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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina Jurnal Anestesi Perioperatif Bali Journal of Anesthesiology Syntax Literate: Jurnal Ilmiah Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research PREPOTIF : Jurnal Kesehatan Masyarakat Neurologico Spinale Medico Chirurgico JOURNAL LA MEDIHEALTICO Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Social Research COMSERVA: Jurnal Penelitian dan Pengabdian Masyarakat Journal of Anesthesiology and Clinical Research Majalah Anestesia & Critical Care (MACC) Cerdika: Jurnal Ilmiah Indonesia International Journal of Psychology and Health Science Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif
I Made Gede Widnyana
Department Of Anesthesiology And Intensive Therapy, Faculty Of Medicine, Udayana University - Central General Hospital Prof. I.G.N.G. Ngoerah, Denpasar, Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences Veterinary Other

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Journal : JOURNAL LA MEDIHEALTICO

 1 
Nebulized Dexmedetomidine to Reduce Delirium after General Anesthesia Sevoflurane Inhalation in Preschool Children Undergoing Elective Surgery Wongkar, Jimmy; Kurniyanta, I Putu; Suarjaya, I Putu Pramana; Tjokorda Gde Agung Senapathi; Widnyana, I Made Gede
Journal La Medihealtico Vol. 6 No. 2 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i2.1965

Abstract

Surgery in children remains a major challenge, particularly due to complications such as post-anesthetic delirium, with an incidence rate of up to 80%, especially in preschool-aged children when sevoflurane is the primary agent. Nebulized dexmedetomidine has been shown to reduce the incidence of post-anesthetic delirium with minimal risk of side effects. This study aims to evaluate the effectiveness of nebulized dexmedetomidine in reducing the incidence of post-anesthetic delirium in preschool-aged children undergoing elective surgery, as part of enhancing recovery after pediatric surgery (ERAPS). This research was a double-blind, randomized controlled trial, involving 72 pediatric patients aged 2–6 years undergoing elective surgery under general anesthesia with sevoflurane. Subjects were randomly divided into two groups; Treatment group receiving nebulized dexmedetomidine 2 mcg/kg (n=36) and Control group receiving nebulized normal saline (n=36). The primary outcome was the incidence of delirium during recovery at 15, 30, 60, and 120 minutes, assessed using the Pediatric Anesthesia Emergence Delirium (PAED) Scale. Statistical analysis revealed a significantly lower incidence of post-anesthetic delirium in the nebulized dexmedetomidine group (19.4%) compared to the control group (52.8%) at 15, 30, and 60 minutes (p<0.05), with a reduction in proportion by 33.4% (p=0.003). Relative risk analysis (RR = 0.427, 95% CI: 0.218–0.835; PF = 0.631) demonstrated that dexmedetomidine provides protective effects and significantly reduces the incidence of post-anesthetic delirium in preschool-aged children undergoing elective surgery with sevoflurane inhalational anesthesia. No side effects requiring intervention were observed during this study.
Comparison of Inflammation, Pain, and Recovery in Colorectal Cancer Patients Undergoing Surgery with General Anesthesia and Combined Epidural Kenzi, Ignatio Armando; Hartawan, IGAG Utara; Sidemen, IGP Sukrana; Agung Senapathi, Tjokorda Gde; Gede Widnyana, I Made
Journal La Medihealtico Vol. 6 No. 2 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i2.2002

Abstract

Colorectal cancer has a high incidence and mortality rate. Surgery can increase the cytokine IL-6 which triggers inflammation and metastasis. The combination of general and epidural anesthesia has the potential to suppress IL-6, improve the tumor microenvironment, provide analgesia and improve postoperative recovery. To compare the effectiveness of postoperative analgesia quality in colorectal cancer patients receiving general anesthesia with combined epidural anesthesia. The single blind RCT study involved 44 patients who underwent surgery on colorectal cancer at Prof. Ngoerah Hospital. The study subjects were divided into two groups, group K who received general anesthesia and group P who received general anesthesia combined with epidural anesthesia. Patients' IL-6 will be evaluated preoperatively and 6 hours postoperatively. VAS and QOR-15 will be assessed 24 hours postoperatively. Of the 44 patients analyzed, the combined general anesthesia with epidural anesthesia group showed a significantly lower difference in IL-6 levels compared to the general anesthesia alone group of -14.69 [95% CI, p = <0.001]. The 24-hour postoperative VAS score was significantly lower than conventional general anesthesia, both in stationary and mobile conditions. In postoperative recovery, it was found that conventional general anesthesia combined with epdiural anesthesia gave greater QOR-15 results compared to conventional general anesthesia. General anesthesia combined with epidural anesthesia in colorectal cancer patients undergoing surgery can provide a lower difference in IL-6, lower VAS and higher QOR-15 postoperative satisfaction than the general anesthesia group.
Co-Authors Adinda Putra Pradhana Agrasidi, Putu Anindya Anak Agung Gde Agung Adistaya Ari Andayani Ariyasa, I Putu Eka Aryasa EM, Tjahya Astuti, Mira Kusuma Bora, Fivilia Anjelina Christopher Ryalino Cynthia Dewi Sinardja Damayanti, Elok Dewi, I Dewa Ayu Mas Shintya Eka Nantha Kusuma, Putu Elisma Nainggolan, Elisma EM, Tjahya Aryasa Emkel Perangin Angin, Emkel Estrada, Ronald Ganakin, Acuyta Gde Agung Senapathi, Tjokorda Gede Semarawima, Gede Hartawan , I.G.A.G. Utara Hartawan, IGAG Utara Hengki Irawan Hengki Irawan Hengky Hengky, Hengky I Dewa Gede Tresna Rismantara, I Dewa Gede Tresna I Gde Raka Widiana I Gede Budiarta I Gede Prima Julianto I Gusti Agung Gede Utara Hartawan I Gusti Ngurah Mahaalit I Gusti Ngurah Mahaalit Aribawa I Ketut Sinardja I Ketut Wibawa Nada I Made Agus Kresna Sucandra I Made Darma Junaedi, I Made I Made Subagiartha I Nyoman Hariyasa Sanjaya I Putu Agus Surya Panji I Wayan Aryabiantara, I Wayan I Wayan Suranadi IB Krisna, IB Ida Bagus Krisna Jaya Sutawan IGNA Putra Arimbawa, IGNA Putra Jeanne, Bianca Jim Anthonio, Jim Jimmy Wongkar Johanes, Kevin Paul Jonathan, Jeremy Junaedi, I Made Darma Kadek Agus Heryana Putra Kadek Agus Heryana Putra, Kadek Agus Kenzi, Ignatio Armando Ketut Semara Jaya, Ketut Semara Kurnia, Prajnaariayi Prawira Kurniyanta, I Putu Made Adi Kusuma Made Agus Kresna Sucandra, Made Agus Kresna Made Wiryana Madyline Victorya Katipana Marilaeta Cindryani Marilaeta Cindryani Lolobali, Marilaeta Cindryani Marilaeta Cindryani, Marilaeta Mark Christsatya Bolla Mas Shintya Dewi, Dewa Ayu Nada, I Ketut Wibawa Otniel Adrians Labobar Pande Nyoman Kurniasari, Pande Pemayun, Cok Istri Dewiyani Pontisomaya Parami Putra, Agung Manik Septiana Putrawan, I Wayan Eka Putu Agus Surya Panji Putu Herdita Sudiantara, Putu Herdita Putu Kurniyanta Putu Pramana Suarjaya Renaldi Reynaldi Reiky Hadiwijaya Richard Richard Riko Riko Satria Pinanditas S Sidemen, I Gusti Ayu Eka Para Santi Sidemen, I.G.P.Sukrana Sidemen, IGP Sukrana Sonni Soetjipto, Sonni Sri Astuti Srinami Dewi Suastika, I Gede Juli Sutyawan, I Wayan Eka Tanggono, Aninda Tirta, Ian Tjahya Aryasa Tjahya Aryasa E M Tjokorda Gde Agung Senapathi Tjokorda Gde Agung Senapathi Wanda, Aprilia Wardani, Dinar Kusuma Win Muliadi