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Anesthesiology and Intensive Therapy Program, Medicine FacultyBrawijaya University, Malang Indonesia Jl. Jaksa Agung Suprapto no.2, Malang, Indonesia
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Journal of Anaesthesia and Pain
Published by Universitas Brawijaya
ISSN : 27223167     EISSN : 27223205     DOI : http://dx.doi.org/10.21776/ub.jap
Core Subject : Health,
Health Professions Medicine & Pharmacology
Journal of Anaesthesia and Pain is a peer-reviewed and open-access journal that focuses on anesthesia and pain. Journal of Anaesthesia and Pain, published by Anesthesiology and Intensive Therapy Specialist Program of Medicine Faculty, Brawijaya University. This journal publishes original articles, case reports, and reviews. The Journal s mission is to offer the latest scientific information on anesthesiology and pain management by providing a forum for clinical researchers, scientists, clinicians, and other health professionals. This journal publishes three times a year. Subjects suitable for the Journal of Anaesthesia and Pain are all subjects related to anesthesiology and pain management.
Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine
Articles 6 Documents
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Search results for , issue "In Press" : 6 Documents clear
Comparison of Analgesic Effects of Nalbuphine and Buprenorphine on Caudal Ropivacaine in Children Undergoing Infraumbilical Surgeries Kaur, Navdeep; Chinnappa, Jithendra; Iyer, Sadashivan S; Suresh, Govindswamy; Turai, Ashwini
Journal of Anaesthesia and Pain In Press
Publisher : Faculty of Medicine, Brawijaya University

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Abstract

Introduction:Caudal anaesthesia is the most commonly performed regional anaesthesia in children. Opioids are the most commonly used additives to Local Anesthetics. Synthetic Opioid Agonist- Antagonists like Nalbuphine and Buprenorphine provide advantage of prolonging duration and quality of analgesia without risk of respiratory depression.OBJECTIVE OF THE STUDYTo study the effects of caudal nalbuphine or buprenorphine on postoperative analgesia produced by caudal Ropivacaine in children undergoing infraumbilical surgery.Materials and Methods Following Institutional Ethical Committee Clearance 54 ASA grade I and II children, aged 1-10 years scheduled for elective infra umbilical surgeries under General Anaesthesia with Caudal Epidural were randomly allocated using Computer Generated Random Number Tables into 3 groups R (Ropivacaine 0.2% 1ml/kg), RN (0.2% Ropivacaine with0.1mg/kg Nalbuphine) and RB (0.2% Ropivacaine with 3mcg/kg Buprenorphine). The time taken for first analgesic was noted and was compared between the groups.RESULTS A Total of 54 patients were enrolled for the study. Both the nalbuphine and buprenorphine provided good analgesia in the post operative period compared to plain ropivacaine group ( p<0.05) with higher incidence of side effects in group RB. CONCLUSIONAddition of Nalbuphine(0.1mg/kg) to caudal ropivacaine provides comparable duration of analgesia with caudal Buprenorphine and ropivacaine (3mcg/kg)with lesser incidence of side effects. KEYWORDSNalbuphine,  Ropivacaine, Buprenorphine, Caudal Epidural CTRI TRIAL REGISTERATION CTRI/2017/08/009445                                             
Comparison of Fentanyl and Tramadol on Pain Sensitivity in Rat Model of Traumatic Barin Injury Deswita, Rinda; Jasa, Zafrullah Khany; Rahmi, Rahmi
Journal of Anaesthesia and Pain Vol. 6 No. 3 (2025): In Press
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Background: Traumatic Brain Injury (TBI) is intracranial tissue damage caused by mechanical processes originating from outside that cause structurally and functionally brain damage. After TBI, these animals often exhibit exaggerated responses to otherwise mild pain stimuli, a condition mimicking chronic pain observed in human TBI patients.Methods: This laboratory experimental study used a pretest-posttest control group design. A traumatic brain injury (TBI) rat model was created using the Feeney weight drop method. Rats received intravenous fentanyl or tramadol every 8 hours for three days. Pain thresholds were measured before and at 1, 6, 24, and 72 hours, and 7 days after TBI.Results: Pain sensitivity peaked at 6 and 24 hours post-trauma, with the control group showing a significant drop in Von Frey test scores. In contrast, the fentanyl and tramadol groups showed gradual improvement from 6 hours, with stable recovery by 72 hours. By day 7, both treatment groups returned to near-baseline sensitivity, while the control group remained impaired. Statistical analysis showed a significant difference between control and intervention groups (p < 0.05). Conclusion: Both fentanyl and tramadol improved pain sensitivity in the early phase after TBI and restored thresholds close to baseline state before TBI while the control group did not.  
Multidisciplinary Management of Severe Hemorrhagic Stroke with Triple Challenge: Subarachnoid Hemorrhage, Intracerebral Hemorrhage, and Hydrocephalus-A Case Report Wijaya, Andryadi; Jufan, Akhmad Yun
Journal of Anaesthesia and Pain Vol. 6 No. 3 (2025): In Press
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2025.006.03.05

Abstract

Background: Hemorrhagic stroke, particularly subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH), is a neurological emergency associated with high morbidity and mortality, especially when complicated by increased intracranial pressure (ICP). This report aims to describe the comprehensive management of a patient with severe hemorrhagic stroke complicated by SAH, ICH, and hydrocephalus Case: This case report describes the management of a 69-year-old female with extensive SAH, ICH, ruptured anterior communicating artery aneurysm, and obstructive hydrocephalus. The patient presented with decreased consciousness post-seizure. Initial management included emergency external ventricular drain (EVD) placement and subsequent surgical clipping of the aneurysm. Non-invasive ICP monitoring using optic nerve sheath diameter (ONSD) demonstrated a reduction from 0.68 cm to 0.49 cm over seven days, reflecting successful ICP control. Complications included vasospasm managed with nimodipine, hypernatremia and polyuria suggestive of central diabetes insipidus treated with desmopressin, and nosocomial pneumonia due to serratia marcescens. Antibiotic therapy was escalated from ceftriaxone to meropenem and de-escalated to cefepime based on culture results. Despite optimal intensive care, the patient showed no significant neurological improvement (persistently low Glasgow Coma Scale [GCS]) and failed ventilator weaning. Given a poor prognosis (WFNS grade 4, Hunt & Hess grade 4, ICH score 3), the patient was transitioned to palliative care.  Conclusion: This case highlights the importance of multidisciplinary management, non-invasive ICP monitoring, and timely transition to palliative care in severe hemorrhagic stroke.
The Role of Intravenous Immunoglobulin in Myasthenic Crisis: A Case Report of Successful Management in an Elderly Patient with Thymoma Hanafia, Mochamad Fauzi; Adiyanto, Bowo
Journal of Anaesthesia and Pain Vol. 6 No. 3 (2025): In Press
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2025.006.03.04

Abstract

Background: Myasthenic crisis represents the most severe and life-threatening manifestation of myasthenia gravis, affecting approximately 15-20% of patients, with mortality rates ranging from 2-16% globally. Intravenous immunoglobulin (IVIG) is emerging as a primary therapeutic modality alongside plasmapheresis for crisis management. The optimal treatment approach in elderly patients with concurrent thymoma remains challenging due to increased perioperative risks and complex clinical presentations. The present case report describes the successful management of myasthenic crisis in an elderly patient with thymoma using intensive IVIG therapy in conjunction with timely surgical interventionCase: A 71-year-old male with established myasthenia gravis presented with myasthenic crisis two days prior to scheduled thymectomy. Clinical manifestations included respiratory distress, bilateral ptosis, drooping head, and dysphonia requiring immediate intensive care management. The patient received three cycles of IVIG therapy (0.4 g/kg/day for 5 days each cycle) in the intensive care unit in conjunction with mechanical ventilation, corticosteroids, pyridostigmine, and urgent thymectomy. Treatment resulted in successful weaning from mechanical ventilation after 8 days, with complete clinical recovery and transfer to the general ward without complications.Conclusion: This case demonstrates the efficacy and safety of intensive IVIG therapy in managing myasthenic crisis in elderly patients with thymoma. The systematic administration of multiple IVIG cycles proved effective in stabilizing respiratory function and facilitating successful surgical intervention, supporting IVIG as a cornerstone therapy in critical care management of severe myasthenia gravis.
Characteristic Outline of Head Trauma Patients at Dr. Saiful Anwar General Hospital Laksono, Buyung Hartiyo; Pertiwi, Previasari Zahra; Siswagama, Taufiq Agus; Isngadi, Isngadi
Journal of Anaesthesia and Pain Vol. 6 No. 3 (2025): In Press
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Background: Traumatic brain injury is defined as a decline in brain function characterized by a decreased level of consciousness, seizures, and focal sensory and motor neurologic deficits caused by blunt force or penetration by a sharp object into the intracranial space. This reseracrh aims to determine the characteristics of head trauma patients at Dr. Saiful Anwar General Hospital, Malang.Methods: This descriptive observational study sampled all head trauma patients at Dr. Saiful Anwar General Hospital, Malang, from March to August 2023. The study variables included patient demographics, cause of trauma, clinical data, pre-and postoperative procedures, outcomes of trauma patients undergoing treatment, and length of stay. Data were analyzed using Microsoft Excel.Results: A total of 227 head trauma patients were identified, most of whom were men aged 20-39 (71). Students (72) were the most common victims of head trauma, most often due to accidents. There were 156 patients with mild head injuries. 208 patients had normal oxygen saturation. 157 patients had normal hemoglobin, 181 patients had normal sodium, and 196 patients had normal blood glucose levels. 102 patients experienced hypocarbia. A normal CT scan of 141 patients was performed. 206 patients underwent surgery, while 214 patients did not undergo tracheostomy. 149 patients underwent surgery with early emergence. The highest number of patients were patients with a hospital stay of more than 14 days (140 patients). The most common outcome was mild disability (84 patients).Conclusion: Most patients were male, aged 20-39. The most common cause was accidents involving students. Most patients with mild head injuries had normal oxygen saturation, hemoglobin,sodium, and blood glucose levels. Most patients with hypocarbia had no bleeding, and CT scans showed no bleeding. Most patients underwent surgery and early emergence, with a hospital stay of more than 14 days, and the most common outcome was mild disability.
Comparative Assessment of Transthoracic and Transesophageal Echocardiography for Assessment of Grading of Aortic Stenosis in Elective Aortic Valve Replacement Surgeries Moinuddin, Gulam; Saiyed, Anjum; Garg, Arun; Yadav, Anuradha
Journal of Anaesthesia and Pain Vol. 6 No. 3 (2025): In Press
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2025.006.03.03

Abstract

Background: Aortic stenosis severity assessment plays a central role in determining appropriate clinical management. Variability between imaging modalities may influence diagnostic accuracy and therapeutic decisions. This study aims to compare transthoracic echocardiography and transesophageal echocardiography in grading aortic stenosis among patients undergoing aortic valve replacement. Methods: This prospective observational study included 50 patients scheduled for aortic valve replacement, each undergoing both transthoracic echocardiography and intraoperative pre-cardiopulmonary bypass transesophageal echocardiography. Aortic valve area (AVA), mean pressure gradient, peak jet velocity, and dimensionless index were measured using standard echocardiographic techniques. Paired comparisons between the two modalities were performed using a paired t-test with α = 0.05 and a 95% confidence interval (CI). Result: Transthoracic echocardiography yielded a mean aortic valve area of 0.584 ± 0.08 cm², whereas transesophageal echocardiography measured 0.623 ± 0.07 cm², demonstrating a significant difference (p = 0.020). Transesophageal echocardiography reported a lower mean pressure gradient (39.08 ± 6.15 mmHg) and peak jet velocity (3.71 ± 0.42 m/s) compared with transthoracic echocardiography (49.14 ± 7.85 mmHg and 4.23 ± 0.53 m/s, respectively), with both parameters showing statistically significant differences (p < 0.001). No significant difference in the dimensionless index was observed between the two modalities (p = 0.250). Conclusion: Transesophageal echocardiography presents higher AVA measurements but lower pressure gradients and peak velocity values than transthoracic echocardiography, potentially altering aortic stenosis severity grading. Dimensionless index values remain consistent between modalities. Standardized evaluation protocols are required to guide the selection of the most appropriate imaging modality for accurate assessment of aortic stenosis.

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