Journal of Anesthesiology and Clinical Research最新文献

{"title":"Oxycodone 5 Miligram is More Effective Than Ketorolac 30 Miligram in Suppressing Cortisol Levels During General Anesthesia","authors":"Kelvin, R. Zainal, Irwanto FH, Erial Bahar","doi":"10.37275/jacr.v2i1.145","DOIUrl":"https://doi.org/10.37275/jacr.v2i1.145","url":null,"abstract":"Background: Preemptive analgesia is a developing clinical concept, which involves administering analgesics before pain stimulation occurs, to prevent the sensitization of the nervous system to further stimuli that can cause pain. Ketorolac has strong analgesic properties oxycodone is a semisynthetic opioid that is synthesized from the alkaloid thebaine opiate. Pain could induce stress hormone such as cortisol. Study to compare ketorolac and oxycodone with cortisol has not been investigated. This study aimed to assess intravenous administration of ketorolac 30 mg compared with intravenous 5 mg oxycodone for pain as measured by cortisol levels post-intervention in surgery performed under general anesthesia. \u0000Method: A study randomized controlled trial in double-blind form for patients at dr. Mohammad Hoesin Palembang, who will undergo elective surgery with general anesthesia at the Central Surgical Installation building, with the period September-October 2020. There are 24 study samples, to anticipate dropouts, an added sample size is 10%, so the sample size is 26 for each treatment group. The selection of subjects according to the purpose of the study was carried out by simple random. Data analysis using SPSS ver 22.0 software. Data were analyzed using Independent T-Test, Mann Whitney, and Chi-Square Test. \u0000Result: The results showed, there was a significant difference in the effectiveness of intravenous administration of ketorolac 30 mg and intravenous oxycodone 5 mg on pain as measured by cortisol levels in patients undergoing general anesthesia at dr. Mohammad Hoesin Palembang (p = 0.013). The value of cortisol levels in pre- operative patients who will be given general anesthesia at dr. There was no statistically significant difference between Mohammad Hoesin in the two groups (p = 0.107). The value of cortisol levels in preoperative patients who were given ketorolac 30 mg intravenously at dr. Mohammad Hoesin was 9.90 ± 4.2. The value of cortisol levels in postoperative patients who were given ketorolac 30 mg intravenously at dr. Mohammad Hoesin was 17.75 ± 6.08. The value of preoperative cortisol levels for patients who were given oxycodone 5 mg intravenously at dr. Mohammad Hoesin was 12.03 ± 5.10. The value of postoperative cortisol levels for patients who were given oxycodone 5 mg intravenously at dr. Mohammad Hoesin is 14.50 ± 4.75. \u0000Conclusion: There was a significant difference in the effectiveness of intravenous administration of ketorolac 30 mg and oxycodone 5 mg intravenously on BSS levels (p = 0.005) and VAS scores (p = 0.001) who underwent general anesthesia at dr. Mohammad Hoesin Palembang.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122780220","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}

{"title":"Is Duration of Endotracheal Tube Intubation Using a Video Laryngoscope Different with a Direct Laryngoscope in Elective Surgery Patients During Pandemic Covid-19?","authors":"Zaky Hasan, Zulkifli, Agustina Br Haloho, Irfannuddin","doi":"10.37275/jacr.v2i1.142","DOIUrl":"https://doi.org/10.37275/jacr.v2i1.142","url":null,"abstract":"Introduction: Aerosol box is a usefull tools to prevent aerosol and droplet contaminations during laryngoscopy and intubation in COVID-19 pandemic. Video laryngoscope is recommended during this era to increase the operator and patient’s distance during the procedure. However, many anesthesiologists still use direct laryngoscopes due to their availability and familiarity. This study aims to compare endotracheal tube intubation with video laryngoscope compared to direct laryngoscope in elective surgery patients. \u0000Methods: This study was a quasi-experimental study. The sample size in each group (video and direct laryngoscope) was 35 subjects. The primary outcome of this study was to compare the duration of intubation between video laryngoscope and direct laryngoscope, while the secondary outcome was to evaluate complications such as broken teeth and sore throat 24 hours post intubation. \u0000Results: Direct laryngoscope had shorter intubation duration than video laryngoscope [12.3 (8.9-21.0) vs 13.3 (11.4 – 21.6; p =0.07) respectively. Two complication reported on video laryngoscope groups. \u0000Conclusion: Duration of ETT intubation using a direct laryngoscope was shorter during intubation with aerosol box compared to video laryngoscope in elective surgery patients. The box which was being used may limit the space of movement making it difficult to intubate.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"126 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124209706","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}

{"title":"A Case Report: Diabetic Ketoacidosis in Patient with type 1 Diabetes Mellitus with Complication Septic Shock and AKI Stage III on HD Triggered by Perianal Abscess","authors":"Muhammad Ikhsan Kartawinata, Yusni Puspita","doi":"10.37275/jacr.v1i1.135","DOIUrl":"https://doi.org/10.37275/jacr.v1i1.135","url":null,"abstract":"Introduction. Diabetic ketoacidosis (DKA) is an acute, life-threatening complication in diabetes mellitus. Infection is a common precipitating cause of diabetic ketoacidosis (DKA) in known diabetic patient, and diabetic ketoacidosis (DKA) often presents as the first symptom of an undiagnosed diabetes. diabetic ketoacidosis (DKA) is diagnosed with combination of hyperglicaemia, acidosis metabolic and ketonuria. \u0000Case Presentation. A 27 years old male patient, admitted to Intensive Care Unit with decrease level of consciousness (GCS 3), he was intubated and present with respiratory distress, metabolic acidosis, high glucose level, ketonuria with renal failure as a target organ. Patient known has perianal abscess as a triggered of diabetic ketoacidosis (DKA), turn into septic shock and underwent debridement surgery to source control the infection. The patient was treated in intensive care unit for 9 days, and sent to ward with GCS 15 an no sequelae of organ failure. The treatment of diabetic ketoacidosis (DKA) should include correcting the often substantial hypovolemia, the hyperglycemia, electrolyte imbalance and the triggering factor of diabetic ketoacidosis (DKA). \u0000Conclusion. Prompt surgical intervention, antibacterial therapy, rapid restoration of glycemic control are crucial to prevent mortality in diabetes mellitus patients complicated with abscess.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130267148","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}

{"title":"Total Placenta Previa with High-risk MAP and Transverse Lie Fetal Position","authors":"Teddy Wijaya","doi":"10.37275/JACR.V1I2.223","DOIUrl":"https://doi.org/10.37275/JACR.V1I2.223","url":null,"abstract":"Placenta accreta is one of the emergency conditions and has resulted in increased mortality and morbidity of pregnant women due to the massive obstetric hemorrhage. Placenta accreta can lead to secondary complications including coagulopathy, multisystem organ failure, acute respiratory distress syndrome, need for repeat surgery, and death. Assessment by anesthesia should be carried out as early as possible before surgery to reduce or even eliminate morbidity and mortality. In this report, we present the case of a patient with total placenta previa and high-risk MAP score with a transverse lie fetal position. The various anesthetic treatments and transfusion strategies are discussed with a multidisciplinary approach to delivery.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115027131","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}

{"title":"Spinal Anesthesia in Patient with Congestive Heart Failure due to Congenital Atrial Septal Defect, and Pulmonary Hypertension Undergoing Cesarean Section Procedure: A Case Report","authors":"Anugerah Ade Periambudi, R. Zainal, M. Lestari","doi":"10.37275/JACR.V1I2.244","DOIUrl":"https://doi.org/10.37275/JACR.V1I2.244","url":null,"abstract":"Introduction. In patients suffering from heart disease, pregnancy is a risk factor for mortality. Heart disease in pregnant women can be in form of rheumatic heart disease, cardiomyopathy, or congenital heart disease. This case report is about the successful spinal anesthesia technique in cesarean section (C-section) patients with congestive heart failure due to congenital atrial septal defect, and pulmonary hypertension (PH). \u0000Case presentation. A pregnant woman, 24 years old, planned to have an emergency C-section. She complained about shortness of breath for 2 days before admission. Three months ago, the patient started to feel shortness of breath during activity and also complained her legs swelled. She has a history of congenital heart i.e. atrial septal defect (ASD), but not routinely been treated. Her examination showed tachypnea, murmur, bibasilar fine crackles lung sound, and pretibial pitting edema. Echocardiography showed ASD with pulmonary hypertension. Spinal Anesthesia using 0.5% isobaric bupivacaine 7.5 mg and fentanyl 25 µcg was given before surgery. Drugs was injected in L3-L4 level with the upper target was as high as T6. the head position is raised 30 degrees. Procedure went well and the APGAR score was 8/9, Patient was admitted to the ICU for one day and discharged from hospital at the 5 days of hospital care. \u0000Conclusion. Spinal single-shot spinal anesthesia with small doses of bupivacaine and adjuvant can be used as an alternative technique in emergency C-section for patients with congestive heart failure due to congenital atrial septal defect, and pulmonary hypertension.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132166241","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}

{"title":"Suitability of CPOT and BPS to Assess Pain Response in Intubated Mohammad Hoesin Hospital Intensive Care Patients","authors":"Dwi Darmanto, A. Haloho, E. Bahar","doi":"10.37275/JACR.V1I2.224","DOIUrl":"https://doi.org/10.37275/JACR.V1I2.224","url":null,"abstract":"Background. Assessing pain in mechanically ventilated patients is an important thing for leads to improved outcome and better quality life of patients in the ICU. CPOT and BPS has been developed for measuring nonverbal patients. \u0000Aims. To validate suitability the use of CPOT and BPS in ICU RSMH. \u0000Methods. Observational analytic with cross sectional design was chosen for 50 samples conducted on July 2020 in ICU RSMH. Data was collected before and after pain procedure. \u0000Result. From 50 patients mostly 27(54%) male with age majority > 30 years old 39 (78%). The lowest GCS 2 and the highest 10. Length of treatment in ICU was 1 – 20 days. Bleeding variations was 0 - 1200 cc. BPS average before painful procedure  was 2 – 5 and after panful procedure was 5 – 7. CPOT average before painful procedure was 1 – 6 and after painful procedure was 3 - 8. Kappa before painful procedure are moderate (kappa=0,435) and after painful procedure are fair (kappa=0,248) with strongly correlated in Pearson correlation (r = 0,644, r = 0,610) (p < 0,05). \u0000Conclusion. This study demonstrated that CPOT more detail than BPS for measuring pain in intubated patients. \u0000Keywords. BPS, CPOT, ICU, Intubated, Pain \u0000","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129953859","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}

{"title":"Continuous Renal Replacement Therapy: A Review","authors":"Muja Hidin, Yasir Teuku","doi":"10.37275/JACR.V1I2.212","DOIUrl":"https://doi.org/10.37275/JACR.V1I2.212","url":null,"abstract":"ABSTRACT \u0000Kidney is an important organ to maintain hemodynamic stability inside the human body. In patient with acute kidney injury (AKI) there was a decreased kidney function that could interfere hemodynamic stability which can lead to multi organ failure even death. Around 5-10% patients with AKI required renal replacement therapy (RRT) to support their decreased renal function. Continuous renal replacement therapy (CRRT) is one of RRT modality that commonly used for patients with AKI who are hemodynamically unstable or in critically ill conditions. \u0000CRRT could divided into 4 mode, slow continuous ultrafiltration (SCUF), continuous veno-venous hemofiltration (CVVH), continuous veno-venous hemodialysis (CVVHD) and continuous veno-venous hemodialfiltration (CVVHDF). CRRT used based on renal and nonrenal indication. Several studies are still trying to prove nonrenal indication of RRT, to ascertain whether CRRT could be used as therapy effectively. Therefore the indication, the mechanism and the comparison of renal replacement therapy are very important to be understood.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"217 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132239425","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}

{"title":"Herbicide Intoxication : Still A Threat In Developing Countries","authors":"S. E. Handrawan, M. Lestari, Zulkifli","doi":"10.37275/jacr.v1i1.197","DOIUrl":"https://doi.org/10.37275/jacr.v1i1.197","url":null,"abstract":"ABSTRACT \u0000The critically ill patient has severe respiratory, cardiovascular or neurological disorder often in combination. The critically ill patient needs intensive care unit (ICU) admission and strict monitoring. Intoxication commonly experienced in a critically ill patient in ICU and can complicate management. In developing countries, poisoning of herbicide still common and used for suicide attempts. Herbicides such as paraquat and glyphosate are often used because of their availability. Paraquat and glyphosate have high mortality rate primarily as a suicide attempt agent in developing countries. The primary target for paraquat toxicity is in the lung and can cause lung fibrosis. Severe glyphosate intoxication can cause dehydration, hypotension, pneumonitis, oliguria, loss of consciousness, liver dysfunction, acidosis, hyperkalemia and dysrhythmia. Diagnosis for herbicide intoxication needs a history of herbicide ingestion, physical examination and laboratory examination. Stabilisation and supportive therapy is the only choice, and there is still no specific treatment for herbicide intoxication. The intoxication of herbicide particular critically ill patient because there is still no such specific treatment for these.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129608240","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}

{"title":"Anesthesia Management in Caesarean Section with Preeclampsia and Partial HELLP Syndrome","authors":"Tiara Wima, A. Haloho","doi":"10.37275/jacr.v1i1.195","DOIUrl":"https://doi.org/10.37275/jacr.v1i1.195","url":null,"abstract":"ABSTRACT \u0000Introduction. Pre-eclampsia is a significant cause of maternal and fetal mortality and morbidity. Pre-eclampsia is characterized by hypertension (blood pressure ≥ 140/90 mmHg), oedema and amount of protein in urine 300 mg in the 24-hour, which appears after 20 weeks of gestation. Pre-eclampsia can cause complications, one of which is HELLP syndrome. This case report discusses the use of anaesthesia in a patient who underwent a cesarean section with indications for pre-eclampsia and partial HELLP syndrome.Case Presentation. A woman, 41 years old, G4P3A0 34 weeks pregnant with pre-eclampsia + syndrome HELLP will undergo emergency cesarean section with ASA IIE physical statusLabouror pain management was carried out using regional spinal anaesthesia technique, using bupivacaine 0.5% hyperbaric agent 12.5 mg. The operation lasted for 1 hour 30 minutes, with 300 ml bleeding, hemodynamically stable.Conclusion. Difficult intubation in emergency cases can be avoided by choosing of neuraxial anaesthesia technique is recommended. It will lead to better uteroplacental perfusion, good analgesia/anaesthesia quality, reducing surgical stress, reducing drugs that enter the uteroplacental circulation, and maternal psychological to be able to see the baby at birth.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"36 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133753664","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}

{"title":"Waste Anesthetic Gase : A Forgotten Problems","authors":"Andi Miarta, M. Lestari, Zulkifli","doi":"10.37275/jacr.v1i1.198","DOIUrl":"https://doi.org/10.37275/jacr.v1i1.198","url":null,"abstract":"ABSTRACT \u0000Waste anesthetic gas (WAG) is a small amount of inhaled anesthetic gas that comes out of the patient’s anesthesia breathing circuit into the envorinment air while the patient is under anesthesia. According to American Occupation Safety and Health Administration (OSHA) more than 200.000 healthcare workers especially aneaesthesiologist, surgery nurse, obstetrician and surgeons are at risk of developing work-related disease due to chronic exposure to WAG. Exposure to WAG in short time associated with multiple problems such as headaches, irritability, fatigue, nausea, drowsiness, decrease work efficiency and difficulty with judgment and coordination. While chronic exposure of WAG is associated with genotoxicity, mutagenicity, oxidative stress, fatigue, headache, irritability, nausea, nephrotoxic, neurotoxic, hepatotoxic, immunosuppressive and reproductive toxicological effect. Waste anesthetic gases are known as environmental pollutants and will be released from the OR to the outside environment then the substance will reach the atmosphere damaging ozone layer. Exposure to trace WAG in the perioperative environment cannot be eliminated completely, but it can be controlled. Controlling WAG can be achieve by using scavenging system, proper ventilation, airway management, ideal anesthetic choice, maintaining anesthesia machine and equipment, hospital regulation and routine healthcare workers health status examination.","PeriodicalId":177081,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131996359","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}