Aidyl Fitrisyah
Departement Of Anesthesiology, Faculty Of Medicine, Universitas Sriwijaya / Mohammad Hosein Hospital, Palembang, Indonesia

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Laparoscopic Cholecystectomy under Segmental Thoracic Spinal Anesthesia Aidyl Fitrisyah; Rizal Zainal; Edi Darwis
Archives of The Medicine and Case Reports Vol. 2 No. 3 (2021): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v2i3.24

Abstract

Introduction: Cholelithiasis or gallstones are hardened deposits of digestive fluid that can form in gallbladder. The treatment of gallstones depends upon the stage of disease. Once gallstones become symptomatic, definitive surgical intervention with cholecystectomy is usually indicated (typically, laparoscopic cholecystectomy is the first-line therapy). Laparoscopic cholecystectomy removes the gallbladder and gallstones through several small incisions in the abdomen. This case report aims to discuss the managent of segmental thoracic spinal anesthesia in laparoscopic cholecystectomy. Case: We report on the cases of 2 patients who undego elective laparoscopic cholecystectomy. Female, 53 years old, will undergo laparoscopic cholecystectomy, performed anesthesia with segmental thoracic spinal anesthesiatechnique using the anesthetic agent 3 ml of Levobupivacaine 0,5% + 25 mcg of Fentanyl, requiring a sensory block to at least T10-T11 dermatom. Patients received a 1,2 mcg target control infusion (TCI) propofol intravenous is administered as intermittent boluses to achieve deep sedation. The operation lasts 1 hour, with a bleeding 15 cc and urine output 100 cc, hemodynamically stable. Female, 42 years old, will undergo laparoscopic cholecystectomy, performed anesthesia with segmental thoracic spinal anesthesia technique using the anesthetic agent 3 ml of Levobupivacaine 0,5% + 25 mcg of Fentanyl, requiring a sensory block to at least T10-T11 dermatom. Patients received a 3 mg of midazolam intravenous is administered as intermittent boluses to achieve deep sedation. The operation lasts 1 hour, with a bleeding 15 cc and urine output 150 cc, hemodynamically stable. The level and duration of sensory block, intensity and duration of motor block were recorded. A 20 % or more decrease in MAP compared to baseline was considered as hypotension, iv ephedrine 5 mgr bolus administreted. Conclusion: Laparoscopy is a surgical procedure that uses minimally invasive surgical techniques (minimally invasive surgery) where the doctor uses a small telescope / camera that is inserted into the stomach and surgical instruments in mini form. This procedure has many advantages because it is not invasive, the amount of bleeding can be reduced, postoperative pain can be minimized. Regional anesthesia procedure in laparoscopic cholecystectomy based on several studies and case reports can be performed and is a safe procedure.
Pain in Gynecological Cancer Patiyus Agustiansyah; Aidyl Fitrisyah; Sartika Nopradilova
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 6 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i6.322

Abstract

The International Association for the Study of Pain defines pain as “unpleasant sensory and emotional experiences associated with actual or potential tissue damage.” Pain is common among patients with cancer, with the prevalence of pain being 66.4% in advanced metastatic disease or terminal, 55% during anticancer treatment, 39.3% after curative treatment, and moderate to severe pain were reported in 38.0% of all patients. Pain is one of the most common and dreaded symptoms in cancer sufferers, but the exact number of cancer patients who experience pain is difficult to determine. There are a wide variety of studies in defining pain and the tools they use to measure the complexity of this symptom. Good or complete pain control can be achieved in 80-90% of cancer patients. Nevertheless, despite major advances in pain control, cancer-related pain continues to be a major public health problem globally.
Pericapsular Nerve Group Block (PENG Block) and Spinal Anesthesia as Multimodal Analgetic in Patient with Bipolar Hip Arthroplasty: A Case Report Aidyl Fitrisyah; Stevanus Eliansyah Handrawan; Afrida Yolanda Putri
Journal of Anesthesiology and Clinical Research Vol. 2 No. 2 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (193.09 KB) | DOI: 10.37275/jacr.v2i2.160

Abstract

Introduction. Intertrochanteric fractures are defined as extracapsular fractures of the proximal femur that occur between the greater and lesser trochanter. Bipolar hip arthroplasty is one of the most common major orthopaedic procedures to improve patient’s functional status and quality of life. Spinal anesthesia is a regional anesthetic technique that is performed by injecting local anesthetic drugs into the subarachnoid space to obtain dermatome-level analgesia and skeletal muscle relaxation. Pain after hip replacement originates mainly from the anterior pelvic capsule. The main target for pelvic analgesia is the anterior capsule which is the most richly innervated part of the joint. PENG block is used to block the articular branches to the pelvis. The patient was assessed with an NRS (numeric rating scale) instrument pre and post operative. Case presentation. A-74 year old woman admitted with complaints of pain in the right hip and diagnosed with a closed fracture of the right intertrochanter and planned for bipolar hip arthroplasty with PENG block and spinal anesthesia. Preoperatively the patient was assessed with an NRS (numeric rating scale) instrument with a score of 6. After the procedure, we reevaluated the pain score using NRS was 2 post operative. Conclusion. Patients receiving a PENG block and spinal anesthesia for intraoperative and postoperative analgesia during hip fracture surgery. Prior to spinal anesthesia, PENG block can be performed as a multimodal analgesia in the patient, PENG block expected to facilitate a sitting position during spinal anesthesia and for postoperative pain management
Pain in Gynecological Cancer Patiyus Agustiansyah; Aidyl Fitrisyah; Sartika Nopradilova
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 6 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i6.322

Abstract

The International Association for the Study of Pain defines pain as “unpleasant sensory and emotional experiences associated with actual or potential tissue damage.” Pain is common among patients with cancer, with the prevalence of pain being 66.4% in advanced metastatic disease or terminal, 55% during anticancer treatment, 39.3% after curative treatment, and moderate to severe pain were reported in 38.0% of all patients. Pain is one of the most common and dreaded symptoms in cancer sufferers, but the exact number of cancer patients who experience pain is difficult to determine. There are a wide variety of studies in defining pain and the tools they use to measure the complexity of this symptom. Good or complete pain control can be achieved in 80-90% of cancer patients. Nevertheless, despite major advances in pain control, cancer-related pain continues to be a major public health problem globally.