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All Journal Indonesian Journal of Anesthesiology and Reanimation (IJAR) Indonesian Journal of Cancer
Wardhana, Burhan Mahendra Kusuma
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Public Health

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Ultrasound-Guided Peripheral Nerve Block as Post-Operative Management of Lower Abdominal Surgery in Ksatria Airlangga Floating Hospital Setjaputra, Vina Lidya; Susianto , Steven Christian; Silitonga , Jessica Deborah; Kusumaningtyas , Maya Hapsari; I Putu Agni Rangga Githa; Atmaja, Robbi Tri; Wardhana, Burhan Mahendra Kusuma; Bandem, I Ketut Mega Purnayasa; Firdaus, Khildan Miftahul; Harianto, Agus
Indonesian Journal of Anesthesiology and Reanimation Vol. 6 No. 2 (2024): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V6I22024.99-105

Abstract

Introduction: Enhanced Recovery After Surgery (ERAS) implementation in remote areas by operating hospital ships is immensely helpful due to high patient turnover, reducing costs, and minimizing the effects of surgical stress. Utilization of regional anesthetics, namely ultrasound-guided Transversus Abdominis Plane (TAP) block or Quadratus Lumborum (QL) block, is applicable and beneficial in this setting. Objective: Due to the limited time, facilities, and health personnel available in floating hospital services surgery, several adjustments in anesthetic methods are required to rapidly return patients to their preoperative physiologic state. Therefore, we wrote this case report. Case Series: We presented case series of lower abdominal surgery performed in Ksatria Airlangga Floating Hospital with the implementation of peripheral nerve blocks as one of the ERAS protocols in one of the remote islands in Indonesia, Gili Iyang Island. Two patients underwent TAP blocks, while the remaining two received QL Blocks. A peripheral nerve block was performed under ultrasound guidance and a 20-mL injection of 0.25% levobupivacaine to QL muscle or TAP. During the observation, we found Visual Analogue Score (VAS) of 1-2 after surgery, no post-operative sedation needed, only 1 patient experienced nausea without vomiting, and the length of health facility stay were less than 3 days. Nearly all of our patients who underwent lower abdomen surgery got benefits from the application of peripheral nerve block. Because there was no opioid consumption in our cases, the risk of unwanted effect of opioids like postoperative nausea and vomiting, were also decreased. Conclusion: Peripheral nerve block, as mentioned TAP Block and QL Block, has emerged as a promising alternative to prevent and manage post-operative pain in remote medicine settings, namely Ksatria Airlangga Floating Hospital, particularly in areas with few medical facilities.
The Impact of Antitumor Treatment on Cancer Patients with COVID-19: A Systematic Review and Meta-Analysis Ananto, Farizky Jati; Purwanto, Heru; Ayuda, Caesar; Wibiseno, Dono Marsetio; Putra, Probo Yudha Pratama; Wardhana, Burhan Mahendra Kusuma; Putra, Doddy Setya Adi
Indonesian Journal of Cancer Vol 18, No 3 (2024): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i3.1158

Abstract

Background: Cancer is a chronic disease that can cause various complications, decrease the immune system, reduce quality of life, and even lead to death. In addition, the COVID-19 pandemic in various countries has had a significant adverse impact on patients. This study analyzed the impact of various antitumor treatments on cancer patients with COVID-19. Methods: This meta-analysis was conducted according to the PRISMA – P pathway. Source searches were conducted in PubMed, Cochrane Library, Research Gate, and Science Direct in cancer patients with COVID-19 receiving various types of antitumor treatment. Analysis was performed using RevMan V.5.3 software with the outcome of mortality rate and severe COVID-19. Results: Twenty-five observational studies met the inclusion criteria with a total of 21,940 patients. There was no significant difference in mortality rate (OR 1.08, 95% CI 0.99 – 1.18, p = 0.09), but there was a significant difference in severe COVID-19 (OR 1.19, 95% CI 1.02 – 1.39, p = 0.02). Immunotherapy provided the most significant worsening of both mortality rate (OR 1.39, 95% CI 1.17 – 1.64, p = 0.0001) and severe COVID-19 (OR 1.82, 95% CI 1.23 – 2.71, p = 0.003). There were no significant differences in other antitumor treatments. Conclusions: Antitumor treatment does not have a significant impact on mortality rate, but has a significant impact on worsening the degree of COVID-19. Among all the antitumor therapies that provide the highest potential for worsening is immunotherapy.
Co-Authors AGUS HARIANTO Atmaja, Robbi Tri Ayuda, Caesar Bandem, I Ketut Mega Purnayasa Farizky Jati Ananto, Farizky Jati Firdaus, Khildan Miftahul Heru Purwanto I Putu Agni Rangga Githa Kusumaningtyas , Maya Hapsari Putra, Doddy Setya Adi Putra, Probo Yudha Pratama Setjaputra, Vina Lidya Silitonga , Jessica Deborah Susianto , Steven Christian Wibiseno, Dono Marsetio