PERUBAHAN TENSI, NADI DAN MAP PASIEN PREEKLAMPSIA SETELAH PEMBERIAN OKSITOSIN PADA OPERASI SECTIO CAESARIA DENGAN ANESTESI EPIDURAL

Kesimpulan yang dapat diambil dari penelitian ini adalah sebagai berikut ini: 1. Perubahan Nadi, Tensi dan MAP pasien preeklamsia setelah pemberian oksitosin terlihat jelas perubahannya, puncak perubahan MAP, Tensi(S) dan Tensi(D) terjadi pada menit ke 1 dan menit ke 3 pada perubahan nadi. Sedangkan Perubahan Nadi, Tensi dan MAP setelah pemberian drip oksitosin puncaknya terjadi pada menit ke 1. 2. Perubahan hemodinamik setelah pemberian oksitosin puncaknya terjadi pada menit 1 yang menyebabkan penurunan MAP >20%. Pada 4 pasien (36.4%) Dan diberikan vasopressor untuk menaikkan MAP tersebut

Relation of the successful block regional anesthesia with increased peripheral venous circumferenceand peripheral skin temperature at distal part of the block

Introduction:Evaluating the success rate of regional anesthesia is performed with pinprick test, Bromage score and pain scales,where they act as indicators of success or otherwise of motor, sensory and nociceptiveblockade. The sympathetic system is also affected by the regional anesthesia blockade.The present study evaluated the relationship of peripheral venous dilatation and the skin temperature of the block area, to be used as an additional tool.Methodology:Ananalytic,observational study was conducted in Dr. Soetomo Surabaya Hospital.18 patients receivedperipheral nerve block (PNB)and 16 patients received subarachnoid block (SAB). Informed consent was obtained from all the participants. The peripheral venous circumference was measuredby using linear probe of Sonosite® M–Turbo ultrasound, before the blocks and thenonehour after PNB and SABto assess the venous dilatation. The peripheral skin temperature was measured with a thermometer (Microlife NC-150 Bluetooth®) infrared thermometer before the blocks, and within the range of 5 minfrom the zerominafter the block until the 30th min. The success rate of the blocks was performed with pain scale (VAS) and absence of motor, sensory and nociceptive responseResults:No relationship was found of sex, age, weight and type of block with increased peripheral venous circumference and peripheral skin temperature (p > 0.05). The block's success was associated with the increased peripheral venous circumference and peripheralskin temperature (p ≤ 0.001)in both PNB and SAB blocks. The average PNB block succeeded in 20 minwhile SAB took only5 min (p <0.05)to affect both of the parameters. The delta value of the increased temperature's successful block was 0.7oC in the PNB,and 0.275oC in the SABgroup.Conclusions:The successofthe peripheral nerve block and the subarachnoid block isassociated with an increase in the peripheral venous circumference and in the peripheral skin temperature in the block area

Relation of the successful block regional anesthesia with increased peripheral venous circumference and peripheral skin temperature at distal part of the block

Introduction: Evaluating the success rate of regional anesthesia is performed with pinprick test, Bromage score and pain scales, where they act as indicators of success or otherwise of motor, sensory and nociceptive blockade. The sympathetic system is also affected by the regional anesthesia blockade. The present study evaluated the relationship of peripheral venous dilatation and the skin temperature of the block area, to be used as an additional tool. Methodology: An analytic, observational study was conducted in Dr. Soetomo Surabaya Hospital. 18 patients received peripheral nerve block (PNB) and 16 patients received subarachnoid block (SAB). Informed consent was obtained from all the participants. The peripheral venous circumference was measured by using linear probe of Sonosite® M–Turbo ultrasound, before the blocks and then one hour after PNB and SAB to assess the venous dilatation. The peripheral skin temperature was measured with a thermometer (Microlife NC-150 Bluetooth®) infrared thermometer before the blocks, and within the range of 5 min from the zero min after the block until the 30th min. The success rate of the blocks was performed with pain scale (VAS) and absence of motor, sensory and nociceptive response. Results: No relationship was found of sex, age, weight and type of block with increased peripheral venous circumference and peripheral skin temperature (p > 0.05). The block's success was associated with the increased peripheral venous circumference and peripheral skin temperature (p ≤ 0.001) in both PNB and SAB blocks. The average PNB block succeeded in 20 min while SAB took only 5 min (p < 0.05) to affect both of the parameters. The delta value of the increased temperature's successful block was 0.7oC in the PNB, and 0.275oC in the SAB group. Conclusions: The success of the peripheral nerve block and the subarachnoid block is associated with an increase in the peripheral venous circumference and in the peripheral skin temperature in the block area

Perioperative Factors Impact on Mortality and Survival Rate of Geriatric Patients Undergoing Surgery in the COVID-19 Pandemic: A Prospective Cohort Study in Indonesia

Background: The COVID-19 pandemic continues to have an impact on geriatric patients worldwide since geriatrics itself is an age group with a high risk due to declined physiological function and many comorbidities, especially for those who undergo surgery. In this study, we determine the association between perioperative factors with 30-day mortality and a survival rate of geriatric patients undergoing surgery during COVID-19 pandemic. Methods: A prospective cohort study was conducted at 14 central hospitals in Indonesia. The recorded variables were perioperative factors, 30-day mortality, and survival rate. Analyses of associations between variables and 30-day mortality were performed using univariate/multivariable logistic regression, and survival rates were determined with Kaplan–Meier survival analysis. Results: We analyzed 1621 elderly patients. The total number of patients who survived within 30 days of observation was 4.3%. Several perioperative factors were associated with 30-day mortality (p p = 0.04), CCI > 3 ( odds ratio [OR], 2.33; 95% confidence interval [CI], 1.03–5.26; p = 0.04), emergency surgery (OR, 3.70; 95% CI, 1.96–7.00; p ≤ 0.01), postoperative ICU care (OR, 2.70; 95% CI, 1.32–5.53; p = 0.01), and adverse events (AEs) in the ICU (OR, 3.43; 95% CI, 1.32–8.96; p = 0.01). Aligned with these findings, COVID-19, CCI > 3, and comorbidities have a log-rank p p p ≤ 0.01), cerebrovascular disease (log-rank p ≤ 0.01), diabetes with chronic complications (log-rank p = 0.03), metastatic solid tumor (log-rank p = 0.02), dementia (log-rank p ≤ 0.01), and rheumatology disease (log-rank p = 0.03). Conclusions: Having at least one of these conditions, such as COVID-19, comorbidities, emergency surgery, postoperative ICU care, or an AE in the ICU were associated with increased mortality in geriatric patients undergoing surgery during the COVID-19 pandemic

Comorbidities and COVID-19 status influence the survival rate of geriatric patients in intensive care units: a prospective cohort study from the Indonesian Society of Anaesthesiology and Intensive Therapy

Background: With the more advanced science in the field of medicine and disease management, the population of geriatric intensive care patients is increasing. The COVID-19 pandemic has impacted healthcare management around the globe, especially on critically-ill elderly patients. We aim to analyse the relationship between underlying illnesses, including COVID-19, and the survival rate of elderly patients who are treated in the intensive care setting. Methods: We conducted a prospective cohort study at 14 teaching hospitals for Anaesthesiology and Intensive Therapy Education in Indonesia. We selected all subjects with 60 years of age or older in the period between February to May 2021. Variables recorded included subject characteristics, comorbidities, and COVID-19 status. Subjects were followed for 30-day mortality as an outcome. We analysed the data using Kaplan-Meier survival analysis. Results: We recruited 982 elderly patients, and 728 subjects were in the final analysis (60.7% male; 68.0 ± 6.6 years old). The 30-day mortality was 38.6%. The top five comorbidities are hypertension (21.1%), diabetes (16.2%), moderate or severe renal disease (10.6%), congestive heart failure (9.2%), and cerebrovascular disease (9.1%). Subjects with Charlson’s Comorbidity Index Score > 5 experienced 66% death. Subjects with COVID-19 who died were 57.4%. Subjects with comorbidities and COVID-19 had lower survival time than subjects without those conditions (p < 0.005). Based on linear correlation analysis, the more comorbidities the geriatric patients in the ICU had, the higher chance of mortality in 30 days (p < 0.005, R coefficient 0.22). Conclusion: Approximately one in four elderly intensive care patients die, and the number is increasing with comorbidities and COVID-19 status