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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 5 Documents
 1 
Search results for , issue "in press" : 5 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                                             
Successful Management of Life-Threatening Adrenal Crisis in an Elderly Patient with Secondary Adrenal Insufficiency: A Case Report of Comprehensive Multidisciplinary Care Setiadi, Teguh; Adiyanto, Bowo
Journal of Anaesthesia and Pain Vol. 7 No. 2 (2026): In Press
Publisher : Faculty of Medicine, Universitas Brawijaya

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

Abstract

Background: Adrenal crisis is an acute, life-threatening manifestation of cortisol deficiency that requires prompt recognition and treatment. Infection and sepsis are important precipitating factors, particularly in patients with underlying adrenal insufficiency. We report the successful multidisciplinary management of adrenal crisis complicated by septic shock and metabolic disturbances in an older patient.Case: A 64-year-old female patient with a diagnosis of adrenal crisis, septic shock, hyponatremia, recurrent hypoglycemia, and hospital-acquired pneumonia (HAP) is reported. Initial management included hydrocortisone administration as an exogenous glucocorticoid to address cortisol deficiency. Associated shock was managed with fluid resuscitation and vasopressors. Additionally, management of complications such as treating hypoglycemia with dextrose administration, correcting hyponatremia, and culture and antibiotic sensitivity testing were performed. Antibiotic therapy was administered in stages, starting with Ceftriaxone (empirical), escalation to Meropenem and Vancomycin, then de-escalation according to culture and sensitivity results. After 8 days of intensive care unit (ICU) treatment, the patient's condition improved, followed by 5 days of step-down care in the high care unit (HCU). The patient was then transferred to the general ward for 4 days. The patient was discharged with the tracheostomy still in place.Conclusion: Adrenal crisis in critically ill patients requires rapid glucocorticoid replacement together with simultaneous treatment of precipitating infection, shock, electrolyte abnormalities, and hypoglycemia. This case highlights the importance of coordinated multidisciplinary care, close physiologic monitoring, and culture-guided antimicrobial therapy in achieving clinical stabilization and recovery.
Ultrasound-Guided Axillary Block for Distal Radius Fracture Surgery during Second-Trimester Pregnancy: a Case Report Putra, I Made Prema; Sudiantara, Putu Herdita; Aryawangsa, Anak Agung Ngurah
Journal of Anaesthesia and Pain Vol. 7 No. 2 (2026): In Press
Publisher : Faculty of Medicine, Universitas Brawijaya

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

Abstract

Background: Non-obstetric surgery during pregnancy requires an anesthetic strategy that preserves maternal safety while minimizing fetal risk. Regional anesthesia is an attractive option for upper-extremity surgery because it avoids airway manipulation and reduces systemic drug exposure. We describe the use of ultrasound-guided axillary block for distal radius fracture surgery during second-trimester pregnancy.Case: A 33-year-old woman (gravida 2, para 1, living 1) at 18–19 weeks’ gestation, American Society of Anesthesiologists physical status II, presented with a closed distal-third right radius fracture requiring open reduction and internal fixation. Obstetric assessment and fetal heart rate were normal. Mild sedation was achieved with intravenous midazolam 1 mg and fentanyl 50 µg, with supplemental oxygen and continuous respiratory monitoring. Ultrasound-guided axillary block was performed using 10 mL 0.5% levobupivacaine, 6 mL 2% lidocaine, and dexamethasone 5 mg; total local anesthetic doses remained within accepted safety limits. Complete sensory and motor block developed within 15 minutes. The 1-hour procedure was completed uneventfully without conversion to general anesthesia, with stable maternal hemodynamics and normal fetal heart rate throughout. Postoperative analgesia was satisfactory, requiring one fentanyl patient-controlled analgesia activation. She was discharged on postoperative day 2. At 37 weeks, elective cesarean delivery resulted in a healthy mother and neonate, with no obstetric complications.Conclusion: Ultrasound-guided axillary block provided effective surgical anesthesia and prolonged postoperative analgesia for distal radius fracture surgery in this second-trimester pregnant patient, with favorable maternal and fetal outcomes. pregnancy, non-obstetric surgery, axillary block, brachial plexus block, distal radius fracture, regional anesthesia.
Dexmedetomidine versus Propofol or Midazolam for Sedation in Neurocritical Care: A Systematic Review and Meta-analysis Indrawan, Khadafi; Sedono, Rudyanto; Wulung, Navy Gerard H. M. Lolong
Journal of Anaesthesia and Pain Vol. 7 No. 2 (2026): In Press
Publisher : Faculty of Medicine, Universitas Brawijaya

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

Abstract

Background: Sedation in neurocritical care must provide adequate comfort and ventilator tolerance while preserving neurological assessment and minimizing hemodynamic instability. Dexmedetomidine, propofol, and midazolam are widely used, but their comparative effects on clinically important outcomes remain uncertain. This systematic review and meta-analysis aimed to evaluate whether dexmedetomidine improves hemodynamic outcomes, intensive care unit (ICU) length of stay, and duration of mechanical ventilation.Methods: This systematic review and meta-analysis included randomized controlled trials and observational studies involving adult neurocritical care patients that compared dexmedetomidine with propofol or midazolam, reported hemodynamic outcomes, ICU length of stay, or duration of mechanical ventilation.  We pooled continuous outcomes as mean differences (MDs) and categorical outcomes as odds ratios (ORs), with 95% confidence intervals (CIs).Results: Of 2,113 records identified, nine studies met the eligibility criteria. Compared with propofol, dexmedetomidine showed no significant difference in bradycardia (OR 2.72; 95% CI 0.62–11.93; p=0.18), hypotension (OR 0.89; 95% CI 0.64–1.25; p=0.51), or mean arterial pressure change (MD 1.12; 95% CI −5.11 to 7.35; p=0.72). ICU length of stay was similar versus propofol (MD −3.21 days; p=0.40) and midazolam (MD −5.97 days; p=0.09). Mechanical ventilation duration was also not significantly reduced versus propofol (MD −1.36 days; p=0.08) or midazolam (MD −2.00 days; p=0.22).Conclusion: Dexmedetomidine showed no significant superiority over propofol or midazolam in neurocritical care. Sedative selection should therefore be individualized according to neurological status, hemodynamic profile, ventilation requirements, and patient-specific risks.
Persistent Post-Dural Puncture Headache in an Autoimmune Patient: Diagnostic Challenges and Successful Management with Epidural Blood Patch Mangkuwerdojo, Liliana; Pryambodho; Sukmono, Raden Besthadi
Journal of Anaesthesia and Pain Vol. 7 No. 2 (2026): In Press
Publisher : Faculty of Medicine, Universitas Brawijaya

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

Abstract

Background: Epidural blood patch (EBP) remains the gold-standard intervention for post-dural puncture headache (PDPH), offering rapid and substantial symptom relief. Case: A female in her 20s underwent diagnostic lumbar puncture for evaluation of suspected autoimmune disease. Approximately three days following the procedure, she developed a progressively worsening orthostatic headache (Visual Analogue Scale [VAS] 3–4 at baseline, escalating to 8–9 with positional changes), accompanied by photophobia, nausea, and pain with eye movement. Conservative management and transnasal sphenopalatine ganglion (SPG) block provided only partial and transient relief. An EBP was subsequently performed using 10 mL of autologous blood, resulting in complete bilateral resolution of headache at 24-hour follow-up without significant adverse effects. Conclusion: This case highlights the effectiveness of EBP in managing refractory PDPH unresponsive to conservative treatments and SPG block, even in patients with complex autoimmune backgrounds. EBP remains the definitive treatment for refractory PDPH as a safe and effective option, including in selected patients with underlying autoimmune disease.

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