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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research
Tjokorda Gde Agung Senapathi
Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Udayana/Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar, Indonesia
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

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Free Opioid Anesthesia in Cancer Patient Undergoing Total Thyroidectomy and Functional Neck Dissection Dextra: A Case Report I Putu Eka Ariyasa; Tjokorda Gde Agung Senapathi; Tjahya Aryasa E.M.
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 7 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i7.846

Abstract

Background: The use of large doses of opioids perioperatively has been found to be associated with early recurrence in patients undergoing surgery for primary cancer. This study aimed to describe the use of opioid free anesthesia in cancer patients. Case presentation: A 72-year-old man with a diagnosis of papillary adenocarcinoma thyroid underwent total thyroidectomy and dextra functional neck dissection. The results of the preoperative assessment stated that the patient had ASA III physical status and would undergo general anesthesia (GA-OTT) and regional anesthesia peripheral nerve block (RA-PNB BPSS). Conclusion: Nonopioid regimens are recommended for pain control in the perioperative and postoperative periods in some cases. The application of free opioids can reduce opioid dependence in patients who routinely receive opioid prescriptions after discharge.
Clonidine as an Adjuvant for Caudal Analgesia in Pediatric Patients Undergoing Infraumbilical Surgery: A Case Report Khalid Walid Ahmad; Tjokorda Gde Agung Senapathi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 8 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i8.849

Abstract

Background: Caudal block is a popular regional anesthetic procedure used in pediatric patients because it is easy and provides a significant analgesic effect, especially infraumbilical surgeries. Clonidine, an alpha 2 agonist, was previously used for antihypertensives but has recently been found to have analgesic properties, which have been demonstrated in several studies. A number of mechanisms have described how clonidine can exert an adjuvant effect on local anesthetic drugs. Case presentation: A 6-month-old toddler girl with a planned operation posterior sagittal anorectoplasty. The patient underwent a caudal block with a regimen of 0.25% bupivacaine + 8 mcg clonidine in 10 ml of 0.9% NaCl. Postoperative patient care was carried out in the usual ward with the analgesic regimen of paracetamol syrup 80 mg every 6 hours and ibuprofen syrup 80 mg every 8 hours. Conclusion: Clonidine, as an adjuvant for the caudal block, has greater benefits than its side effects in pediatric patients undergoing surgery, especially in areas infraumbilical.
Free Opioid Anesthesia in Cancer Patient Undergoing Total Thyroidectomy and Functional Neck Dissection Dextra: A Case Report I Putu Eka Ariyasa; Tjokorda Gde Agung Senapathi; Tjahya Aryasa E.M.
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 7 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i7.846

Abstract

Background: The use of large doses of opioids perioperatively has been found to be associated with early recurrence in patients undergoing surgery for primary cancer. This study aimed to describe the use of opioid free anesthesia in cancer patients. Case presentation: A 72-year-old man with a diagnosis of papillary adenocarcinoma thyroid underwent total thyroidectomy and dextra functional neck dissection. The results of the preoperative assessment stated that the patient had ASA III physical status and would undergo general anesthesia (GA-OTT) and regional anesthesia peripheral nerve block (RA-PNB BPSS). Conclusion: Nonopioid regimens are recommended for pain control in the perioperative and postoperative periods in some cases. The application of free opioids can reduce opioid dependence in patients who routinely receive opioid prescriptions after discharge.
Clonidine as an Adjuvant for Caudal Analgesia in Pediatric Patients Undergoing Infraumbilical Surgery: A Case Report Khalid Walid Ahmad; Tjokorda Gde Agung Senapathi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 8 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i8.849

Abstract

Background: Caudal block is a popular regional anesthetic procedure used in pediatric patients because it is easy and provides a significant analgesic effect, especially infraumbilical surgeries. Clonidine, an alpha 2 agonist, was previously used for antihypertensives but has recently been found to have analgesic properties, which have been demonstrated in several studies. A number of mechanisms have described how clonidine can exert an adjuvant effect on local anesthetic drugs. Case presentation: A 6-month-old toddler girl with a planned operation posterior sagittal anorectoplasty. The patient underwent a caudal block with a regimen of 0.25% bupivacaine + 8 mcg clonidine in 10 ml of 0.9% NaCl. Postoperative patient care was carried out in the usual ward with the analgesic regimen of paracetamol syrup 80 mg every 6 hours and ibuprofen syrup 80 mg every 8 hours. Conclusion: Clonidine, as an adjuvant for the caudal block, has greater benefits than its side effects in pediatric patients undergoing surgery, especially in areas infraumbilical.
Co-Authors I Putu Eka Ariyasa Khalid Walid Ahmad Tjahya Aryasa E.M.