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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 "Vol. 5 No. 2 (2024): May" : 5 Documents clear
Thoracotomy: An Overview of Perioperative Anaesthetic Management Solanki, Nilesh Maganbhai; Engineer, Smita; Shah, Namrata; Mistry, Nirmal; Tamilanban, Soundarya
Journal of Anaesthesia and Pain Vol. 5 No. 2 (2024): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.02.02

Abstract

Background: The anesthesiologist's role during open thoracotomy includes using a double lumen tube (DLT) for lung isolation, maintaining oxygenation with one-lung ventilation (OLV), and providing postoperative analgesia. This study aims to describe patient demographics, comorbidities, perioperative anesthetic management, complications, and the effectiveness of epidural catheter analgesia.Methods: In this prospective, observational study, patients who underwent open thoracotomy for decortications were evaluated. Thoracotomy was done under general anaesthesia, OLV with DLT, and epidural analgesia. Postoperatively, all the patients were shifted to the intensive care unit. Collected data included patient demographics, associated co-morbidities, severity of lung diseases, complications, and postoperative recovery. Postoperative analgesia was assessed by the visual analogue scale (0-10).   Result: Of 20 patients, 16 were male, and 4 were female, with a mean age of 35 years (range 15-60) and a mean weight of 52 kg (range 36-66). History of hypertension (N=5), hypertension with diabetes (N=3), obstructive lung disease (N=6), restrictive lung disease (N=11), and both combined (N=3) were noted on pre-anesthetic check-ups. Intraoperative complications were hypotension (N=3), desaturation (N=3), respiratory acidosis (N =7), and metabolic acidosis (N=3). Postoperative analgesia was managed with an epidural catheter (N=18) & systemic analgesia (N=2). All patients had uneventful postoperative courses except one patient who had pulmonary edema and did not survive.Conclusion: Patients undergoing open thoracotomy had an increased risk for adverse perioperative outcomes. The incidences of perioperative morbidity are high in patients with associated comorbidities. Proper OLV strategy helps to correct intraoperative desaturation. Epidural analgesia plays a key role in postoperative recovery.
Comparison of Hemodynamic Response to Endotracheal Intubation with Nebulized Lignocaine and Dexmedetomidine: a Prospective Randomized Controlled Trial Dash, Sulochana; Sree, Pasupala Subba Kavya; Panigrahy, Sasmita; Sahu, Alisha; Nath, Abinash Kumar; Rani, Pedireddy Sobha
Journal of Anaesthesia and Pain Vol. 5 No. 2 (2024): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.02.01

Abstract

Background: Though different studies have compared intravenous (IV) lignocaine with dexmedetomidine for blunting laryngoscopic and intubation response, there is hardly any study comparing nebulized Lignocaine and dexmedetomidine for the same. This study compared the effectiveness of nebulized dexmedetomidine and Lignocaine for blunting hemodynamic response to laryngoscopy and intubation.Methods: This prospective randomized double-blinded study among 60 patients was divided into two equal groups of 30 (groups D and L). Group D patients were nebulized with 1 µg/kg of dexmedetomidine diluted in 0.9% saline to a total volume of 4 ml, and Group L patients were nebulized with 4ml of 4% Lignocaine hydrochloride in the preoperative room over 5 min. After induction of general anesthesia, laryngoscopy and intubation were performed, and hemodynamic changes were recorded for statistical analysis. A two-sample t-test was applied to compare means in two groups with a confidence interval of 95%.Result The Dexmedetomidine group demonstrated a significant difference, with lower values of mean heart, systolic, diastolic, and mean arterial pressure rate immediately before laryngoscopy till 10 minutes postintubation (recorded at 2 mins intervals till 10mins) compared to the lignocaine group. The p-values for all the parameters were < 0.001, underlining the robustness of our findings.Conclusion: Nebulised Dexmedetomidine before laryngoscopy is not just an alternative technique, but a superior one for blunting the hemodynamic response to laryngoscopy and endotracheal intubation. It outperforms Nebulised Lignocaine without significant adverse effects, such as postoperative sore throat and sedation, making a compelling case for its adoption in clinical practice.
Bilateral Diaphragm Paralysis in Deep Neck Infection: Mimicking Respiratory Distress in Sepsis Yakushiji, Tatsumi; Hakozaki, Takahiro; Iseki, Yuzo; Inoue, Satoki
Journal of Anaesthesia and Pain Vol. 5 No. 2 (2024): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.02.03

Abstract

Background: This case report highlights an occurrence of bilateral diaphragm paralysis following surgical drainage for deep neck infection.Case: A 56-year-old male underwent surgical drainage and tracheostomy for a deep neck infection. Before the second surgical drainage, he exhibited tachypnea (>30 bpm), although his general condition was not significantly compromised. Following a successful drainage procedure, he was transferred to the intensive care unit and placed on mechanical ventilation. Despite attempts at spontaneous breathing trials (SBT), he failed each trial, leading to a deterioration in his general condition. Subsequently, he was diagnosed with diaphragm paralysis.Conclusion: The clinical manifestations of bilateral diaphragm paralysis closely resemble the common symptoms of sepsis. Therefore, it is crucial to recognize that surgical interventions for deep neck infections may pose a risk of developing diaphragm paralysis, likely associated with phrenic nerve palsy.
Perioperative Management of Neuroanesthesia in Patients with Supratentorial Tumors Who Have Excised Tumors Using Neuroprotection Technique and Total Intravenous Anesthesia Aditiarso, Candra; Laksono, Buyung Hartiyo
Journal of Anaesthesia and Pain Vol. 5 No. 2 (2024): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.02.04

Abstract

Background: Neuroanesthesia management presents a unique challenge for anesthesiologists. They must provide an optimal surgical condition without worsening the patient's neurological deficits. Therefore, we need drugs with neuroprotective abilities. This case report explains the perioperative management of neuroanesthesia in patients with supratentorial tumors who have excised tumors using a neuroprotection technique and total intravenous anesthesia (TIVA).Case: A 43-year-old female patient with space-occupying process cerebri with the differential diagnosis of meningioma frontotemporal dextra, post trepanation frontal sinistra tumor excision, edema cerebri, and hydrocephalus on ventriculoperitoneal shunt. On physical examination, Glasgow coma scale E3M6Vaphasia, aphasia and left hemiparesis were found. She underwent a tumor excision procedure with total intravenous anesthesia modified with neuroprotection techniques and total intravenous anesthesia techniques using 300 mg thiopental, 2 mg midazolam, 150 µg fentanyl, 80 mg lidocaine, and 50 mg rocuronium. Intraoperative anesthesia management was carried out by administering propofol 50 mg/hour, fentanyl 50 µg/hour, and atracurium 15 mg/hour.Conclusion: Total intravenous anesthesia is a complete general anesthesia method used in all intravenous agents, where the benefits of this method are used in neurosurgery, including accelerating the patient's return from the effects of anesthesia, faster recovery of cognitive function, as well as reducing intracranial pressure and the risk of ischemia.
Peritonsillar Block with Triamcinolone as a Preemptive Analgesia in Tonsillectomy with Bipolar Electrocauter Firdaus, Faundra Arieza
Journal of Anaesthesia and Pain Vol. 5 No. 2 (2024): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.02.05

Abstract

Background: Tonsillectomy is one of the common types of ear, nose, and throat (ENT) surgery. Patients undergoing tonsillectomy frequently experience significant postoperative pain due to oropharyngeal muscle spasms and irritation of afferent nerve fibers. According to previous studies, triamcinolone for peritonsillar block was used to reduce postoperative pain in patients who have undergone tonsillectomy. The aims and objectives of this study were to observe the effectiveness of peritonsillar block using triamcinolone for reducing pain in patients with post-tonsillectomy using the bipolar electrocautery technique.Case: A 34-years-old male patient with chronic tonsillitis and obstructive sleep apnea (OSA) was undergoing tonsillectomy with general anesthesia and peritonsillar block after general anesthesia with triamcinolone 0,5 mg/kg body weight in the right and left fossa peritonsillar. Postoperative hemodynamic monitoring was carried out in the inpatient room. Patients were assessed for pain scale after tonsillectomy and side effects of triamcinolone, with pain indicator using the Wong-baker faces pain rating scale, numeric pain rating scale, and Face, legs, activity, cry and consolability (FLACC) Scale. Pain scales were assessed 1 hour after the tonsillectomy in the recovery room, 3 hours after the tonsillectomy in the inpatient room, 8 hours after the tonsillectomy in the inpatient room, 1 day after the tonsillectomy in the inpatient room, and 2 days after the tonsillectomy by phone. The patient went out of the hospital after 1 day of tonsillectomy.Conclusion: Peritonsillar block with triamcinolone is effective in reducing pain after tonsillectomy and can be the drug of choice when administering peritonsillar block.

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