Pub Date : 2022-04-30DOI: 10.20961/soja.v2i1.55441
Fanniyah Fanniyah, I. Isngadi
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
{"title":"Anesthesia Management for Section Cesarean Delivery in Patient with Severe Mitral Stenosis","authors":"Fanniyah Fanniyah, I. Isngadi","doi":"10.20961/soja.v2i1.55441","DOIUrl":"https://doi.org/10.20961/soja.v2i1.55441","url":null,"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","PeriodicalId":345991,"journal":{"name":"Solo Journal of Anesthesi, Pain and Critical Care (SOJA)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115865935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-30DOI: 10.20961/soja.v2i1.59180
Hafizh Nur Santoso, Dykall Naf’an Dzikri
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.
{"title":"Perioperative Management of Chronic Kidney Disease Patients with Bowel Perforation","authors":"Hafizh Nur Santoso, Dykall Naf’an Dzikri","doi":"10.20961/soja.v2i1.59180","DOIUrl":"https://doi.org/10.20961/soja.v2i1.59180","url":null,"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.","PeriodicalId":345991,"journal":{"name":"Solo Journal of Anesthesi, Pain and Critical Care (SOJA)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124695035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-30DOI: 10.20961/soja.v2i1.59185
Mathilda Panggabean, Yutu Solihat
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.
{"title":"Post-General Anesthesia Angioedema After General Anesthesia","authors":"Mathilda Panggabean, Yutu Solihat","doi":"10.20961/soja.v2i1.59185","DOIUrl":"https://doi.org/10.20961/soja.v2i1.59185","url":null,"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.","PeriodicalId":345991,"journal":{"name":"Solo Journal of Anesthesi, Pain and Critical Care (SOJA)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114053790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-30DOI: 10.20961/soja.v2i1.55491
Gusti Ayu Putu Ika Bella Saptaning Astyari, Rabel Relianta Zagoto, Oby Mesakh Ngahu
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.
{"title":"Neonatal Resuscitation in Primary Health Care Facilities","authors":"Gusti Ayu Putu Ika Bella Saptaning Astyari, Rabel Relianta Zagoto, Oby Mesakh Ngahu","doi":"10.20961/soja.v2i1.55491","DOIUrl":"https://doi.org/10.20961/soja.v2i1.55491","url":null,"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.","PeriodicalId":345991,"journal":{"name":"Solo Journal of Anesthesi, Pain and Critical Care (SOJA)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116873878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-30DOI: 10.20961/soja.v2i1.55897
Ardana Tri Arianto, Sugeng Budi Santosa, Anindita Anindita
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.
{"title":"Comparison of Magnesium Sulfat Gargle and Ketamine Gargle on The Incidence of Sore Throat and Cough After Extubation","authors":"Ardana Tri Arianto, Sugeng Budi Santosa, Anindita Anindita","doi":"10.20961/soja.v2i1.55897","DOIUrl":"https://doi.org/10.20961/soja.v2i1.55897","url":null,"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.","PeriodicalId":345991,"journal":{"name":"Solo Journal of Anesthesi, Pain and Critical Care (SOJA)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133483494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.20961/soja.v1i2.55191
Iin Novita Nurhidayati Mahmuda, N. Nurkusumasari, Fakhri Nofaldi, Prihatin Puji Astuti, Ferika Dian Syafitri, D. Dessy
Coronary heart disease (CHD), is one of the non-communicable diseases that has a tendency to increase every year and have an impact not only on developed countries, but also in developing countries. According to the World Health Organization (WHO), in 2012 there were 56 million deaths worldwide caused by non-communicable disease and heart disease contributed 46.2% or caused 17.5 million deaths. This review article to give brief explanation about CHD from risk factors, diagnosed criteria, management therapy and prognosis. Risk factors for CHD can be distinguished into major risk factors and minor risk factors. Symptoms of CHD are discomfort in the chest ranging from pain crushed during activity and improved with rest to continuous chest pain. The diagnosis of CHD is established based on anamnesis, physical examination, and laboratory examination. The CHD classification consists of Stable Angina Pectoris (APS) and Acute Coronary Syndrome (ACS). Lifestyle changes accompanied by right medication can reduce complications caused by CHD.
{"title":"Coronary Heart Disease: Diagnosis and Therapy","authors":"Iin Novita Nurhidayati Mahmuda, N. Nurkusumasari, Fakhri Nofaldi, Prihatin Puji Astuti, Ferika Dian Syafitri, D. Dessy","doi":"10.20961/soja.v1i2.55191","DOIUrl":"https://doi.org/10.20961/soja.v1i2.55191","url":null,"abstract":"Coronary heart disease (CHD), is one of the non-communicable diseases that has a tendency to increase every year and have an impact not only on developed countries, but also in developing countries. According to the World Health Organization (WHO), in 2012 there were 56 million deaths worldwide caused by non-communicable disease and heart disease contributed 46.2% or caused 17.5 million deaths. This review article to give brief explanation about CHD from risk factors, diagnosed criteria, management therapy and prognosis. Risk factors for CHD can be distinguished into major risk factors and minor risk factors. Symptoms of CHD are discomfort in the chest ranging from pain crushed during activity and improved with rest to continuous chest pain. The diagnosis of CHD is established based on anamnesis, physical examination, and laboratory examination. The CHD classification consists of Stable Angina Pectoris (APS) and Acute Coronary Syndrome (ACS). Lifestyle changes accompanied by right medication can reduce complications caused by CHD.","PeriodicalId":345991,"journal":{"name":"Solo Journal of Anesthesi, Pain and Critical Care (SOJA)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128121944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.20961/soja.v1i2.49731
Eko Setijanto, Teddy Wijaya
Surgery in patients with astrocytoma is performed based on the size of the tumor in the brain and the functional status of the patients. Management of patients with intracranial hypertension can be guided by monitoring intracranial pressure (ICP) perioperatively. A variety of ventricular, intraparenchymal, and subdural equipment can be installed by neurosurgeons to provide ICP measurements.We reported a 50-year-old female patient, with a complaint of having a speech disorder since four years ago. Preoperative physical examination showed GCS E4V5M6, patient's body mass index was 29.29 kg/m2 (obese). Patient’s physical status was assessed with ASA 3. There was no significant abnormality in laboratory examination. MRI Brain contrast examination showed solid cystic lesion in supratentorial left temporal lobe with size 2.3x3.5x4.7cm accompanied by broad perifocal edema in the left frontal, temporal and parietal lobe. The chest X-ray showed cardiomegaly and pneumonia. Electrocardiography showed normal sinus rhythm.Craniotomy in patients with astrocytoma is performed based on the size of the tumor in the brain and the functional status of the patient. Preoperative evaluation for patients undergoing craniotomy should be carried out to determine the presence or absence of intracranial hypertension. In principle, postoperative management in the ICU is to control the respiratory system, optimize the cardiovascular system, and prevent possible complications.Management of intracranial pressure control in reciprocal grade 3 astrocytoma patient should be paid attention to various things and consider the condition of the patients. Preoperative preparations, as well as perioperative and postoperative monitoring, should be carefully observed to prevent complications that will adversely affect patients.
{"title":"Management of Intracranial Pressure Control in Reciprocal Grade 3 Astrocytoma Patient In Dr. Moewardi General Hospital Surakarta: Case Report","authors":"Eko Setijanto, Teddy Wijaya","doi":"10.20961/soja.v1i2.49731","DOIUrl":"https://doi.org/10.20961/soja.v1i2.49731","url":null,"abstract":"Surgery in patients with astrocytoma is performed based on the size of the tumor in the brain and the functional status of the patients. Management of patients with intracranial hypertension can be guided by monitoring intracranial pressure (ICP) perioperatively. A variety of ventricular, intraparenchymal, and subdural equipment can be installed by neurosurgeons to provide ICP measurements.We reported a 50-year-old female patient, with a complaint of having a speech disorder since four years ago. Preoperative physical examination showed GCS E4V5M6, patient's body mass index was 29.29 kg/m2 (obese). Patient’s physical status was assessed with ASA 3. There was no significant abnormality in laboratory examination. MRI Brain contrast examination showed solid cystic lesion in supratentorial left temporal lobe with size 2.3x3.5x4.7cm accompanied by broad perifocal edema in the left frontal, temporal and parietal lobe. The chest X-ray showed cardiomegaly and pneumonia. Electrocardiography showed normal sinus rhythm.Craniotomy in patients with astrocytoma is performed based on the size of the tumor in the brain and the functional status of the patient. Preoperative evaluation for patients undergoing craniotomy should be carried out to determine the presence or absence of intracranial hypertension. In principle, postoperative management in the ICU is to control the respiratory system, optimize the cardiovascular system, and prevent possible complications.Management of intracranial pressure control in reciprocal grade 3 astrocytoma patient should be paid attention to various things and consider the condition of the patients. Preoperative preparations, as well as perioperative and postoperative monitoring, should be carefully observed to prevent complications that will adversely affect patients. ","PeriodicalId":345991,"journal":{"name":"Solo Journal of Anesthesi, Pain and Critical Care (SOJA)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124302913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.20961/soja.v1i2.54642
A. Praniarda, Buyung Hartiyo Laksono
Hemophilia is a serious inherited blood disease, transmitted by women, that affects mainly men and lasts for a lifetime. Hemophilia A is the most common form. If any of the factors necessary for blood clotting are absent or insufficient, the clotting mechanism is disturbed, causing insatiable bleeding. The most common cause of death in hemophilia patients is cerebral hemorrhage due to head trauma. In cases of intracranial hemorrhage, surgery should be performed immediately to obtain a better prognosis. A 17-year-old man diagnosed with a 2x4 loss of consciousness due to intracranial subdural hemorrhage (SDH) in the left frontotemporoparietal region and cerebral edema on day 4 accompanied by subfalcine herniation to the right with hemophilia A, planned trepanation decompression for SDH evacuation. The patient received 4000 units of factor VIII injection before surgery. Bleeding during surgery was 1100cc and he received a transfusion of 1940cc blood products until hemodynamically stable. In the postoperative phase, he was admitted to the ICU for 8 days, extubation was performed after the condition improved. In patient with hemophilia, evacuation of bleeding should be performed immediately, but there is a high risk of rebleeding. A recombinant factor VIII substitute should be administered immediately for the treatment of acute bleeding in patients with severe haemophilia A. Anesthetic maintenance should include reducing the risk of hypertension and tachycardia to minimize bleeding.
{"title":"Perioperative Management of Subdural Hemorrhage (SDH) Trepanation Decompression with Hemophilia A","authors":"A. Praniarda, Buyung Hartiyo Laksono","doi":"10.20961/soja.v1i2.54642","DOIUrl":"https://doi.org/10.20961/soja.v1i2.54642","url":null,"abstract":"Hemophilia is a serious inherited blood disease, transmitted by women, that affects mainly men and lasts for a lifetime. Hemophilia A is the most common form. If any of the factors necessary for blood clotting are absent or insufficient, the clotting mechanism is disturbed, causing insatiable bleeding. The most common cause of death in hemophilia patients is cerebral hemorrhage due to head trauma. In cases of intracranial hemorrhage, surgery should be performed immediately to obtain a better prognosis. A 17-year-old man diagnosed with a 2x4 loss of consciousness due to intracranial subdural hemorrhage (SDH) in the left frontotemporoparietal region and cerebral edema on day 4 accompanied by subfalcine herniation to the right with hemophilia A, planned trepanation decompression for SDH evacuation. The patient received 4000 units of factor VIII injection before surgery. Bleeding during surgery was 1100cc and he received a transfusion of 1940cc blood products until hemodynamically stable. In the postoperative phase, he was admitted to the ICU for 8 days, extubation was performed after the condition improved. In patient with hemophilia, evacuation of bleeding should be performed immediately, but there is a high risk of rebleeding. A recombinant factor VIII substitute should be administered immediately for the treatment of acute bleeding in patients with severe haemophilia A. Anesthetic maintenance should include reducing the risk of hypertension and tachycardia to minimize bleeding.","PeriodicalId":345991,"journal":{"name":"Solo Journal of Anesthesi, Pain and Critical Care (SOJA)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124653924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.20961/soja.v1i2.54703
M. Yusuf, R. Hartono
Chronic myelogenous leukemia (CML) is a type of cancer caused by a disturbance in the hematopoietic stem cells. CML itself rarely occur on women who are in labor and an advanced procedure in this event has become a special challenge for medics, especially an anesthesiologist. This limits the development of standard anesthesia guidelines, so in this case we describe the incidence of CML in pregnancies performed by Cesarean section with general anesthesia.The first pregnant patient was 36 weeks pregnant; the patient was first diagnosed with Chronic myelogenous leukemia (CML) at the age of 26-28 weeks, at that time the patient complained of frequent dizziness, abdominal pain and weakness, then the patient complained of bleeding gums, and currently the patient complained of nosebleeds. The Bone Marrow shows Conclusion an accelerated phase chronic myeloid leukemia (CML) (suspected atypical CML) with nutritional deficiency. We perform General Anesthesia technique Rapid Sequence Intubation with Regimen Fentanyl 100 mcg, Propofol 80 mg and Rocuronium 50 mg.The patient was admitted to the ICU for 2 days before transferring to intensive care and the patient received intravenous paracetamol 1 gram four times, cefazolin 1 gram twice a day, lansoprazole 30 mg once a day, tranexamic acid 1gr three times a day, and 15 mcg per hour fentanyl contionously. Hemodynamic patients in the ICU are in a stable condition. On the second postoperative day of care, the patient was transferred to the High care ward, then at the third postoperative day the patient's hemodynamics was stable and the patient was transferred to a normal room.
{"title":"Management of Patient Primigravida 36-37 Weeks with Chronic Myeloid Leukemia, Anemia, and Thrombocytopenia: A Case Report","authors":"M. Yusuf, R. Hartono","doi":"10.20961/soja.v1i2.54703","DOIUrl":"https://doi.org/10.20961/soja.v1i2.54703","url":null,"abstract":"Chronic myelogenous leukemia (CML) is a type of cancer caused by a disturbance in the hematopoietic stem cells. CML itself rarely occur on women who are in labor and an advanced procedure in this event has become a special challenge for medics, especially an anesthesiologist. This limits the development of standard anesthesia guidelines, so in this case we describe the incidence of CML in pregnancies performed by Cesarean section with general anesthesia.The first pregnant patient was 36 weeks pregnant; the patient was first diagnosed with Chronic myelogenous leukemia (CML) at the age of 26-28 weeks, at that time the patient complained of frequent dizziness, abdominal pain and weakness, then the patient complained of bleeding gums, and currently the patient complained of nosebleeds. The Bone Marrow shows Conclusion an accelerated phase chronic myeloid leukemia (CML) (suspected atypical CML) with nutritional deficiency. We perform General Anesthesia technique Rapid Sequence Intubation with Regimen Fentanyl 100 mcg, Propofol 80 mg and Rocuronium 50 mg.The patient was admitted to the ICU for 2 days before transferring to intensive care and the patient received intravenous paracetamol 1 gram four times, cefazolin 1 gram twice a day, lansoprazole 30 mg once a day, tranexamic acid 1gr three times a day, and 15 mcg per hour fentanyl contionously. Hemodynamic patients in the ICU are in a stable condition. On the second postoperative day of care, the patient was transferred to the High care ward, then at the third postoperative day the patient's hemodynamics was stable and the patient was transferred to a normal room.","PeriodicalId":345991,"journal":{"name":"Solo Journal of Anesthesi, Pain and Critical Care (SOJA)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125853794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.20961/soja.v1i2.54984
Rafael Bagus Yudhistira, M. Yudhistira, R. Supraptomo
The elevated cases of pregnant women infected with COVID-19 who needed to undergo caesarean section is a great challenge to anesthesiologists. Morbid obesity and preeclampsia in pregnancy are also another challenge to medical practice especially when the patient requires caesarean section. To describe the perioperative management of a morbidly obese preeclamptic patient with COVID-19. A pregnant woman with mild case of COVID-19, severe preeclampsia and obesity underwent an emergency caesarean section. Spinal anesthesia was performed using a Whitacre 26G spinal needle with 76 mm length, bupivacaine 0.5% 12.5 mg as spinal anesthesia agent and fentanyl 25 mcg as adjuvant. All operating teams use PPE according to COVID-19 guidelines and standard procedures. The operation went with a good outcome without any transmission to the operating team. The patient underwent treatment without postoperative complications. Spinal anesthesia is considered safe to be a usual technique for parturient with preeclampsia and morbid obesity. A proper COVID-19 surgery protocol is crucial in order to protect health workers handling COVID-19 patients.
{"title":"Perioperative Management in Parturient with Severe Preeclampsia, Obesity, and COVID-19","authors":"Rafael Bagus Yudhistira, M. Yudhistira, R. Supraptomo","doi":"10.20961/soja.v1i2.54984","DOIUrl":"https://doi.org/10.20961/soja.v1i2.54984","url":null,"abstract":"The elevated cases of pregnant women infected with COVID-19 who needed to undergo caesarean section is a great challenge to anesthesiologists. Morbid obesity and preeclampsia in pregnancy are also another challenge to medical practice especially when the patient requires caesarean section. To describe the perioperative management of a morbidly obese preeclamptic patient with COVID-19. A pregnant woman with mild case of COVID-19, severe preeclampsia and obesity underwent an emergency caesarean section. Spinal anesthesia was performed using a Whitacre 26G spinal needle with 76 mm length, bupivacaine 0.5% 12.5 mg as spinal anesthesia agent and fentanyl 25 mcg as adjuvant. All operating teams use PPE according to COVID-19 guidelines and standard procedures. The operation went with a good outcome without any transmission to the operating team. The patient underwent treatment without postoperative complications. Spinal anesthesia is considered safe to be a usual technique for parturient with preeclampsia and morbid obesity. A proper COVID-19 surgery protocol is crucial in order to protect health workers handling COVID-19 patients.","PeriodicalId":345991,"journal":{"name":"Solo Journal of Anesthesi, Pain and Critical Care (SOJA)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129612587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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