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All Journal Solo Journal of Anesthesi, Pain and Critical Care Cermin Dunia Kedokteran
Fitriani, Calcarina
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Chemical Engineering, Chemistry & Bioengineering Health Professions Medicine & Pharmacology Nursing Public Health

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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.
Lupus Eritematosus Sistemik (SLE) dengan Krisis Hipertensi pada Kehamilan: Laporan Kasus Kusumandaru, Novierta Prima; Fitriani, Calcarina
Cermin Dunia Kedokteran Vol 52 No 4 (2025): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i4.1144

Abstract

Introduction:  Although SLE prevalence lacks specific Indonesian data, it predominantly affects women of childbearing age. Case: A 24-yearold pregnant woman with a history of SLE experienced worsening shortness of breath, leg swelling, and fatigue since her second month of pregnancy. Hospital admission revealed severe hypertensive crisis, active SLE affecting kidneys, joints, skin, congestive heart failure, and anemia. She underwent rigorous medical treatments and ICU monitoring. Discussion: SLE affects multiple organs. Careful management and monitoring are required during pregnancy for maternal and fetal well-being. Conclusion: Pregnant women with SLE may encounter various pregnancy-related complications. Effective and comprehensive management is vital to achieve favorable outcomes.
Co-Authors Ali, Farhan Kusumandaru, Novierta Prima SATRIYAS ILYAS Utomo, Wandito Gayuh