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All Journal Indonesian Journal of Cancer Academic Hospital Journal
Darwito, Darwito
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Journal : Academic Hospital Journal

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Tunneled Epidural Analgesia for Refractory Scrotal Cancer Pain: A Case-Based Evaluation of Therapeutic Efficacy Nur Azza, Kamala Kan; Tomo, Wahyu Kartiko; Darwito, Darwito; Puspitasari, Ika; Mahmud, Mahmud; Widyastuti, Yunita
Academic Hospital Journal Vol 7, No 2 (2025)
Publisher : Rumah Sakit Akademik Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ahj.v7i2.109434

Abstract

Background: Scrotal Squamous Cell Carcinoma (SCC) is a rare malignancy. Although SCC typically demonstrates slow progression, in advanced stages with significant size, it can cause considerable pain due to mass effect and local tissue invasion. The management of cancer-related pain encompasses a wide spectrum of approaches, ranging from pharmacologic to surgical interventions. In cases where patients become intolerant to the side effects of pharmacologic therapies and adequate pain relief cannot be achieved, while surgical options are either not feasible, interventional pain management may offer an effective alternative. Tunneled Epidural Analgesia represents one such interventional technique that can be considered for refractory pain. This case report aims to evaluate the efficacy of tunneled epidural analgesia administration in managing intractable pain associated with advanced scrotal SCC.Materials and methods: This case report is structured according to the CARE (Case Report) guideline. The study was conducted at UGM Academic Hospital, where the patient received evaluation and treatment.Case: A 65-year-old male diagnosed with SCC presented experiencing refractory cancer pain. Despite receiving conventional analgesic therapy, he experienced no significant pain relief and developed adverse effects. Pain management was subsequently escalated to an interventional approach using a bupivacaine 0.125% and fentanyl 25 mcg administered via a tunneled epidural drug delivery system. This intervention resulted in effective pain control, enabling him to do daily activities. With this modality, the pain remained well managed, although occasional breakthrough pain occurred, which was successfully managed with 1% lidocaine as a rescue analgesic.Conclusion: Tunneled epidural analgesia using a combination of opioid and bupivacaine has demonstrated effectiveness in the management of refractory scrotal cancer pain.
Characteristics of Trauma Patients Who Died at UGM Academic Hospital (RSA UGM) Prananingrum, Febriana; Tyas, Humaera Elphananing; Caswita, Aditya Bagas; Dewa Rachmat, Radyan Artha; Widyastuti, Rina; Lestari, Ade Febrina; Darwito, Darwito; Pratama, Yanasta Yudo
Academic Hospital Journal Vol 6, No 1 (2024)
Publisher : Rumah Sakit Akademik Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ahj.v6i1.94712

Abstract

BACKGROUND : Trauma becomes the main health problem worldwide due to its high mortality rate. Traffic accidents are a trauma with a high incidence and death rate in Indonesia, specifically in Yogyakarta. Factors causing trauma-related death are the lack of hospital infrastructure, the lack of quality human resources, the lack of standardization of trauma management, and the limited number of hospitals providing comprehensive trauma services. This research aims to identify the characteristics of trauma patients who died while receiving medical treatment at UGM Academic Hospital and to analyze the mortality of patients according to the trimodal distribution to prepare this hospital to become a trauma center hospital.METHOD : This quantitative descriptive research used a cross-sectional method. Data were taken from medical records of patients admitted to the ER of UGM Academic Hospital in 2018-2023 based on predetermined inclusion and exclusion criteria. The research was conducted from March to November 2023.RESULT : This research involved 58 patients consisting of 42 (72.4%) male and 16 (27.6%) female patients. The most common cause of death was brain injury (63%), followed by spinal cord injury (13.7%), multi-organ failure and sepsis (8.6%), cardiac and respiratory arrest (6.8%), and comorbidities patients (6.8%).CONCLUSION : The majority of trauma patients who died at the UGM Academic Hospital are male and aged 60-80 years with the main cause of death of brain injury. The patient dies at the late death stage based on trimodal distribution of death time.
Co-Authors Andreasta Meliala Caswita, Aditya Bagas Dewa Rachmat, Radyan Artha Ika Puspitasari Khonsa, Oni Lestari, Ade Febrina Mahmud Mahmud Nur Azza, Kamala Kan Prananingrum, Febriana Tomo, Wahyu Kartiko Tyas, Humaera Elphananing Widyastuti, Rina Yanasta Yudo Pratama Yunita Widyastuti