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All Journal Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif
Alfaruq, Ahmad Umar
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Education Health Professions Medicine & Pharmacology Public Health

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Anesthetic Management of Supraglottic Tumors Undergoing Direct Laryngoscopy Ajie, Astrandaya; Listiarini, Dian Ayu; Alfaruq, Ahmad Umar
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 1 (2025): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.63062

Abstract

Background: Supraglottic tumors are a type of tumor in the larynx that often causes airway obstruction. Comorbidities such as pulmonary tuberculosis (TB) and malnutrition can threaten patient safety during surgery. Comprehensive special perioperative anesthetic management involving multidisciplinary procedures and good communication between anesthesiologists and surgeons is needed. The aim of this case report is to understand the anesthetic management of a patient with a supraglottic laryngeal tumor with comorbid pulmonary TB, atelectasis and malnutrition.Case: A 44-year-old man came to the ear, nose and throat (ENT) clinic with complaints of shortness of breath since the previous month accompanied by pain while swallowing. The patient had a history of smoking and pulmonary TB. Computed tomography (CT) revealed a supraglottic tumor that was suspected to be malignant. The patient was programmed to undergo direct laryngoscopy for tissue biopsy.Discussion: The patient was intubated with a size 5 nonkinking endotracheal tube (ET tube) on the inside, which was connected to a size 7 kinking ET tube on the outside because the glottis rima was narrowed because of a tumor in the supraglottis so that only a small ET tube could pass to secure the airway. In this patient, induction therapy was performed with propofol and opioids. Muscle relaxants are not given to maintain respiratory muscle tone, especially in patients with pulmonary TB and atelectasis, who require full function of the respiratory muscles due to impaired lung development.Conclusion: Special perioperative management is needed in patients with supraglottic tumors with comorbid pulmonary TB, atelectasis and malnutrition. Airway management and the drugs and anesthesia induction techniques chosen must be agents that have minimal side effects on the respiratory tract and maintain respiratory muscle tone.
ANALISIS HUBUNGAN EARLY WARNING SCORE (EWS) DENGAN KEJADIAN IN HOSPITAL CARDIAC ARREST (IHCA) : STUDI RETROSPEKTIF DI RS PENDIDIKAN UTAMA Listiarini, Dian Ayu; Yulianti, Suryani; Alfaruq, Ahmad Umar; Safira, Alya
Jurnal Anestesi Perioperatif Vol 13, No 2 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n2.4062

Abstract

Henti jantung saat masih menjadi penyebab utama kematian di dunia. Kejadian in-hospital cardiac arrest (IHCA) perlu dideteksi sedini mungkin oleh tenaga kesehatan agar dapat segera dilakukan penaganan. Salah satu instrumen yang digunakan untuk mendeteksi perubahan klinis pasien ialah early warning sign (EWS). Nilai EWS yang tinggi dikaitkan dengan peningkatan risiko terjadinya IHCA. Penelitian ini bertujuan untuk menganalisis hubungan antara EWS dan kejadian IHCA di RS Islam Sultan Agung Semarang. Penelitian ini merupakan studi retrospektif dengan desain cross sectional menggunakan data sekunder dari rekam medis pasien di RS Islam Sultan Agung Semarang periode Mei–Juli 2023. Sebanyak 110 subjek pada penelitian ini diperoleh melalui metode non probability sampling dengan teknik consecutive sampling. Analisis data dilakukan menggunakan uji spearman untuk menilai hubungan dan keeratan antar variabel. Hasil penelitian menunjukan bahwa pasien dengan EWS risiko tinggi (skor>7) memiliki hubungan yang signifikan terhadap kejadian IHCA (p<0,001) dengan keeratan sedang (r=0,638). Temuan ini menunjukan bahwa pasien dengan skor EWS>7 berisiko tinggi mengalami IHCA. 
Co-Authors Ajie, Astrandaya Dian Ayu Listiarini Safira, Alya Yulianti, Suryani