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EFFECT OF CLONIDINE ADDED TO CAUDAL ROPIVACAINE IN PEDIATRIC INFRAUMBILICAL SURGERIES Solanki, Dr. Nilesh M.; Rathod, Ajay; Maheshwari, Khevana; Bhimani, Maulik
Bali Journal of Anesthesiology Vol 2, No 3 (2018)
Publisher : DiscoverSys Inc.

Â Background: Caudal epidural block is the most popular regional anesthesia technique in pediatrics. Several agents are required as an adjuvant with a local anesthetic to prolong the duration of caudal analgesia by single shot technique in children. The aim of this study was to compare the efficacy of clonidine with ropivacaine versus ropivacaine alone for caudal analgesia in children undergoing infraumbilical surgeries under general anesthesia.Methods: Sixty patients of ASA grade I â II between the ages of 1-12 years, of either sex, undergoing infraumbilical surgeries under general anesthesia were included randomly into two groups: Control group (Group A) ropivacaine 0.2% (1ml/kg) with maximum volume 12 ml and clonidine group (Group B) ropivacaine 0.2% (1ml/kg) with clonidine 1Âµg/kg with maximum volume 12 ml. The changes of hemodynamic parameters were recorded intraoperatively. The FLACC pain score, sedation score, duration of analgesia and requirement of analgesic were recorded in the recovery room.Results: The demographic characteristic were comparable in both the groups. The mean duration of analgesia was significantly prolonged (707.3 + 59.56 minutes) in group B compared to (411.83 + 14.82 minutes) in group A.Â The requirement of first rescue analgesic medication was significantly prolonged in group B compared to group A (P < 0.05). Total analgesic consumption was significantly higher in group A (180+70 mg) compared to group B (90+70 mg) (P < 0.05)Conclusion: Addition of clonidine 1Âµg/kg to ropivacaine 0.2 % in caudal analgesia significantly increases the duration of postoperative analgesia compared to plain ropivacaine 0.2% without any significant sedation.

DIFFICULT MASK VENTILATION RESCUED BY A PEDIATRIC FACEMASK Govil, Nishith; Singh, Girish Kumar; Chandra, Prakash; Ittoop, Amanta Lucy
Bali Journal of Anesthesiology Vol 2, No 3 (2018)
Publisher : DiscoverSys Inc.

Anesthetic challenges arises in securing airway due to difficult mask ventilation because of obstructed nasal passage and unanticipated intraoral extension by a tumour mass leading to difficult intubation also. This sometime lead to the dreaded path of âCannot Intubate & Cannot Ventilateâ. We are describing a successfully managed case of ossifying fibroma arising from the maxilla causing difficulty in ventilation with the help of pediatric circular facemask and airway.

PAIN MANAGEMENT IN BURN INJURY Jaya, A A Gde Putra Semara; Anggreni, Anak Agung Ayu; Senapathi, Tjokorda Gde Agung
Bali Journal of Anesthesiology Vol 2, No 3 (2018)
Publisher : DiscoverSys Inc.

Burn injury is one of the challenging cases in medical practice, which need comprehensive and multidiscipline management. Pain management is one of an important factors in caring for the burn patient. Pain management in burn injury is challenging and the patient may be at risk for undertreatment. Undertreated severe acute pain can lead to adverse consequences of many organ systems, delay recovery and discharge process, and potentially lead to chronic pain. Reports of inadequate pain relief persist, although there are advances in the acute pain management in recent years.An understanding of pain pathway can achieve effective burn injury pain management, types of pain in burn injury, analgesics selection, continuous and accurate assessment of the pain and the response to therapy, dose adjustment to achieve maximum effect and minimal side effect, and role of nonpharmacological treatment as a complement to medication. Acute pain service plays an important role in providing effective burn injury pain management for reducing morbidity and mortality.

SURGEONS BEHAVIOR TOWARD PROPHYLAXIS ANTIBIOTICS IN SANGLAH HOSPITAL Suranadi, I Wayan; Sukrama, Dewa Made; Budayanti, Ni Nyoman Sri; Pradhana, Adinda Putra; Amin, Yusuf Sidang
Bali Journal of Anesthesiology Vol 2, No 3 (2018)
Publisher : DiscoverSys Inc.

Â Background: The emergence of antibiotic resistance is a complicated problem due to many factors, especially its use and abuse. Inappropriate use of antibiotics is very common in both developed and developing countries. The goal of this study was to see the knowledge of the surgeons toward prophylaxis antibiotic at Sanglah Hospital.Methods: This is a descriptive study of 55 surgeons who performed elective surgery at Sanglah Hospital. A questionnaire was filled by the surgeons randomly without prior notice about the study. The information about their behavior toward prophylaxis antibiotics was gathered from medical record of the day.Result: Out of the 55 surgeons participated in this study, 85.5% have followed a training on rational antibiotic use. The level of knowledge about factors that can increase surgical wound infections is quite good (94.4%), while the knowledge regarding factors that can reduce surgical wound infections very low (16.4%). Almost all (92.7%) clean-surgery patients were given prophylactic antibiotics. The most given antibiotic was ceftriaxone (72.7%), the third generation of cephalosporins.Conclusion: The mean knowledge of the surgeons toward antibiotic prophylaxis was 59.8%. The most used antibiotic as pre-surgical prophylaxis was ceftriaxone. And the time of administration for prophylaxis antibiotic was 16-60 minutes prior to surgical incision.

ANAESTHESIA CHALLENGES DURING MANAGEMENT OF EMERGENCY CESAREAN SECTION IN A POST-PNEUMONECTOMY PRIMIGRAVIDA WITH PLACENTA PREVIA Chavan, Surekha Sudhir; Raghuvanshi, Amruta Arvind; Gedam, Priyanka H
Bali Journal of Anesthesiology Vol 2, No 3 (2018)
Publisher : DiscoverSys Inc.

Pulmonary disease is a known risk factor for perioperative respiratory complications. So anesthesiologists are expected to experience these postpneumonectomy patients coming for elective or emergency surgeries. But there is little data to anesthesia management for cesarean delivery of postpneumonectomy parturient. On reviewing the literature, there is only one reported case of the trial of vaginal delivery followed by cesarean section done under epidural anesthesia, a 41 years-old parturient having preoperative respiratory failure and pneumonia in the antenatal period which was managed on continuous positive airway pressure (CPAP) simultaneously. Our case presented a 24 years-old primigravida of 34 weeks gestation with placenta previa and complaints of two days per vaginal bleeding was posted for the emergency cesarean section. She had past history of left lung lobectomy 10 years back, video bronchoscopy 3 years back and history of admission for treatment of an episode of pneumonia at 32 weeks of present gestation. Emergency cesarean section was managed successfully under spinal anesthesia. This case report highlights that spinal anesthesia may remain a good option in anesthesia management for cesarean section in a primigravida with postpneumonectomy.

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.

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Home Page

OAI Link

Editorial Team

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Reviewer

Google Scholar

Contact Name -

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Location Kota denpasar, Bali INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
-

Contact Email
-

Phone
-

Journal Mail Official
-

Editorial Address
-

Location
Kota denpasar,

Bali

INDONESIA