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Radiofrequency ablation of genicular nerve in a patient with knee pain associated with osteoarthritis Mulyawan, Erwin; Prasetyadhi, Jokevin
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

ABSTRACTOsteoarthritis is a leading cause of pain and disability in the elderly. In addition to the economic burden, the pain caused by knee osteoarthritis may also reduce the quality of life and affect the patient's psychological condition. Surgery is the best option for patients with severe osteoarthritis. However, a patient with severe osteoarthritis generally tend to be elderly and have multiple co-morbidities, and thus, may not be a suitable candidate for surgery. In regards to several interventional methods that have been investigated, radiofrequency ablation (RFA) neurotomy showed promising results. We report a case of 65-year-old woman with chronic knee osteoarthritis pain that underwent a conventional RFA procedure for right genicular nerve.

Factors associated with the need for intraoperative packed red cells transfusion in pediatric liver transplant patients Kapuangan, Christopher; Utariani, Arie; Hanindito, Elizeus
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

Background: Massive hemorrhage is one of the most common problems encountered during a liver transplantation procedure. Correction of the blood loss using packed red cells (PRC) is essential during the procedure to improve outcome. This retrospective study aims to investigate preoperative and intraoperative factors that may predict the PRC need.Materials and Methods: Thirty-four patients who underwent pediatric liver transplantation procedure within 2010-2018 were included in this study. Their medical record was examined and the data was analyzed using a comparison of mean and regression model.Results: The mean bleeding in this study was found to be 906.62±674.30 mL, while the mean PRC transfusion was 566.71±307.30 mL. Correction of blood loss was also compensated with other means such as a crystalloid or colloid fluid.Conclusion: This study statistically demonstrated that pre-operative weight, as well as bleeding volume, significantly affect the PRC transfusion requirement (p <0.05). However, other factors such as hemoglobin and surgical duration may also be clinically significant factors to predict PRC transfusion need.

Comparison between lidocaine and nacl 0.9% inhalation in heart rate and blood pressure changes during laryngoscopy and intubation Soenarto, Ratna Farida; Pryambodho, Pryambodho; Adji, Muhammad Prakoso
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

Introduction: Laryngoscopy and intubation is an invasive procedure routinely done during general anesthesia. The cardiovascular response to these procedures can be harmful in patients who are vulnerable, especially those who have cardiac or cerebrovascular problems. One method to attenuates the cardiovascular response was the use of anesthetics, including lidocaine. This study aimed to assess the effect of inhaled lidocaine on cardiovascular responses after laryngoscopy and intubation.Patients and Methods: This study was a randomized double-blind clinical trial on 50 subjects who underwent elective surgery, 24 subjects were given inhaled lidocaine 1.5 mg/kg and 25 subjects were given 0.9 % NaCl inhalation before laryngoscopy and intubation. Cardiovascular parameters being investigated were changes in systolic and diastolic blood pressure, mean arterial pressure (MAP) and heart rate in a serial manner.Results: In the first minute after intubation, MAP and heart rate were higher in the NaCl group. The difference in MAP was 15.5 mmHg (p <0.001) while heart rate was 9.5 beats/min (p <0.001). In the 3rd minute after intubation, MAP and heart rate kept different in both groups: 16.6 mmHg (p <0.001) and 11.2 beats/minute (p <0.001), respectively. In the 5th minute after intubation, MAP and heart rate remained different between two groups: 16.7 mmHg (p <0.001) and 10.0 beats/min (p=0.03), respectively.Conclusion: Lidocaine inhalation was able to attenuate cardiovascular response due to pain stimuli and sympathetic stimulation after laryngoscopy and intubation.

Minimally invasive pain management in chronic musculoskeletal pain: A Community service at Blahkiuh I Health Center Parami, Pontisomaya; Suranadi, I Wayan; Utara Hartawan, I Gusti Agung Gede; Mahaalit, I Gusti Ngurah; Ryalino, Christopher; Pradhana, Adinda Putra
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

ABSTRACTPain is a common complaint found in the population. Inadequate knowledge about pain management is the most common reason that triggers the inadequate management of pain. Pharmacological pain management is also not without risk. Various risks from the use of pharmacological agents related to side effects that can arise may also cause new problems. Several medical intervention techniques with invasive procedures for pain have also been carried out, although they are still less popular, due to a lack of public knowledge of this technique. We conducted a cost-free, minimally invasive pain procedure in people with chronic musculoskeletal pain in a public health center in a rural area in Bali Island to alleviate their pain-associated symptoms and to introduce this minimally invasive pain management technique.

Aerosol propellants leading to factitious reading by gas monitoring Adabala, Vijay; Gupta, Priyanka
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

A well-equipped Anaesthesia workstation is boon for safe anaesthesia practice. Anaesthesia agent gas monitoring has become an integral part of intraoperative monitoring. The infrared analyzers are commonly used for measuring anaesthetic agents. These advanced gas monitoring devices help in accurate titration of delivery of anaesthetics to patients particularly at low flows. However as with any technology, gas monitoring is also associated with inherent errors. Newer aerosol propellants like hydro-flouro- alkanes (HFA) are known to cause erroneous detection of inhalational anaesthetic agents during general anaesthesia.

Antimicrobial susceptibility patterns of Acinetobacter baumanii isolates from ICU and non-ICU wards Budayanti, Ni Nyoman Sri; Suranadi, I Wayan; Tarini, Made Adi; Violentina, Gusti Ayu Dianti; Sathya Deva, I Dewa Gde
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

ABSTRACTIntroduction: Acinetobacter baumanii is the most common agent of hospital-acquired infection with the increasing fatality rate due to multidrug-resistant (MDR) strain infection. The magnitude of the problem in Indonesia is unknown. Here, we provide data regarding susceptibility pattern of A. baumanii isolated from a tertiary referral hospital in Bali, Indonesia between 2012 and 2014.Methods: Data were collected retrospectively from culture-based records in the Clinical Microbiology department, Sanglah General Hospital during 2012-2014. A. baumanii was isolated from clinical specimens. Identification and antimicrobial susceptibility test were conducted using micro-dilution method (Vitek-2 Compact system). Isolates that resistant to ≥ 3 antibiotic classes were categorized as multi-drug resistant (MDR) A. baumanii.Results: A. baumanii collected from sputum in intensive care unit (ICU) wards were 7.9%, 11.1%, and 7.0%, while the isolates from sputum in non-ICU wards were 13.1%, 15.6%, and 19.9% in 2012, 2013, and 2014, respectively. There was a reduced susceptibility of A. baumanii to ciprofloxacin, levofloxacin, ceftazidime, aztreonam, imipenem, ampicillin-sulbactam, and piperacillin-tazobactam in ICU ward. Meanwhile, the susceptibility of A. baumanii to Cotrimoxazole remained high in both ICU and non-ICU ward. MDR A. baumanii is found to be resistant to fluoroquinolones, cephalosporins, aztreonam, aminoglycosides, beta-lactamase inhibitors, and carbapenem. Data were analyzed and presented in a descriptive manner.Conclusion: Three years surveillance showed that the susceptibility of A. baumanii to most common antibiotics was decreasing. MDR A. baumanii was found to be resistant to all classes of common antibiotics mostly from ICU ward isolates.

A comparative study between supraclavicular brachial plexus block and Infraclavicular brachial plexus block for upper limb orthopedic surgeries: A prospective, randomized, double-blind study Sarkar, Siddharth; Doshi, Shilpa Mitul
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

Introduction: Supraclavicular brachial plexus block is a common approach as it provides faster and dense blockade. In the past few years, infraclavicular brachial plexus block has become a method of increased interest as it has a lower complication rate and near to equal efficacy. The goal of this study was to compare block performance time, block characteristics, quality of block, patient’s satisfaction, and complications between infraclavicular and supraclavicular techniques for brachial plexus block.Patients and Methods: 100 subjects were randomized in a double-blind fashion, to receive either an infraclavicular block (Group I, n=50) or supraclavicular block (Group S, n=50) using nerve locator apparatus. Block performance time, onset, peak, duration of sensory and motor blockade, any change in hemodynamics, complications were recorded at scheduled intervals intra-operatively and post-operatively as per study protocol. Data were analyzed using GraphPad INSTAT version 3.06 software by Chi-square test or Mann-Whitney U test to compare categorical variables.Results: The block performance time was faster in the Group S compared to the Group I (4.8±4.4 minutes vs. 6.3±1.39 minutes, p <0.001). The sensory block onset time was faster in Group S compared to the Group I (6.9±1.58 minutes vs. 7.6±1.34 minutes, p=0.019). Other observed variables were considered statistically not significant.Conclusion: From our study, it is inferred that nerve locator guided Infraclavicular block by a vertical coracoid approach using multineurostimulation method is less rapidly executed as nerve locator guided supraclavicular block with a similar degree of surgical anesthesia and lesser complication rate.

The correlation between the depth extent of Tuohy epidural needle with body mass index (BMI) to achieve loss of resistance in patients undergoing epidural anesthesia Hartawan, I Gusti Agung Gede Utara; Senapathi, Tjokorda Gde Agung; Aribawa, I Gusti Ngurah Mahaalit; Parami, Pontisomaya; Pradhana, Adinda Putra; Syamsuddin, Johanis Bosco Troy
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

ABSTRACTBackground: Anesthesia management in obesity is quite challenging. Epidural anesthesia become one of the choices. The attention should be addressed in order to prevent the misidentification of epidural space. The estimation of the depth extent of epidural space becomes crucial, especially in obese patients due to an accumulation of subcutaneous and epidural adipose tissue, which consequently complicate the epidural catheter insertion. This study aimed to analyze the correlation of the depth extent of Tuohy epidural needle to achieve loss of resistance between normal-weighted and obese patients.Method: This study was conducted with 56 adult patients aged 17 to 65 years who underwent elective surgery by epidural anesthesia inserted at level L2-L3 or L3-L4 interspace. Subjects are divided into normal and obese groups. Shapiro-Wilk and chi-square tests were used in the normality test. For normally distributed data, an independent t-test was used to test the hypothesis, otherwise, we used Mann-Whitney test Results: The results showed that the loss of resistance in epidural needle insertion procedures was 60 mm in a patient with BMI more than 30 kg/m2 and 50 mm in those with BMI <30 kg/m2 (p<0.001).Conclusion: The loss of resistance depth in epidural Tuohy needle insertion is significantly determined by BMI.

The relationship between nutritional status based on nutritional risk index (NRI) and length of stay of digestive surgery patients Kusuma, Dian Reginalda; Putra, Kadek Agus Heryana; Kurniyanta, I Putu
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

ABSTRACTBackground: Malnutrition is a common concomitant illness that can be found in digestive surgery patients.The risk of malnutrition in digestive surgery patients is often overlooked even though malnutrition has beenknown to be associated with poor postoperative outcomes. The study aimed to analyze the relationship of nutritional status based on the Nutritional Risk Index (NRI) and length of stay of digestive surgery patientsin Sanglah General Hospital. Patients and Methods: The design of this study is an analytical cross-sectional using secondary data fromthe medical record of the digestive surgery patients in Sanglah General Hospital. Data on body weight andserum albumin level were used to identify the preoperative nutritional status of the patients based on NRI. Results: Of the 42 patients involved in this study, 54.8% of patients have poor nutritional status and the remainder 45.2% of patients have good nutritional status. The result of the statistical analysis showed asignificant relationship between nutritional status and length of stay. The result of the logistic regressiontest showed that the prevalence of long hospitalizations (≥11 days) were 5.2 times greater in digestivesurgery patients with poor preoperative nutritional status compared to patients with good nutritionalstatus. Conclusion: This study shows that poor nutritional status is a significant problem for digestive surgery patients and it is one of the factors that contribute to a longer hospital stay.

Ketamine: old drug, a new option Chandra, Susilo
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

Unique properties and recent development in the areas of clinical properties of ketamine make this agent to be popular for a long time. This anesthetic agent has wide range of indications. Many areas of clinical application of ketamine are explored in many studies. However, not many clinicians are familiar with the wide range of clinical applications of ketamine. As time passes there are many new alternative use of ketamine, a well-established anesthetic agent. The analgesic profile of ketamine is explored to have more benefits, such as postoperative pain control and as preemptive analgesia. The other aspect, which has been studied extensively, is the neuroprotective profile of ketamine. The administration of ketamine is not associated with increased intracranial pressure if normocapnia is achieved, making it possible anesthetic for neurosurgery. The other areas to explore include the role of ketamine to prevent opioid-induced acute tolerance and treat major depressive disorder.

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Abstract

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Contact Name
-

Contact Email
-

Phone
-

Journal Mail Official
-

Editorial Address
-

Location
Kota denpasar,

Bali

INDONESIA