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Bali Journal of Anesthesiology

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Published by Bali Journal of Anesthesiology

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Core Subject : Health, Education,

Health Professions Medicine & Pharmacology Other

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Articles 17 Documents

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Search results for , issue "Vol 3, No 2 (2019)" : 17 Documents clear

Role of flow velocity and transient hyperemic response evaluated by transcranial doppler for assesing brain autoregulation in mild traumatic brain injury: a case report Demoina, I Gede Patria; Wiryana, Made; Suarjaya, Putu Pramana; Pradhana, Adinda Putra
Bali Journal of Anesthesiology Vol 3, No 2 (2019)
Publisher : DiscoverSys Inc.

Head injuries are a common case throughout the world, based on data from the Centers for Disease Control, emergency cases, hospitalization cases, and also deaths due to head injuries have increased in the decade 2001-2010. Cerebral autoregulation (CA) is a mechanism for cerebral blood flow (CBF) regulation if there is a change from cerebral perfusion pressure (CPP). The mechanism of brain autoregulation is negative feedback that holds back the increase in mean arterial pressure (MAP) by reducing the diameter of blood vessels so that CBF returns to normal, whereas if MAP falls, brain autoregulation tends to widen blood vessel diameter so that CBF is normal. Transcranial doppler examination can be one of the modalities of investigation that is very useful in patients with head injuries. Transcranial doppler in patients with a head injury can be used to measure mean flow velocity of cerebral artery media and transient hyperemic response test, both of which can assess the prognosis of a course of head injury.

Characteristics of cervical myofascial pain in medical students Samatra, Dewa Putu Gede Purwa; Widyadharma, I Putu Eka; Haditya, Yogi; Suryamulyawan, Kadek Adi; Devi, Gusti Ayu Putu Giti Livia; Lim, Demetria Jesica; Wijayanti, Ida Ayu Sri; Adnyana, I Made Oka; Purwata, Thomas Eko
Bali Journal of Anesthesiology Vol 3, No 2 (2019)
Publisher : DiscoverSys Inc.

Background: Cervical myofascial pain or neck pain is in the fourth most disease that causes disability after back pain, depression, and other musculoskeletal diseases. Cervical myofascial pain is characterized by pain originating from a trigger point located in the skeletal muscle, commonly referred as myofascial trigger points (MTrPs).Methods: An observational study with a cross-sectional design, conducted on 3 to 9 of December 2018 with research subjects were medical students at Udayana University who undergoing 5th and 6th year in clinical clerkship at Sanglah General Hospital Denpasar. The data was taken using Google Form which was filled in online by the subject and then analyzed using SPSS version 21.Results: From 307 respondents, 62.2% stated experiencing neck pain (196 respondents) with the majority of women 65.4%, the duration of neck pain occurred for <24 hours with the most frequent frequency at least once per month (46.1%), and appeared most often at night (39.8%) and occurs after night shift in 106 subjects (55.5%). The pain was said getting worse by activity in 102 subjects (52.4%) and getting better when resting in 185 subjects (96.9%). Most of the subjects did not use pain relievers to treat neck pain experienced (84.3%). In subjects who use painkillers, Paracetamol is the most often drug of choice to relieve pain (11%). For non-pharmacological treatment, 53.4% of respondents chose to rest or sleep.Conclusion: Most of the respondents who were clerkship reported experiencing neck pain at least once a month and often felt after a night shift. Respondents who reported neck pain were mostly women.

Estimation of surgical blood loss and transfusion requirements in orthopaedic soft tissue tumor surgery: associated factors Auerkari, Aino Nindya; Tantri, Aida Rosita; Alatas, Anas
Bali Journal of Anesthesiology Vol 3, No 2 (2019)
Publisher : DiscoverSys Inc.

Over half of soft tissue tumor surgeries require intraoperative Packed Red Cell (PRC) transfusion. Transfusion should be sufficient, as inadequacy will increase risk of tissue ischemia, morbidity and mortality. On the other hand, liberal transfusion is related to infection, tumor recurrence, and immunosuppression. Therefore, good PRC planning measures in preoperative period are essential. Several factors that can be identified in the preoperative period, have been associated with surgical bleeding and transfusion in soft tissue tumor surgery. These factors are ASA score, preoperative hemoglobin (Hb) value, malignancy, size, and location of tumor. By acknowledging influencing factors, a system for predicting blood requirement can be established to promote patient safety and avoid waste. This study aimed to determine factors associated with surgical blood loss and intraoperative PRC transfusion.A retrospective cohort was analyzed on 84 records of orthopaedic soft tissue tumor surgery during 2014-2018. In all subjects, the aforementioned factors, amount of intraoperative bleeding and intraoperative PRC transfusion was recorded. Data was analyzed by linear regression to see the relationship of factors to the amount of bleeding and by logistic regression to assess the probability of receiving intraoperative PRC transfusions. A multivariate analysis identified tumor size as an independent determining factor of bleeding. In further analysis, it was found that tumor size and preoperative Hb value were predictors of the probability of requiring intraoperative PRC transfusion.

Awake Intubation Fiberoptic Bronchoscope on Pregnancy Patient Undergo Decompression Laminectomy and Cervical Fusion Stabilization Saputra, Darmawan Jaya; Senapathi, Tjokorda Gde Agung; Aribawa, I Gusti Ngurah Mahaalit; Ryalino, Christopher
Bali Journal of Anesthesiology Vol 3, No 2 (2019)
Publisher : DiscoverSys Inc.

The traumatic and ankylosing cervical spine being rare in pregnancy can cause serious problems continuing pregnancy. Extensive neurological involvement which is rapidly progressive due to compression should be considered for immediate decompression. We present a case of a patient in the 19th weeks with diagnosis C5 compression fracture and paracervical abscess C5 et causa suspect TB spondylosis, complaints with paralysis in all four limbs. Surgical intervention was deemed necessary and was performed in the prone position. The early operative treatment and appropriate anaesthetic procedure resulted in good clinical outcome with improvement of neurological recovery.

Anaesthesia management on pregnancy with co-morbid asthma undergoing non-obstetric surgery Aryasa, Tjahja; Senapathi, Tjokorda GA; Ryalino, Christopher; Pranoto, Theodorus Pascalis Yullie
Bali Journal of Anesthesiology Vol 3, No 2 (2019)
Publisher : DiscoverSys Inc.

In the pregnancy process, there is a significant physiological change in the mother. Physiological changes, pre-pregnancy conditions, or those that arise during the pregnancy process will affect the delivery outcome. Also, it turns out that the presence of this preexisting condition will affect the outcome process, especially the anaesthetic technique used, the chosen anaesthetic technique is determined based on the age of the pregnancy, surgical procedures to be performed, surgery site, and overall patient condition. Whatever technique is selected, it must use the right method based on clinical decisions and accordingly to the existing guidelines. This condition is a challenge for an anesthesiologist.

The Effect of Contralateral Head Rotation on Internal Jugular Vein to Carotid Artery Distance and Overlap Ratio Heriwardito, Aldy; Dachlan, Muhammad Ruswan; Hidayat, Jefferson; Rokyama, Hadli
Bali Journal of Anesthesiology Vol 3, No 2 (2019)
Publisher : DiscoverSys Inc.

Introduction: Carotid artery puncture during central venous catheter (CVC) insertion could lead to serious complication if there was overlapping of internal jugular vein (IJV) and carotid artery (CA). IJV and CA overlap ratio and distance were determined by contralateral head rotation angle. Optimal angle of contralateral head rotation during CVC insertion can decrease the risk of CA puncture complication. This study was aimed to investigate the optimal angle of contralateral head rotation on IJV to CA distance and overlap ratio at the cricoid level by ultrasound guidance.Methods: This was a cross-sectional study of 34 patients undergoing elective surgery with CVC insertion. IJV to CA distance and overlap ratio at the cricoid level on each subject in supine position was measured by using two-dimensional ultrasound (Sonosite® M-Turbo, 6-13 MHz probe) at 0o, 30o, 45o, 60o contralateral head rotation of insertion site. Collected data were analyzed using SPSS 21.0.Results: There were significant differences on IJV to CA distance and overlap ratio at different contralateral rotation angles (0o, 30o, 45o, 60o, p<0.001). Overlapping of IJV and CA started to occur at contralateral head rotation 30o (11.72%) and increased in line with the increasing of contralateral head rotation angle (21.21% at 45o).Conclusion: There were significant effects of contralateral head rotation to distance and overlapping IJV to CA at cricoid level. Optimal contralateral head rotation angle for CVC was less than 30o to prevent IJV and CA overlapping.

Anesthesia management of carotid body tumour excision kumara, vijaya
Bali Journal of Anesthesiology Vol 3, No 2 (2019)
Publisher : DiscoverSys Inc.

Carotid body tumour (CBT) is a rare tumour of chemoreceptor cells, which arises at the bifurcation of the carotid artery. These cells sense the partial pressure of oxygen and carbon dioxide from the blood. Hence, the carotid body plays an important role in the control of ventilation during hypoxia, hypercapnia and acidosis. The tumour arising from these cells is benign and tends to turn out malignant. This tumour is found in persons who live at high altitudes. Removal of tumour poses several anaesthetic challenges and perioperative morbidity or mortality. We report successful anaesthetic management of CBT excision.

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INDONESIA