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Septian Adi Permana
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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 75 Documents
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Functional and Quality of Life Outcomes of Multimodal Pain Management in Head and Neck Cancer Patients: A Case Series Ocktarini, Rizky; Mahmud, Mahmud
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 5, No 1 (2025): April 2025
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v5i1.91795

Abstract

Background: Head and neck cancer (HNC) is the sixth most common cancer globally. Patients often experience severe pain, impacting their functional status and quality of life (QoL). Multimodal pain management in head and neck cancer (HNC) is an evidence-based, integrated strategy that combines pharmacological interventions, interventional techniques, and non-drug therapies to target multiple pain pathways simultaneously, thereby optimizing relief while minimizing side effects and improving quality of life.Methods: This retrospective cohort study analyzed nasopharyngeal carcinoma (NPC) patients at Dr. Sardjito General Hospital (January-June 2023). Inclusion required histologically confirmed NPC with informed consent; exclusion criteria were life-limiting comorbidities or pre-terminal status. We assessed Karnofsky Performance Status (KPS), EORTC QLQ-C30, and Visual Analogue Scale (VAS) at baseline, 1-month, and 12-month intervals. Pain management strategies (pharmacological, physical therapy, psychosocial) were evaluated. Statistical analysis used paired t-tests with Bonferroni correction (SPSS v27; significance p<0.05). Ethical approval was obtained (KE-FK-1413-EC-2023).Results: Out of 23 initial candidates, 12 patients were included in the final analysis. Significant improvements were observed across all parameters: EORTC QLQ-C30 scores increased from a mean baseline of 69.6 to 88.6 at 1 month and 89.7 at 12 months (p < 0.01), KPS scores improved from 75 to 85 and 90 (p < 0.05), and VAS scores decreased from 8 to 5 and 3 (p < 0.05).Conclusion: A multimodal pain management approach significantly improves pain control and QoL in NPC patients. The combined use of NSAIDs, opioids, adjuvant medications, psychosocial support, and physical therapy demonstrates efficacy in managing pain and enhancing patient well-being.
Extracorporeal Liver Support in Liver Failure: A Comprehensive Review of MARS, SPAD, Prometheus, ADVOS, and Bioartificial Systems Synthana, Meta Restu; Jufan, Akhmad Yun; Wisudarti, Calcarina Fitriani Retno; Deviatika, Fiandila Elvana
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 5, No 2 (2025): October 2025
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v5i2.107158

Abstract

Background : Acute and chronic liver failure are life-threatening conditions often requiring liver transplantation as definitive therapy. To delay or substitute the need for transplantation, various extracorporeal liver support systems have been developed. This article aims to review current artificial and bioartificial liver support systems including the Molecular Adsorbent Recirculating System (MARS), Single Pass Albumin Dialysis (SPAD), Prometheus, ADVanced Organ Support (ADVOS), and Bioartificial Liver (BAL) devices.Discussion : MARS and SPAD utilize albumin-based dialysis to remove protein-bound and water-soluble toxins. Prometheus applies a fractionated plasma separation and adsorption approach, while ADVOS enables individualized acid-base correction. Bioartificial liver systems integrate hepatocyte bioreactors with plasma dialysis to provide more physiological metabolic support. While these systems show promise in improving clinical outcomes, long-term survival benefit remains under investigation.Conclusion :  Extracorporeal liver support systems offer essential bridging and supportive therapies for patients with liver failure. Selection should be tailored to patient condition, therapeutic goals, and technology availability.
Anesthetic Management for Atrial Septal Defect Closure in a Patient with Bidirectional Shunt and Pulmonary Hypertension Hapsari, Paramita Putri; Kurniawaty, Juni
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 4, No 1 (2024): April 2024
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v4i1.82249

Abstract

Background : ASD bidirectional shunt occurs when flow moves between left and right depending on the higher pressure, either systemic vascular resistance (SVR) or pulmonary vascular resistance (PVR). The anesthetic management aimed to maintain the left-to-right shunt and control factors that could increase PVR while retaining SVR within normal or slightly elevated ranges.Case Illustration : We reported a 39-year-old female patient with ASD, bidirectional shunt, and pulmonary hypertension (PH) who underwent defect closure. Due to the mean pulmonary pressure exceeded 50% of mean systemic pressure, an intentional ASD creation was performed. It is not a routine procedure; however, it serves as a “way out” if there is severe left ventricular dysfunction. Attention and intervention were promptly administered for any identified post-surgical issues, including PH crisis or right ventricular dysfunction. The management of PH was conducted during perioperative period and the patient was successfully extubated at 17 hours post-surgery.Conclusion : Perioperative management of bidirectional shun ASD with PH requires a SVR and PVR. Factors that can increase PVR must be avoided/controlled and on the other hand SVR must be maintained.
Therapeutic Plasma Exchange (TPE) Response in Thrombotic Thrombocytopenic Purpura (TTP): A Case Report Santoso, Jony; Permana, Septian Adi
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 5, No 1 (2025): April 2025
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v5i1.91331

Abstract

Background: Thrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy. It derives from a severe deficiency of disintegrin-like metalloproteinase with thrombospondin motif type 1 member 13-regulates (ADAMTS13). This case report aims to describe how therapeutic plasma exchange (TPE) with steroids can improve good clinical outcomes in TTP.Case Illustration: A 72-year-old male presented to the emergency department with complaints of fever persisting for 1 week. The patient also complained of a productive cough and shortness of breath. Patient was found apathetic (E3M6V4) and fever (38.1°C). Other vital signs were normal. Thorax examination revealed minimal bilateral basal crackles. Minimal pitting-edema was found in both lower extremities. Patient underwent complete blood count that indicates leukocytosis (shift to the left), thrombocytopenia, hypoalbuminemia, and impaired renal function tests. Chest X-Ray revealed pulmonary edema in both lungs and infiltrates with air-bronchogram in the right paracardiac area. Diagnosis of TTP was established based on history and physical examinations related to TTP pentad criteria (fever, thrombocytopenia, microangiopathic hemolytic anemia, neurological abnormalities, and impaired renal function tests). Patient was then treated with TPE and steroids. Symptomatic treatments for the patient's complaints were given. Patient was then discharged from hospital after treatments.Conclusion: This study provides a review of the expected course of treatment for patients with TTP. Treatment using TPE and steroids can increase platelet counts resulting in significant clinical improvements.
Combating Respiratory Failure in Guillain–Barré Syndrome within a Resource-Limited Rural ICU: A 7-Month Weaning Journey Handoko, Felicia; Kasmantinno, Emmanuel Nera Kurnia; Kurniasari, Pande Nyoman; Swarningasih, I Gusti Ayu Ketut; Rakateja, Made Bayu Agastia; Amanda, Astrid Priscilla
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 5, No 2 (2025): October 2025
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v5i2.91577

Abstract

Background : Respiratory failure in Guillain–Barré syndrome (GBS) is the most dangerous complication. Approximately 22% of patients with GBS require a mechanical ventilation (MV) within the first week of hospital admission. Management of the patient with prolonged MV during ICU stay has been challenging, especially in resource-limited rural areas. The important consideration is the patient's ability to regain spontaneous breathing to evaluate the readiness to wean and the optimal time for deciding to decannulation.Case Illustration : We reported a case about the management of respiratory failure due to GBS in the ICU involving a 37-year-old woman presented to the emergency room due to rapidly progressive weakness. The patient was treated with a 5-day course of intravenous immunoglobulin (IVIG). After 25days with a MV, the patient underwent bedside PDT as a choice for critically ill patients who require prolonged MV in the ICU. The patient's motor development during the treatment period in the ICU showed a slow progression. There was no further significant progress in the patient's motor development for up to six months. Furthermore, on day 183 of the treatment, muscle recovery began to become obvious. We found a successful liberation of dependency after 207 days on MV and successful decannulation of the tracheostomy tube on day 215 in a hospital with limited facilities in rural areas. The patient was transferred from the ICU to the ward on day 217 and discharged on day 219. A one-month follow-up showed there were no respiratory complaints.Conclusion: Long-term care for a GBS patient with prolonged MV in the ICU requires a multidisciplinary team approach, including optimization of treatment, nutrition, rehabilitation as well as psychological support. Comprehensive ICU care is the key to success in our case.

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