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All Journal e-CliniC International Journal of Health and Pharmaceutical (IJHP)
Panduwinata, Dicky
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Health Professions Nursing Public Health

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Median and Ulnar Nerve Repair Using Sural Nerve Graft: A Case Report Prasetyo, Eko; Oley, Maximillian C.; Manuhutu, Yovanka N.; Panduwinata, Dicky
e-CliniC Vol. 12 No. 1 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i1.46482

Abstract

Abstract: Most peripheral nerve injuries (PNI) are caused by trauma. Upper extrimities are most likely to get injured, and the radial nerve is the most common part in upper extrimites to be affected. There are different surgical options available to repair PNI. We reported a 48-years-old male consulted to the Neurosurgery Department for right upper limb weakness and numbness. He had history of laceration due to iron sheeting in the right arm. There was an irregular scar, weakness on right lower arm with hypesthesia, but no neurovascular distal (NVD) abnormalities were found. Further examination showed claw hand. EMG examination revealed total lesion of the right median and ulnar nerve, partial lesion of the right radial nerve with the lesion at wrist level, possibly neurotmesis according to Seddon Classification. Initial debridement, suturing, and repairing of radial artery and flexor carpi ulnar tendon were performed. The patient was then diagnosed as total lesion of the right median and ulnar nerve, partial lesion of the right radial nerve, post repair right ulnar and radial artery and flexor carpi ulnar tendon repair with the planning of nerve graft with no complication under monitoring. The patient was scheduled for sural nerve graft procedure. Early nerve repair or reconstruction is needed even though it only results in incomplete recovery for months to years. The sural nerve is great either in diameter or length which can be a huge source for the grafting of nerve and revealed good outcomes. Recent study showed incomplete recovery especially seen when the patient could not fully clench his hand and his thumb did not move properly during the movement. In conclusion, sural nerve graft is an appropriate choice for peripheral nerve injuries with more benefits included. Prognosis depends on how early the treatment performed and how severe the lesion is. Keywords: median nerve; sural nerve; peripheral nerve injury; nerve repair; nerve grafting
Pattern of Visual Analog Score Changes in Metastatic Urogenital Cancer Patients Undergoing Sympathectomy Panduwinata, Dicky; Ch Oley, Maximillian; Prasetyo, Eko
International Journal of Health and Pharmaceutical (IJHP) Vol. 4 No. 4 (2024): November 2024
Publisher : CV. Inara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51601/ijhp.v4i4.357

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This study aimed to evaluate the effectiveness of sympathectomy in reducing pain in patients with metastatic urogenital cancer. A single-blind randomized clinical trial involving five patients who underwent neurolytic ganglion impar block using a transcoccygeal approach, followed by radiofrequency ablation (RFA), was conducted. Five patients with metastatic urogenital cancer, averaging 58.4 ± 16.9 years old, showed a significant reduction in pain after sympathectomy. The average Visual Analog Scale (VAS) reduction was 2 points on the first day, 4 points on the third day, and 5 points on the fifth day. This pain reduction was accompanied by a decrease in the patients' dependence on opioid medication. Sympathectomy and radiofrequency ablation have proven effective in reducing pain in patients with metastatic urogenital cancer. These findings support the use of sympathectomy as part of comprehensive pain management in metastatic cancer patients, improving quality of life and reducing opioid usage. This approach offers a promising alternative for managing chronic pain in this patient population, particularly when oral therapy is insufficient.
Co-Authors Ch Oley, Maximillian Eko Prasetyo Heni Pujiastuti Manuhutu, Yovanka N. Oley, Maximillian C.