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Marthendro, Triade
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Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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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.
Co-Authors Ananda, Pratama Dino Irawan Hidayat, Nopian Muharrami, Vera