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RACHMAT HIDAYAT
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Journal of Anesthesiology and Clinical Research
Published by HM Publisher
ISSN : -     EISSN : 27459497     DOI : https://doi.org/10.37275/jacr
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience
Journal of Anesthesiology and Clinical Research/JACR that focuses on anesthesiology; pain management; intensive care; emergency medicine; disaster management; pharmacology; physiology; clinical practice research; and palliative medicine.
Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine
Articles 123 Documents
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Post-C-Section Pain Management with the Enhanced Recovery after Surgery and Multimodal Analgesia Methods: A Case Series Poppy Novita Rini; Charles Wijaya Tan
Journal of Anesthesiology and Clinical Research Vol. 4 No. 1 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.266

Abstract

Introduction: This study aims to present the management of postoperative c-section pain using multimodal analgesia. Case presentation: There were two patients who received multimodal analgesia as a treatment for postoperative C-section pain. The first patient, a woman 15 years old, will undergo a Caesarean section operation with indications G1P0A0, term pregnancy, and cephalopelvic disproportion (CPD). The second patient, a 23-year-old woman, will undergo a Caesarean section operation with indications G1P0A0, term pregnancy, and 1x umbilical cord. Physical examination of both patients showed vital signs within normal limits. Laboratory evaluation within normal limits. Both patients were included in the ASA II category. The anesthetic method used intraoperatively was subarachnoid block with hyperbaric bupivacaine 0.5% 10 mg and morphine 50 mcg. Lidocaine infiltration injection is performed intraoperatively in combination with the following; lidocaine 2% (3 ampoules), dexamethasone 4 mg, ketorolac 60 mg, and morphine 4000 mcg dissolved in aquabides into 20 ml subcutaneously. Conclusion: A multimodal analgesia is an appropriate approach for postoperative pain management in patients undergoing cesarean section.
Neural Prolotherapy in Persistent Post-Surgery Pain: A Case Report Abdul Muttalib; Nur Surya Wirawan
Journal of Anesthesiology and Clinical Research Vol. 4 No. 1 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.268

Abstract

Introduction: Persistent postoperative pain is a clinical condition of discomfort (pain) and lasts more than 2 months after surgery without other causes, such as chronic infection or pain due to chronic conditions that occurred before surgery. This study aims to describe PPSP management and its outcomes. Case presentation: A woman, 54 years old, a housewife, came to the hospital with complaints of persistent pain from a surgical scar in the abdominal area. The pain has gotten worse in the last 3 months and sometimes feels like it's spreading to the area around the surgical wound. The pain is felt sharp and hot, spreads to the area around it, and is felt when resting, aggravated by activity experienced 5 months ago since the operation to remove the uterus. The patient was diagnosed with persistent post-surgical pain. Neural prolotherapy is performed on patients with PPSP indications. The drugs used are 5% dextrose solution and 2% lidocaine. Injection of 0.5-1 ml of dextrose was carried out in the area along the surgical scar and its surroundings. After the injection, the patient felt that the pain was reduced (numeric rating scale 1/10). Conclusion: Neural prolotherapy can be used in the management of patients with PPSP complaints. Treatment with neural prolotherapy injection using a mixture of D5% solution and lidocaine has a good prognosis for symptom improvement and relatively minimal complications.
Management of Postherpetic Neuralgia with Pulsed Radiofrequency Dorsal Root Ganglion: A Case Report Muh Dahlan; Alamsyah Ambo Ala Husain
Journal of Anesthesiology and Clinical Research Vol. 4 No. 1 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.269

Abstract

Introduction: Radiofrequency therapy is a minimally invasive procedure that has been used for about three decades to treat various chronic pain, such as postherpetic pain. This case study aims to describe the use of PRF in postherpetic neuralgia. Case presentation: A woman, 71 years old, came with complaints of right low back pain. Pain that is felt like burning, burning, sometimes pain feels like being stabbed, electrocuted, throbbing, and the pain will increase if the area of the skin is touched by a cloth. The pain began to be felt approximately 11 years ago. Physical examination shows vital signs; blood pressure 140/75 mmHg, pulse 76x/minute, respiratory rate 20x/minute, oxygen saturation 97%, temperature 36,5oC, numeric rating scale (NRS) 8-9/10. On examination of the right lumbar region, hypopigmented lesions appeared around the right waist at L3, L4, and L5 levels. No hyperemia and edema were found, and no obvious sensory loss. Assessment of pain score according to the Socrates method 8/10, S-LANSS score (self-report Leeds assessment of neuropathic symptoms and signs) 16. The patient has been diagnosed with postherpetic neuralgia. Patients were treated with a pulsed radiofrequency (PRF) procedure on the dorsal root ganglion (DRG). Pulsed radiofrequency was performed on the dorsal root ganglion at L1, L2, L3, and L4 levels. Concussion: The pulsed radiofrequency procedure on the dorsal root ganglion is a minimally invasive procedure that is effective and safe in treating postherpetic neuralgia pain. The use of imaging guidance in this procedure can improve the accuracy of needle tip placement and prevent side effects and complications.
Combination of Local Anesthetics and Corticosteroids as Pain Management in Supraspinatus Tendinitis: A Case Report Nurhayati Dumbela; Alamsyah Ambo Ala Husain
Journal of Anesthesiology and Clinical Research Vol. 4 No. 1 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.270

Abstract

Introduction: This study aimed to report the treatment of tendinitis in combination with local anesthetics and corticosteroids. Case presentation: A man, 34 years old, came to the hospital with complaints of pain in the right shoulder. This pain is felt especially when moving the right shoulder, and the patient also cannot raise his right hand. Pain when moving the right arm appeared after falling off a motorbike about 1 month ago. The intensity of pain has been getting higher for the last 14 days, especially when going to bed, so the patient complains of difficulty sleeping. The patient has been treated at the public health center for a month and has received pain relievers. Physical examination showed vital signs within normal limits and pain intensity of 8/10 based on the visual analogue scale. Examination of the extremity shows the abduction of pain starting at 60°-70° on activity and no pain on passive movement. In the special tests, the Neer test is positive, the Hawkin test is positive, and the Empty Can test is positive. The patient was diagnosed with supraspinatus tendinitis. The treatment for this patient is supraspinatus tendon injection. The anesthetic agent used was 2% lidocaine combined with 20 mg triamcinolone corticosteroids. This procedure is performed under ultrasound guidance for precise injection sites. Evaluation after the action found no side effects. After 1 month of action, the patient felt that the pain was greatly reduced (1/10) and the joint movement was not limited. Conclusion: The use of a combination of triamcinolone and lidocaine is beneficial in reducing pain in cases of supraspinatus tendinitis.
Ablation of Rami Communicans in Patients with Symptomatic Schmorl's Nodes: A Case Report Henny Widyastuti
Journal of Anesthesiology and Clinical Research Vol. 4 No. 1 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.271

Abstract

Introduction: Schmorl's node is a herniation or extrusion of an intervertebral disc nucleus into the end plate of an adjacent vertebral body. This case study aims to report a patient with symptoms of axial pain followed by MRI overview that supports the clinical symptoms. Presentation case: A man, 36 years old, working as a soldier, came to the hospital with complaints of low back pain. The patient is referred by an orthopedic doctor. The patient complained of lower back pain 2 years ago. Initially, the pain was intermittent, but in recent months it has been continuous. The pain gets worse when the patient gets out of bed, moves, and performs movements such as bowing, breathing, and coughing. The pain subsides when the patient is in a lying position. Physical examination showed pain intensity based on a visual analogue scale (VAS) 8-9/10. Examination of the extremities showed 5/6 motor strength in all extremities. Facet loading test: positive extension, forward bending (+). Anteroposterior/lateral lumbosacral X-ray examination showed no abnormalities. MRI examination showed degenerative disc disease and Schmorl's nodes corpus VL 1-2-4-5 (Figure 1). The patient was diagnosed with chronic discogenic et causa Schmorl’s node pain. Conclusion: Ablation of rami communicans is useful in the management of Schmorl's node pain.
Current Anesthesia Management of Congenital Diaphragmatic Hernia: A Narrative Literature Review Syukur, Rusmin Bolo; Elizeus Hanindito
Journal of Anesthesiology and Clinical Research Vol. 4 No. 2 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v5i1.276

Abstract

Congenital diaphragmatic hernia (CDH) is a congenital disorder characterized by a defect in the diaphragm, which causes the contents of the stomach to protrude into the chest cavity. Increased survival of CDH patients related to initial management in the form of a ventilator strategy, management of pulmonary hypertension, improvement of surgical and anesthetic techniques, and use of extracorporeal membrane oxygenation (ECMO) when indicated. Early stabilization of the patient is a priority before performing a surgical intervention for the hernia organ. This narrative literature review aimed to explain the current management, especially in the field of anesthesia in a congenital diaphragmatic hernia. In conclusion, the current management aims to improve survival rates and reduce the morphology of CDH patients.
Non-Sleep Non-Apnea Nasal Fiber Optic Intubation for Difficult Airway Management: A Case Series Bora, Fivilia Anjelina; I Made Gede Widnyana
Journal of Anesthesiology and Clinical Research Vol. 4 No. 2 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.297

Abstract

Introduction: Patients with tumors on the neck and mouth are known to be at risk for difficult intubation. Failing to secure the airway can lead to increased patient morbidity and mortality. This study aimed to present a case series with non-sleep non-apnea fiber optic intubation for difficult airway management. Case presentation: In this paper, we present three patients; a 57-year-old woman, a 59-year-old man, and a 68-year-old woman who have airway problems with a tumor located on their neck and mouth but were successfully intubated by non-sleep non-apnea nasal fiber optic intubation, one of airway management technique. Good visualization was achieved by fiber optic devices. Preparing the patient holistically and systematically during the perioperative period was the other important thing to do. MOANS score and LEMON score are used to predict the potential event of a difficult airway preoperatively. These scores help the physician to decide what step will be done with the patient. Conclusion: Anesthetic morbidity and mortality can be reduced with better preoperative evaluation and clear guidelines and practice for difficult intubation.
Validity of Acute Physiology and Chronic Health Evaluation (APACHE) IV for the Prediction of Prolonged Intensive Care Unit (ICU) Length of Stay in Dr. Sardjito General Hospital in the COVID Era Muhammad Mufti Sofyanoor; Widyastuti, Yunita; Juni Kurniawaty; Djayanti Sari
Journal of Anesthesiology and Clinical Research Vol. 4 No. 2 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.302

Abstract

Introduction: APACHE IV was a good predictor of ICU length of stay in the USA and some countries outside the USA but poor in others. It is important to develop a scoring system for the Indonesian population, especially in this scope, Dr. Sardjito General Hospital. To develop such a scoring system, it is reasonable to study the validity of APACHE IV in ICU Dr. Sardjito General Hospital for predicting prolonged length of stay. Methods: A retrospective cohort observational study using data from January 1st, 2020, to December 31st, 2020, taken from the ICU of Dr. Sardjito General Hospital. The data are the patient's observed ICU LOS and data required in calculating APACHE IV score and ICU LOS prediction. Discrimination is calculated using the area under (AUC) the receiver operating characteristic curve (ROC) and calibration by the Hosmer-Lemeshow test. Results: Samples were 329 patients. APACHE IV ICU length of stay prediction showed moderate discriminatory ability (AUC-ROC: 0.74) and poor calibration (p <0.001) to predict prolonged ICU stay. The APACHE IV score has a strong discriminatory ability (AUC-ROC: 0.83). Using the DeLong method, the AUC from ROC APACHE IV score was greater than the AUC from ROC predicted length of stay in APACHE IV ICU (p <0.001). APACHE IV predicted ICU length of stay overestimated observed ICU length of stay. Conclusion: APACHE IV ICU length of stay prediction has moderate discrimination and poor calibration to predict prolonged ICU stay. The APACHE IV score has better discrimination than the APACHE IV ICU length of stay prediction in predicting prolonged ICU stay.
Anesthetic Management of Wilms’ Tumor Patient Using Thoracal Epidural Block: A Case Report Tenggara, Alamsyah; Dewa Ayu Mas Shintya Dewi
Journal of Anesthesiology and Clinical Research Vol. 4 No. 2 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.306

Abstract

Introduction: Wilms’ tumor or nephroblastoma is an embryonal tumor that develops from the remaining immature kidney and is the fourth most common primary renal tumor malignancy in children. An asymptomatic abdominal mass is present in more than 90% and hematuria in 30% of patients. Preoperative workup includes complete laboratory blood tests and imaging to ensure intrarenal mass. This study aimed to describe the anesthetic management of Wilms’ tumor patients. Case presentation: A two-year-old girl was diagnosed with Wilms' tumor with the main complaint of intermittent hematuria. An abdominal CT scan showed an enlargement mass in the right kidney with a size of +/- 7.4 x 5.9 x 9.5 cm. The patient was planned for radical nephrectomy. In addition to general anesthesia, an epidural catheter is placed at the 10th-11th thoracic level (T10-T11). Conclusion: Epidural placement in pediatrics undergoing abdomen surgery have various beneficial considerations, such as superior analgesia, minimal opioid use, reduced intraoperative bleeding, and decreased postoperative ventilator requirements.
Epidural Anaesthesia Technique in Caesarean Section Operation in Pregnant Patients with Rheumatic Heart Disease and Severe Mitral Stenosis Wangsa, Aditya; FX Adinda Putra Pradhana; Tjahya Aryasa EM; Cynthia Dewi Sinardja
Journal of Anesthesiology and Clinical Research Vol. 4 No. 2 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.324

Abstract

Introduction: Mitral stenosis (MS) is the most common form of rheumatic heart disease (RHD). Pregnant women with moderate/severe MS are more prone to heart failure and pulmonary edema than normal pregnant women. It is very important to prevent the potential for maternal heart failure before delivery. This study aimed to present a case report on the epidural anaesthesia technique in caesarean section in pregnant patients with rheumatic heart disease and severe mitral stenosis. Case presentation: A 31-year-old pregnant woman patient came to the hospital with complaints of shortness of breath and found rheumatic heart disease and severe mitral stenosis. The patient was premedicated with fentanyl 50 mcg and midazolam 1 mg intravenously, followed by oxygen supplementation with a 2 lpm nasal cannula. Anaesthesia was performed using a lumbar epidural technique, with the insertion of an epidural catheter in the L1-L2 intervertebral space, targeting the T10-L1 dermatome and T6-L1 target of the viscerotome. The local anaesthesia agent chosen was plain bupivacaine with a concentration of 0.5% and a volume of 25 ml. The onset of action of epidural anaesthesia is achieved within 15 minutes as long as the operation is reached a total blockade as high as T6. During surgery, the patient is monitored with standard monitors and an artery line. There were no complaints of shortness of breath felt by the patient during the operation. Conclusion: Epidural anaesthesia technique can be performed safely in pregnant women with comorbid mitral regurgitation and atrial fibrillation, with good intraoperative hemodynamic stability.

Page 5 of 13 | Total Record : 123

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