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All Journal Solo Journal of Anesthesi, Pain and Critical Care Jurnal Neuroanestesi Indonesia
Rindiati, Fanda Ayyu
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Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Penggunaan Calcium Channel Blocker pada Tatalaksana Anestesi Clipping Aneurisma Otak Rindiati, Fanda Ayyu; Sasongko, Himawan; Harahap, M Sofyan
Jurnal Neuroanestesi Indonesia Vol 8, No 3 (2019)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2754.016 KB) | DOI: 10.24244/jni.v8i3.232

Abstract

Perdarahan subarachnoid dapat diartikan sebagai proses pecahnya pembuluh darah di ruang yang berada dibawah arakhnoid (subarachnoid). Prevalensi terjadinya perdarahan subaraknoid dapat mencapai hingga 33.000 orang per tahun di Amerika Serikat. Penyebab paling sering perdarahan subarachnoid adalah ruptur aneurisma salah satu arteri di dasar otak dan adanya malformasi arteriovena (MAV). Pada umumnya aneurisma terjadi pada sekitar 5% dari populasi orang dewasa, terutama pada wanita. Penanganan pada aneurisma pembuluh darah otak salah satunya dengan clipping aneurisma. Tindakan tersebut beresiko terjadi vasospasme serebral. Nimodipine adalah suatu calcium chanel blocker yang penting dalam pengelolaan operasi aneurisma karena mempunyai efek vasodilatasi pembuluh darah serebral dan termasuk dalam bagian dari manajemen vasospasme serebral. Pada laporan ini, dilaporkan dua kasus tindaan clipping aneurisma. Pasien pertama adalah wanita usia 69 tahun, berat badan 60 kg dengan diagnosa SAH hari ke 18 yang mengalami defisit neurologi berupa hemiparese dextra dan afasia motorik. Pasien kedua adalah wanita usia 57 tahun berat badan 60 kg dengan diagnosa SAH hari ke 20 dan mengalami defisit neurologi hemiparese kanan dan afasia sensorik. Pada kedua pasien dilakukan tindakan pembedahan kraniotomi clipping aneurisma. Kedua pasien memiliki hasil akhir yang baik. Akan tetapi, ada perbedaan lama perawatan antara pasien yang menjalani terapi awal nimodipine dan yang tidak menerima terapi tersebut.Administration of Calcium Channel Blocker in Anaesthesia Management of Cerebral Aneurysm ClippingAbstractSubarachnoid hemorrhage can be interpreted as the process of rupture of blood vessels in the space under the arachnoid (subarachnoid). The prevalence of subarachnoid hemorrhage can reach up to 33,000 people per year in the United States. The most common causes of subarachnoid bleeding are ruptured aneurysm in one of the arteries at the base of the brain and the presence of arteriovenous malformations (MAV). In general, aneurysms occur in about 5% of the adult population, especially in women.Therapy in cerebral vascular aneurysms, one of which is clipping aneurysms. These actions are at risk of cerebral vasospasm. Nimodipine is a calcium channel blocker which is important in the management of aneurysm surgery because it has a vasodilating effect on cerebral vessels and is included in the management of cerebral vasospasm. In this report, two cases of clipping aneurysm are reported. The first patient was a woman aged 69 years, body weight 60 kg with a diagnosis of SAH day 18 who had a neurological deficit in the form of hemiparese dextra and motor aphasia. The second patient was a 57-year-old woman weighing 60 kg with a diagnosis of SAH day 20 and had a neurological deficit in the form of right hemiparese and sensory aphasia. In both patients, clipping aneurysm was performed by craniotomy surgery. Both patients had good results. However, there is a difference in the length of stay between patients who underwent initial nimodipine therapy and who did not receive it.
Effectiveness of Intraperitoneal Bupivacaine in General Anesthesia for Laparoscopic Appendectomy Caverina, Sarah Lorenza; Rindiati, Fanda Ayyu; Respati, F.X. Andhi Haris
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 4, No 1 (2024): April 2024
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v4i1.67397

Abstract

Introduction: Appendicitis is an inflammation of vermiform appendix organ. It is a medical emergency case and one of the most common acute abdominal cases. The removal of acute appendix with minimally invasive surgery, laparoscopic procedure, is associated with shortened recovery time and length of stay in hospital, reduced risk of postoperative wound infections, also improved cosmetic outcomes. Anesthesia procedure for laparoscopic in Indonesia is usually performed under general anesthesia (GA) which has effective and safe form of sedation. One local anesthesia agent that often used in laparoscopic procedure is bupivacaine. Studies have shown that intraperitoneal bupivacaine as analgesia after laparoscopy can reduce postoperative pain, such as visceral pain associated with tissue injury and the stretching of nerve endings in the peritoneal cavity, parietal pain related to the incisional trauma at the port sites, and shoulder pain referred by stretching of the diaphragm.Case report: Mr. TA, 27 years old, his lower right abdomen hurt and he was diagnosed with acute appendicitis ASA II. Patients performed with laparoscopic procedure under general anesthesia. Fentanyl 2 mcg/kg, propofol 2 mg/kg, rocuronium 0.6 mg/kg, and sevoflurane 1 MAC, 50% FiO2 : 50% water, 4 lpm flow were administered. After 90 minutes of surgery, 40 cc of 0.5% intraperitoneal bupivacaine was administered. Patient was assessed for the NRS score within 30 minutes after laparoscopic procedure. The NRS score was 0.Conclusion: It has been reported a patient underwent laparoscopic appendicitis procedure received intraperitoneal bupivacaine as a postoperative analgesia which provided quicker recovery and good improvement of pain control without any significant negative consequences.
Co-Authors Caverina, Sarah Lorenza Harahap, M Sofyan Himawan Sasongko Respati, F.X. Andhi Haris