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All Journal Solo Journal of Anesthesi, Pain and Critical Care The Journal of Society Medicine (JSOCMED) Jurnal Inovasi Global
Lestari, Mayang Indah
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Astronomy Chemical Engineering, Chemistry & Bioengineering Education Engineering Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Mathematics Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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A Case Series of Bleeding Complication Post Percutaneous Dilatational Tracheostomy and Management Lubis, Batian; Purwaamidjaja, Dis Bima P; Lestari, Mayang Indah; Faisal; Thamrin, Muhammad Husni; Belinda, Febri Akhmad
Journal of Society Medicine Vol. 2 No. 12 (2023): December
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i12.108

Abstract

Introduction: Percutaneous Dilatational Tracheotomy (PDT) is a procedure established for the management of airway and ventilation in the medium to long term for critically ill patients in the ICU. Bleeding is one of the most frequent early complications of tracheostomy. The comorbid conditions of critically ill patients increase the risk of bleeding complications. The aim of this case was to identify factors that increase the risk of bleeding complications in critically ill patients undergoing Percutaneous Dilatational Tracheostomy (PDT) and its management Case: Two cases of patients experiencing bleeding complications after PDT were reported. The bleeding in these patients were suspected to be caused by coagulation disorders due to sepsis and chronic kidney disease. The bleeding occurred on day-1 and 2 post-PDT procedure. Bleeding complications that were not resolved with general management were managed by subcutaneous suturing in the anatomical region of branching arteries and veins that supply the trachea. Conclusion: Bleeding after PDT are a part of early complications of tracheostomy procedures. This complication is more often found in critically ill patients. Management can be carried out by suturing the anatomical region of branching arteries and veins supplying the trachea.
Strategies for Successful Anesthetic Management in Patients With Threatened Thyroid Storm: a Systematic Review of Case Reports Fitrisyah, Aidyl; Sofiah, Nur Ilmi; Murtadh, Masagus Ahmad Rifqi; Lestari, Mayang Indah
Jurnal Inovasi Global Vol. 3 No. 11 (2025): Jurnal Inovasi Global
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jig.v3i11.450

Abstract

Patients with uncontrolled hyperthyroidism undergoing emergency non-thyroid-related surgeries are at increased risk of perioperative complications, including thyroid storm (TS). This systematic review synthesizes findings from multiple case reports to determine optimal anesthetic management strategies. A systematic review of published case reports, including an additional case report contributed by the authors, was conducted. Cases were analyzed for anesthetic strategies, perioperative complications, and outcomes, with a focus on TS occurrence, survival rates, and risk factors. Five case reports and an additional case were reviewed. The use of beta-blockers, glucocorticoids, antithyroid drugs, and regional anesthesia was found to mitigate TS risk. General anesthesia was employed in most cases, with vigilant intraoperative monitoring. TS was reported in one case, emphasizing the need for early recognition and aggressive management. Comprehensive preoperative assessment, intraoperative vigilance, and postoperative monitoring are critical in managing patients with uncontrolled hyperthyroidism undergoing emergency surgery. Beta-blockers, steroids, and regional anesthesia appear to be key in minimizing TS risk.
Spinal Anesthesia in a Patient with Complete Placenta Previa and Suspected Placenta Accreta Undergoing Cesarean Hysterectomy: Is it Possible? Irwanda, Awang Dody; Handrawan, Stevanus Eliansyah; Lestari, Mayang Indah
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 5, No 1 (2025): April 2025
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v5i1.61448

Abstract

Background : Placenta accreta spectrum (PAS) is a major contributor to peripartum hemorrhage and an important cause of maternal morbidity and mortality. Anesthetic management in such cases requires planning to minimize complications. Case Illustration : This report describes the perioperative management of a 39-year-old woman, gravida 4 para 2 at 35 weeks' gestation, who was diagnosed with complete placenta previa and suspected placenta accreta based on ultrasonography and clinical presentation. She underwent cesarean section followed by hysterectomy under spinal anesthesia using 0.5% hyperbaric bupivacaine (12 mg) and clonidine (30 mcg) at the L4-L5 interspace. Intraoperative monitoring included non-invasive blood pressure, ECG, SpO₂, EtCO₂, body temperature, urine output, and serial blood glucose. The operation lasted approximately 2.5 hours with an estimated blood loss of 2000 ml. Fluid resuscitation consisted of crystalloids, albumin, and packed red cells, achieving a calculated fluid replacement of 11.1 mL/kg/h. The baby was delivered in good condition with an APGAR score of 7 and 9 at 1 and 5 minutes, respectively. Postoperative recovery within 24 hours was stable, with minimal pain and no complications. Conclusion : This case demonstrates that with appropriate preparation, spinal anesthesia can be safely and effectively used in selected patients with PAS.
Co-Authors Belinda, Febri Akhmad Faisal Fitrisyah, Aidyl Handrawan, Stevanus Eliansyah Irwanda, Awang Dody Lubis, Batian Muhammad Husni Thamrin, Muhammad Husni Murtadh, Masagus Ahmad Rifqi Purwaamidjaja, Dis Bima P Sofiah, Nur Ilmi