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Anesthesia Management of Patients with Esophageal Atresia/Traceoesophageal Fistula undergoing Thoracostomy and Esophagostomy Procedures Marthendro, Triade; Irawan, Dino; Muharrami, Vera; Hidayat, Nopian; Ananda, Pratama
Journal La Medihealtico Vol. 5 No. 5 (2024): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v5i5.1597

Abstract

Esophageal atresia is a congenital disorder characterized by a disruption in the continuity of the esophageal lumen. Esophageal atresia may be accompanied by tracheoesophageal fistula, which is a lumen connection between the proximal and or distal part of the esophagus and the airway (trachea). Type C atresia is the most prevalent, which is approximately 88.5% to 90% of cases, where there is proximal esophageal atresia with distal tracheoesophageal fistula. In this case, a 9-day-old infant was admitted to Arifin Ahmad Hospital for thoracostomy and esophagostomy surgery due to continuous mucus discharge. The patient underwent awake intubation and was positioned intraoperatively, with a tilt to the right when an orogastric tube was placed. During surgery, the patient maintained stable hemodynamic and was subsequently admitted to the NICU using a ventilator. Infants with esophageal atresia often show symptoms of hypersalivation and shortness of breath caused by aspiration pneumonia. When the nasogastric tube cannot pass through the esophagus, atresia can be suspected. Radiology studies play an important role in diagnosing esophageal atresia, confirming esophageal atresia with or without fistula and diagnosing other anomalies associated with VACTERL.
Management of Anesthesia in Mandibular Tumors with Difficult Airway Marthendro, Triade; Irawan, Dino
Journal La Medihealtico Vol. 5 No. 4 (2024): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v5i4.1604

Abstract

A 39 year old female patient with a diagnosis of mandibular tumor underwent mandibulectomy and Free Fibular Flap reconstruction. Preoperative evaluation is carried out on patients, namely by carrying out anamnesis, physical examination and supporting examinations to determine the problem and conclude the patient's physical status. The patient's physical status is ASA III. The patient was intubated awake with a video laryngoscope. After that, sedation and muscle relaxants are given. The operation lasted 10 hours with stable hemodynamics. Post-operatively, patients are treated in the ICU, vital signs are observed and post-operative pain is managed. A closed study conducted by the Professional Committee of the American Society of Anesthesiologists (ASA) revealed that the risks and serious complications of anesthesia are most often closely related to airway management problems. Success in dealing with complications depends on early detection of symptoms and corrective action to prevent the situation from getting worse. In this patient, airway management was based on the Difficult Airway Algorithm.
Korelasi antara Body Mass Index (BMI) dan Respon Hemodinamik pada Pasien Hipertensi yang Menjalani Intubasi Endotrakeal Irawan, Dino; Marthendro, Triade
Jurnal Ilmu Kesehatan Masyarakat Vol. 15 No. 01 (2026): Jurnal Ilmu Kesehatan Masyarakat
Publisher : UIMA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33221/jikm.v15i01.4059

Abstract

Penelitian ini bertujuan untuk menyelidiki hubungan antara Body Mass Index (BMI) dan respon hemodinamik pada pasien hipertensi yang menjalani intubasi endotrakeal di RSUD Provinsi Arifin Achmad Riau. Penelitian ini menggunakan desain quasi-eksperimental dengan pendekatan cross-sectional pada 60 pasien ASA II dengan hipertensi terkontrol yang menjalani operasi elektif dengan anestesi umum di RSUD Arifin Achmad. Sampel diperoleh melalui teknik consecutive sampling dan dikelompokkan berdasarkan jenis laringoskop yang digunakan. Data yang dikumpulkan mencakup karakteristik pasien, BMI, serta parameter hemodinamik sebelum dan setelah intubasi. Analisis dilakukan secara deskriptif untuk menggambarkan karakteristik responden dan nilai hemodinamik, dilanjutkan dengan uji komparatif untuk menilai perbedaan respons hemodinamik antara kedua metode intubasi, serta uji korelasi untuk melihat hubungan antara BMI dan perubahan hemodinamik. Hasil penelitian menunjukkan bahwa tindakan intubasi endotrakeal memiliki dampak yang berbeda secara signifikan  (p < 0.05) pada tekanan darah sistolik pada fase preintubasi setelah menit pertama. Klinis juga menunjukkan bahwa pemeliharaan BMI kurang dari 25 kg/m2 efektif dalam mencegah hipertensi dan penurunan berat badan mengurangi tekanan darah pada sebagian besar subjek hipertensi.