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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 125 Documents
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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.
Dexmedetomidine for Awake Intubation Procedure in Subtotal Thyroidectomy Riyanti, Riandini Pramudita; Hapsari, Paramita Putri
Journal of Anaesthesia and Pain Vol 3, No 2 (2022): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.02.04

Abstract

Background: Giant struma makes airway management difficult for the anesthesiologist due to the risk of tracheal intubation failure. Awake fiberoptic intubation(AFOI) is the gold standard in the management of a predicted difficult airway. Giving analgesia and sedation can facilitate operator and patient comfort during the awake intubation procedure.Case: We report the case of a 63-year-old woman with a giant struma who was planned for a subtotal thyroidectomy. We provide ondansetron and dexamethasone premedication, analgesia and sedation using dexmedetomidine, propofol induction, muscle relaxant atracurium, with maintenance anesthetic sevoflurane. Dexmedetomidine was administered on loading dose 0.8 µg /kg/hour in the first 10 minutes then continue on analgesia dose 0.2 µg /kg. During the AFOI procedure, 100% oxygenation was given with the patient's hemodynamic range, namely systolic blood pressure of 110-131 mmHg, diastolic blood pressure of 75-93 mmHg, heart rate of 77-91 beats per minute, and SpO2 of 98-100%. Postoperatively the patient was transferred to the Intensive care unit (ICU) with an endotracheal tube intube. Monitoring of postoperative complications such as production of thyroid crisis drainage and extubation 24 hours after surgery was confirmed by the cuff leak test.Conclusion: Giving dexmedetomidine is better than opioids in the AFOI procedure because of its minimal respiratory depressant effect. Maintaining hemodynamic stability during the AFOI procedure is very important to avoid hemodynamic fluctuations so it can minimize the risk of perioperative complications.
High Spinal Anesthesia in Total Knee Replacement Belinda, Febri Ahmad; Sumaryono, Hery Budi
Journal of Anaesthesia and Pain Vol 3, No 2 (2022): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.02.03

Abstract

Background: Osteoarthritis (OA) is the most common degenerative disease at people aged 63-70 years. Human ageing is associated with an increase in weakness around the joints, decreased joint flexibility, calcification of cartilage, and decreased chondrocyte function. Total knee replacement (TKR) is performed to treat pain and immobilisation in osteoarthritis patients. This procedure is done with spinal anaesthesia.Case: A 73 years old man diagnosed with bilateral OA and underwent TKR. The patient had left knee pain six months ago with a history of high blood pressure. If blood pressure <160/90 mmHg subarachnoid block was planed. The patient entered the operating room with an intravenous (IV) line of ringer lactate 10 dpm. Preoperatively, the patient was given ranitidine 50 mg IV and ondansetron 4 mg. The anaesthetic agent was hyperbaric bupivacaine 0.5% 15 mg + fentanyl 25 µg; the patient was hemodynamically monitored and maintained with O2 4 lpm. After 45 minutes of spinal anesthesia, the patient experienced respiratory distress, so we placed a masked and intubated the patient with endotracheal tube (ETT) 7.0. It is suspected that the patient had high spinal anesthesia.Conclusion: A 73-year-old man has been subjected to regional spinal anesthesia with total knee replacement surgery. However, spinal anesthesia failed and was converted to general anesthesia with ETT, with a duration of operation of 4 hours, hemodynamically stable, postoperatively the patient was admitted to the high care unit.
Perioperative Application of 2% Lidocaine Dewi, Fitri Hapsari; Nugroho, Andy; Muttaqin, Fandi Ahmad
Journal of Anaesthesia and Pain Vol 3, No 2 (2022): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.003.02.01

Abstract

Perioperative intravenous lidocaine (IVL) can help minimize opioid-related side effects that impede the postoperative recovery process. Neurological side effects were averaged at an 8 mg/kg dose, and cardiotoxicity side effects were reported at plasma values greater than 21 g/ml. Approximately 90% of lidocaine is converted to monoethylglycinexylidide (MEGX) in the liver via oxidative demethylation (dealkylation). Analysis of MEGX concentrations after lidocaine administration can be a method used to evaluate liver function. Perioperative intravenous lidocaine lowers discomfort, nausea, the duration of ileus, the need for opioids, and the length of time spent in the hospital after surgery. During injection, low blood concentrations can result in these symptoms, which may last for several hours or days after termination. Postoperative problems, such as pain and organ failure, can be caused by anti-inflammatory and pro-inflammatory components. Analgesic, anti-inflammatory, and anti-hyperalgesic are just some of the other effects of lidocaine. It also decreases the volume of the airways and the rate of breathing, prolongs the duration of exhalation, reduces the respiratory rate and tidal volume, also causes vasoconstriction at low concentrations and vasodilation at high concentrations. In clinical applications, lidocaine can prevent propofol injection pain, improve postoperative recovery, and play a role in various surgical procedures. Perioperative IVL application is proven to provide more benefits in various surgeries compared to other available anesthetic options. Very few studies have systematically analyzed the occurrence of side effects, and the quality of evidence is low. 
C-Section in Uncorrected Ventricular Septal Defect and Pulmonary Hypertension Management in Anesthesia Perspective Febrianti, Rizki Fitria; Supraptomo, Robertus Theodorus
Journal of Anaesthesia and Pain Vol 3, No 2 (2022): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.02.02

Abstract

Background: Pregnancy with cardiac defects and pulmonary hypertension happen 0.2% to 3% and is correlated with valuable hemodynamic burden due to cardiocirculatory changes which becomes a remarkable indirect cause of maternal mortality and poor fetal outcome. Ventricular septal defect (VSD) is one of the most common forms of heart disease among pregnant women, meanwhile the VSD-specific pregnancy data are insufficient. This case report addresses the anesthetics management for patient with uncorrected ventricular septal defect and pulmonary hypertension.Case: A 30-year-old multigravida with 37 weeks of gestation weighing 52 kg referred elective cesarean section and tubal ligation. She was compos mentis with arterial oxygen saturation was 87-88% room air. A grade IV/VI systolic murmur was heard at the second intercostal space of the left midclavicular line and the punctum maximum at the fourth intercostal spaces of the left sternal border. She had cyanotic in all of her extremities and clubbing fingers. Other examination is within normal limit. Titrated epidural was given at L1-2 level with parenteral levobupivacaine and fentanyl used as an adjuvant. The patient was stable during the surgery. Both maternal and fetal had a good outcome. The patient was discharged at the 7th day after surgery.Conclusion: To achieve a good outcome from management of the high-risk obstetric patients requires multidisciplinary approach involving anesthetist, obstetrician, and cardiologist in planning and managing the case. 
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.

Page 5 of 13 | Total Record : 125

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