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Ristiawan Muji Laksono
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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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Kota malang,
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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 3 (2022): September" : 6 Documents clear
Management of Local Anesthetics Systemic Toxicity in a 66-Year-Old Male Undergoing Nephrostomy Percutaneous Andi Nugroho; Restian Rudy Oktavianto
Journal of Anaesthesia and Pain Vol 3, No 3 (2022): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.03.06

Abstract

Background: Neuraxial anesthesia compares favourably with other systemic and regional methods about safety and efficacy. The complications related to neuraxial anaesthesia including transient neurological symptoms, inadvertent intrathecal injection and cardiac arrest. Local anesthetics systemic toxicity (LAST) is one of a life-threatening complication when the effects of local anesthetics reach the systemic circulation.Case: We report a local systemic toxicity on 66-year-old male who underwent bilateral nephrostomy percutaneous. Patient were hemodynamically stable and were placed in supine position, preoperatively. Head-to-toe examination showed an increased bronchial breath sounds and rough crackles in the 4-5 left and right intercostal space. Laboratory examinations revealed anemia (Hb 10.6 g/dl) and impairment on kidney function (ureum 148 mg/dl; creatinine 4.9 mg/dl). Patient were planned to do an epidural at the level of L2 - L3 with a 14 ml levobupivacaine 0.5% in incremental doses 5 mg - 5 mg – 4 mg. Shortly after receiving the third incremental doses of levobupivacaine the patient experienced in disruption on cardiovascular and neurovascular system which showed as persistent bradycardia and loss of consciousness. Patient decided to undergo general anesthesia with lipid emulsion infusion and showed an improvement afterwards.Conclusion: The main principle of LAST management is to ensure adequate ventilation and organ perfusion with sufficient oxygen-rich-blood to perfuse on brain, heart, and kidneys to prevent acidosis until lipid emulsion therapy. LAST management requires prompt and precise diagnosis and treatment to get a good outcome.
Social Service of Pain Management for Patients Unresponsive to Conservative Treatment Ristiawan Muji Laksono; Taufiq Agus Siswagama; Buyung Hartiyo Laksono; Aswoco Andyk Asmoro; Priscilla Tulong; Emilia Tiara Shantikaratri; Haffidz Wahyu Aji; Yudhistira Yuliandra; Dadik Prasetya Hutama; Candra Aditiarso
Journal of Anaesthesia and Pain Vol 3, No 3 (2022): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.03.01

Abstract

Pain is one of the most common complain encountered in outpatient clinic. Inadequate pain management has been widely reported. As an anesthesiologist and pain physician, we perform a social service of pain management for patients unresponsive to conservative treatment. The social service  was held from April - June 2022. We enrolled thirty-two patients from other physician reference and Primary Health Care in several districts around Malang city to come to Brawijaya University Hospital with the age range of 30-80 years old. The pain interventions given to the participants mainly include prolotherapy, pulsed radiofrequency (PRF), and others. The pain measurement of the patients were assessed with Numerical Rating Scale (NRS), pre and post-intervention. The social service is performed on 32 patients (male 34,37%, female 65.62%), majority aged 60 years od and older (34.37%) with low back pain become the major complaint (43.75%). The majority of patients receive prolotherapy (68%). The mean NRS decrease from 6.19 ± 0.18 (before treatment) to 2.69 ± 0.10 (after treatment). After this social service, most patients (96.875%) have obtained better pain control after given pain interventions. 
Management of Anesthesia in Preeclamptic Patient with Thrombocytopenia and COVID-19 Infection Muhamad Ramdani Ibnu Taufik
Journal of Anaesthesia and Pain Vol 3, No 3 (2022): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.03.02

Abstract

Background: Coronavirus Disease 2019 (COVID-19) has become a world health emergency. Pregnant women and newborns are two groups of people who are susceptible to disease. Corona virus infection in 2019 has been associated with systemic consequences such as high blood pressure, kidney disease, thrombocytopenia, and liver damage. Anesthetic management of emergency cesarean section in a preeclampsia patient with thrombocytopenia and COVID-19 infection is described in this case report..Case: A 30-year-old woman, G2P1A0 (Gravida: 2, Partus: 1, Abortus: 0), 38 weeks pregnant, came to our hospital complaining of irregular contractions. In addition, the patient had a fever and cough. After 24 hours of testing, a positive test result for COVID-19 was obtained. The patient is then immediately sent to the isolation room. Contractions began regularly within 5 hours, and cervical examination revealed a dilation of 2 cm. Due to the positive impact of COVID-19, the obstetrics and gynecology department chose to undergo a cesarean section. The cesarean section procedure was carried out according to the COVID-19 operating protocol.Conclusion: Patient with severe thrombocytopenia can safely use spinal anesthesia, while COVID-19 patient should avoid general anesthesia to reduce transmission.
Management of Respiratory Failure in Patients with COVID-19 and Multiple Myeloma Slamet Hadi Santoso; Arie Zainul Fatoni
Journal of Anaesthesia and Pain Vol 3, No 3 (2022): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.03.03

Abstract

Background: Cancer patients have higher risk of getting COVID-19. Individuals with malignancy who infected COVID-19 often underwent prolonged hospitalization or death. Here, we report respiratory failure management of of COVID-19 patient with multiple myeloma (MM).Case: A 66-year-old man came with complaints of shortness of breath. The patient was intubated and treated in the intensive care COVID. Patients with a history of multiple myeloma and who have chemotherapy cycle. The laboratory results showed an increase in markers of inflammation, hypoalbuminemia, and bicytopenia. The results of the polymerase chain reaction swab were positive.  There are 4 managements in this patient, airway management: intubation and ventilator settings using the Lung Protective Strategy principle. Management Breathing: administration of antibiotics according to sputum culture results. Circulation Management: Fluid management using a non-invasive Contractility Index (ICON) monitor. Management of Disability: Spontaneous Awakening Trial (SAT) and Spontaneous Breathing Trial (SBT) when the aggravating disease has been handled.Conclusion: Management of respiratory failure in patients with multiple myeloma and COVID-19 infection is primarily focused on supportive care such as airway management, breathing management, fluid management and disability management.
Epidural Anesthesia Management in Cesarean Section with Placenta Accreta Aura Ihsaniar; Pandu Anggoro
Journal of Anaesthesia and Pain Vol 3, No 3 (2022): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.03.05

Abstract

Background: In pregnant women, the spectrum of placenta accreta is considered a high risk syndrome. Placenta accreta is responsible for 7-10% of all maternal deaths worldwide. This study reports on a patient with placenta accreta who underwent a cesarean section using epidural anesthesia.Case: A 30-year-old woman (Gravida: 3, Abortus: 1, Partus: 1) with a gestational age of 8 months came to the hospital.  with 8 months of gestation was diagnosed with antepartum hemorrhage et causa placenta previa totalis morbidly adherent placenta high risk with planned elective cesarean section with bilateral tubectomy to hysterectomy, Double J (DJ) stent, Ballooning using epidural anesthesia with physical American Society of Anesthesiologists (ASA) II status. Local anesthetic with 2% lidocaine 2 ml, 12 ml of 0.5% bupivacaine given in incremental doses of 4 ml every 5 minutes while monitoring the patient's hemodynamics. Intraoperative drugs consist of intravenous (IV) dexamethasone 5 mg IV, ondansetron 8 mg IV, tranexamic acid 1 gram, paracetamol 1 gram IV, bupivacaine 0.5% 3ml every 1 hour via an epidural catheter. Maintenance using O2 3 lpm. The operation lasted 450 minutes, with stable outcome both maternal and fetal.Conclusion: Anesthesia management in patients with bleeding during labor is very important. In this case, epidural anesthesia provide a good outcome in maternal and fetal after cesarean section in placenta accreta patient. 
Difficult Airway Management in Pediatric Patient with Neck Contracture Pradipta Arief Pramono; Fitri Hapsari Dewi
Journal of Anaesthesia and Pain Vol 3, No 3 (2022): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.03.04

Abstract

Background: A specific airway evaluation and physical examination should be performed in all pediatric patients undergoing anesthesia. Pediatric difficult airway problems can occur due to congenital, inflammation, trauma, or malignant disorders. Laryngeal mask airway (LMA) is an alternative breathing device for difficult airway cases.Case: We reported a 5-year-old girl, 12 kg of weight, with a diagnosis of Colli region contracture planned for contracture release. Physical examination revealed glasgow coma scale score 15, with a pulse of 98 beats per minute, a breath rate of 22 times per minute and SpO2 of 98% on the room air. In the airway evaluation, it was found that the lower mouth was pulled down by the contracture tissue, 2-fingers-wide of mouth opening, the mallampati score was difficult to evaluate, there was no obstruction and neck motion was limited due to contractures. In this report, intubation via video laryngoscope was failed due to the severely restricted neck motion caused by the contracture. The use of LMA became an alternative difficult airway management in this patient after failed intubation with a video laryngoscope.Conclusion: Preoperative evaluation for assessing and evaluating difficult airway in pediatric patients greatly determines the success of airway management. The use of airway devices such as LMA is still very helpful in cases of pediatric difficult airway. 

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