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Rizki Arisandi
Fakultas Kedokteran, Universitas Lampung
Education Medicine & Pharmacology Neuroscience Public Health

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Single-Shot Anestesi Spinal Segmental Thoracic Atau Thoracic Spinal Anesthesia (TSA) Untuk Operasi Embolectomy Pada Pasien Dengan Acute Limb Ischemia (ALI) Stadium IIB : Laporan Kasus Imam Ghozali; Tasrif Hamdi; Rizki Arisandi; Alda Putri Rahmadilla
Medula Vol 12 No 4 (2022): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v12i4.530

Abstract

General anesthesia is the most widely used anesthetic and is the standard for most surgeries. However, general anesthesia has several disadvantages, including side effects of the drugs used, longer recovery time, and inadequate pain control. Therefore, the use of regional anesthesia is an alternative option to reduce the adverse effects of general anesthesia, one of which is spinal segmental thoracic anesthesia. In this case report, a 52-year-old woman that diagnosed with Stage IIb Acute Limb Ischemia (ALI) underwent embolectomy under thoracic spinal segmental anesthesia. The patient presented with ASA III physical status with type II DM, CHF, CAD3VD and increased coagulation factors. Thoracic spinal anesthesia with a paramedian approach at the level of the T10-11 vertebrae using a regimen of levobupivacaine 5 mg and bupivacaine 2.5 mg. The adjuvants used were dexmedetomidine 5 mcg, ketamine 15 mg, and fentanyl 25 mg. During the operation there were no hemodynamic fluctuations. Post-operative monitoring of the patient's condition was stable, pain control was good, and there were no complaints of headache, nausea, and vomiting. Segmental thoracic spinal anesthesia has several advantages such as the need for lower anesthetic doses, safer than lumbar spinal anesthesia, good pain control, faster recovery, and avoiding the side effects of general anesthesia. Therefore, this anesthetic technique can be an effective alternative choice for general anesthesia
Penatalaksanaan Holistik Pada Laki-Laki Usia 69 Tahun Dengan PPOK Dan Hipertensi Grade II Melalui Pendekatan Kedokteran Keluarga Rizki Arisandi; Dian Isti Angraini
Medula Vol 12 No 4 (2022): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v12i4.533

Abstract

Changes in the level of welfare of the Indonesian people have led to an increase in the prevalence of non-communicable diseases, one of which is Chronic Obstructive Pulmonary Disease (COPD). The prevalence of COPD in Indonesia is 3.7% and in Lampung the prevalence is 2.04% and ranks number 7 of the 10 most common diseases found in Lampung. In addition, it is estimated that there are 1.28 billion people aged 30-79 years who have hypertension, of which two thirds live in developing countries, and about 46% are not aware of having hypertension. Less than half (42%) of the population with hypertension is diagnosed and treated. In this case report, it is reported that a 69-year-old male patient with COPD and grade II hypertension had concerns that his complaints would increase and not improve. The limited knowledge about the patient's health condition in the form of risk factors, disease prevention, treatment patterns and the lack of motivation and encouragement from the family to stop smoking and take the patient for routine health control are factors that cause problems that occur in patient and family. The management was carried out holistically using a family medicine approach and after evaluation it was found that the patient's symptoms were reduced, increased knowledge, and changes in the patient's diet and physical activity.
Co-Authors Alda Putri Rahmadilla Dian Isti Angraini IMAM GHOZALI Tasrif Hamdi