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All Journal Solo Journal of Anesthesi, Pain and Critical Care Jurnal Komplikasi Anestesi
Utomo, Wandito Gayuh
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Chemical Engineering, Chemistry & Bioengineering Health Professions Medicine & Pharmacology Nursing Public Health

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Manajemen Anestesi pada Pasien Tricuspid Absent (Free Flow) yang Menjalani Operasi Labioplasti Fajar, Ratih Kumala; Wisudarti, Calcarina Fitriani Retno; Utomo, Wandito Gayuh
Jurnal Komplikasi Anestesi Vol 9 No 3 (2022): Volume 9 Number 3 (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.v9i3.8338

Abstract

Approximately 750,000-1,000,000 pediatric and adult patients with congenital heart disease undergo non-cardiac surgery. This requires anesthetic manajement that will adapt to the congenital heart disease defect, the degree of cardiopulmonary abnormalities and the type of surgical procedure planned and postoperative analgesic management. Male aged 10 months with the diagnosis as physical status ASA 3 with Absent Tricuspid Valve, Small ASD secundum, Mild PS valvar planned for labioplasty. The patient was anesthetized with GA Intubation with ETT no 3.0 cuff semiclose control breath system with analgesic fentanyl 120 mcg, induction with propofol 15 mg, Sevoflurane dial 2.5%, followed by muscle relaxant atracurium 3.5 mg. The patient was admitted to the Pediatric Intensive Care Unit postoperatively, treated for 5 days and transferred to the ward on the 6th day conscious. Pre-anesthesia assessment, stages of anesthesia procedures to postoperative monitoring of labioplasty patients with tricuspid absent require special management to reduce patient mortality and morbidity during and after surgery.ward.
Tata Laksana Badai Tiroid di Instalasi Gawat Darurat Sudadi; Pratomo, Bhirowo Yudo; Utomo, Wandito Gayuh
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 3 (2021)
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.v8i3.8375

Abstract

A thyroid storm is one of endocrinology emergency. Its incidence is very rare but has a very high mortality. Early diagnosis and aggressive treatment must be made in this case so that the patient has a good prognosis. Thyroid storm is often occurring in patients with hyperthyroidism who are not given adequate treatment and are triggered by infection, trauma, thyroid surgery, or uncontrolled diabetes mellitus. Initial treatment in Emergency Department includes assessment and management of the ABCDSs, appropriate intravenous (IV) fluid resuscitation, electrolyte replacement, precipitate factors management, and thyroid-specific therapy (include Anti Thyroid Drugs [ATDs], inorganic iodine, corticosteroid, betaAdrenergic Agonists [beta-AAs]). After getting proper treatment in Emergency Department, the patient must continue his care in the Intensive Care Unit (ICU) for clinical and treatment close monitoring. Therapeutic plasmapheresis (TPE) should be considered if clinical improvement is not noted within 24–48 hours of initial treatment.
Thoracal Paravertebral vs. Serratus Anterior Plane Block in Combination with COMBIPECS for Modified Radical Mastectomy Utomo, Wandito Gayuh; Fitriani, Calcarina; Sudadi, Sudadi; Ali, Farhan
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 4, No 2 (2024): October 2024
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v4i2.93110

Abstract

Background: Breast cancer is one of the most common malignancies in women worldwide. Surgical options for breast cancer include modified radical mastectomy (MRM), in which the entire breast is removed but the pectoralis major muscle is spared. Routine anesthesia modalities for MRM include general anesthesia (GA), epidural blockade combined GA, and nerve blockade combined GA . Thoracic paravertebral block (TPVB) is still recognized as the gold standard analgesic procedure for breast surgery. However, TPVB is more difficult to perform with possible complications such as hypotension, pneumothorax, and unintentional spread of anesthetic agent to epidural space. Serratus anterior plane block (SAPB) is a promising new procedure that is relatively easier to perform and safer. Previous studies have reported its benefit in reducing the need of postoperative opioids and postoperative pain.Case illustration: We describe the case of 2 females with left breast cancer undergoing unilateral MRM, both with ASA class II. First patient was given TPVB, PEC 1, and PEC 2 (COMBIPECS). Second patient was given nerve block and guided ultrasonography using SAPB, PEC1, and PEC 2 (COMBIPECS). Each patient was sedated with a dexmedetomidine loading dose of 1mcg/kg/10 minutes, titration 0.2-0.4mcg/kg/hour. Both types of blocks provide adequate anesthesia. Ketorolac 30mg/8 hour was given post-operative. Both patients showed normal vital signs, and the same post-operative NRS of 0. No block related complication was found in both cases.Conclusions: TVPB and SAP combined with COMBIPECS have similar results in terms of post-operative pain score and minimal complication.
Co-Authors Ali, Farhan Bhirowo Yudo Pratomo Calcarina Fitriani Retno Wisudarti Fitriani, Calcarina Ratih Kumala Fajar Apsari SATRIYAS ILYAS Sudadi