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All Journal Jurnal Kedokteran Brawijaya Journal of Agromedicine and Medical Sciences JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
Dananjaya, Vigyan
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Health Professions Medicine & Pharmacology Public Health

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Opioid-sparing versus opioid-free anesthesia following cancer surgery : Effect on pain severity and patient-reported outcomes Dananjaya, Vigyan; Adi Santika, Suparno
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 16, No 2, (2025)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol16.Iss2.art13

Abstract

Opioid use in anesthesia during cancer surgery causes concerns about adverse effects, including postoperative nausea, vomiting, respiratory depression, and potential impacts regarding cancer recurrence. In response, opioid-sparing and opioid-free anesthesia procedures have emerged as promising strategies to reduce opioid consumption while maintaining effective pain management. This study aimed to analyze the outcome of opioid-sparing anesthesia compared to opioid-free anesthesia on pain severity and patient-reported outcomes following cancer surgery. Randomized controlled trials and observational research that met predefined inclusion criteria were systematically selected, with data extracted and analyzed. The analysis revealed that both opioid-sparing and opioid-free anesthesia techniques reduced postoperative pain severity significantly in comparison to traditional opioid-based anesthesia. Additionally, patients who received opioid-free anesthesia reported better overall outcomes, including reduced nausea, faster recovery times, and improved satisfaction scores. Although pain control differences between opioid-sparing and opioid-free anesthesia techniques were statistically insignificant, both techniques showed substantial as safer, effective alternatives in perioperative cancer care, supporting their broader adoption in clinical practice.
Retrograde Intubation as an Alternative Approach to Failed Video-Assisted and Fiber Optic Laryngoscope in Patient with Predicted Difficult Intubation: Case Report Dananjaya, Vigyan; Suparno Adi Santika; Robeth Ardyansyah, Rizky; Salma Auliya Syahida
Jurnal Kedokteran Brawijaya Vol. 33 No. 4 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2025.033.04.11

Abstract

Difficult intubation is a challenge for an Anesthesiologist. Expertise in effective airway management which includes initial assessment to follow-up care. In this article we reported a 58-year-old male with a history of tracheostomy, craniotomy, and Open Reduction and Internal Fixation (ORIF) placement on the maxilla dextra, who will undergo a cranioplasty procedure under general anaesthesia. On physical examination, a mallampati class IV assessment was obtained, the distance between incisors < 3 fingers. The pre-anesthesia assessment an American Society of Anesthesiologist (ASA) II with LEMON score of 4. The intraoperative process used intravenous induction with fentanyl 150 mg, midazolam 5 mg, Propofol 150 mg, and Rocuronium 50 mg. Two airway management scenarios in this patient failed, which were video-assisted laryngoscopy and fibre optic laryngoscopy, therefore a third scenario was performed using retrograde intubation technique. Retrograde intubation is an effective alternative in patients with intubation difficulties.
Comparison of APACHE II Score and SOFA Score for Predicting Survival Rate in ICU: A Systematic Review Dananjaya, Vigyan; Adi Santika, Suparno
Journal of Agromedicine and Medical Sciences Vol. 11 No. 3 (2025)
Publisher : Faculty of Medicine, Universitas Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19184/ams.v11i3.53757

Abstract

Predicting mortality in critically ill patients is a key challenge in intensive care units (ICUs), and scoring systems such as SOFA (Sequential Organ Failure Assessment) and APACHE II (Acute Physiology and Chronic Health Evaluation II) are commonly used to estimate prognosis. This systematic review aimed to assess how accurately these two scoring systems predict ICU survival outcomes. The review was conducted in accordance with the PRISMA guidelines and registered on PROSPERO (CRD42024600239). Relevant studies published from 2014 to 2024 were identified through a comprehensive search of PubMed, ScienceDirect, SpringerLink, ProQuest, and the Cochrane Library. After screening 1,427 studies, 25 peer-reviewed articles met the inclusion criteria and were analyzed. The results consistently demonstrated that higher SOFA and APACHE II scores were significantly associated with increased mortality rates and prolonged ICU stays. The APACHE II score thresholds varied from 13 to 18.5, while SOFA score cutoffs ranged from 4.5 to 9. Several studies suggested that combining both scoring systems may enhance prognostic accuracy and inform clinical decision-making more effectively than either system alone. In conclusion, both SOFA and APACHE II scores are valid and dependable predictors of ICU mortality. Their combined use may improve risk stratification, support timely interventions, and optimize outcomes in critical care practice.
Co-Authors Adi Santika, Suparno Robeth Ardyansyah, Rizky Salma Auliya Syahida Suparno Adi Santika