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All Journal Medicinus : Jurnal Kedokteran Journal of Anesthesiology and Clinical Research
Bora, Fivilia Anjelina
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Non-Sleep Non-Apnea Nasal Fiber Optic Intubation for Difficult Airway Management: A Case Series Bora, Fivilia Anjelina; I Made Gede Widnyana
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.v4i2.297

Abstract

Introduction: Patients with tumors on the neck and mouth are known to be at risk for difficult intubation. Failing to secure the airway can lead to increased patient morbidity and mortality. This study aimed to present a case series with non-sleep non-apnea fiber optic intubation for difficult airway management. Case presentation: In this paper, we present three patients; a 57-year-old woman, a 59-year-old man, and a 68-year-old woman who have airway problems with a tumor located on their neck and mouth but were successfully intubated by non-sleep non-apnea nasal fiber optic intubation, one of airway management technique. Good visualization was achieved by fiber optic devices. Preparing the patient holistically and systematically during the perioperative period was the other important thing to do. MOANS score and LEMON score are used to predict the potential event of a difficult airway preoperatively. These scores help the physician to decide what step will be done with the patient. Conclusion: Anesthetic morbidity and mortality can be reduced with better preoperative evaluation and clear guidelines and practice for difficult intubation.
The Association Between Preoperative Anxiety and Pain Severity, Opioid Requirement, Neutrophil-to-Lymphocyte Ratio, and Postoperative Blood Glucose After Gynecologic Laparotomy at Ngoerah Hospital Bora, Fivilia Anjelina; Dewi, Dewa Ayu Mas Shintya; Kurniyanta, I Putu; Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Suarjaya, Putu Pramana; Aribawa, I Gusti Ngurah Mahaalit; EM, Tjahya Aryasa; Parami, Pontisomaya; Labobar, Otniel Andrians
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10969

Abstract

Background: We assessed whether preoperative anxiety is associated with postoperative pain severity, opioid requirement, neutrophil-to-lymphocyte ratio (NLR), and blood glucose after gynecologic laparotomy. Methods: Prospective cohort at Ngoerah Hospital (May to June 2025). Anxiety was measured preoperatively with APAIS and categorized as non-anxious, mild, moderate, or severe. Outcomes were NRS pain at 6, 12, and 24 hours, total fentanyl in the first 24 hours, and NLR and blood glucose at 6 hours postoperatively. Multivariable analysis used MANCOVA (99% confidence intervals). Result: Fifty-four patients were included (mean age 41.78 ± 10.58 years). Anxiety distribution was 46.3% non-anxious, 25.9% mild, 24.1% moderate, and 3.7% severe. Higher anxiety was associated with higher NRS at 6 hours (B 0.842; 99% CI 0.475 to 1.209; p < 0.001), 12 hours (B 0.381; 0.247 to 0.515; p < 0.001), and 24 hours (B 0.158; 0.048 to 0.269; p = 0.048). Anxiety was associated with higher 24-hour fentanyl requirement (B 147.8 microg; 99% CI 124.062 to 171.651; p < 0.001), higher postoperative NLR (B 4.31; 99% CI 0.609 to 8.027; p = 0.024), and higher postoperative blood glucose (B 19.4 mg/dL; 99% CI 7.912 to 30.912; p = 0.001). Conclusions: Higher preoperative anxiety was independently associated with worse pain, greater opioid requirement, and higher postoperative NLR and blood glucose after gynecologic laparotomy.
Co-Authors Dewi, Dewa Ayu Mas Shintya EM, Tjahya Aryasa I Gusti Ngurah Mahaalit Aribawa I Made Gede Widnyana Kurniyanta, I Putu Labobar, Otniel Andrians Pontisomaya Parami Putu Pramana Suarjaya Tjokorda Gde Agung Senapathi