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Charles Wijaya Tan
Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Treatment of de Quervain's Tenosynovitis with Prolotherapy: A Case Report Veronika Susanty Siampa; Charles Wijaya Tan
Journal of Anesthesiology and Clinical Research Vol. 4 No. 1 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i1.257

Abstract

Introduction: De Quervain's tenosynovitis is a disease with pain in the styloid process area due to chronic inflammation of the tendons covering the abductor pollicis longus and extensor pollicis brevis muscles at the level of the distal radius. This study aims to describe the treatment of de Quervain's tenosynovitis with prolotherapy. Case presentation: A woman, 49 years old, working as a cleaning service, came to the hospital with complaints of pain in her right thumb and wrist. Pain has been felt since 1.5 years ago, especially when using the hand and moving the thumb. The pain has been getting worse in the last 4 months and is sometimes swollen and red near the thumb. Physical examination showed nodules measuring 2x1 cm in the right radial region, positive tenderness, positive Allen test, active and passive movement of digit 1, rotation and adduction inhibition, wrist extension and digitorum positive, wrist flexion and digitorum positive, and a positive Finkelstein test. The patient was diagnosed with de Quervain's tenosynovitis dextra. Prolotherapy was carried out as pain management in this patient. Conclusion: Treatment with injection prolotherapy of patients with complaints of de Quervain's tenosynovitis using a mixture of D40% solution and lidocaine has a good prognosis for symptom improvement and relatively minimal complications.
Continuous Intravenous Ketamine for Management of Acute Pain Postoperative Laparotomy with Septic Shock: A Case Report Sri Ayu Nugrainy; Charles Wijaya Tan
Journal of Anesthesiology and Clinical Research Vol. 4 No. 1 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i1.264

Abstract

Introduction: Ketamine used for patients in the intensive care unit provides a combination of sedation and analgesia as well as a beneficial effect on hemodynamics. This study aims to describe the use of continuous intravenous ketamine as postoperative laparotomy pain management in septic shock. Case presentation: A man, 55 years old, came to the emergency room with complaints of abdominal pain accompanied by bloating, nausea, and vomiting. From the anamnesis and physical examination and support, a diagnosis of peritonitis generalisata et causa hernia suspect incarceration was found. In postoperative observation, vital sign examination showed blood pressure 80/50, pulse 128x/minute, respiratory rate 24x/minute, temperature 37.7ºC, and numeric rating scale 5/10. The treatment the patient got was simple oxygen mask 6-7 L/ minutes, IVFD ringer lactate 3000 cc/24 hours, intravenous ceftriaxone 1gr/12 hours, intravenous metronidazole 500 mg/8 hours, norepinephrine 0.15-0.2 mcg/kg/minute titration, dobutamine 7.5 mcg/kg/minute titration, fentanyl 0.5 mcg/kg/hour titration, ketamine 0.08-0.1 mg/kg/hour and intravenous paracetamol drips 1gr/ 6 hours. The patient experienced improvement and decreased the need for postoperative fentanyl analgesia from 0.5 mcg to 0.3 mcg/kg/hour. Conclusion: The addition of continuous ketamine for acute pain management has been shown to reduce opioid requirements in critically ill patients. The combination of low doses of ketamine together with continuous opioids resulted in a lower pain scale and decreased cumulative use of opioids.
Co-Authors Sri Ayu Nugrainy Veronika Susanty Siampa