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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Anesthesiology and Clinical Research Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif
Made Septyana Parama Adi
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Physics

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Perioperative Management of Intradural Extramedullary Tumor Patients Undergoing Hemilaminectomy and Tumor Resection: A Case Report Oka Rastini, Luh Ratna; Made Septyana Parama Adi
Journal of Anesthesiology and Clinical Research Vol. 4 No. 2 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.329

Abstract

Introduction: Intradural extramedullary (IDEM) tumor is a benign neoplasm originating in the spinal canal and accounts for approximately two-thirds of cases of primary spinal tumors. This case report aimed to further discuss the anesthetic management of IDEM tumor patients who underwent hemilaminectomy and tumor resection. Case presentation: A 25-year-old woman came with complaints of right hemiparesis, hypoesthesia as high as L3-L4, and unable to hold back urination since 4 months ago. Magnetic resonance imaging (MRI) examination showed a heterogeneous intradural extramedullary solid mass in the central spinal cord as high as Th 10-11 posterior, which narrowed the spinal canal. Dextra hemilaminectomy, tumor resection, and unilateral stabilization of dextra Th10-12 fusion were performed under general anesthesia and thoracolumbar interfascial plane blocks (TLIP). General anesthesia with non-kinking endotracheal intubation, controlled ventilation, and prone position is required for spinal thoracic surgery in adult patients. Propofol is a good induction agent, especially in maintaining the depth of anesthesia, because it can prevent side effects that arise from inhalation anesthetics. Conclusion: Bilateral modified TLIP block was performed in patients after induction of anesthesia with a median approach and ultrasonography (USG) guidance. TLIP block can reduce cumulative opioid consumption, acute pain intensity, the need for rescue analgesia, and the incidence of nausea and vomiting.
Successful Post-Resuscitation Care in End-Stage Renal Disease Patients: A Case Report Merry; Made Septyana Parama Adi; I Gusti Agung Gede Utara Hartawan; I Gusti Ngurah Mahaalit Aribawa; I Putu Fajar Narakusuma; I Gusti Agung Made Wibisana Kurniajaya
Journal of Anesthesiology and Clinical Research Vol. 6 No. 1 (2025): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v6i1.673

Abstract

Introduction: Cardiac arrest in end-stage renal disease (ESRD) patients presents unique challenges due to their complex medical conditions. Post-resuscitation care for these patients requires careful management of various factors, including hemodynamic instability, electrolyte imbalances, and fluid overload. This case report describes the successful post-resuscitation care of an ESRD patient who experienced cardiac arrest and achieved a return of spontaneous circulation (ROSC). Case presentation: A 50-year-old female with ESRD on hemodialysis (HD) presented with acute dyspnea and cardiac arrest. After 8 minutes of cardiopulmonary resuscitation (CPR), ROSC was achieved. The patient was managed with a comprehensive post-resuscitation care protocol, including brain resuscitation (targeted temperature management, ventilation optimization, and hemodynamic control) and sustained low-efficiency dialysis for fluid balance. Despite the severity of her condition, the patient showed significant neurological recovery and was successfully extubated after 7 days of mechanical ventilation. She was discharged after 12 days with follow-up for her chronic conditions. Conclusion: This case highlights the importance of individualized management strategies for ESRD patients post-cardiac arrest, including the need for prolonged resuscitation and careful monitoring to improve patient outcomes.
Pain Management in Blast Crisis Phase of Chronic Myeloid Leukemia: A Case Report Soerodjotanojo, Simson Samuel; Michael Humianto; I Putu Pramana Suarjaya; Made Septyana Parama Adi
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.v8i2.921

Abstract

Background: Chronic myeloid leukemia (CML) is a slow-growing type of cancer that begins in the bone marrow's blood-forming cells and is caused by a chromosomal mutation that is assumed to develop spontaneously. As CML advances into the rapid or blast phase, it can cause significant pain. This study aimed to describe pain management in the blast crisis (BC) phase of CML. Case presentation: A 48-year-old female diagnosed with CML in the BC phase complained of severe pain in the head, shoulders, back, and tailbone area with a numeric rating scale (NRS) of 9/10. The patient received multimodal analgesic therapy with continuous IV fentanyl at a rate of 0.25 mcg/kg/hour and ketamine at 1.3 mcg/kg/minute for 24 hours. The dosage was gradually increased through titration with a target NRS of 4/10. On the fifth day, we replaced fentanyl with morphine at 0.04 mg/kg/hour and ketamine at 1.3 mcg/kg/minute, and we reduced the titration dose according to the patient’s NRS, and her pain was controlled with NRS 3-4/10 after 7 days of treatment. On the 9th day, she was discharged with oral therapy. Conclusion: Multimodal analgesia has been shown to effectively reduce the intensity of the pain in blast crisis phase.
Pain Management in Blast Crisis Phase of Chronic Myeloid Leukemia: A Case Report Soerodjotanojo, Simson Samuel; Michael Humianto; I Putu Pramana Suarjaya; Made Septyana Parama Adi
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.v8i2.921

Abstract

Background: Chronic myeloid leukemia (CML) is a slow-growing type of cancer that begins in the bone marrow's blood-forming cells and is caused by a chromosomal mutation that is assumed to develop spontaneously. As CML advances into the rapid or blast phase, it can cause significant pain. This study aimed to describe pain management in the blast crisis (BC) phase of CML. Case presentation: A 48-year-old female diagnosed with CML in the BC phase complained of severe pain in the head, shoulders, back, and tailbone area with a numeric rating scale (NRS) of 9/10. The patient received multimodal analgesic therapy with continuous IV fentanyl at a rate of 0.25 mcg/kg/hour and ketamine at 1.3 mcg/kg/minute for 24 hours. The dosage was gradually increased through titration with a target NRS of 4/10. On the fifth day, we replaced fentanyl with morphine at 0.04 mg/kg/hour and ketamine at 1.3 mcg/kg/minute, and we reduced the titration dose according to the patient’s NRS, and her pain was controlled with NRS 3-4/10 after 7 days of treatment. On the 9th day, she was discharged with oral therapy. Conclusion: Multimodal analgesia has been shown to effectively reduce the intensity of the pain in blast crisis phase.
Efektivitas dan Keamanan Deksmedetomidine Nebulisasi Dibandingkan Rute Intravena sebagai Premedikasi Anestesi: Tinjauan Naratif Katarina, Ida; I Putu Fajar Narakusuma; Made Septyana Parama Adi
Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 3 (2025): JATI Desember 2025
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/93296c76

Abstract

Laringoskopi dan intubasi trakea merupakan prosedur rutin anestesi yang sering memicu respons hemodinamik berupa peningkatan tekanan darah dan denyut jantung, yang dapat berisiko pada pasien dengan komorbiditas kardiovaskular atau serebrovaskular. Deksmedetomidine, agonis reseptor α2 adrenergik selektif, terbukti efektif dalam menekan respon tersebut melalui efek simpatolitik dan sedatif. Namun, pemberian intravena sering menyebabkan efek samping berupa hipotensi dan bradikardia. Tinjauan naratif ini bertujuan membandingkan efektivitas dan profil keamanan deksmedetomidine nebulisasi dengan rute intravena sebagai agen premedikasi untuk mengontrol respon hemodinamik selama laringoskopi dan intubasi. Berdasarkan hasil sintesis, deksmedetomidine nebulisasi mampu menurunkan lonjakan tekanan darah dan denyut jantung secara efektif dengan insidensi hipotensi dan bradikardi yang lebih rendah dibandingkan pemberian intravena, serta mengurangi kebutuhan obat induksi anestesi tanpa menimbulkan komplikasi serius. Dengan demikian, deksmedetomidine nebulisasi berpotensi menjadi alternatif premedikasi yang efektif dan lebih aman untuk stabilisasi hemodinamik selama anestesi, meskipun masih diperlukan uji klinis multisenter berskala besar untuk memperkuat bukti dan menentukan dosis optimal.
Efektivitas dan Keamanan Deksmedetomidine Nebulisasi Dibandingkan Rute Intravena sebagai Premedikasi Anestesi: Tinjauan Naratif Katarina, Ida; I Putu Fajar Narakusuma; Made Septyana Parama Adi
Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 3 (2025): JATI Desember 2025
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/93296c76

Abstract

Laringoskopi dan intubasi trakea merupakan prosedur rutin anestesi yang sering memicu respons hemodinamik berupa peningkatan tekanan darah dan denyut jantung, yang dapat berisiko pada pasien dengan komorbiditas kardiovaskular atau serebrovaskular. Deksmedetomidine, agonis reseptor α2 adrenergik selektif, terbukti efektif dalam menekan respon tersebut melalui efek simpatolitik dan sedatif. Namun, pemberian intravena sering menyebabkan efek samping berupa hipotensi dan bradikardia. Tinjauan naratif ini bertujuan membandingkan efektivitas dan profil keamanan deksmedetomidine nebulisasi dengan rute intravena sebagai agen premedikasi untuk mengontrol respon hemodinamik selama laringoskopi dan intubasi. Berdasarkan hasil sintesis, deksmedetomidine nebulisasi mampu menurunkan lonjakan tekanan darah dan denyut jantung secara efektif dengan insidensi hipotensi dan bradikardi yang lebih rendah dibandingkan pemberian intravena, serta mengurangi kebutuhan obat induksi anestesi tanpa menimbulkan komplikasi serius. Dengan demikian, deksmedetomidine nebulisasi berpotensi menjadi alternatif premedikasi yang efektif dan lebih aman untuk stabilisasi hemodinamik selama anestesi, meskipun masih diperlukan uji klinis multisenter berskala besar untuk memperkuat bukti dan menentukan dosis optimal.
Co-Authors I Gusti Agung Gede Utara Hartawan I Gusti Agung Made Wibisana Kurniajaya I Gusti Ngurah Mahaalit Aribawa I Putu Fajar Narakusuma Katarina, Ida Merry Michael Humianto Oka Rastini, Luh Ratna Putu Pramana Suarjaya Soerodjotanojo, Simson Samuel