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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 3, No 1 (2022): January" : 6 Documents clear
Ultrasound-Guide Hydrodissection for Ulnar Nerve Entrapment at Arcade of Struthers Kamala Kan Nur Azza; Said Sofwan; Albertus Sugeng Wibisono
Journal of Anaesthesia and Pain Vol 3, No 1 (2022): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.01.05

Abstract

Background: Ulnar nerve entrapment (UNE) causes a tingling or numbness in the fourth and fifth fingers and appears when provoked by bending the elbow. In some severe cases, UNE often causes weakness of the fourth and fifth fingers when grasping or difficulty in coordinating movements. In severe cases, it causes muscle atrophy. Case: A 39-year-old male patient had complaints of pain and numbness in the right arm above the elbow radiating to the fourth and fifth fingers. There is a burning sensation on the right arm when exposed to the wind, with a visual analog scale (VAS) 4-5. Two years ago, the patient had a history of pain in his entire right arm and shoulder blade after falling from a cliff. The patient received treatment with mefenamic acid 500 mg, three times a day, ranitidine 150 mg, two times a day, but the pain did not improve. The patient was diagnosed with ulnar nerve entrapment at the arcade of Struthers. The patient was treated with hydrodissection using ultrasound guidance with 2% lidocaine and steroids (Triamcinolone Acetonide 40 mg/ml). Evaluation on the seven days after hydrodissection, burning sensation at the injection site, tingling and numbness have disappeared. Conclusion: Ultrasound-guided hydrodissection is clinically effective in ulnar nerve entrapment at the arcade of Struthers management. 
Anesthesia Management in Patient with Uncorrected Double Outlet Right Ventricle Underwent Cesarean Section: Serial Case Report Ilham Fadlilah; Ruddi Hartono; Isngadi Isngadi
Journal of Anaesthesia and Pain Vol 3, No 1 (2022): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.01.06

Abstract

Background: Double outlet right ventricle (DORV) is a rare cardiac condition in which the heart demonstrates single ventricle physiology. Pregnancy complicates cyanotic heart disease as the decrease in systemic vascular resistance (SVR) worsens the right-to-left shunt. The effect worsens by neuraxial anesthesia for cesarean delivery. Anesthesia for these patients needs understanding for the physiology of DORV in order to maintain stable hemodynamics. Heart defect still become non obstetric main factor causing morbidity and mortality in pregnant woman.Case: We present three case of parturients with DORV scheduled for cesarean section. Elective caesarean section was scheduled using spinal anesthesia hyperbaric bupivacain combined with fentanyl.  Hemodynamic during operation was stable.Conclusion: Low dose spinal anesthesia performed in this patient did not cause hypotension and minimal hemodynamic changes because the intensity of the sympathetic block was lower.
Hypervolemic Hemodilution as a Management During Predicted Massive Bleeding Sectio Caesarea in Placenta Accreta Patient Fanniyah Fanniyah; Ruddi Hartono
Journal of Anaesthesia and Pain Vol 3, No 1 (2022): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.01.04

Abstract

Background: Placenta accreta represent one of the most morbidity condition in modern obstetrics, with high rates of hemorrhage, hysterectomy and intensive care unit admission. Alternative management during intraoperative bleeding is haemodilution. There are two techniques in hemodilution, autonomic normovolemic hemodilution (ANH) and hypervolemic hemodilution.Case: A gravida patient with ASA 2 physical status with a suspected placenta accreta was planned for a sectio caesarea. To anticipate bleeding, hypervolemic hemodilution was conducted. Hemodilution was performed with a total fluid of 2000cc. Total bleeding during surgery is 3500 cc. A close monitoring of haemoglobin (Hb) and haematocrit (Hct) was conducted. The initial Hb and Hct were 9.9 mg/dl and 29.8%, respectively. The Hb and Hct results post-haemodilution were 5.7 and 17.1, respectively. The postoperative Hb and Hct results were 5.4 mg/dl and 16.6%, respectively. The patient was given a blood transfusion of 450 cc PRC (packed red cells).. The patient was observed in the ICU for 24 hours postoperatively and was subsequently transferred to the ward.   Hemodilution, in this case, was proven to be effective based on the post-hemodilution and post-haemorrhage Hb and Hct results. The total bleeding was 3500 cc, and there was a reduction of Hb from 5.7 to 5.4 and haematocrit from 17.7% to 16.6%. Conclusion: Due to the hemodilution, not only the red blood cells were lost, but also the hemodilution fluids. Hemodilution may be an alternative management during intraoperative haemorrhage. However, the anticipation and effect that might arise from hemodilution should be considered.  Keywords: Accreta, Hemodilution, Hypervolemic hemodilution, massive hemorrhage. 
Thoracic Spinal Anaesthesia for Modified Radical Mastectomy (MRM) Derajad Bayu Atmawan; Hanifa Agung Kurniawan; Priyambada Priyambada
Journal of Anaesthesia and Pain Vol 3, No 1 (2022): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.01.01

Abstract

Background: Breast cancer mostly affects patients older than 65 years old. Geriatric patients may have comorbidities so the selection of anaesthesia for breast cancer surgery is challenging. In the past decade, thoracic spinal anaesthesia as regional anaesthesia was feasibly performed for laparoscopic cholecystectomy and minor breast surgery. This article aims to evaluate thoracal spinal anaesthesia for Modified Radical Mastectomy (MRM) in our hospital settings.Case: Three cases of Thoracal Spinal Anaesthesia were carried out for MRM surgery after neoadjuvant chemotherapy treatment. This procedure consists of removal of breast tissue and the ipsilateral axillary contents. The comorbidities include hypertension, cardiomegaly, and mild anaemia. There was no conversion to general anaesthesia during surgery until completion. Duration for surgery less than 120 minutes.  No significant hemodynamic instability and complaint were found during intra and postoperative. Conclusion: From these cases, thoracal spinal anaesthesia was acceptable as regional anaesthesia for MRM in geriatric patient.
Neuroanesthesia Management in Pediatric with Traumatic Brain Injury in Emergency Operation Fitri Hapsari Dewi; Achmed Rizal Fatahillah
Journal of Anaesthesia and Pain Vol 3, No 1 (2022): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.01.02

Abstract

Background: Pediatric neuroanaesthesia is an exciting and challenging branch of anaesthesia. Because the anatomy and physiology of the neurological system of children are still immature, the management of neuroanaesthesia in children is different from that of adults, from hemodynamic control, selection of anaesthetic drugs used, to endotracheal intubation.Case: In this case report, we report a 1-month-old male infant, weighing 4.6 kg, with a diagnosis of acute on chronic SDH in the frontotemporoparietal region. Physical examination revealed a decrease in consciousness GCS E2V2M5, with a pulse of 157 times per minute, a respiratory rate of 48 times per minute and a 100% SpO2 with oxygen administration of 2 litres per minute through a nasal cannula. On examination of the airway, there was no gurgling, snoring, or hoarseness. The patient was hemodynamically stable during the 90-minute operation. Postoperatively the patient was admitted to the PICU.Conclusion: Anaesthesia treatment for traumatic brain injury in infants has unique problems that require knowledge of the anatomy and physiology of the pediatric brain. Keywords: frontotemporoparietal region, neuroanaesthesia, paediatrics, traumatic brain injury
Axilary Block Ultrasound Guiding in Patient with Pseudoaneurysm Regio Brachii Sinistra pro Repair Pseudoaneurysm Heri Dwi Purnomo; Emmanuel Kurnia Kasmantino
Journal of Anaesthesia and Pain Vol 3, No 1 (2022): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.01.03

Abstract

Background: An aneurysm may be a true aneurysm or a pseudoaneurysm. Pseudoaneurysm is defined as a defect in the arterial wall, making a connection between the lumen and the extraluminal space. The main etiology of brachial artery pseudoaneurysm is incidental arterial puncture during venous cannulation for hemodialysis.Case:: Anesthetic management was performed on a female patient 56 years old, body weight 45 kg, height 150 cm. The patient had other comorbidities such as hypertension, diabetes mellitus, chronic renal kidney with a diagnosis of left brachial pseudoanuerysm. Pro Pseudoanurysm repair surgery. The anesthetic technique uses axillary peripheral nerve block with ultrasound guiding. The duration of surgery is ± 120 minutes. After the operation, the patient was treated in the hospital ward.Conclusion: Choosing the most appropriate anesthetic technique for patients with renal impairment is necessary to maintain normovolemia and normotension in order to avoid unexpected complications. Using regional anesthetic technique for sympathetic nerve block may be favorable in these patients. With ultrasound guiding, the incidence of failure is lower, the time required is shorter, the latency is shorter, the blockade is longer, and the risk of accidental vascular puncture is lower so that vascular lesions are less likely.

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