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All Journal Bali Journal of Anesthesiology
Junaedi, I Made Darma
DiscoverSys Inc.
Health Professions Medicine & Pharmacology Other

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PERIOPERATIVE EFFECTS OF CO-ADMINISTRATION OF TCI PROPOFOL COMBINED WITH CLONIDINE AND KETAMINE Aryabiantara, I Wayan; Sinardja, I Ketut; Sutawan, Ida Bagus Krisna Jaya; Sinardja, Cynthia Dewi; Parami, Pontisomaya; Ryalino, Christopher; Junaedi, Made Darma
Bali Journal of Anesthesiology Vol 2, No 3 (2018)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (371.815 KB) | DOI: 10.15562/bjoa.v2i3.69

Abstract

Background: Propofol is often used in Total Intravenous Anesthesia (TIVA). Studies found that adding clonidine and ketamine can increase the potential to achieve an adequate level of anesthesia while reducing inflammation and post-operative pain. The goal of this study is to see if the combination of Target Controlled Infusion (TCI) propofol plus clonidine and ketamine is more effective in reducing the IL-6 level, maintaining intraoperative stability, and reducing postoperative pain and morphine consumption.Methods: Forty patients planned for major oncology surgery were divided into two groups. The treatment group (Group T) received pre-medication with clonidine, induction with TCI propofol, and intraoperative ketamine. The control group (Group C) received normal saline solution.Results: The difference of IL-6 level increase between the two groups was not statistically significant (13.6 vs. 16.6 pg/mL, p>0.05). Mean systolic blood pressure (SBP) and mean arterial pressure (MAP) in group T were higher in 5 and 10 minutes after incision, but lower in minutes 30, 60, and 120 (p <0.05). Heart rate in group T was higher in minutes 5, 10, 15, 30, 60, and 120. Visual analog scale (VAS) in 4, 8, 12, and 24 hours post-surgery were lower in group T compared to group C. And post-operative morphine consumptions in group T were also lower. (3.6 ± 1.5 vs 9.9 ± 3.3, p <0.05).Conclusion: TIVA using TCI propofol combined with preoperative clonidine and intraoperative ketamine is effective in maintaining hemodynamic stability, reducing post-operative and reducing morphine consumption compared to TCI propofol alone.
A PRELIMINARY STUDY ON THE PECTORALIS BLOCK II AS A PART OF MULTIMODAL ANALGESIA FOR INTRA AND POSTOPERATIVE PAIN MANAGEMENT IN MODIFIED RADICAL MASTECTOMY Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Ryalino, Christopher; Junaedi, I Made Darma
Bali Journal of Anesthesiology Vol 2, No 3 (2018)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (503.41 KB) | DOI: 10.15562/bjoa.v2i3.106

Abstract

Background: Inadequate acute postoperative pain management is the main risk factor for chronic pain after breast surgery. Pectoralis blocks I and II (pecs block I and II) are novels peripheral nerves block techniques introduced since 2011 by Blanco et al.Methods: Ten patients diagnosed with breast cancer planned for modified radical mastectomy (MRM), from preoperative evaluation patients with a physical status of American Society of Anesthesiologist (ASA) I and II. Anesthesia management under general anesthesia with an endotracheal tube and we performed PECS block II after general anesthesia. We recorded the systolic blood pressure, mean arterial pressure (MAP), and heart rate intraoperatively, and the pain scale at 4th, 6th, 12th, and 24th hours postoperatively.Results: The pain scale at 4th and 6th hours postoperatively were 0.3±0.5 and 0.6±0.5 respectively. The pain scale at resting starts to increase at the 12th and 24th hours (1.2±0.4 and 1.1±0.6). The mean total use of morphine recorded on PCA was 3.3 ± 0.9 (mg). No pecs block II complications were recorded in this study.Conclusion: Pecs block II is a relatively easy, safe, and effective for MRM surgeries. Further larger and double-blinded studies are needed to know its effectiveness compared to other techniques available.
Co-Authors Christopher Ryalino Cynthia Dewi Sinardja I Ketut Sinardja I Made Gede Widnyana I Wayan Aryabiantara, I Wayan Ida Bagus Krisna Jaya Sutawan Pontisomaya Parami Tjokorda Gde Agung Senapathi