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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 129 Documents
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Management Anesthesia of Esophagostomy in a Patient with a Double Outlet Right Ventricle Bimo Kusumo Bhirowo; Rudy Vitraludyono
Journal of Anaesthesia and Pain Vol 2, No 2 (2021): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.02.06

Abstract

Background: Esophageal atresia is a congenital disorder in which there is no esophagus because the proximal and distal esophagus is not connected. Babies with esophageal atresia can show several symptoms: foamy mouth, cyanosis, coughing and tightness, flatulence, oliguria, or worse, pneumonia symptoms. Accompanying anomalies occur in greater than 50% of neonates with esophageal atresia. Esophageal atresia is identified by ultrasound at 18 weeks of gestation, ultrasound, and Magnetic resonance imaging (MRI) of the fetal neck, or examination of a nasogastric tube in the neck of a newborn. The management of esophageal atresia is challenging. The main choice remains the surgical procedure, which usually involves making a stoma on the proximal esophagus and gastrostomy. However, surgery has risky complications.Case: In this case, it was reported that a 22-day-old baby with tracheoesophageal fistula (TEF) type C with Ventricular Septum Defect and Atrial Septum Defect and Double Outlet Right Ventricle (DORV) underwent esophagostomy surgery with general anesthesia.Conclusion: Anesthesia management with general anesthesia, intubation using intravenous ketamine 3 mg, fentanyl 3µg, atracurium 1.5 mg gives stability for esophagostomy in a patient with a double outlet right ventricle.
Manajemen Anestesi Torakotomi Ligasi Fistel Pasien Tracheoesophageal Fistle Tipe C dengan Atrial Septal Defect (ASD) Sinus Venosus Besar dan Patent Ductus Arteriosus (PDA) Muhamad Akbar Sidiq; Karmini Yupono
Journal of Anaesthesia and Pain Vol 2, No 1 (2021): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.01.03

Abstract

Latar Belakang: Insiden tracheoesophageal fistula (TEF) dan esophageal atresia (EA) berkisar antara 1:3000 dan 1:4500 kelahiran. Antara 20% sampai 50% bayi dengan TEF/EA memiliki defek kongenital lainnya yang biasa disebut VACTERL (vertebral, anal, cardiac, tracheoesophageal, renal, limb).Kasus: Bayi usia 30 hari berat badan 2600 gram dengan diagnosis TEF tipe C dengan komplikasi pneumonia neonatal dan penyakit jantung bawaan ASD sinus venosus besar dan PDA sedang direncanakan tindakan thorakotomi ligasi fistel. Pasien sudah dilakukan gastrostomi dan esofagostomi sebelum tindakan ligasi.  Pasien dilakukan manajemen anestesi dengan general anestesi intubasi dengan kontrol ventilasi. Selama operasi terjadi beberapa kali desaturasi akibat retraksi paru yang dimanajemen dengan ventilasi manual dengan pemberian PEEP dan pengurangan retraksi oleh operator. Dua hari post operasi pasien dilakukan ekstubasi dan diganti dengan CPAP.Kesimpulan: Manajemen anestesi dengan TEF/EA memerlukan evaluasi dan perencanaan mulai preoperatif, intraoperatif, dan postoperatif. Evaluasi preoperatif berupa investigasi VACTERL, masalah kardiak dan respirasi berkaitan perencanaan manajemen anestesi yang akan dilakukan. Manajemen intraoperatif termasuk teknik intubasi, pemilihan teknik awake atau apnea bergantung kondisi dan komorbid dari pasien. Manajemen postoperatif berupa perawatan ventilator, kontrol nyeri optimal serta pengawasan kardiorespirasi.
Manajemen Pasien Dekstroskoliosis Berat dengan Kegagalan Napas yang disebabkan oleh Syok Septik dan Pneumonia Aulia Martyana Achsar; Arie Zainul Fatoni
Journal of Anaesthesia and Pain Vol 2, No 1 (2021): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.01.05

Abstract

Latar belakang: Dekstroskoliosis adalah jenis skoliosis dengan deformitas kurva tulang belakang ke kanan. Dekstroskoliosis berat dengan Cobbs Angle > 70o mengakibatkan berkurangnya kapasitas paru, Functional Residual Capacity (FRC), volume tidal, dan mempunyai kondisi seperti penyakit paru restriktif. Pada kondisi berat dapat menyebabkan hipoksemia, hiperkapnia dan gagal napas. Penyebab tersering gagal napas pada pasien dekstroskoliosis berat ialah sepsis/syok septik yang disebabkan oleh pneumonia. Sampai saat ini belum ada tatalaksana khusus yang menjelaskan tentang manajemen pasien dekstroskoliosis berat dengan gagal napas yang disebabkan syok septik dan pneumonia.Kasus: Pria berusia 46 tahun dengan berat badan 40 kg dan tinggi badan 165 cm rujukan dari Rumah Sakit luar dengan riwayat sesak napas dan kehilangan kesadaran sejak satu minggu sebelumnya, masuk ke Instalasi Gawat Darurat dengan laju pernapasan 40 x/menit, dengan menggunakan Nonrebreathing Mask 15 lpm saturasi oksigen terukur hanya 90% dengan tekanan darah 60/40 mmHg dan laju nadi 120 x/menit. Pasien memiliki riwayat batuk dengan dahak kuning dan demam sekitar 1 bulan. Pasien dinilai sebagai gagal napas dengan dekstroskoliosis berat dan penyulit syok septik dan Community Acquired Pneumonia, kami lakukan tindakan intubasi dan resusitasi sesuai sepsis bundle terbaru, pasien kemudian kami rawat di Intensive Care Unit (ICU) selama 10 hari dengan bantuan ventilasi mekanik invasif dengan menggunakan prinsip Lung protective strategy dan Survival Sepsis Campaign Bundle terbaru, hari ke 11 pasien stabil bisa lepas dari ventilator dan dipindahkan ke bangsal.Kesimpulan: Lung protective strategy dan Survival Sepsis Campaign Bundle dapat digunakan untuk manajemen pasien dekstroskoliosis berat dengan gagal napas yang disebabkan syok septik dan pneumonia. 
The Use of Dexmedetomidine on Pediatrics Undergoing Magnetic Resonance Imaging (MRI) Examination Gembong Pandhu Suprobo; Karmini Yupono; Rudy Vitraludyono
Journal of Anaesthesia and Pain Vol 2, No 2 (2021): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.02.05

Abstract

Dexmedetomidine, an α2 adrenergic agonist, has been commonly used as an off-label anesthetic adjuvant in various procedures and age groups. Lately, dexmedetomidine is increasingly preferred as sedation for pediatric patients undergoing MRI, which requires the patient to remain still in a deep sedation without disturbing airway patency. Dexmedetomidine administration via intranasal or buccal route is preferred for pediatric patients. Dexmedetomidine does not undergo significant pharmacokinetic changes when used in conjunction with other anesthetics, and has a good safety profile. It is 8-10 times more selective against α2 receptors than clonidine and produces sedation, analgesia, vasodilation, and bradycardia without significant airway and respiratory depression risk. Unlike other anesthetic agents, dexmedetomidine does not have any negative effect on brain development. Compared with propofol, dexmedetomidine has a longer onset and duration of action. Thus, dexmedetomidine can be used as the sole sedating agent in infants and children undergoing MRI procedures, with good sedation results and minimal side effects. However, correct dosing is very important given the side effects of bradycardia and hypotension that can occur with its use.
Regenerative Pain Medicine, the New Era of Interventional Pain Management, Restart Now! Mirza Koeshardiandi
Journal of Anaesthesia and Pain Vol 2, No 2 (2021): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.02.01

Abstract

Musculoskeletal conditions become the leading contributor of the total years lived disability (YLD) by causing 21.3% of the YLDs, after mental and behavioral problems.  Several musculoskeletal conditions give a disproportional impact on low back pain, one of the leading causes of disability. Lateral epicondylitis with a prevalence of  1-2%, commonly suffered by adults in their 30-65 years old. Epicondylitis was also suffered by a small population of athletes, such as professional tennis players (10% of epicondylitis population). The severe repetitive injuries that affect the individual daily activity also increase the daily health care cost.Osteoarthritis and tendinopathy often become the cause of pain and musculoskeletal disability. However, the etiology of pain in osteoarthritis is multifactorial. The incidence of osteoarthritis reaches 6% in 30 years old population and increases due to aging.Degenerative disease, the reduction of function or structure of the tissue or organ due to aging, encourages the pain specialist to perform a reliable pain management/therapy. Prolotherapy, especially dextrose prolotherapy, has become a promising technique by providing a safe degenerative therapy, easy to performed, and highly available in health facilities.  Nowadays, it is necessary to pay more attention to causative-based treatment strategies than symptom-based treatment. A multidisciplinary team is also needed to provide appropriate treatment.
Peranan C-Reactive Protein (CRP) pada Pasien Sepsis di Intensive Care Unit (ICU) Harri Kurnia Chandra; Arie Zainul Fatoni
Journal of Anaesthesia and Pain Vol 2, No 1 (2021): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.01.01

Abstract

Sepsis adalah suatu keadaan gawat darurat yang merupakan respons imunologis sistemik tubuh terhadap proses infeksi yang dapat berujung pada kerusakan organ dan kematian. Sepsis merupakan salah satu penyebab utama morbiditas dan mortalitas di seluruh dunia. Tatalaksana sepsis juga terus mengalami perubahan dari waktu ke waktu. C-reactive protein (CRP) merupakan salah satu marker inflamasi sederhana yang mudah dilakukan, memiliki sensitivitas yang cukup baik terhadap diagnosis sepsis.Kadar CRP yang tinggi telah dipelajari dalam kaitannya dengan prognosis dan mortalitas pada pasien sepsis di intensive care unit (ICU)
Management of Geriatric Anesthesia on Emergency Surgery Achmad Hariyanto; Isngadi Isngadi
Journal of Anaesthesia and Pain Vol 2, No 2 (2021): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.02.03

Abstract

In geriatric patients, emergency surgery is more common than elective surgery. The incidence of medical complications increases along with aging while the rate of surgical complications remains constant. Postoperative complications escalates short-term morbidity and mortality and also associated with decreasing long-term survival. The main purposes of geriatric patients' care were to maintain hemodynamics, speed up recovery, and perform an assessment to avoid any further decline in functional capacity. The choice of anesthesia and how to administer anesthesia agents should be adjusted for the geriatric patient.
Acute Respiratory Distress Syndrome (ARDS) pada Pneumonia COVID-19 Arie Zainul Fatoni; Ramacandra Rakhmatullah
Journal of Anaesthesia and Pain Vol 2, No 1 (2021): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.01.02

Abstract

Coronavirus disease 2019 (COVID-19) merupakan penyakit pernafasan akut yang ditandai dengan pneumonia dan gagal paru-paru. Agen penyebab COVID-19 telah dikonfirmasi sebagai virus korona baru, yang sekarang dikenal sebagai severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Acute respiratory distress syndrome (ARDS) adalah salah satu komplikasi COVID-19 yang paling sering dengan angka kematian yang cukup tinggi. ARDS muncul sebagai salah satu gambaran disfungsi organ pada fase hiperinflamasi COVID-19. Patofisiologi dan manifestasi klinis ARDS yang disebabkan COVID-19 memiliki perbedaan dengan ARDS pada umumnya. Oleh sebab itu, kami merekomendasikan manajemen ARDS pada COVID-19 disesuaikan dengan tipe ARDS yang terjadi sehingga dapat memperoleh luaran yang baik
Pulsed Radiofrequency Dorsal Root Ganglion-Fluoroscopy Guide for Lumbar Radicular Pain Nugroho Wicaksono
Journal of Anaesthesia and Pain Vol 2, No 2 (2021): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.02.02

Abstract

Background: Lumbosacral radicular pain is the most common neuropathic pain. Pulsed Radio Frequency (PRF) is a method that believes to be safe and effective for reducing pain.Case: A 43-year-old woman experiences chronic right lumbar radiculopathy due to Herniated nucleus pulposus (HNP) L4-5. Anamnesis and physical examination show a sign of neuropathic pain. The MRI examination shows a paracentral disc protrusion L4-5 that compresses the transversing nerve L5. The conservative management did not produce a satisfying result indicated by the patient still experience pain with the Numeric Rating Scale (NRS) 4-5. Patient unable to do activity properly. We perform pain management using the dorsal root ganglion L5 pulsed radiofrequency-fluoroscopy (PRF) and producing a positive outcome. Patients experience a decrease in pain intensity with NRS 1. The examination on one and two months post-intervention show an improvement. Patient able to do the daily activity with NRS 1-2.Conclusion: Pulsed radiofrequency dorsal root ganglion-fluoroscopy guide that relatively safe, minimum complications, and minimal side effects, making it the preferred treatment for chronic lumbar radicular pain.
Kombinasi Blok Pleksus Servikal Superfisial – Interskalenus untuk Operasi Fiksasi Klavikula pada Pasien dengan Pneumothoraks Ismail Hari Wahyu; Dwi Pantja Wibowo
Journal of Anaesthesia and Pain Vol 2, No 1 (2021): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.01.04

Abstract

Latar belakang: Operasi klavikula lebih sering dilakukan dalam anestesi umum. Fraktur klavikula dengan cedera penyerta pneumothoraks yang berukuran kecil dan tidak bergejala dapat menjadi tension pneumothoraks ketika mendapat ventilasi tekanan positif pada paru-paru setelah induksi anestesi umum. Kombinasi blok pleksus servikal superfisial–interskalenus diharapkan dapat memberi analgesia yang cukup dan menghindarkan pasien dari komplikasi paru yang lebih berat akibat anestesi umum. Kasus : Pasien pria 54 tahun mengalami nyeri dan bengkak pada bahu kiri akibat terjatuh. Pemeriksaan rontgen menunjukan adanya fraktur sepertiga tengah klavikula kiri. Pemeriksaan computed tomography (CT) scan dada menunjukan adanya kontusio paru, fraktur iga VIII-IX dan pneumothoraks minimal pada paru kiri. Dokter spesialis paru menatalaksana pneumothoraks secara konservatif karena berukuran kecil dan tidak bergejala. Pasien direncanakan menjalani operasi reduksi terbuka dan fiksasi internal klavikula kiri. Kami melakukan kombinasi blok pleksus servikal superfisial - interskalenus dengan panduan ultrasound untuk mendapatkan analgesia intra dan pasca operasi yang adekuat. Kesimpulan : Kombinasi blok pleksus servikal superfisial – interskalenus dengan panduan ultrasound dapat menjadi anestesi tunggal pada operasi fraktur klavikula. Metode ini menjadi alternatif anestesi umum terutama bagi pasien yang berisiko tinggi.

Page 3 of 13 | Total Record : 129

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