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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
 1 
Search results for , issue "Vol 2, No 3 (2021): September" : 6 Documents clear
Dextrose Prolotherapy for Occipital Neuralgia Management Taufiq Agus Siswagama; Buyung Hartiyo Laksono; Mirza Koeshardiandi
Journal of Anaesthesia and Pain Vol 2, No 3 (2021): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.03.02

Abstract

Background: Occipital neuralgia defined as a pain such as being stabbed in the skin according to the dermatomes of the greater occipital nerves (GON) and lesser occipital nerves (LON).Case: An 80-year-old male patient diagnosed with occipital neuralgia. Previously, patients were diagnosed with lung cancer six months ago and planned for follow-up chemotherapy. Patient already receive medications including paracetamol, Non-steroidal anti-inflammatory drugs (NSAIDs), minor tranquilizers, and antidepressants, but the pain still exist. Patient then scheduled to receive blocks of GON and LON-ultrasound-guided using plain lidocaine 2% and steroids dexamethasone 10 mg. Fifteen days later, patient receive perineural deep injection along with prolo-hydrodissection in GON and LON using dextrose 15% and local anesthesia lidocaine plain 2% with a volume of 3 cc each nerve.  The intervention give a positive outcomes, pain is reduced with NRS rest 0-1, NRS motion 2-3, hearing improves, and the noise in the ear disappears. The patient can sleep using a pillow. Conclusion: Block GON and LON, perineural deep injection along with prolo-hydrodissection  provides a positive outcome for occipital neuralgia pain management. This case showed an opportunity for pain specialist to develop pain intervention based on prolotherapy.  
Perioperative Management of Percutaneous Dilated Tracheostomy for Patient during Intensive Care after Ventriculoperitoneal (VP) Shunt Installation Angky Hari Satriawan
Journal of Anaesthesia and Pain Vol 2, No 3 (2021): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.03.04

Abstract

Background: Tracheostomy is a technique used to treat patients with inadequate ventilation and upper airway obstruction by making air passage through the neck directly into the trachea. Percutaneous dilated tracheostomy is usually performed in patients requiring long-term use of a ventilator in an intensive care unit. Basic knowledge of perioperative management of percutaneous dilated tracheostomy is fundamental and must be mastered by anesthesiologists.Case: A woman, 45 years old is treated at dr. Moewardi hospital with decreased consciousness E2V2M3, non-communicant hydrocephalus, and intraventricular hemorrhage. The patient underwent ventriculoperitoneal shunt surgery and was admitted to the intensive care unit. Patients require long-term use of a ventilator and thus require percutaneous dilated tracheostomy. The percutaneous dilated tracheostomy procedure was successfully performed and there were no complications after the procedure.Conclusion: Percutaneous dilated tracheostomy is a minimally invasive tracheostomy technique as an alternative to conventional techniques, with lower complications and shorter time. 
Management of Local Anesthetics Systemic Toxicity In A 78 Year Old Man Undergoing Remove Of Inplate Wike Yuliana; Heri Dwi Purnomo
Journal of Anaesthesia and Pain Vol 2, No 3 (2021): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.03.05

Abstract

Background: Local anesthetics have been widely used over the past 50 years in many clinical practices, ranging from emergency departments to operating rooms. Local anesthetics systemic toxicity (LAST) is a life-threatening condition when the effects of local anesthetics reach the systemic circulation with an incidence of 0.03% or 0.27 incidence of 1000 episodes of Peripheral nerve block (PNB).Case: We report a 78-year-old male who underwent of remove of inplate (ROI) and open reduction internal fixation (ORIF) reconstruction. Preoperative physical examination revealed GCS E4V5M6, blood pressure 195/76, other vital signs within normal limits, SpO2 99% in the supine position. On examination of the lungs, there were increased bronchial breath sounds and rough crackles, especially in the 2-5 left intercostal space. Other physical and laboratory examinations were within normal limits. The patient was hemodynamically stable after infusion lipid emulsion. The main principle of LAST management is to ensure adequate ventilation and organ perfusion with sufficient oxygen-rich blood to reach the brain, heart, and kidneys to prevent acidosis until lipid emulsion therapy.Conclusion: LAST management requires prompt and precise diagnosis and treatment to get a good outcome.
Ultrasound-Guided Sciatic and Femoral Block in Patient with Recent Embolism Stroke Undergo Amputation Above the Knee Propan Hanggada Satyamakti Mubarak
Journal of Anaesthesia and Pain Vol 2, No 3 (2021): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.03.06

Abstract

Background: Patients undergoing amputation of the lower extremities usually have poor circulation and other comorbidities and, therefore, present a challenge to the anesthesiologist. The combination of sciatic and femoral nerve block is reported to be an effective anesthetic technique for patients undergoing knee surgery, and it is known to be an effective method of postoperative analgesia in patients undergoing major surgery on the subject's lower extremities.Case: A 70-year-old man with a recent embolism stroke, death of his limb on the right cruris region, and underwent an amputation above the knee. Preoperative physical examination showed GCS E4 V, motor aphasia M6, blood pressure 131/82 mmHg, pulse 114 bpm, RR 20 times/minute with bodyweight 70 kg, height 160 cm, SpO2 97%. There was cyanosis in the right cruric region with motor power of 1/5 1/5. The value of leukocytes 18,600/ul, platelets 309,000/ul, Prothrombin Time (PT) 15.8 seconds, Activated partial thromboplastin time (APTT) 25.9 seconds,  International normalized ratio (INR) 1,330, neutrophils 81.7%, lymphocytes 12.6%, creatinine 1.8 mg/dl, urea 137 mg /dl, blood sugar at the time 258 mg/dl, Cl 95 mmol/l.  This case report suggests that ultrasound-guided peripheral nerve blocks may be useful for major lower extremity surgery in patients with severe hemodynamic impairment.Conclusion: Perioperative management of embolism stroke patients undergoing above-knee amputation requires special attention in selecting anesthetics. Ultrasound-guided peripheral nerve blocks minimize patient hemodynamic changes and provide better postoperative pain control.
Difficult Airway Management in Pediatric with a Large Cystic Hygroma Colli Undergoing One-Stage Excision Surgery Mahendratama Purnama Adhi; Hery Poerwosusanta
Journal of Anaesthesia and Pain Vol 2, No 3 (2021): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.03.01

Abstract

Background: A large cystic hygroma colli is a complicating factor in airway management in pediatric. Proper preparation, planning, and anticipation can reduce the risk of complications, morbidity, and mortality during difficult airway management. The fundamental principle of difficult airway management is to maintain adequate oxygenation and avoid hypoxemia by maintaining spontaneous ventilation.Case: A 22-month-old girl, weighing 9 kg, diagnosed with a large cystic hygroma colli who underwent single-stage excision surgery. Cystic hygroma was experienced since birth and with age, the cysts enlarge to a size of 25 x 17 x 12 cm which extends towards the face and shoulders. The patient did not experience stridor and symptoms of airway obstruction. The chest x-ray reveals no expansion of the cyst into the chest cavity and showed minimal tracheal deviation to the right. The difficult airway management was accomplished while maintaining the patient's spontaneous breathing. Sedation and analgesia obtained with intravenous administration of dexmedetomidine, ketamine, and nebulized lidocaine. A video laryngoscope is used to facilitate intubation. Awake extubation was performed after confirming that there was no risk of complications of laryngeal edema, laryngeal nerve injury, and tracheomalacia using a cuff-leak test.Conclusion: Maintaining spontaneous breathing, optimal levels of sedation and analgesia by administering dexmedetomidine, ketamine, and nebulizing lidocaine, and the use of a video laryngoscope can provide successful management of difficult airways due to a large cystic hygroma colli in pediatric patients.
Effective Enteral Treatment of Antibiotic for Patient with Respiratory Failure and Septic Shock in the Intensive Care Unit Maya sari; Wiwi Jaya; Arie Zainul Fatoni
Journal of Anaesthesia and Pain Vol 2, No 3 (2021): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.03.03

Abstract

Background: Pneumonia is a lung infection involving pulmonary alveoli caused by microbes, including bacteria, viruses, and fungi. It is a major infection that causes hospitalization and death worldwide and exacts an enormous cost in economic and human terms. The study to assess clinical outcomes for a critically ill patient treated with an enteral antibiotic for bacterial pneumonia is still limited.Case: We reported a case of pneumonia from 68 years old patient that caused respiratory failure and septic shock in the intensive care unit treated by enteral antibiotic and had a good outcome.Conclusion: Pneumonia can cause respiratory failure and septic conditions. Optimum antibiotic management is one of the methods to solve this problem. The benefit of utilizing enteral antibiotics is substantial and probably appropriate in certain patients.

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