Article Per Year (5 Year)
p-Index From 2020 - 2025
0.408
P-Index
This Author published in this journals
All Journal Open Access Indonesian Journal of Medical Reviews
Yasyfie Asykari
Unknown Affiliation
Health Professions Medicine & Pharmacology

Published : 2 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 2 Documents
Search

 1 
Navigating the Triad of Trauma: A Case Report on Managing Concurrent Pulmonary Contusion, Traumatic Brain Injury, and Cervical Fracture in a Geriatric Patient Yasyfie Asykari; Septian Adi Permana; Eko Setijanto
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.v5i5.771

Abstract

The management of geriatric patients with multiple severe injuries presents a formidable clinical challenge due to reduced physiological reserve and the complex interplay of competing therapeutic goals. This report details the case of a geriatric patient suffering from the triad of pulmonary contusion (PC), moderate traumatic brain injury (TBI), and an unstable cervical spine fracture, highlighting the intricate balance required in neuroprotective and lung-protective ventilatory strategies. A 68-year-old male was admitted following a 10-meter fall, sustaining a moderate TBI with a temporoparietal subdural hemorrhage, a complete C3 vertebral fracture, and significant bilateral pulmonary contusions. His hospital course was marked by acute respiratory distress and neurological deterioration, with a Glasgow Coma Scale (GCS) score of E3V4M5 and hypoxemia requiring intubation and mechanical ventilation in the intensive care unit (ICU). Management focused on the cautious application of positive end-expiratory pressure (PEEP) to improve oxygenation without exacerbating intracranial pressure (ICP), alongside strict cervical spine immobilization and neuro-monitoring. After eight days of complex critical care, the patient’s prolonged need for mechanical ventilation and significant sputum retention necessitated a percutaneous dilational tracheostomy (PDT) to facilitate respiratory weaning and improve pulmonary toilet. In conclusion, this case underscores the profound difficulty of managing concurrent lung and brain injuries in the context of cervical instability. The successful navigation of this trauma triad hinged on a highly individualized, multidisciplinary approach, with judicious ventilator management and timely procedural intervention like PDT being pivotal. It affirms the need for integrated care protocols that can dynamically balance competing organ-system priorities in complex geriatric trauma.
Anesthetic and Analgesic Management for Mastectomy of a Giant Phyllodes Tumor: A Case Report on the Central Role of the Serratus Anterior Plane Block Heri Dwi Purnomo; Bara Aditya; Yasyfie Asykari; Rafael Bagus Yudhistira
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.v5i5.784

Abstract

Mastectomy for giant breast tumors presents a formidable clinical challenge due to the anticipated extensive surgical trauma, significant inflammatory response, and high risk of severe postoperative pain. This intense nociceptive barrage can lead to central sensitization and the development of debilitating Post-Mastectomy Pain Syndrome (PMPS). A robust, opioid-sparing multimodal analgesic strategy is therefore not just beneficial, but essential. The Serratus Anterior Plane Block (SAPB) is a regional anesthetic technique integral to such a strategy. We present the case of a 39-year-old, 60 kg female with a giant (24 x 22 x 18 cm) right-sided phyllodes tumor scheduled for mastectomy. The anesthetic plan consisted of general anesthesia and a preemptive, ultrasound-guided deep SAPB using 20 mL of 0.25% levobupivacaine. The procedure was performed with meticulous attention to sonoanatomy and technique. Intraoperatively, the patient maintained profound hemodynamic stability with minimal requirement for volatile anesthetic. Postoperatively, the patient reported complete analgesia, with Visual Analog Scale (VAS) scores of 0 at rest and 0-1 with movement (dynamic pain) for the first 24 hours. Sensory testing confirmed a dense block from T2 to T7. The patient required no rescue analgesia, mobilized early, and reported high satisfaction with her recovery. The final pathology confirmed a borderline phyllodes tumor. In conclusion, this case report demonstrates that a meticulously performed, ultrasound-guided deep SAPB can serve as the cornerstone of an effective, opioid-sparing analgesic regimen for high-pain-risk breast surgery. It can provide complete and functional postoperative analgesia, enhance hemodynamic stability, and facilitate recovery, embodying the core principles of Enhanced Recovery After Surgery (ERAS) pathways.
Co-Authors Bara Aditya Eko Setijanto Heri Dwi Purnomo Rafael Bagus Yudhistira Septian Adi Permana