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All Journal Jurnal Komplikasi Anestesi
Kusuma, Danur Adi
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Medicine & Pharmacology

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Anestesi Inhalasi dengan Teknik Low Fresh Gas Flow Pratomo, Bhirowo Yudo; Kurniawaty, Juni; Kusuma, Danur Adi
Jurnal Komplikasi Anestesi Vol 10 No 2 (2023): Volume 10 Number 2 (2023)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v10i2.8292

Abstract

Any technique that employs a fresh gas flow that is less than the alveolarventilation can be classified as low-flow anesthesia. The complexities involvedin the calculation of uptake of anesthetic agents during the closed-circuitanesthesia made this technique less popular. However, the awareness of thedangers of operating theatre pollution with trace amounts of the anestheticagents and the prohibitively high cost of the new inhalational agents, havehelped in the rediscovery of low-flow anesthesia.
Manajemen Pasien dengan Hoarseness Paskatiroidektomi Total Dipacu Kusuma, Danur Adi; Pratomo, Bhirowo Yudo; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022): Volume 10 Number 1 (2022)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v10i1.8324

Abstract

look at the clinical appearance of the patient who appears hoarse after extubation, thevoice becomes softer, the ability to cough is not strong but the respiration rate is stillnormal 18 times/minute with a saturation of 98% then The probability of injury isunilateral. Pathophysiologically hoarseness can mean there is a possibility of injury toeither the bilateral superior laryngeal nerve or unilateral recurrent laryngeal nerve (RLN).Then the possibility of injury is unilateral RLN unilateral in this patient. Ideally thedifferential diagnosis of postoperative hoarseness requires examination such as simplelaryngoscopy, stroboscopy or intra and extralaryngeal electromyography. In practice it isdifficult to distinguish between damage caused by thyroid surgery and anaestheticfactors. There are a number of anesthetic-related factors that may predispose to hoarseness in these patients such as the risk of doubling in patients who are intubated for3-6 hours (in patients 3.5 hours). This could be ruled out if we could measure the ET cuffpressure during surgery. While from the surgical factor there are several risk factors suchas surgery on the neck area (thyroid surgery), excessive neck extension during surgery,pulling the RLN causing injury. In the last operation the position of the neck extended, forRLN in the operation report has been identified. It is better to assess vocal cord functionprior to extubation, such as a cuff leak test or insertion of a flexible intubation scopethrough the lumen of the ET tube.
Co-Authors Akhmad Yun Jufan Bhirowo Yudo Pratomo Juni Kurniawaty Muhdar Abubakar Djayanti Sari