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This Author published in this journals
All Journal The International Journal of Medical Science and Health Research Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif
I Ngurah Arya Wicaksana
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Dentistry Health Professions Medicine & Pharmacology Nursing Physics Public Health Veterinary

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A Rare Case of Neonatal Thoracotomy for a Penetrating Chest Injury Caused by a Pitbull Bite I GNA Bayu Wiradinatha; I Made Indra Prasetya; Ni Made Sukewanti; I Ngurah Arya Wicaksana
The International Journal of Medical Science and Health Research Vol. 14 No. 2 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/ny7r2735

Abstract

Introduction: Penetrating thoracic trauma in the neonatal period is a rare and highly lethal event. Dog bites, particularly from powerful breeds, can inflict catastrophic injuries that present a formidable challenge to even the most prepared trauma centers. This report details the successful management of a neonate with life-threatening thoracic injuries following a pitbull attack. Case Report: A 2.7 kg male neonate presented in respiratory failure and shock after being mauled by a pitbull. Examination revealed an open pneumothorax, flail chest, multiple displaced rib fractures, and visible lung lacerations. After initial stabilization, he underwent an emergency left thoracotomy. The procedure involved primary repair of multiple deep lung lacerations and stabilization of the flail chest segment. The postoperative course was complex, requiring nine days of mechanical ventilation, management of atelectasis, multiple blood product transfusions, and broad-spectrum antibiotic therapy. The patient made a full recovery and was discharged after 20 days. Discussion: The successful outcome was contingent upon a rapid, coordinated, multidisciplinary response. Key interventions included immediate life-saving procedures in the emergency department, aggressive surgical control of hemorrhage and air leak, and meticulous postoperative critical care. Management focused on lung-protective ventilation, infection prevention, and nutritional support, which were crucial for navigating the complicated recovery period. Conclusion: Catastrophic thoracic trauma in a neonate, while having a grim prognosis, is survivable. This case demonstrates that immediate, aggressive surgical intervention combined with prolonged, high-acuity intensive care can lead to a positive outcome, underscoring the importance of an integrated trauma system.
Comparison Between Opioid Free Anesthesia and Opioid Based Anesthesia in Laparoscopic Hysterectomy: A Systematic Review Mahesa Putra, Ode; I Ngurah Arya Wicaksana
Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 2 (2025): JATI Agustus 2025
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JATI.2025.v01.i02.p03

Abstract

Introduction: In Gynecology field, laparoscopy surgery is used for many procedures that were traditionally performed via laparotomy. Hysterectomy associated with postoperative pain, which greatly affected postoperative recovery and patient satisfaction. Combinations of opiod base analgesia (OBA) and opioid free analgesia (OFA) agents are combined with local or regional anesthesic techniques whenever possible. Methods: A systematic search of relevant databases was conducted to identify case control studies comparing OBA and OFA post hysterectomy procedure. Inclusion criteria encompassed studies reporting Visual Analog Scale (VAS) and Numeric Rating Scale (NRS) as an outcome measure. Quality assessment and data extraction were performed independently by author. Results: The systematic review identified a total of four case-control studies meeting the inclusion criteria with total of 357 patients undergone hysterectomy procedure. The sample sizes varied across the studies, with the smallest study including 30 patients and the largest study including 157 patients. The outcomes were assessed using VAS and NRS scores. The results consistently showed that either OBA or OFA administration giving similar outcome on pain scale. Conclusion: All studies concluded whether OBA or OFA administration peri or postoperative given similar or not significantly different of pain scoring outcomes. Although OFA would give a better result to maintain post operative nausea and vomitting (PONV) and reducing opiod-related adverse events that happen postoperatively.
Comparison Between Opioid Free Anesthesia and Opioid Based Anesthesia in Laparoscopic Hysterectomy: A Systematic Review Mahesa Putra, Ode; I Ngurah Arya Wicaksana
Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 2 (2025): JATI Agustus 2025
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JATI.2025.v01.i02.p03

Abstract

Introduction: In Gynecology field, laparoscopy surgery is used for many procedures that were traditionally performed via laparotomy. Hysterectomy associated with postoperative pain, which greatly affected postoperative recovery and patient satisfaction. Combinations of opiod base analgesia (OBA) and opioid free analgesia (OFA) agents are combined with local or regional anesthesic techniques whenever possible. Methods: A systematic search of relevant databases was conducted to identify case control studies comparing OBA and OFA post hysterectomy procedure. Inclusion criteria encompassed studies reporting Visual Analog Scale (VAS) and Numeric Rating Scale (NRS) as an outcome measure. Quality assessment and data extraction were performed independently by author. Results: The systematic review identified a total of four case-control studies meeting the inclusion criteria with total of 357 patients undergone hysterectomy procedure. The sample sizes varied across the studies, with the smallest study including 30 patients and the largest study including 157 patients. The outcomes were assessed using VAS and NRS scores. The results consistently showed that either OBA or OFA administration giving similar outcome on pain scale. Conclusion: All studies concluded whether OBA or OFA administration peri or postoperative given similar or not significantly different of pain scoring outcomes. Although OFA would give a better result to maintain post operative nausea and vomitting (PONV) and reducing opiod-related adverse events that happen postoperatively.
Co-Authors I GNA Bayu Wiradinatha I Made Indra Prasetya Mahesa Putra, Ode Ni Made Sukewanti