Garuda - Garba Rujukan Digital

Awake Fiberoptic Intubation in a Patient with T4N2M1 Buccal Tumor and Pulmonary Metastasis: A Case Report and Anesthetic Challenges Numbi Akhmadi Teguh; Jeffri Prasetyo Utomo; Taufiq Agus Siswagama
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 3 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i3.1208

Background: Advanced buccal cancer with pulmonary metastasis presents significant challenges for airway management due to potential anatomical distortions and respiratory compromise. Awake fiberoptic intubation (AFOI) is often the preferred technique in these cases. This report describes the successful anesthetic management of a patient with a T4N2M1 buccal tumor and lung metastasis using AFOI. Case presentation: A 64-year-old male with a T4N2M1 buccal tumor and pulmonary metastasis presented for an open biopsy and biopsy of the oral cavity. He had limited mouth opening (Mallampati 2), anemia, and hypoalbuminemia. AFOI was performed using dexmedetomidine and topical lidocaine. General anesthesia was induced with propofol and atracurium and maintained with sevoflurane. Postoperative pain was managed with paracetamol and ketorolac. The patient's recovery was uneventful. Conclusion: This case highlights the importance of AFOI in securing the airway for patients with advanced buccal cancer and pulmonary metastasis. Meticulous preoperative planning, including optimization of comorbidities and vigilant perioperative monitoring, is essential for successful outcomes in these complex cases.

Effective Pain Management in a Patient with Colon Cancer: A Case Report of Combined Quadratus Lumborum and Transabdominal Plane Blocks Shallahudin; Ristiawan Muji Laksono; Taufiq Agus Siswagama; Aswoco Andyk Asmoro; Buyung Hartiyo Laksono
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 2 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i2.703

Cancer-related pain, particularly in cases of advanced colon cancer, presents a significant challenge to healthcare providers. Traditional pain management strategies, including opioids, often prove inadequate or are associated with undesirable side effects. Quadratus lumborum block (QLB) is an emerging regional anesthesia technique offering potential benefits in managing abdominal pain. This case report describes the successful implementation of combined QLB and transabdominal plane (TAP) blocks for effective pain management in a patient with colon cancer. A 53-year-old male patient with a history of colon cancer presented with severe abdominal pain at the site of his stoma radiating to his back. The pain was exacerbated by movement and significantly impacted his quality of life. Despite receiving a multimodal analgesic regimen, including a fentanyl patch and oral medications, his pain remained poorly controlled. After careful consideration, a combined QLB and TAP block was performed using ultrasound guidance. Following the procedure, the patient experienced significant pain relief, with his Numerical Rating Scale (NRS) score decreasing from 7-9 to 1-2 at rest and from 5-6 to 2-3 during movement. He reported no nausea or vomiting and was able to mobilize comfortably. This improvement in pain control facilitated his recovery and enhanced his overall well-being. In conclusion, this case report highlights the potential of combined QLB and TAP blocks as an effective pain management strategy for patients with colon cancer. This approach may offer a valuable alternative or adjunct to traditional methods, particularly in cases where opioid use is limited by side effects or tolerance. Further research is warranted to investigate the long-term efficacy and safety of this technique in a larger patient population.

Awake Fiberoptic Intubation in a Patient with T4N2M1 Buccal Tumor and Pulmonary Metastasis: A Case Report and Anesthetic Challenges Numbi Akhmadi Teguh; Jeffri Prasetyo Utomo; Taufiq Agus Siswagama
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 3 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i3.1208

Background: Advanced buccal cancer with pulmonary metastasis presents significant challenges for airway management due to potential anatomical distortions and respiratory compromise. Awake fiberoptic intubation (AFOI) is often the preferred technique in these cases. This report describes the successful anesthetic management of a patient with a T4N2M1 buccal tumor and lung metastasis using AFOI. Case presentation: A 64-year-old male with a T4N2M1 buccal tumor and pulmonary metastasis presented for an open biopsy and biopsy of the oral cavity. He had limited mouth opening (Mallampati 2), anemia, and hypoalbuminemia. AFOI was performed using dexmedetomidine and topical lidocaine. General anesthesia was induced with propofol and atracurium and maintained with sevoflurane. Postoperative pain was managed with paracetamol and ketorolac. The patient's recovery was uneventful. Conclusion: This case highlights the importance of AFOI in securing the airway for patients with advanced buccal cancer and pulmonary metastasis. Meticulous preoperative planning, including optimization of comorbidities and vigilant perioperative monitoring, is essential for successful outcomes in these complex cases.

A Comparative Analysis of Ipsilateral, Contralateral, and Bilateral Average ONSD in Correlating with Cerebral Midline Shift: Re-framing a Non-Invasive Tool from a Quantitative Predictor to a Clinical Classifier Ramadina Putri Cahyanti Ghofar; Buyung Hartiyo Laksono; Taufiq Agus Siswagama
Archives of The Medicine and Case Reports Vol. 6 No. 4 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i4.823

In traumatic brain injury (TBI), non-invasive proxies for mass effect are crucial. The optic nerve sheath diameter (ONSD) is used to estimate intracranial pressure (ICP), but its correlation with structural outcomes like midline shift (MLS) is poorly defined, particularly regarding the optimal measurement method (unilateral vs. bilateral). We prospectively enrolled 38 adult TBI patients who received both a CT scan and a bedside ONSD ultrasound within 24 hours. Data was re-analyzed to classify ONSD relative to lesion location (Ipsilateral, Contralateral) and to correlate these, plus the Bilateral Average (ONSD-Avg), with CT-measured MLS using Spearman's correlation. We used linear regression to assess quantitative prediction (R-square) and binary logistic regression (ROC curve) to assess clinical classification (AUC) for predicting MLS >5mm. A significant, positive correlation was found between MLS and Ipsilateral-ONSD (rs = 0.450, p = 0.005) and ONSD-Avg (rs = 0.383, p = 0.018). The Contralateral-ONSD correlation was not significant (rs = 0.210, p = 0.206). A Wilcoxon test confirmed Ipsilateral-ONSD was significantly wider than Contralateral-ONSD (p < 0.01). The linear regression model for MLS quantification was statistically significant (p = 0.015) but had a very low predictive power (R-square = 0.153). In contrast, the logistic regression model found ONSD-Avg to be an excellent classifier for detecting surgical MLS (> 5mm), with an Area Under the Curve (AUC) of 0.88 (95% CI 0.75-0.96). In conclusion, ONSD measurement is significantly affected by asymmetric, unilateral TBI pathology. The bilateral average (ONSD-Avg) is the most reliable screening method, as it compensates for unilateral pressure gradients. The low R-square (15.3%) confirms ONSD is a poor quantitative predictor of MLS, reflecting the non-linear pressure-volume relationship. However, the high AUC (0.88) proves ONSD is an excellent clinical classifier for identifying patients with surgical-threshold mass effect. ONSD should not be used to "quantify" MLS, but rather to "classify" patient risk.

Title

Found 4 Documents
Search

Abstract

Abstract

Abstract

Abstract

Title Search

Found 4 Documents Search

Abstract

Abstract

Abstract

Abstract

Title

Found 4 Documents
Search