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All Journal MNJ (Malang Neurology Journal) Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Setjaputra, Vina Lidya
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Medicine & Pharmacology Neuroscience

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THE SAFETY AND OUTCOME OF ACUTE ISCHAEMIC STROKE PATIENTS WITH COVID-19 TREATED WITH INTRAVENOUS RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR: A SYSTEMATIC REVIEW Machin, Abdulloh; Setjaputra, Vina Lidya; Susianto, Steven Christian; Husni, Nadya; Sugondo, Alexander Tikara
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.02.12

Abstract

Background: Strokes associated with SARS-CoV-2 may be linked to increased mortality rates. The utilization of intravenous thrombolysis is anticipated to enhance the clinical results in such patients. Moreover, emerging evidence underscores the importance of evaluating the safety and effectiveness of intravenous thrombolysis in individuals suffering from Acute Ischaemic Stroke along with COVID-19. Objective: To assess the safety and effectiveness of intravenous thrombolysis in Acute Ischaemic Stroke patients with COVID-19. Methods: A systematic literature search (Pubmed, Elsevier, and Cochrane database) with keywords (((intravenous thrombolysis) AND (acute ischemic stroke)) AND (covid-19)) AND (outcome))). We selected research studies for evaluation based on specific inclusion and eligibility criteria. Two independent reviewers then proceeded to extract and analyze various data points, including the name of the first author, the year of publication, the study's design, the National Institute of Health Stroke Scale (NIHSS) scores at admission and post-treatment, hospitalization-related mortality, and the occurrence of hemorrhagic transformation. Results: Three studies (n=153 patients) were included, mostly men with advanced age with the most common comorbidity being hypertension. Median of NIHSS Score of subjects on admission is 11, 12, and 13, with interquartile range from 3 to 20 (minor to severe stroke). The mRS at discharge and 1 month after admission is: 0–2 pts in 57 patients, ≥2 in 43 patient. Hemorrhagic transformation involved 3.23% of patients from total samples, death within hospitalization and 1-month mortality were in 23 patients (15%). In numerous studies, there was inadequate data available to determine the precise reason for mortality. Conclusion: Following IV-rTPA therapy, our COVID-19 infection subjects' mRS scores ranged from mild to moderate disability. Fifteen percents of all subjects died, and 3.23% of subjects experienced hemorrhagic transformation. However, majority of our subjects have high median NIHSS scores at admission, advanced age, complicated with baseline risk factors as high blood pressure, diabetes, and hyperlipidemia.
Ultrasound-Guided Peripheral Nerve Block as Post-Operative Management of Lower Abdominal Surgery in Ksatria Airlangga Floating Hospital Setjaputra, Vina Lidya; Susianto , Steven Christian; Silitonga , Jessica Deborah; Kusumaningtyas , Maya Hapsari; I Putu Agni Rangga Githa; Atmaja, Robbi Tri; Wardhana, Burhan Mahendra Kusuma; Bandem, I Ketut Mega Purnayasa; Firdaus, Khildan Miftahul; Harianto, Agus
Indonesian Journal of Anesthesiology and Reanimation Vol. 6 No. 2 (2024): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V6I22024.99-105

Abstract

Introduction: Enhanced Recovery After Surgery (ERAS) implementation in remote areas by operating hospital ships is immensely helpful due to high patient turnover, reducing costs, and minimizing the effects of surgical stress. Utilization of regional anesthetics, namely ultrasound-guided Transversus Abdominis Plane (TAP) block or Quadratus Lumborum (QL) block, is applicable and beneficial in this setting. Objective: Due to the limited time, facilities, and health personnel available in floating hospital services surgery, several adjustments in anesthetic methods are required to rapidly return patients to their preoperative physiologic state. Therefore, we wrote this case report. Case Series: We presented case series of lower abdominal surgery performed in Ksatria Airlangga Floating Hospital with the implementation of peripheral nerve blocks as one of the ERAS protocols in one of the remote islands in Indonesia, Gili Iyang Island. Two patients underwent TAP blocks, while the remaining two received QL Blocks. A peripheral nerve block was performed under ultrasound guidance and a 20-mL injection of 0.25% levobupivacaine to QL muscle or TAP. During the observation, we found Visual Analogue Score (VAS) of 1-2 after surgery, no post-operative sedation needed, only 1 patient experienced nausea without vomiting, and the length of health facility stay were less than 3 days. Nearly all of our patients who underwent lower abdomen surgery got benefits from the application of peripheral nerve block. Because there was no opioid consumption in our cases, the risk of unwanted effect of opioids like postoperative nausea and vomiting, were also decreased. Conclusion: Peripheral nerve block, as mentioned TAP Block and QL Block, has emerged as a promising alternative to prevent and manage post-operative pain in remote medicine settings, namely Ksatria Airlangga Floating Hospital, particularly in areas with few medical facilities.
Co-Authors AGUS HARIANTO Atmaja, Robbi Tri Bandem, I Ketut Mega Purnayasa Firdaus, Khildan Miftahul Husni, Nadya I Putu Agni Rangga Githa Kusumaningtyas , Maya Hapsari Machin, Abdulloh Silitonga , Jessica Deborah Sugondo, Alexander Tikara Susianto , Steven Christian Susianto, Steven Christian Wardhana, Burhan Mahendra Kusuma