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All Journal E-Jurnal Medika Udayana Bali Journal of Anesthesiology Syntax Literate: Jurnal Ilmiah Indonesia Hearty : Jurnal Kesehatan Masyarakat PREPOTIF : Jurnal Kesehatan Masyarakat Neurologico Spinale Medico Chirurgico Journal of Anaesthesia and Pain Jurnal Kesehatan Tambusai Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Anesthesiology and Clinical Research Journal of Global Pharma Technology Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif
Adinda Putra Pradhana
Department Of Anesthesiology And Intensive Care, Faculty Of Medicine, Udayana University, Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences Other

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Manajemen Anestesi pada Pasien Pediatri yang Menjalani Operasi Reseksi Tumor dengan Posisi Pronasi: Sebuah Laporan Kasus Kamaswari, Ida Ayu Dwi; Pradhana, Adinda Putra; Senapathi, Tjokorda Gde Agung
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v9i12.17001

Abstract

Posisi pronasi dapat menimbulkan tantangan dalam manajemen anestesi, khususnya pada pasien pediatri. Sacrococcygeal teratoma (SCT) adalah tumor pediatrik langka dan menimbulkan tantangan anestesi yang signifikan karena lokasi anatomi dan komplikasi yang terkait. Laporan kasus ini membahas manajemen anestesi pada seorang anak perempuan berusia tiga tahun dengan massa pada regio sacrococcygeal yang semakin membesar sejak lahir, menyebabkan nyeri intermiten tanpa gejala fungsional atau sistemik. Pemeriksaan fisik menunjukkan refleks normal dan anemia normositik normokromik ringan dengan trombositosis. Temuan magnetic resonance imaging (MRI) menunjukkan adanya massa heterogen dengan komponen kistik dan lemak yang menginfiltrasi otot di sekitarnya dan menekan rektum, menunjukkan adanya massa jaringan lunak ganas yang memerlukan reseksi bedah dan rekonstruksi. Evaluasi pra operasi mengikuti protokol standar, termasuk puasa dan pemantauan terperinci. Induksi anestesi melibatkan midazolam, ketamine, dan sevoflurane, dengan manajemen intraoperatif memastikan oksigenasi yang memadai dan stabilitas hemodinamik. Nyeri pasca operasi ditangani dengan fentanil, parasetamol, dan ibuprofen. Laporan ini menggarisbawahi pentingnya pelaporan protokol anestesi dalam posisi pronasi pada pasien pediatri secara rinci untuk perbandingan dan evaluasi langsung. Perbedaan fisiologis terkait usia secara signifikan berdampak pada stabilitas dan hasil hemodinamik, seperti terlihat pada kondisi intraoperatif yang berbeda antara pasien ini dan kasus neonatal yang dilaporkan. Selain itu, temuan MRI dapat bervariasi berdasarkan waktu diagnosis dan pertumbuhan tumor, sehingga memengaruhi presentasi klinis dan perencanaan pembedahan. Penanganan dan pemeriksaan diagnostik yang lebih komprehensif diperlukan untuk meningkatkan penanganan dan manajemen anestesi pada kasus SCT.
The Role of Invasive Hemodynamic Monitoring in Patients with Severe Mitral Regurgitation Undergoing Herniorrhaphy Operation Kapitan, Titin Agustin; Adinda Putra Pradhana; Cynthia Dewi Sinardja
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 2 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i2.920

Abstract

Background: Mitral regurgitation (MR) indeed presents challenges during noncardiac surgeries, especially as the severity of MR tends to increase with age and poses a higher risk of perioperative complications. Accurate hemodynamic monitoring becomes crucial in these cases to manage potential complications effectively. However, the standard monitoring in MR conditions during operation, such as TEE, is not always available, but there are other options for invasive monitoring, such as arterial lines, which provide accurate hemodynamic monitoring. Case presentation: A 64-year-old, male, presented with Reponible Lateral Inguinal Hernia with comorbid of severe mitral and tricuspid regurgitation alongside congestive heart failure. The patient was premedicated with fentanyl 25 mcg intravenously, followed by oxygen supplementation with 3 lpm nasal cannula and insertion of the arterial line. Anaesthesia was performed using a lumbar epidural technique, with the insertion of an epidural catheter in the L1-L2 intervertebral space, Reponible Lateral Inguinal Hernia. The local anesthesia agent chosen was plain bupivacaine with a concentration of 0.5% and a volume of 8 ml. The onset of action of epidural anesthesia is achieved within 20 minutes as long as the operation reaches a total blockade as high as T8. The patient is monitored with standard monitors and an artery line during surgery. There were no complaints of shortness of breath, chest heaviness, or chest pain felt by the patient during the operation. Conclusion: Epidural anesthesia technique can provide stable hemodynamics in patients with severe mitral-tricuspid regurgitation and congestive heart failure and hemodynamic monitoring plays an important role postoperatively to prevent further deterioration and maintain stability.
Difficult Airway Management of Reconstructive Surgery for Noma (Cancrum oris): A Rare Neglected Disease Supono, Benny; Adinda Putra Pradhana; I Gusti Putu Sukrana Sidemen; Putu Kurniyanta
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 3 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i3.937

Abstract

Background: Noma is a rare necrotizing gangrenous stomatitis that occurs due to poor oral hygiene and chronic malnutrition. Noma’s survivors usually had significant facial deformities that needed reconstructive surgery as its definitive treatment. However, this facial deformity can result in a difficult airway that is very challenging for anesthesiologists. Case presentation: A 22-year-old male patient had a significant deformity on his left face due to Noma. Preoperative evaluation revealed a potentially difficult airway due to deformity of the maxilla and mandible, malocclusion, inadequate mask seal, and incomplete dentition. Nasal fiberoptic intubation was chosen as the management of a difficult airway in this patient. A tracheostomy was prepared as the emergency invasive airway in the event of failed intubation attempts. Intubation attempts were limited to three times, and the nasal fiberoptic intubation in this patient was successful on the third attempt. The patient was stable, and the airway was safely maintained during the surgery. Conclusion: Detailed and careful perioperative evaluation had vital role assessing potential difficult airway and planning the optimal airway management for patient with facial deformity. Nasal fiberoptic intubation is still the safest choice with high success rate for Noma patient with significant facial deformity.
Managemen Anestesi pada Congenital Diapragmatic Hernia dengan Ventrikel Septal Defek dan Atrium Septal Defek pada Pasien Pediatrik : Laporan Kasus Mauritius Septa; Adinda Putra Pradhana; I Putu Kurniyanta; Ketut Wibawa Nada; Novandi Kurniawan; Tjokorda Gde Agung Senapathi
Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 2 (2025): JATI Agustus 2025
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JATI.2025.v01.i02.p06

Abstract

Congenital diaphragmatic hernia (CDH) merupakan kelainan kongenital pada diafragma yang terjadi pada pediatri. Insiden terjadinya hernia tipe Borchdalek lebih sering terjadi pada sisi kiri dari pada sisi kanan. Penyulit lain pada CDH adalah hipoplasia paru, hipertensi paru dan kelainan pada jantung. Pada kasus ini kami mendiskusikan bayi 12 hari dengan kelainan CDH sisi kanan dengan kelainan jantung berupa ventrikel septal defek (VSD) dan atrium septal defek (ASD) yang dilakukan operasi laparotomi hernia. Manajemen anestesi pada pasien ini menggunakan  inhalasi sevoflurane, fentanil, volume tidal rendah, obat inotropik dengan kondisi hemodinamik yang stabil selama pembedahan. Kami melaporkan management anestesi dengan  sevoflurane yang dikombinasi dengan volume tidal rendah dan inotropik dobutamine pada operasi congenital diaphragmatic herdia dengan VSD dan ASD membantu dalam keberhasilan intraoperatif. Setelah operasi, pasien dilakukan perawatan di NICU untuk  perawatan secara ketat.
Combined Lumbar Plexus and Sciatic Nerve Blocks Improve Postoperative Recovery in Lower Extremity Surgery: A Randomized Controlled Trial Wiranata, Jeremia Alvian; Aribawa, I Gusti Ngurah Mahaalit; Parami, Pontisomaya; Senapathi, Tjokorda Gde Agung; Hartawan, I Gusti Agung Gede Utara; Adi, Made Septyana Parama; Kurniajaya, I Gusti Agung Made Wibisana; Pradhana, Adinda Putra
Journal of Anaesthesia and Pain Vol. 7 No. 1 (2026): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Background: Patients undergoing lower extremity orthopedic surgery often experience moderate to severe postoperative pain, commonly managed with opioids. Regional anesthesia techniques, such as peripheral nerve blocks, offer promising alternatives. This study evaluates the efficacy of combined lumbar plexus block (LPB) and sciatic nerve block (SNB) versus intravenous opioid analgesia in enhancing postoperative recovery and pain control. Methods: In a single-blind, randomized controlled trial, 42 patients scheduled for lower extremity orthopedic surgery under spinal anesthesia were allocated to two groups. Group P1 received postoperative LPB and SNB using 20 mL of 0.25% bupivacaine, while group P2 received intravenous opioids. Outcomes at 24 hours included quality of recovery (QoR-40) scores, total morphine consumption, duration of analgesia, and monitored adverse events. Result: Group P1 showed significantly better recovery scores [QoR-40: 183 (178–188) vs. 152 (136–161.5), p < 0.001], reduced morphine consumption [4 (4–6.5) mg vs. 18 (16–22) mg, p < 0.001], and longer analgesia duration [480 (340–600) min vs. 75 (60–110) min, p < 0.001]. No adverse events were observed. Conclusion: Combined LPB and SNB significantly improve postoperative recovery quality and analgesia in patients undergoing lower extremity orthopedic surgery, reducing opioid requirements and extending pain-free duration compared to intravenous opioids.
Co-Authors Adi, Made Septyana Parama Agus Roy Rusli Hamid Amin, Yusuf Sidang Andi Irawan Andi Kusuma Wijaya, Andi Cahyono, Ardy Wibowo Christopher Ryalino Cynthia Dewi Sinardja Demoina, I Gede Patria Deni Salmon Dewa Ayu Karunia Dewi Dewa Ayu Mas Shintya Dewi Dwipayana, I Made Agus Yudha Eric Makmur, Eric Eva Dharma Yanti Farha, Nabilla Hartawan, IGAG Utara Heryana, Kadek Agus I Dewa Made Sukrama I Gede Budiarta I Gusti Agung Gede Utara Hartawan I Gusti Ngurah Mahaalit Aribawa I Gusti Putu Sukrana Sidemen I Ketut Sinardja I Made Darma Junaedi, I Made I Made Dwi Pramana I Made Gede Widnyana I Putu Agus Surya Panji I Wayan Aryabiantara, I Wayan I Wayan Suranadi Kadek Agus Heryana Putra, Kadek Agus Kamaswari, Ida Ayu Dwi Kapitan, Titin Agustin Ketut Wibawa Nada Kurniajaya, I Gusti Agung Made Wibisana Labobar, Otniel Adrians Made Widnyana Made Wiryana Mahaalit, I Gusti Ngurah Mauritius Septa Murti, Dede Taruna Kreisnna Nada, I Ketut Wibawa Nantha Kusuma, Putu Eka Narakusuma, I Putu Fajar Ni Nyoman Sri Budayanti Ni Putu Novita Pradnyani, Ni Putu Novandi Kurniawan Pande Nyoman Kurniasari, Pande Pontisomaya Parami Prisca Oriana Sutanto Putra, Putu Enggi Pradana Putu Kurniyanta Putu Pramana Suarjaya Raka-Sudewi A. A. Rapa, Fransiscus Braveno Senapathi, Tjokorda Gede Agung Sonni Soetjipto, Sonni Sumanti, Alan F. A. Supono, Benny Suwardana, Muhammad Bayu Syamsuddin, Johanis Bosco Troy Tjokorda Gde Agung Senapathi Wiranata, Jeremia Alvian Yadikusumo, Andrian