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All Journal Open Access Indonesian Journal of Medical Reviews Journal of Anesthesiology and Clinical Research International Journal of Psychology and Health Science
Ristiawan Muji Laksono
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing

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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

Abstract

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.
Injection of the Sphenopalatine Ganglion With C-Arm And Radiofrequency For Trigeminal Neuralgia Satriyanto, Muhammad Dwi; Ketut Ngurah Gunapriya; Ristiawan Muji Laksono; Saiful Anwar
International Journal of Psychology and Health Science Vol. 2 No. 1 (2024): International Journal of Psychology and Health Science (January-March 2024)
Publisher : Greenation Publisher & Yayasan Global Research National

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.38035/ijphs.v2i1.459

Abstract

Trigeminal Neuralgia (TN) is the most severe pain in the world, where patients experience a painful condition from the face that significantly impacts the quality of life and socio economic function of affected patients. The pathophysiology of TN is still unclear, it is thought that TN occurs due to compression of the root entry zone of the trigeminal nerve near the origin of the brain stem and this local pressure causes demyelination which leads to abnormal depolarization which results in ectopic impulses. The sphenopalatine ganglion is a parasympathetic ganglion that is connected to the trigeminal, facial, and sympathetic systems and consists of somatosensory, sympathetic, and parasympathetic nerve fibers. This ganglion receives sensory impulses from around the face. TN Management can in a way pharmacological and surgical; however, it is not capable in a way of effectively relieving, since the technology of radiofrequency ablation, TN patients can be done with radiofrequency ablation with satisfactory results, even one daycare.
Epidural Tunneling for Effective Management of Severe Cancer Pain: A Case Report Imam Safi'i; Ristiawan Muji Laksono
Journal of Anesthesiology and Clinical Research Vol. 6 No. 1 (2025): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v6i1.714

Abstract

Introduction: Severe pain is a common and debilitating symptom for many cancer patients, often requiring multimodal approaches for effective management. While oral opioids and adjunctive therapies are frequently the first line, some patients with refractory pain necessitate interventional procedures. This case report describes the successful use of epidural tunneling for long-term pain management in a patient with severe cancer pain due to bone metastases. Case presentation: A 55-year-old woman with severe cancer pain secondary to bone metastases from breast cancer presented with intractable pain in her hips, buttocks, and legs, radiating to her feet with associated numbness. Despite high doses of oral opioids, paracetamol, amitriptyline, and a fentanyl syringe, her pain remained poorly controlled, significantly impacting her sleep and quality of life. A lumbosacral X-ray revealed osteolytic-blastic lesions with vertebral compression and other metastatic involvement. Given the severity and refractory nature of her pain, an epidural tunneling procedure was performed. Conclusion: Epidural tunneling proved to be a safe and effective method for managing severe, chronic cancer pain in this patient, leading to a substantial reduction in pain intensity and a decreased need for systemic opioids. This technique offers a valuable option for patients with persistent pain who have failed conventional analgesic therapies, particularly in advanced stages of cancer.
Preoperative Fasting Duration as a Potential Predictor of Glycemic Instability in Non-Diabetic Emergency Surgery Patients: A Prospective Observational Pilot Study Mustaqiem Isda; Aswoco Andyk Asmoro; Ristiawan Muji Laksono; Rudy Vitraludyono
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 5 (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.v5i5.789

Abstract

Preoperative fasting is a cornerstone of anesthetic safety, yet in emergency surgery, fasting periods are frequently prolonged and unregulated. The metabolic consequences of such extended fasting in non-diabetic patients, who are often assumed to be metabolically resilient, are poorly understood. This pilot study aimed to investigate the association between prolonged fasting and pre-induction glycemic instability. We conducted a prospective, observational pilot study at a tertiary referral hospital, enrolling 30 non-diabetic adult patients (ASA I-E/II-E) undergoing emergency surgery. The primary exposure was preoperative fasting duration, analyzed as both a continuous variable and a dichotomized category (≤8 vs. >8 hours). The primary outcomes were pre-induction blood glucose levels, analyzed continuously and with two categorical thresholds: glycemic instability (<85 mg/dL) and clinically significant hypoglycemia (<70 mg/dL). Associations were assessed using Chi-Square tests and Spearman's rank correlation. A majority of patients (60%) fasted for >8 hours. A strong negative correlation was found between the duration of fasting and pre-induction blood glucose levels (Spearman's ρ = -0.78, p<0.001). Using the <85 mg/dL threshold, 83.3% of patients fasting >8 hours exhibited glycemic instability, compared to 25% of those fasting ≤8 hours (p=0.002). Using the standard <70 mg/dL threshold, 55.6% of patients fasting >8 hours developed clinically significant hypoglycemia, compared to 8.3% of those fasting ≤8 hours (p=0.011). In conclusion, this pilot study provides a strong preliminary signal that prolonged preoperative fasting is significantly associated with a decline in blood glucose and an increased incidence of both glycemic instability and clinically significant hypoglycemia in non-diabetic emergency surgical patients. These findings challenge the assumption of metabolic security in this population and underscore the urgent need for larger, definitive studies. Routine pre-induction glucose monitoring should be strongly considered as a potential safety standard in this vulnerable group.
Co-Authors Aswoco Andyk Asmoro Buyung Hartiyo Laksono Imam Safi'i Ketut Ngurah Gunapriya Mustaqiem Isda Rudy Vitraludyono Saiful Anwar Satriyanto, Muhammad Dwi Shallahudin Taufiq Agus Siswagama