2024): 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.V6I12024.32-41

Abstract

Introduction: Cluster headache is one of the neurovascular headaches characterized by severe recurrent unilateral pain distributed around the orbit and accompanied by autonomic symptoms such as lacrimation, conjunctival injection nasal congestion or rhinorrhea, edema of the eyelid, sweating, and miosis. The attack usually lasts for 15 to 180 minutes. The possible mechanism of cluster headache is through the trigeminal-autonomic reflex. Management of the cluster headache is divided into pharmacological therapy including abortive and prophylaxis, as well as interventional pain management like deep brain stimulation, occipital nerve stimulation, and radiofrequency of the sphenopalatine ganglion. Objective: This report aims to demonstrate the effectivity of pulsed radiofrequency sphenopalatine ganglion on cluster headaches secondary to meningioma. Case Report: A 47-year-old female consulted the pain clinic with a chief complaint of profound facial pain for a year. The patient also reported autonomic symptoms such as rhinorrhea and lacrimation. The patient was diagnosed with meningioma and already treated with conventional therapy such as gabapentine, carbamazepine, omeprazole, and mecobalamin. Due to the location of meningioma which causes the tumor inoperable. The patient complained of constant and worsening pain, therefore pulsed radiofrequency on sphenopalatine ganglion was chosen to treat the patient. The patient reported relief of pain ever since. Discussion: Among the consequences and benefits, pulsed radiofrequency is the choice of interventional pain management. Possibly the pain from the compression of the greater palatine nerve, intervention on the sphenopalatine will cause relief of the pain. Pulsed radiofrequency on sphenopalatine ganglion was reported successful in alleviating the pain of the patient. Conclusion: Pulsed radiofrequency of the sphenopalatine ganglion successfully alleviates the pain of the cluster headache due to meningioma. However, further study with a bigger population is recommended to see the efficacy of interventional pain management objectively.