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Solo Journal of Anesthesi, Pain and Critical Care
Published by Universitas Sebelas Maret
ISSN : 27761770     EISSN : 27970035     DOI : https://doi.org/10.20961
Core Subject : Health, Engineering,
Chemical Engineering, Chemistry & Bioengineering Health Professions Medicine & Pharmacology Nursing Public Health
Case Report, Original Research and Review Article in the scope of : Life Support Emergency and Trauma Cardiovascular Anesthesia Pediatric Anesthesia Neuro Anesthesia Pain Management Intensive Care Obstetry Anesthesia Geriatric and Oncology Anesthesia Regional Anesthesia Ambulatory Anesthesia
Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine
Articles 40 Documents
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Neonatal Resuscitation in Primary Health Care Facilities Gusti Ayu Putu Ika Bella Saptaning Astyari; Rabel Relianta Zagoto; Oby Mesakh Ngahu
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 2, No 1 (2022): April 2022
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v2i1.55491

Abstract

Background : Neonatal resuscitation is an action that must be done in the first minute when a newborn with severe asphyxia is born.Case Illustration : The case was infant  whom born spontaneously from 41 years old woman, G7P6A0 in primary health care facilities at Kokoda Utara District, with a condition did not cry or breathe, the skin color was bluish, there was no muscle tone, APGAR score was 0. Infant did not show any response, so we gave positive pressure ventilation using a bagging mask and chest compression with compression techniques by using both thumbs and other fingers around the chest supporting from the back, with a ratio of 3 compressions per 1 breath. After 60 minutes of resuscitation, the baby can cry loudly and the APGAR score is 10, heart rate was 140 beats per minute, breathing is 35 times per minute, SpO2 98%, blood glucose is 46 mg/Dl, body weight 2300 grams, body length 40 cm, head circumference 33 cm, chest circumference 32 cm, which indicates that the baby is no longer in asphyxia.Conclusion : Rapid initial assessment of the newborn and appropriate implementation of neonatal resuscitation determines success and reduces mortality.
Comparison of Magnesium Sulfat Gargle and Ketamine Gargle on The Incidence of Sore Throat and Cough After Extubation Ardana Tri Arianto; Sugeng Budi Santosa; Anindita Anindita
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 2, No 1 (2022): April 2022
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v2i1.55897

Abstract

Background : Postoperative sore throat (POST) or postoperative sore throat is one of the most common complications in patients receiving endotracheal intubation. The incidence of sore throat is reduced by administering mouthwash analgesics. The purpose of this study was to determine the difference in the effectiveness of magnesium sulfate gargle and ketamine gargle on the incidence of sore throat and cough after endotracheal extubation.Methods : The research was conducted at the Central Surgical Installation of RSUD Dr. Moewardi Surakarta, started in August 2020. This study is an experimental double-blind randomized control trial in patients undergoing general anesthesia after endotracheal extubation. Mann Whitney U test was used to process the data. The research group was divided into two groups, namely magnesium sulfate gargle (M) and ketamine gargle (K).Results : This study found a significant difference in sore throat when using magnesium sulfat gargle and ketamine gargle on the NRS scale. From the results of the study, there was a significant difference between magnesium sulfate and ketamine gargle at NRS 1 (p = 0.01) and NRS 6 (p = 0.022). In the incidence of cough, there were 7 patients in the magnesium sulfat group who had cough (30.4%) and 7 patients in the ketamine group who had cough (30.4%), the statistical test got p = 1,000 (p> 0.050).Conclusion : There is a significant difference in the incidence of sore throat which is lower in the administration of magnesium sulfate gargle compared to ketamine gargle and there is no significant difference between the administration of magnesium sulfate gargle and ketamine gargle on the incidence of cough after endotracheal extubation.
Perioperative Management of Chronic Kidney Disease Patients with Bowel Perforation Hafizh Nur Santoso; Dykall Naf'an Dzikri
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 2, No 1 (2022): April 2022
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v2i1.59180

Abstract

Background: Anesthesia management applied during surgery in patients with chronic kidney disease (CKD) is different from ordinary anesthetic management. It is known that currently, there are not many case reports discussing anesthetic management in patients with CKD.Case Illustration: A 70-year-old patient with abdominal colic et causa abdominal perforation complained of abdominal pain accompanied by heavy bowel movements and flatus throughout the abdominal area. The patient was anesthetized by regional anesthesia with local agent bupivacaine and treated with laparotomy. Bupivacaine is the first local anesthetic drug with an acceptable onset of action, long duration of action, and a tendency for the sensory block to be greater than its motor block.Conclusion: This case report explains the novelty of anesthetic management of CKD patients undergoing exploratory laparotomy surgery using the reported patient cases. Operations in patients with CKD are preferable to regional anesthesia.
Post-General Anesthesia Angioedema After General Anesthesia Mathilda Panggabean; Yutu Solihat
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 2, No 1 (2022): April 2022
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v2i1.59185

Abstract

Background: General anesthesia includes the administration of avariety medicines to patient/in/ fairly short/period. Numerous negative consequences can occur because of reaction from the drugs given, one example is anaphylaxis that may lead to death if not been recognized and handled quickly & promptly.Case Illustration: A sixty-seven years old male patient 152 cm 65 kg with multiple cholecystitis and obstructive jaundice, who was scheduled to undergo laparoscopic cholecystectomy. Patient had no records of allergy to medication and food. Family has no records to hypersensitive reactions or angioedema. At initial evaluation, blood pressure was 190/90 mmHg and hemoglobin 10,4 g/dL while the rest parameter was within normal limits. We given propofol and rocuronium to induce relaxation and facilitate intubation in surgery. Approximately 90 minutes after rocuronium injection, patient evolved angioedema across the face/area, tongue, and floor of the mouth. Patient also complained of not being able to talk. Soon after that, we give 10 mg of dexamethasone and 100 mg hydrocortisone to the patient. Within 60 minutes after hydrocortisone administration the patient shows/clinical improvement that marked by swelling began to decrease and the patient was able to speak again. Then we educate patient about angioedema and its alert.Conclusion: Anaphylaxis is a type of hypersensitivity response that take place to a particular allergen and mostly self-limited, but 11% of hypersensitive reaction require airway intervention. Most of anesthetic medication such as thiopental sodium, propofol, muscle relaxants, and etomidate may induce anaphylactic reaction during anesthesia induction. Discontinuation of underlying agent and airway control may prevent mortality and morbidity.
Anesthesia Management for Section Cesarean Delivery in Patient with Severe Mitral Stenosis Fanniyah Fanniyah; Isngadi Isngadi
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 2, No 1 (2022): April 2022
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v2i1.55441

Abstract

Background: Heart defects in pregnancy is one main nonobstetric factor causing morbidity and mortality in pregnant women. Mitral stenosis is common in pregnancy. The choice of anesthetic management has to consider hemodynamics, type of heart disease, and drugs used. Neuraxial anesthesia has been significantly used because it is considered safer than general anesthesiaCase: A 26-year-old woman with gestational age 32-34 weeks with severe mitral stenosis, moderate mitral regurgitation, severe tricuspid regurgitation, pulmonary hypertension, pericardial effusion, and atrial fibrillation underwent cesarean section with a low dose of spinal anesthesia using 5mg bupivacaine heavy 0.5% and Fentanyl 50 mcg. The sensory and motoric block was achieved in 5 minutes. Hemodynamic was stable during the perioperative phase. There was no heart failure or postoperative hemodynamic deterioration.Conclusion: Low-dose spinal anesthesia using 5 mg of bupivacaine and fentanyl adjuvant can be used in cesarean section in patients with severe mitral stenosis due to rapid onset, adequate block level, stable hemodynamic, block duration, and healthy born babies.Keywords: Pregnancy; mitral stenosis; C-section; neuraxial block; low dose
Combined Axillary Block with Spinal Block Anaesthesia Arsil Radiansyah; John Frans Sitepu; Luwih Bisono
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 2, No 2 (2022): October 2022
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v2i2.59188

Abstract

Background:  Patients undergoing upper limb trauma surgery have reported various benefits of regional anesthesia over general anesthesia, including better perioperative analgesia, less opiate use, less postoperative nausea and vomiting (PONV), and a shorter post-anesthesia care period. …………………………….. Case Illustration: We reported an evaluation of 72 years old, 165 cm height and 60 kg weight male patient who was planned for open reduction and internal fixation surgery for neglected left radius ulna close fracture and left neglected tibia fibula close fracture that he was beneath follow-up for hypertension (HT), and was using antihypertensive drugs. Preoperative risk of the patient was assessed as with American Society of Anesthesiologists (ASA) with score 3.General anesthesia would be unsafe due to geriatric issue, cardiovascular problem and delayed surgery term, we chosed to utilize combine axillary block with spinal block. we utilized USG guided infusion procedure in arrange to diminish local anesthetic dosage, and minimize error. During surgical procedure there is no hypotension, bradycardia or decreased oxygen saturation. Surgical anesthesia occurred in left hand within 20 minutes after drug delivery and 10 minutes in lower extremity. Surgery complications was not reported particularly related to vascular punction or adjacent anesthetic and nerve block applications. No complaint was detailed from the patient who was watched for 12 hours after the surgery.Conclusion: Peripheral nerve block and neuraxial block, when utilized appropriately in combination, appear be able to supplant common anesthesia within the larger part of case.
Anesthesia Management in Pregnancy with Heart Disorder using Walking Epidural Analgesia (WELA) Yoram Yudhatama
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 2, No 2 (2022): October 2022
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v2i2.59805

Abstract

Background: Heart disease in pregnancy is one of the leading causes of morbidity and mortality in pregnancy and childbirth. The intrapartum and postpartum periods are critical periods in which most of the deaths occur in this period. Manifestations appear in the form of heart failure which increases maternal and fetal morbidity and mortality.Case Illustration: We will report a case report of a 23-year-old woman with a diagnosis of G2P0A1 H 40 weeks, a single live intrauterine fetus with congestive heart failure due to rheumatic heart disease with mitral stenosis.Conclusion: The patient successfully underwent spontaneous labor under anesthesia facilitated by the walking epidural analgesia (WELA) technique with levobupivacaine and fentanyl agents which were administered continuously using a syringe pump during the labor process.
Spinal Anesthesia in Caesarean Section with Ovarian Cyst Permagna with Meigs Syndrome Aulia Iqbal; Susi Sembiring
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 2, No 2 (2022): October 2022
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v2i2.59961

Abstract

Background: The ovarian cyst is the very common cyst intra-abdominal in the ovary. If it need termination, the common procedure is cesarean section then the best anesthesia technique that suitable is spinal anesthesia. The Meigs Syndrome is an uncommon clinical condition, in which benign ovarian tumors are usually accompanied by ascites and pleural effusion. About 1% of ovarian tumors can indicate Meigs syndrome. Meigs Syndrome case have been reported in woman before 30 years old.Case Illustration: We reported an evaluation of a 29 years old woman, Gestational 1 Partus 3 Abortus 0, 60 kg weight and 165 cm height came to hospital with enlargement of abdomen since 3 months ago. There wasn’t history of bleeding and fluid discharged from genital. There’s no complaint in urination and defecation. The patient has felt an enlarged abdomen since the age of 7 months of pregnancy during antenatal care to a obstetrician. The patient hemodynamic and vital signs are stable and the pregnancy already in 37-38th week. Based on that the obstetrician decided to terminate the pregnancy, we choose to do spinal anesthesia in the cesarean section because it’s easy, common, and best technique for short surgical procedures.Conclusion: In patient with Ovarian Cysts Permagna with Meigs Syndrome in Pregnancy, we need to understand the risk of complication of ovarian cyst is higher in the prenatal period than after birth. The diagnosis of fetal ovarian cyst should not affect the schedule and method of delivery. The management of Meigs Syndrome in Pregnancy this time we terminate the pregnancy because it’s already in 37-38th week, the spinal anesthesia management is nothing different with the normal pregnancy.
The Relationship of Renal Resistive Index and Central Venous Pressure As Predictors of Acute Kidney Injury in Critically III Patients of Intensive Care Unit Adam Malik General Hospital Medan Muhammad Apriandi Wira; Achsanuddin Hanafie; Asmin Lubis; Bastian Lubis
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 2, No 2 (2022): October 2022
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v2i2.59946

Abstract

Background: Changes in the doppler-based renal resistive index (RRI) occur prior to the changes of glomerular filtration rate (GFR) during the development of acute kidney injury (AKI) and during the healing process from AKI. Central venous pressure (CVP) is not only a marker for resuscitation, but also can determine the microcirculatory perfusion pressure as outflow obstruction.Objective: This study aims to determine the relationship between RRI and CVP as a predictor of AKI in critically ill patients admitted to the intensive care unit (ICU) of Adam Malik General Hospital.Methods: This was an observational study with prospective cohort design and diagnostic test method. This research was conducted at the Adam Malik General Hospital Medan from June to July 2020. Forty patients aging 18-65 years old who met the diagnostic criteria of sepsis and septic shock were examined for RI and CVP when admitted to the ICU.Results: RI had better sensitivity and specificity than CVP in predicting the incidence of AKI (sensitivity 68% vs 59%, specificity 77% vs 55.5%, Receiver operating characteristics (ROC) 0.870 vs 0.321 (95% confidence interval)).Conclusion: Based on the results of this study, the renal resistive index has better sensitivity and specificity than central venous pressure in predicting the incidence of AKI in critical patients in the ICU.
Implementation of Enhanced Recovery After Caesarean Section (ERACS) in Elective Procedure : A Case Report Sardimon Sardimon; Yusmalinda Yusmalinda; Zafrullah Khany Jasa; Rahmi Rahmi; Fauzan Bachtiar Amin
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 2, No 2 (2022): October 2022
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v2i2.58950

Abstract

Background: Enhanced Recovery After Cesarean Section (ERACS) protocol includes every component of the pre-operative, intra-operative and post-operative pathway. In the pre-operative phase, the protocol applied to this patient included the shortest possible fasting interval, oral intake of liquid carbohydrate and patient counselling. For intra-operative pathway, the components applied are prevention of hypotension, maintenance of normothermia, optimal uterotonic administration, IONV (intra-operative nausea and vomiting)/PONV (post-operative nausea and vomiting) prophylaxis, multi-modal analgesia and optimization of fluid administration. Post-operatively, the patient was given early nutritional intake, early mobilization, urinary catheter removal, venous thrombo-embolism prophylaxis, multi-modal analgesia and glycemic control. ERACS prove useful for early discharge, improving outcomes such as breastfeeding or reducing post-discharge opioid use.Case Illustration: A 31-year-old woman came with the chief complaint of fluid discharge since ± 3 hours prior to admission to the hospital. Based on the medical history, physical examination, and laboratory findings, the patient was diagnosed with premature rupture of membranes in a gestational age of 37-38 weeks and had a live, single-headed presentation of the fetus. Patient’s physical status is ASA II and scheduled for elective C-section procedure with spinal anesthesia.Conclusion: The implementation of the ERACS protocol in this case has been shown to reduce the rate of infection and post operative complications as well as reducing length of stay for the mother.

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