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All Journal Medula Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine
Hario Tri Hendroko
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Dentistry Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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A Case Report of Modified Radical Mastectomy (MRM) In A 59-Year-Old Female Patient With Comorbid Bronchiectasis Using Thoracic Segmental Spinal Anesthesia (TSA) Imam Ghozali; Hario Tri Hendroko; Dansen Rudyanto; Marcella Dena Fernanda
Medula Vol 13 No 6 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i6.831

Abstract

Breast cancer is a disease with the highest incidence of malignancy in Indonesia and the world. Epidemiological studies have shown that cancer affects billions of women each year. The incidence of breast cancer increases with age. In the elderly, the possibility of co-morbidities which are comorbid major medical problems makes anesthetic management decisions more complicated and perioperative care more challenging. Increasing age and comorbidities are the most important risk factors for postoperative complications. TSA was performed on a 59-year-old female patient with comorbid bronchiectasis who received MRM. The level of needle insertion was between T5-T6, premedication in the form of 0.5 mg alprazolam tablets, initiation of TSA with 1 ml of 0.5% hyperbaric bupivacaine and 20 mcg of fentanyl. The level of sensory block achieved was between T1-T7. TSA resolved without complications. The patient remained comfortable during the operation and there was no significant change in the patient's hemodynamics, airway and breathing. There were no postoperative complications. Thoracal segmental spinal anesthesia (TSA) is a safe alternative in performing modified radical mastectomy (MRM) and other breast surgeries because it has highly selective spinal block capabilities, ensures better control during induction and surgical processes, stability of the respiratory system and cardiovascular, and reduces the need for local anesthetics and has a lower risk of toxicity.
6 YEARS OLD CHILD WITH DENGUE HAEMORRHAGIC FEVER Hario Tri Hendroko
Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine Vol. 1 No. 3 (2014): Jurnal Agromedicine
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

Dengue hemorrhagic fever is a severe and sometimes fatal infection which are widely distributed in subtropical and tropical areas of the world. It is a mosquito-borne disease transmitted by Aedes aegypty mosquitoes and caused by the dengue virus. A child, 6 years old, came with fever since 3 days earlier, suddenly and continually. Physical examination found hypotension, narrowed pulse pressure, tachycardia, cool or mottled skin, prolonged capillary refill time, decreased urine output, and torniquet test positif. Laboratorry examination found trombositopenia (94000/mL), increased hematocrit level >20%, dengue serology examination IgM(+) and IgG (+). Patient was diagnosed and treated as dengue hemorrhagic fever grade III. Patient received care imediately andfinally recover without any ongoing problems and complications. The prognosis for patient with dengue hemorrhagic fever grade IIIdepends on how early the condition was detected and how early the patient was treated. [J Agromed Unila 2014; 1(3):244-248]Keywords: dengue hemorrhagic fever, pediatric, torniquet test
Co-Authors Dansen Rudyanto IMAM GHOZALI Marcella Dena Fernanda