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All Journal Jurnal Anestesiologi Indonesia Berkala Ilmiah Kedokteran Duta Wacana Journal of Medicine and Health
Masjkur, Diana
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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EMERGENCY NON-OBSTETRIC SURGERY DURING PREGNANCY: ANESTHETIC AND PAIN MANAGEMENT IN OVARIAN CYST TORSION Leonardo, Peter; Anggraeni, Novita; Masjkur, Diana
Berkala Ilmiah Kedokteran Duta Wacana Vol. 9 No. 2 (2024): BERKALA ILMIAH KEDOKTERAN DUTA WACANA
Publisher : Faculty of Medicine Universitas Kristen Duta Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21460/bikdw.v9i2.1036

Abstract

The management of non-obstetric emergency surgeries during pregnancy presents unique challenges that necessitate careful consideration of both maternal and fetal health. This case report outlines the management of a pregnant patient (G3P2A0H2, 10-11 weeks gestation) who presented with acute abdominal pain due to a suspected ovarian cyst torsion. The patient underwent exploratory laparotomy under spinal anesthesia with bupivacaine, morphine, and fentanyl. Postoperative pain was managed using a multimodal analgesic strategy including surgical wound infiltration with 0.25% ropivacaine combined with dexamethasone. This technique was used to minimize opioid use and enhance recovery. The patient experienced stable hemodynamics and minimal postoperative pain (VAS 1-2), and was discharged on the third postoperative day. This case highlights the importance of effective pain management, particularly during non-obstetric surgeries during pregnancy. Regional anesthesia, along with local infiltration of ropivacaine and dexamethasone, provides an effective pain control strategy, contributing to faster recovery and enhanced patient satisfaction while minimizing systemic opioid exposure.
Malignant Hyperthermia Fajri, Doni; Hidayat, Nopian; Masjkur, Diana
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 2 (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.v0i0.62676

Abstract

Malignant hyperthermia (MH) is a life-threatening clinical syndrome caused by hypermetabolism involving skeletal muscle. MH is very rare, but it is one of the causes of death in the operating room. MH is an autosomal dominant disease and can be triggered when exposed to certain anesthetic drugs. Genetic tests can help diagnose, but the gold standard is the caffeine halothane contracture test (CHCT). Initial symptoms are a decrease in pH and oxygen, as well as an increase in CO2, lactate, potassium, and temperature. The increase in lactate reflects tissue hypoxia. Dantrolene is an antidote to MH, by reducing calcium loss from the sarcoplasmic reticulum in skeletal muscle and returning metabolism to normal conditions. Immediate detection and treatment can improve MH outcomes.
Tantangan Perioperatif pada Pasien Penyakit Jantung Rematik yang menjalani Prosedur Seksio Sesarea – Laporan Kasus Hotabilardus, Nusi A; Masjkur, Diana; Anggraeni, Novita
Journal of Medicine and Health Vol 7 No 1 (2025)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v7i1.9982

Abstract

Rheumatic heart disease (RHD) is a major contributor to maternal morbidity and mortality in developing countries, including Indonesia. Severe preeclampsia further complicates management by exacerbating cardiovascular strain and increasing the risk of adverse outcomes for both mother and fetus. This case report highlights the importance of multidisciplinary collaboration and careful perioperative planning for pregnant women with RHD, particularly in resource-limited settings. We report the case of a 31-year-old woman (G3P2A0) at 40–41 weeks of gestation, diagnosed with severe preeclampsia, severe mitral stenosis, moderate mitral regurgitation, and severe tricuspid regurgitation due to RHD. An elective cesarean section was performed under epidural anesthesia with 0.75% ropivacaine, ensuring hemodynamic stability throughout the procedure and during a 24-hour ICU observation. Despite limited access to cardiovascular specialists and surgical options, a team-based approach and tailored anesthetic management ensured a favorable outcome. In conclusion, this case demonstrates that even in settings with constrained resources, proper planning, close monitoring, and multidisciplinary coordination can mitigate the risks associated with multivalvular heart disease and severe preeclampsia in pregnancy. Interdisciplinary collaboration and individualized anesthetic strategies are crucial for optimizing maternal and fetal outcomes in such complex scenarios.
Co-Authors Fajri, Doni Hidayat, Nopian Hotabilardus, Nusi A Leonardo, Peter Novita Anggraeni