Journal of Anesthesiology and Clinical Research最新文献_第2页

Anesthesia Approach for Nephrectomy in Full-Term Neonate with Suspected Wilms Tumor and Patent Foramen Ovale: A Case Report 怀疑肾母细胞瘤并卵圆孔未闭的足月新生儿肾切除术的麻醉入路1例

Journal of Anesthesiology and Clinical Research Pub Date : 2023-11-09 DOI: 10.37275/jacr.v5i1.412

Ida Katarina, Otniel Adrians Labobar, I Putu Kurniyanta

{"title":"Anesthesia Approach for Nephrectomy in Full-Term Neonate with Suspected Wilms Tumor and Patent Foramen Ovale: A Case Report","authors":"Ida Katarina, Otniel Adrians Labobar, I Putu Kurniyanta","doi":"10.37275/jacr.v5i1.412","DOIUrl":"https://doi.org/10.37275/jacr.v5i1.412","url":null,"abstract":"Introduction: Nephrectomy for Wilms tumor presents a considerable challenge in pediatric anesthesia. This study aimed to describe the anesthesia approach for nephrectomy in a full-term neonate with suspected Wilms tumor and patent foramen ovale. Case presentation: A 25-day-old male neonate was referred with a longstanding intraabdominal mass present since birth. Echocardiography revealed a patent foramen ovale with a diameter of 2.7 mm and a left-to-right shunt. The patient also had a diagnosis of partial ileus obstruction, likely caused by the tumor's pressure on the left kidney. Preoperative fasting adhered to a \"6-4-3-1\" regimen. Normoglycemia was maintained throughout the perioperative period. The case was managed under general anesthesia without the use of the rapid sequence induction technique. Caudal analgesia was administered using 1.14 ml of 0.175% bupivacaine. Vigilant monitoring of blood loss, prevention of hypothermia, and effective pain management are vital aspects of the surgical procedure. For postoperative pain management, analgesia and morphine infusion were employed. The patient was then transferred to the neonatal intensive care unit (NICU) for observation for any signs of complications related to anesthesia and surgery. Conclusion: Nephrectomy in neonates is one of the challenges of pediatric anesthesia. Pre-anesthesia preparation in relation to hypertension control, analgesia plan and postoperative care site, transfusion strategy, and management of intravascular extension.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":" 47","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135244535","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}

引用次数: 0

The Use of Inferior Vena Cava Ultrasonography to Assess Fluid Overload in Acute Lung Oedema in Severe Preeclampsia Patient 应用下腔静脉超声评估重度子痫前期患者急性肺水肿的液体负荷

Journal of Anesthesiology and Clinical Research Pub Date : 2023-10-26 DOI: 10.37275/jacr.v5i1.410

Eko Setyo Pamrikso, None Muhammad Husni Thamrin

{"title":"The Use of Inferior Vena Cava Ultrasonography to Assess Fluid Overload in Acute Lung Oedema in Severe Preeclampsia Patient","authors":"Eko Setyo Pamrikso, None Muhammad Husni Thamrin","doi":"10.37275/jacr.v5i1.410","DOIUrl":"https://doi.org/10.37275/jacr.v5i1.410","url":null,"abstract":"Introduction: Accurate evaluation of volume status is essential for appropriate therapy because inadequate assessment of volume status can result in unnecessary administration of therapy, which can increase mortality. This study aimed to describe the use of inferior vena cava ultrasound in assessing fluid overload in severe preeclampsia patients. Case presentation: We report a 23-year-old female patient with a diagnosis of acute pulmonary oedema, and severe preeclampsia at G1P0A0 40 weeks gestation with complaints of shortness of breath. On physical examination, the patient appeared short of breath with RR 32 x/minute, fine wet crackles in both lung fields, SpO2 92% with NRM 15 L/m, HR 160 x/minute, lifting strength, CRT < 2 seconds, blood pressure 160/120 mmHg. This patient underwent emergency termination of pregnancy by C-section under general anesthesia rapid sequence induction followed by intensive care in the ICU. Management in the ICU this patient was given mechanical ventilation, midazolam sedation 0.05 mg/kg, analgesic morphine 10 mcg/kg, fluid restriction with a fluid balance target of (-)1000 ml/24 hours and given furosemide 10 mg/hour to reduce fluid overload so that fluid in the lungs can be reduced. Evaluation of fluid overload by IVC ultrasound. Conclusion: Acute pulmonary edema requires proper management to get a good outcome. Measurement of the diameter of the inferior vena cava (IVC) can also be used to assess fluid volume status. Lack of volume is assessed with an IVC diameter of <1.5 cm, while an IVC diameter of >2.5 cm indicates volume overload.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"6 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134906736","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}

引用次数: 0

Mechanical Ventilation Management for Aneurysmal Subarachnoid Hemorrhage in ICU Settings: A Literature Review ICU病房动脉瘤性蛛网膜下腔出血的机械通气管理:文献综述

Journal of Anesthesiology and Clinical Research Pub Date : 2023-09-29 DOI: 10.37275/jacr.v4i2.394

Joseph Ivan Jacoeb, None Bernadus Realino Harjanto, None Tommy Nugroho Tanumihardja, None Joshua Kurniawan, None William Gilbert Satyanegara

{"title":"Mechanical Ventilation Management for Aneurysmal Subarachnoid Hemorrhage in ICU Settings: A Literature Review","authors":"Joseph Ivan Jacoeb, None Bernadus Realino Harjanto, None Tommy Nugroho Tanumihardja, None Joshua Kurniawan, None William Gilbert Satyanegara","doi":"10.37275/jacr.v4i2.394","DOIUrl":"https://doi.org/10.37275/jacr.v4i2.394","url":null,"abstract":"Aneurysmal Subarachnoid Hemorrhage (aSAH) is one of the challenging neurologic emergencies with a high mortality rate along with various permanent disabilities. In order to provide the patient with the most appropriate and accurate treatment, as well as to prevent further complications, a multidiscipline approach is required. This study aimed to review the various mechanisms, indications, management, and sedation of mechanical ventilation in aSAH, along with a review of prone positioning and acute respiratory distress management in aSAH. Although the main injured organ is the brain, aSAH also affects the respiratory system through various mechanisms. The usage of mechanical ventilation plays an important part in brain oxygenation and perfusion and helps prevent related complications. Levels of oxygen and carbon dioxide in the blood might play some roles in aSAH patients. No significant difference was found in using various sedative regimens. Prone positioning is indeed beneficial for the oxygenation of aSAH patients, provided that continuous monitoring is done. Blood glucose and calcium levels might be able to help predict the outcome of aSAH patients. Mechanical ventilation plays an important part in aSAH management. Clinicians must be aware of the impact of mechanical ventilation on neurological organs and the cardiopulmonary system. Balancing between oxygenation, ventilation, and sedation must be in line with aSAH condition. Several prognostic factors and tools can help predict aSAH mortality that might be able to help the clinician tailor aSAH management to their patient's needs.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135243985","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}

引用次数: 0

Perioperative Management of Patients with Extra Axial Tumors in the Region Suprasella et causa Suspected Pituitary Macroadenoma Undergoing Tumor Resection Craniotomy Procedures Endonasal Transphenoid with Postoperative Diabetes Insipidus Complications 疑垂体大腺瘤上鞍区轴外肿瘤行肿瘤切除术的围手术期处理鼻内蝶腺瘤术后尿崩症并发症

Journal of Anesthesiology and Clinical Research Pub Date : 2023-08-18 DOI: 10.37275/jacr.v4i2.343

Eugenius Silvester Cung Flavyanto, None Tjokorda Gde Agung Senapathi

{"title":"Perioperative Management of Patients with Extra Axial Tumors in the Region Suprasella et causa Suspected Pituitary Macroadenoma Undergoing Tumor Resection Craniotomy Procedures Endonasal Transphenoid with Postoperative Diabetes Insipidus Complications","authors":"Eugenius Silvester Cung Flavyanto, None Tjokorda Gde Agung Senapathi","doi":"10.37275/jacr.v4i2.343","DOIUrl":"https://doi.org/10.37275/jacr.v4i2.343","url":null,"abstract":"Introduction: Perioperative management of a patient with a pituitary macroadenoma involves a complex set of procedures, including careful clinical evaluation, decision making regarding the surgical strategy, preparation of the patient before surgery, execution of the operation with the correct technique, and care.post operation effective. Case presentation: A 52-year-old female patient with the diagnosis of extra axial tumor R. Suprasella ec susp pituitary macroadenoma, the plan is to perform craniotomy for transphenoid endonasal tumor resection. Induction with TCI propofol and preoxygenation. For analgesia can be given fentanyl 2-5 g/kg during induction, but before intubation. Ensure adequate neuromuscular blockade prior to intubation to avoid coughing/straining. Intubation with a videolaryngoscope is the technique we use to secure the airway. The position of the patient will depend on the location of the tumor. Maintain anesthesia with TCI propofol target effect 2-3 µg/kg/min, dexmedetomidine 0.2-0.7 mcg/kg/hour, and intermittent fentanyl 0.5-1 mg/kg/hour. Use light hyperventilation (PaCO2 30-35 mm Hg). Maintain euvolemia (Ringer Fundin/iso osmolar fluid) and neuromuscular relaxation. Conclusion: In these cases the anesthetic technique must be targeted towards hemodynamic stability, maintenance of adequate cerebral oxygenation and normal intracranial pressure. Postoperative care must also be considered considering the bleeding complications due to large blood vessel trauma and diabetes insipidus which often occurs post operation.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136020678","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}

引用次数: 0

Fluid Overload Management in HELLP Syndrome with Pulmonary Edema Underwent Caesarean Section 剖宫产对HELLP综合征合并肺水肿患者的体液超载处理

Journal of Anesthesiology and Clinical Research Pub Date : 2023-08-18 DOI: 10.37275/jacr.v4i2.341

Mona Agustina, Christopher Ryalino, Article Info

{"title":"Fluid Overload Management in HELLP Syndrome with Pulmonary Edema Underwent Caesarean Section","authors":"Mona Agustina, Christopher Ryalino, Article Info","doi":"10.37275/jacr.v4i2.341","DOIUrl":"https://doi.org/10.37275/jacr.v4i2.341","url":null,"abstract":"Introduction: HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome is a multisystemic disorder. HELLP syndrome is a life-threatening condition with high maternal and infant mortality rates. This study aimed to present an unexpected case of HELLP syndrome complicated by pulmonary edema. Case presentation: A 40-year-old woman, 80 kg, who was 26-27 weeks into her pregnancy, came to the obstetric department due to fever and nausea in the past three days. She was then referred to the internal medicine department and diagnosed with dengue fever by the symptom of fever and thrombocytopenia. After two days of in-patient treatment, the obstetrician diagnosed her with HELLP syndrome, followed by elevated liver enzymes. She was then posted for an urgent caesarean section, and we managed this case under general anaesthesia. Postoperatively, we aimed for -500 to -1,000 mL cumulative fluid balance to avoid further hypovolemia. Conclusion: The patient showed improvement, as evidenced by chest X-ray and oxygen saturation. Management of fluid overload in this patient with HELLP syndrome was challenging. On the second day in ICU, the antibiotic was changed from meropenem combined with levofloxacin to meropenem combined with amikacin because the leucocyte level increased and procalcitonin level increased in 48-72 hours.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123545082","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}

引用次数: 0

Perioperative Management and Anesthesia in Patients with Hemifacial Spasm Undergoing Microvascular Decompression: A Case Report 面肌痉挛患者行微血管减压术的围手术期处理和麻醉:1例报告

Journal of Anesthesiology and Clinical Research Pub Date : 2023-08-07 DOI: 10.37275/jacr.v4i2.332

Tjok Dwi, Agustyawan Pemayun, Igamw Kurniajaya

{"title":"Perioperative Management and Anesthesia in Patients with Hemifacial Spasm Undergoing Microvascular Decompression: A Case Report","authors":"Tjok Dwi, Agustyawan Pemayun, Igamw Kurniajaya","doi":"10.37275/jacr.v4i2.332","DOIUrl":"https://doi.org/10.37275/jacr.v4i2.332","url":null,"abstract":"Introduction: Microvascular decompression (MVD) is an operation performed to treat a symptom of hemifacial spasm. Hemifacial spasm is described as a disorder of neuromuscular movement characterized by repeated to persistent involuntary contractions affecting the muscles innervated by the facial nerve. \u0000Case presentation: A 33-year-old woman came to consciousness with complaints of twitching on the right side of her face since 1 year ago. Initially, the complaint was felt for the first time 3 years ago, only on the upper right eyelid, but it has been getting worse over the past year. Magnetic resonance imaging (MRI) was obtained vascular loop on the right anterior inferior cerebellar artery (AICA) in level cerebellar pontine angle (CPA). MVD is a unilateral neurosurgical procedure in the axial section of the posterior fossa. Positions that can be used are supine and modified lateral decubitus or park bench. The management of anesthesia-related to posterior fossa surgery includes, first, the effect of the drug on the ability of the lungs to hold air from entering the venous circulation. Intravenous administration of anesthetics, for example, fentanyl, can maintain a higher threshold for retaining air bubbles in the pulmonary circulation compared with inhalational anesthetics. \u0000Conclusion: Optimal hemodynamic monitoring, good analgesia, and adequate muscle relaxation are the principles of anesthesia monitoring that aim to facilitate the operator in finding access to the disturbed nerve complex.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"29 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130588367","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}

引用次数: 0

Anesthetic Management in Preeclampsia Patients with Thalassemia Minor B: A Case Report 子痫前期伴轻度地中海贫血患者的麻醉处理B: 1例报告

Journal of Anesthesiology and Clinical Research Pub Date : 2023-08-02 DOI: 10.37275/jacr.v4i2.330

Kadek Dwipa Dyatmika, Tjahya Aryasa, Otniel Adrians Labobar, Kadek Dwipa, Dyatmika

{"title":"Anesthetic Management in Preeclampsia Patients with Thalassemia Minor B: A Case Report","authors":"Kadek Dwipa Dyatmika, Tjahya Aryasa, Otniel Adrians Labobar, Kadek Dwipa, Dyatmika","doi":"10.37275/jacr.v4i2.330","DOIUrl":"https://doi.org/10.37275/jacr.v4i2.330","url":null,"abstract":"Introduction: One of the complications of anesthesia that can be encountered in thalassemia patients is cardiovascular instability caused by chronic anemia, cardiomyopathy, and endocrinopathy. In addition, patients with preeclampsia may also experience postoperative risks such as sustained hypertension, stroke, venous thromboembolism, and seizures. This case report will discuss the anesthetic management of pregnant women with preeclampsia and β thalassemia minor. \u0000Case presentation: The patient is a pregnant woman G6P0141, 34 weeks gestation, with preeclampsia and a history of minor β thalassemia without therapy. Patients with thalassemia minor are often asymptomatic before pregnancy, but physiological changes during pregnancy can contribute to anemia during pregnancy. Beta thalassemia minor is also associated with an increased incidence of hypertension in pregnancy. Neuraxial anesthesia is recommended in preeclamptic patients to avoid severe hypertension and has a protective effect against postoperative apnea in premature infants. \u0000Conclusion: Anesthetic management in asymptomatic patients with minor thalassemia is not much different from normal pregnant women. The risk of bleeding needs special attention, especially in thalassemia patients who have anemia. In patients with preeclampsia, neuraxial anesthesia is preferred over general anesthesia. Postoperative patient care is carried out in an obstetric high dependency unit (OHDU). The patient went home after being treated for 3 days without complications at the hospital.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129492352","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}

引用次数: 0

Perioperative Management of Intradural Extramedullary Tumor Patients Undergoing Hemilaminectomy and Tumor Resection: A Case Report 硬膜内髓外肿瘤半椎板切除术及肿瘤切除术围手术期处理1例

Journal of Anesthesiology and Clinical Research Pub Date : 2023-07-31 DOI: 10.37275/jacr.v4i2.329

Luh Ratna, Oka Rastini, Made Septyana Parama

{"title":"Perioperative Management of Intradural Extramedullary Tumor Patients Undergoing Hemilaminectomy and Tumor Resection: A Case Report","authors":"Luh Ratna, Oka Rastini, Made Septyana Parama","doi":"10.37275/jacr.v4i2.329","DOIUrl":"https://doi.org/10.37275/jacr.v4i2.329","url":null,"abstract":"Introduction: Intradural extramedullary (IDEM) tumor is a benign neoplasm originating in the spinal canal and accounts for approximately two-thirds of cases of primary spinal tumors. This case report aimed to further discuss the anesthetic management of IDEM tumor patients who underwent hemilaminectomy and tumor resection. \u0000Case presentation: A 25-year-old woman came with complaints of right hemiparesis, hypoesthesia as high as L3-L4, and unable to hold back urination since 4 months ago. Magnetic resonance imaging (MRI) examination showed a heterogeneous intradural extramedullary solid mass in the central spinal cord as high as Th 10-11 posterior, which narrowed the spinal canal. Dextra hemilaminectomy, tumor resection, and unilateral stabilization of dextra Th10-12 fusion were performed under general anesthesia and thoracolumbar interfascial plane blocks (TLIP). General anesthesia with non-kinking endotracheal intubation, controlled ventilation, and prone position is required for spinal thoracic surgery in adult patients. Propofol is a good induction agent, especially in maintaining the depth of anesthesia, because it can prevent side effects that arise from inhalation anesthetics. \u0000Conclusion: Bilateral modified TLIP block was performed in patients after induction of anesthesia with a median approach and ultrasonography (USG) guidance. TLIP block can reduce cumulative opioid consumption, acute pain intensity, the need for rescue analgesia, and the incidence of nausea and vomiting.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122902266","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}

引用次数: 0

Hemodynamic Response and Patient Comfort in Conscious Intubation with Recurrent Laryngeal Nerve Block 喉返神经阻滞有意识插管的血流动力学反应和患者舒适度

Journal of Anesthesiology and Clinical Research Pub Date : 2023-07-25 DOI: 10.37275/jacr.v4i2.326

Fransiscus Braveno Rapa, A. Pradhana, Fransiscus Braveno

{"title":"Hemodynamic Response and Patient Comfort in Conscious Intubation with Recurrent Laryngeal Nerve Block","authors":"Fransiscus Braveno Rapa, A. Pradhana, Fransiscus Braveno","doi":"10.37275/jacr.v4i2.326","DOIUrl":"https://doi.org/10.37275/jacr.v4i2.326","url":null,"abstract":"Introduction: Anesthetic management of conscious intubation in difficult airway cases can be done with topical anesthetics, airway nerve blocks, or a combination of both. Inadequate quality of anesthesia can cause hemodynamic turmoil, pain, gag reflex, and patient discomfort. This study presents a case report on the use of recurrent laryngeal nerve blocks in patients who were consciously intubated. \u0000Case presentation: This man was premedicated in the reception room using 10 mg IV dexamethasone, 10 mg IV diphenhydramine, 2 drops of 0.05% oxymetazoline right nose, 4 ml of 4% lidocaine nebulization, 10% lidocaine spray on the uvula and 2 puffs of pharyngopalatine fauces. Once in the operating room, this man was given midazolam 1.5 mg IV, fentanyl 25 mcg IV, followed by ultrasound-guided recurrent laryngeal nerve block. The local anesthetic used was 2 ml of 2% lidocaine. After that, right intranasal conscious intubation was performed. During intubation, this man began to show discomfort in the form of frowning when the flexible scope (FIS) was in the larynx and briefly passed the vocal cords. In addition, a gag reflex and cough are seen when the FIS and airways pass over the larynx and vocal cords. Intubation is done in about 4 minutes with 1 attempt. \u0000Conclusion: Awake intubation can be performed with topical anesthesia, airway block, or a combination of the two. Awake intubation with a combination of laryngeal recurrent nerve blocks and topical anesthesia, in this case, was inadequate because there was coughing, gag reflex, and increased heart rate during intubation.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126135085","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}

引用次数: 0

Epidural Anaesthesia Technique in Caesarean Section Operation in Pregnant Patients with Rheumatic Heart Disease and Severe Mitral Stenosis 风湿性心脏病合并严重二尖瓣狭窄孕妇剖宫产术的硬膜外麻醉技术

Journal of Anesthesiology and Clinical Research Pub Date : 2023-07-18 DOI: 10.37275/jacr.v4i2.324

Aditya Wangsa, FX Adinda Putra Pradhana, Tjahya Aryasa, C. Sinardja

{"title":"Epidural Anaesthesia Technique in Caesarean Section Operation in Pregnant Patients with Rheumatic Heart Disease and Severe Mitral Stenosis","authors":"Aditya Wangsa, FX Adinda Putra Pradhana, Tjahya Aryasa, C. Sinardja","doi":"10.37275/jacr.v4i2.324","DOIUrl":"https://doi.org/10.37275/jacr.v4i2.324","url":null,"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. \u0000Case 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. \u0000Conclusion: Epidural anaesthesia technique can be performed safely in pregnant women with comorbid mitral regurgitation and atrial fibrillation, with good intraoperative hemodynamic stability.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115531261","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}

引用次数: 0