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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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Comparison of Blockbuster LMA with Air Q LMA for Success of Blind Tracheal Intubation in Patients Undergoing General Anesthesia Endigeri, Archana; Hulakund, Shivanand; Rajanna, Raghavendra; Ganeshnavar, Anilkumar; Kelageri, Satish; Teja, Palluri Sai
Journal of Anaesthesia and Pain Vol 4, No 2 (2023): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2023.004.02.03

Abstract

Background: Blockbuster Laryngeal mask airway (LMA) is a device gaining popularity in airway management, and advantageous in ventilation and intubation. Air Q LMA is a supraglottic airway device with a shorter and wider breathing tube designed for ventilation as well as intubation in difficult airway. We aimed to evaluate the success of tracheal intubation using these devices.Methods: Overall 80 participants aged 18-60 years with ASA I and II were randomized into Group A (Air Q LMA) and Group B (Blockbuster LMA) using computer generated random numbers. The objectives of our study were to evaluate first pass successful intubation, ease, time and attempts taken for device insertion, oropharyngeal leak pressure, time for LMA removal and post operative complications. Association between variables were assessed with chi square test and unpaired t test.Result: There was a statistically significant difference in the first pass successful intubation between the groups which was higher in Group B (90%) than Group A (60%) (P<0.001), the overall successful intubation was more in Group B 97.5% compared to Group A 85%. The device insertion was easy in 85% patients in Group A and 95% patients in Group B. The time taken for introduction of Air Q was longer (38.15±4.92sec) when compared with blockbuster LMA (26.25±4.44sec), (P<0.001).  Mean Oropharyngeal leak pressure of blockbuster LMA (32.40±3.99cmH2O) was greater than Air Q LMA (29.10±2.61cmH2O), (P<0.001).Conclusion: Blockbuster LMA provides greater success of blind tracheal intubation when compared to air Q LMA.
Serratus Anterior Block as Analgesia in Post-Thoracotomy Patients: Serial Case Parathon, Nugroho Satya; Basuki, Djudjuk Rahmad
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

Abstract

Providing analgesia in postoperative period for those undergone thoracotomy is chalenging, because nessesity to relieve postoperative pain and to prevent pulmonary complication following thoracotomy. Analgesic options for thoracotomy are various with each having benefits and disadvantages. It is mentioned that thoracic epidural is the gold standard for management of thoracotomy pain. Other option include paravertebral block, interpleural block, intrathecal opioid. Serratus anterior plane block (SAPB) is a relatively new compartment block technique for thoracic wall pain first developed in 2013 by Blanco et al. SAPB is a sensory nerve block that provides analgesia to the ipsilateral hemithorax form second thoracic (T2) to T9 dermatomes. SAPB has ben used in several procedure such as breast surgery, thoracoscopy, rib fracture analgesia, and shoulder injury as a good alternative analgesic method after thoracoscopic surgeries.This case series found that SAPB was an effective as post-operative analgesia after thoracotomy with good efficacy. Further investigation is still needed to determine the role of SAPB in the management of a variety of patients with acutely painful conditions and to understand possible side effects that my arise. 
Neuroanesthesia Management in Transspenoidal Pituitary Cyst Surgery Subagyo, Houdini Pradanawan; Nofiyanto, Eko
Journal of Anaesthesia and Pain Vol 5, No 1 (2024): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.01.03

Abstract

Background: Neuroanesthesia management of patients with masses in the sella area undergoing transspenoidal surgery is a challenge for anesthesiologists. Good preoperative, intraoperative and postoperative management is shown to improve the patient’s quality of life.Case: A 45-year-old man with chief complaints of headache and visual disturbances, from the results of the vision examination obtained visus 1/60 (count fingers) and narrowed visual field area. From computerized tomography (CT) scan and Magnetic resonance imaging (MRI) images of the Head obtained a picture of cystic mass of the suprasellar sella pressing the optic chiasm. The patient was planned for surgical excision of pituitary cyst per transspenoidal. The patient underwent general anesthesia with endotracheal intubation with intravenous induction fentanyl, propofol, atracurium and lidocaine, followed by maintenance with sevoflurane inhalation agent with 60% oxygen. During the operation the hemodynamic condition was stable and postoperatively the patient was extubated in the operating room and then treated in the intensive care unit.Conclusion: In pituitary cyst patients undergoing transspenoidal surgery, the preoperative evaluation is mainly aimed at airway assessment, neurological disorders and hormonal disorders in patients. During intraoperative, the anesthesiologist is expected to optimize cerebral oxygenation, maintain hemodynamic stability, facilitate the surgical area, prevent and manage intraoperative complications and rapid recovery of consciousness. Postoperatively a good neuroendocrine evaluation is required
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.
Pain and Complications Assessment in Gynecological Cancer Brachytherapy Patients Under Spinal Anesthesia Setiawan, Alfredo Abrian Erlangga; Fitrisyah, Aidyl; Zainal, Rizal; Santoso, Budi; Laeto, Arwan Bin
Journal of Anaesthesia and Pain Vol 4, No 3 (2023): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2023.004.03.03

Abstract

Background: Brachytherapy is a radiation therapy that can deliver radiation to cancer by minimizing radiation exposure to adjacent organs or tissues. In its implementation, brachytherapy can cause pain so that adequate anesthesia is needed in order to get optimal results. This study was aimed to determine the adequacy of anesthesia and complications that occur in gynecological cancer patients undergoing brachytherapy with spinal anesthesia.Methods: A descriptive observational study using primary data that taken by interviewing the patients who underwent gynecological brachytherapy under spinal anesthesia at dr. Mohammad Hoesin Palembang. The number of samples in this study that met the inclusion criteria was 18 subjects. Pain was assessed using an 11-point numeric rating scale. Data were collected in 5 different times, before procedure, during applicator insertion, during radiation process, during applicator removal, and 4 hours after brachytherapy. in addition, all complications that occurred during the procedure were recorded. Data were analyzed to describe the mean, median, minimum, and maximum of pain scores.Result: The average pain score before brachytherapy was 0.78, at the time of applicator insertion was 0, 0.28 at irradiation, 0,11 at removal of the applicator and 1.33 after the brachytherapy procedure. The most common complications were back pain (27.8%) and urinary retention (27.8%).Conclusion: For most patients, high dose rate (HDR) brachytherapy under spinal anesthesia was well tolerated, in fact most patients experienced no pain and no significant life-threatening complications. The post-brachytherapy pain score had the highest average score. Then, back pain and urinary retention were the most common complications.
Scorpion Envenomation: The Cause of Inadequate Subarachnoid Block - A Case Series Pakhare, Vandana Patilbuwa; Nanda, Ananya; Priyanka, Reddy Devi Sai; Gopinath, Ramchandran
Journal of Anaesthesia and Pain Vol 4, No 2 (2023): May
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2023.004.02.05

Abstract

Background: Failure of neuraxial or regional anaesthesia can result from factors such as drug errors, technical inefficiencies, and poor patient positioning. While these causes are well-known, resistance to local anaesthetic action due to mutations in sodium channels or scorpion sting is a lesser-known contributor to block failure. In India, a tropical country with a significant number of patients presenting for surgical procedures, a history of scorpion bites is not uncommon.Case: We observed seven cases of failed regional anesthesia who had history of scorpion sting. All the patients received intrathecal bupivacaine by experienced anesthesiologists, of seven patients five patients did not develop sensory or motor block. One patient had delayed successful subarachnoid block after second attempt and one patient had successful block at first attempt.Conclusion: Our observations revealed instances of failed spinal blocks, despite adequate drug dosages and experienced anesthesiologists performing the procedures, in patients with a history of scorpion envenomation. Accordingly, our study concludes that obtaining a thorough scorpion sting history during pre-anesthesia check-ups, particularly in endemic areas, can effectively prevent unnecessary repeated pinpricks, escalating dosages, patient and surgeon discomfort, and skepticism towards the skills of anesthesiologists.
Fluid Management for Critically Ill Patients, Based on the ROSE Concept, an Old Method but Effective Enough Agustina, Ayu Yesi; Wisudarti, Calcarina Fitriani Retno; Widodo, Untung
Journal of Anaesthesia and Pain Vol 5, No 1 (2024): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.01.02

Abstract

Fluid therapy is one of the most essential things in managing critical patients, such as ICU patients. Although it seems simple, this is difficult to do in this group of patients. The fluid needs of ICU patients vary according to the course of the disease. Therefore, fluids must be given according to individual needs, and each phase of the disease must be reassessed. To support this, there is a conceptual model that explains fluid administration based on the phases of the disease that the patient is going through. The ROSE concept (resuscitation, optimization, stabilization, and evacuation) describes the phases of a patient's illness and how fluids should be administered. In the resuscitation phase, the goal is lifesaving and is achieved by positive fluid balance. In the optimization phase, fluid balance is neutral and aims to save organs. In the stabilization phase, the fluid balance has started to move in a negative direction and aims to support the organs. Finally, in the evacuation phase, fluid balance is negative and organ repair has occurred. By implementing this model, it is hoped that ICU patients will have better outcomes
Patients Perceptions of Opioid Use for Chronic Lower Back Pain in Rural Guatemala Ruan, Tiffany; Puga, Troy Brian; Onwenu, Jason; Amani, Tafadzwa; Tyler, Robert
Journal of Anaesthesia and Pain Vol 4, No 3 (2023): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2023.004.03.01

Abstract

Background: Chronic lower back pain is a common cause of disability. Opioids, although not first-line treatment, are often prescribed for chronic lower back pain. The purpose of this study is to understand the perceptions of opioids among the rural Guatemalan population for chronic low back pain to best optimize a shared decision-making process in pain management. Methods: Participants were given a survey regarding demographic information, whether they were offered an opioid prescription for chronic lower back pain, and whether they would take the medication if offered. Participants completed the Prescription Opioid Overdose Knowledge Score (Rx-OOKS) questionnaire, to evaluate knowledge of opioid overdose.Result: The survey results showed that 93.3% of participants were never offered an opioid prescription for chronic low back pain by a provider in Guatemala. However, a majority would have taken an opioid if given the opportunity. Scores on the Rx-OOKS revealed a statistically significant lower mean (p< 0.05) than the United States’ study baseline for the knowledge of signs of prescription opioid overdose construct, actions to take in the opioid overdose construct, and total score construct.Conclusion: This research study was able to show that although there is a low prevalence of opioid use in rural Guatemala and decreased knowledge of opioid overdose. Thus, physicians and other healthcare providers must do their due diligence to educate their communities about opioid use, opioid overdose, and naloxone use for a potential overdose. This process is essential in the development of a shared decision-making process for pain management.
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.
Assessment of Quality of Pain and Patient Satisfaction using ASSIST Questionnaire Following Intraperitoneal Instillation of Ropivacaine Compared with the Addition of Adjuncts Ketamine versus Dexmedetomidine in Laparoscopic Cholecystectomy patients Kapoor, Ruchi; Dua, Steffi; Saxena, Ashok Kumar
Journal of Anaesthesia and Pain Vol 5, No 1 (2024): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.01.01

Abstract

Background: Evaluation of patient satisfaction score and to assess quality of pain relief following intraperitoneal instillation of Ropivacaine with adjuncts Dexmedetomidine vs Ketamine using modified version of revised APS-POQ in patients undergoing laparoscopic cholecystectomy.Methods: Sixty patients undergoing laparoscopic cholecystectomy were randomised into three groups of  20 each and received Ropivacaine 0.2 % (group R), Ropivacaine 0.2 % with Dexmedetomidine 0.7µg/ kg (group RD) and Ropivacaine with Ketamine 0.5 mg/kg (group RK) in a total volume of 40 ml. Pain severity, subjective pain complaints, pain interference in physical activity, and patient's and caregiver's satisfaction were evaluated using a modified version of the revised APS-POQ at 24 hours postoperatively.Result: Mean pain scores for worst pain were observed to be least in Group RD, with mean values being 1.75±1.743, followed by 5.45±1.701 in Group R and mean value of 5.60±0.754 in Group RK. Mean patient satisfaction scores were found to be highest in Group RD (94.00±8.826), followed by Group R (80.00±15.218), and least in Group RK (78.50±12.258). This difference was observed to be statistically significant (p<0.05) in all groups. Primary care physicians caring for the RD group had higher satisfaction scores (9.40±0.883) compared to Group RK (7.85±1.226) and Group R (8.05±1.468)Conclusion: Quality of pain relief improved the best with Dexmedetomidine followed by Ketamine and least when Ropivacaine used alone for intraperitoneal instillation. The overall patients' satisfaction was found to be more with Ropivacaine with Dexmedetomidine when compared to Ropivacaine alone or with Ketamine

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