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Journal : JOURNAL LA MEDIHEALTICO

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 A A Gde Putra Semara Jaya Adi, Made Septyana Parama Adinda Putra Pradhana Adistaya, Anak Agung Gde Agung Albert Albert Anak Agung Gde Agung Adistaya Andi Irawan Andi Kusuma Wijaya, Andi Anggreni, Anak Agung Ayu Aprilnita, Aida Aryasa EM, Tjahya Aryawangsa, Anak Agung Ngurah Astawa N. M., Astawa N. Astawa P., Astawa Astuti, Mira Kusuma Astuti, Mira Kusuma Bayu Saputra, Ida Bagus Prema Satia Brillyan Jehosua Toar Budiadnyana, I Made Pasek Budiarta, Gede Cahyono, Ardy Wibowo Christopher Ryalino Christopher, Michael Cindryani Ra Ratumasa, Marilaeta Cung Flavyanto, Eugenius Silvester Cynthia Dewi Sinardja D.H., Asterina David Rendra Mahardika Dewa Ayu Mas Shintya Dewi Dewi, Dewa Ayu Mas Shintya Dewi, I Dewa Ayu Mas Shintya Doddy Setiawan Ekaputra Ekaputra, Ekaputra Elisma Nainggolan, Elisma EM, Tjahya Aryasa Emkel Perangin Angin, Emkel Eric Makmur, Eric Ery Oktadiputra Estrada, Ronald Eugenia, Michelle Ferry, Ferdinand Gede Semarawima, Gede Gede Wirya Kusuma Duarsa Giovanni, Malvin Hadiwijono, Vanessa Juventia Hartanto, Wijaya Hartawan , I.G.A.G. Utara Hartawan, IGAG Utara Hengky Hengky, Hengky Humianto, Michael I Dewa Made Sukrama I Gede Budiarta I Gede Prima Julianto I Gusti Agung Gede Utara Hartawan I Gusti Ayu Putri Purwanthi I Gusti Ngurah Mahaalit Aribawa I Ketut Sinardja I Ketut Wibawa Nada I Made Agus Kresna Sucandra I Made Bakta I Made Darma Junaedi, I Made I Made Gede Widnyana I Made Prema Putra I Made Subagiartha I Made Wiryana, I Made I Putu Agus Surya Panji I Putu Fajar Narakusuma I Wayan Aryabiantara, I Wayan I Wayan Suranadi Ida Bagus Krisna Jaya Sutawan IGNA Putra Arimbawa, IGNA Putra Jayantha Ananda, I Gusti Ngurah Bagus Jeanne, Bianca Jhoni Pardomuan Pasaribu Jimmy Wongkar Johanes, Kevin Paul Junaedi, I Made Darma Kadek Agus Heryana Putra Kadek Agus Heryana Putra, Kadek Agus Kamaswari, Ida Ayu Dwi Kenzi, Ignatio Armando Ketut Semara Jaya, Ketut Semara Ketut Wibawa Nada Ketut Yudi Arparitna, Ketut Yudi Komang Ady Widayana Komang Alit Artha Wiguna Komang Alit Artha Wiguna Kurnia, Prajnaariayi Prawira Kurniajaya, I Gusti Agung Made Wibisana Kurniyanta, I P Kurniyanta, I Putu Kusuma, Oscar Indra Labobar, Otniel Adrians Leo, Joseph Nelson Lesmana, Pita Mora Leton, Yohanes PT Made Agus Kresna Sucandra Made Agus Kresna Sucandra, Made Agus Kresna Made Bagus Cahya Maha Putra Made Widnyana Made Wiryana Marilaeta Cindryani Marilaeta Cindryani Lolobali, Marilaeta Cindryani Marilaeta Cindryani, Marilaeta Marting, Millenia Mauritius Septa Murti, Dede Taruna Kreisnna Nada, I Ketut Wibawa Nandaswari, Ni Made Nilam Narakusuma, I Putu Fajar Ni Nyoman Sri Budayanti Ni Putu Novita Pradnyani, Ni Putu Novandi Kurniawan Pande Nyoman Kurniasari, Pande Panji, I PAS Patricia, Yoshie Pontisomaya Parami Pramana, Putu Bagus Gin Gin Pranoto, Theodorus Pascalis Yullie Pratana, Yolanda Jenny Putu Agus Surya Panji Putu Gede Ary Sanjaya Putu Herdita Sudiantara, Putu Herdita Putu Kurniyanta Putu Pramana Suarjaya Ra Ratumasa, Marilaeta Cindryani Raka-Sudewi A. A. Ratumasa, Marilaeta Cindryani Ra Reynaldi Reiky Hadiwijaya Riko Riko Santo, Budi Saputra, Darmawan Jaya Satoto D., Satoto Satria Pinanditas S Sidabutar, Beny Pratama Sidemen, I Gusti Ayu Eka Para Santi Sidemen, I.G.P.Sukrana Sidemen, IGP Sukrana Sonni Soetjipto, Sonni Sri Maliawan Stefanus Taofik stefanus taofik, stefanus Suarjaya, I PP Suastika, I Gede Juli Sucandra, I Made Agus Kresna Sucandra, I MK Sumanti, Alan F. A. Sunanda Naibaho Suranadi , I Wayan Suryadi N. T., Suryadi N. Suryana, I Ketut Syamsuddin, Johanis Bosco Troy Tanuwijaya, Tommy M Tirta, Ian Tjahya Aryasa Tjahya Aryasa Tjahya Aryasa E M Tjokorda Gde Bagus Mahadewa Togi Stanislaus Patrick Virayanti, Luh Putu Diah W. A., W. Wardani, Dinar Kusuma Welly, Julian Widnyana, I MG Widyana, I Made Gede Wirananggala, Nyoman Bendhesa Wiranata, Jeremia Alvian Wiryana M., Wiryana Yadikusumo, Andrian Yustisia, Putu Ngurah Krisna Denta