No abstract

Hundreds of surgeries are postponed every day during the global COVID -19 pandemic. The hospital and clinicians are in dilemma scheduling elective procedures during the pandemic. The current study was designed to evaluate postoperative pulmonary complications and mortality in COVID-19 patients in a systematic review and meta-analysis of globally published peer-reviewed literatures. A systematic literature search was conducted using the selection criteria in five databases. A quality assessment was made with a validated Newcastle-Ottawa Scale. The meta-analysis worked as a generic inverse variance meta-analysis. A total of 308 articles were identified from different databases and 5 articles with a total 1408 participants were selected for evaluation after successive screenings. The meta-analysis revealed a high global rate of postoperative mortality among COVID-19 patients, as high as 23% (95% CI: 15 to 26), and high postoperative pulmonary complications including pneumonia and acute respiratory distress syndrome. The 30-days mortality rate and prevalence of pulmonary complications were high. There was one death for every five COVID-19 patients undergoing surgical procedures, indicating the need for mitigating strategies to decrease perioperative mortality, transmission to healthcare workers, and non-COVID-19 patients. Larger samples and/or multicenter trials are needed to explore the perioperative mortality dan morbidity rate of patients with COVID-19 undergoing surgeries, and in particular, factors with the highest impact on perioperative mortality. There should be a clinical guideline to determine when to operate or not to operate on patients with COVID-19 for elective and emergency surgeries.

Background: Mitral stenosis heart valve abnormalities in pregnant women is a complication of pregnancy that is quite common, accompanying rheumatic heart disease, endocarditis, and congenital abnormalities. In pregnancy, there have been changes in the cardiorespiratory system caused by increased cardiac output, which the presence of mitral valve stenosis can then exacerbate. Anesthesia management plays an essential role in the safety of the mother and baby during and after surgery. The choice of technique and anesthesia management depends on the abnormality’s severity. Case: We report the successful management of anesthesia with pure central neuraxial epidural block and combined spinal epidural (CSE) in two cases of a cesarean section of 3rd-trimester pregnant women with mitral stenosis and class II functional heart failure caused by rheumatic heart disease. Conclusion: Central neuraxial block epidural anesthesia and combined spinal epidural (CSE) anesthesia are safe anesthesia techniques for both mother and baby because they can maintain hemodynamic stability.

Craniopharyngiomas are benign histological brain tumors originating less frequently fromembryonic pituitary gland tissue that are seen most frequently in children between the ages of 5and 10 years. In this case report we present a 25-year-old patient with a craniopharyngiomatumor. Patients with decreased consciousness since 4 months before admission to the hospital,which started with memory loss that was getting worse and more difficult to communicate. Thepatient was diagnosed with a brain tumor and underwent surgery for tumor therapy in 2018. Theprocedure was performed using a transcranial approach. Considerations for preoperativeanesthesia should include evaluation of radiological features to identify tumor mass andpreoperative neurologic status. Other examinations of concern include examination of blood gasanalysis and examination of electrolytes. The goals of treatment can be to remove the tumor,reduce or control the size of the tumor.

Pendahuluan: Berbagai macam teknik anestesi regional sudah banyak dikembangkan guna memfasilitasi pengendalian nyeri selama operasi maupun paska operasi, blok pleksus servikalis superfisialis (BPSS) merupakan salah satunya. Penulis mempresentasikan kasus, pasien laki-laki berusia 53 tahun yang menjalankan operasi tiroidektomi. Dilakukan anestesi umum pada pasien dengan adjuvan BPSS guna mengendalikan nyeri intra maupun paska operasi. Dari laporan kasus ini dapat disimpulkan bahwa BPSS adalah teknik anestesi regional yang mudah aplikasikan dan secara efektif dapat menjadi adjuvant pada pembedahan tiroidektomi serta dapat mengurangi penggunaan opioid selama operasi.Ilustrasi Kasus: Pada laporan kasus ini, dilakukan pengamatan pada pasien laki-laki berusia 53 Ilustrasingan keluhan benjolan pada leher sejak 1 bulan yang lalu, yang menjalani pembedahan tiroidektomi. Pasien mendapatkan premedikasi dan setelah prosedur intubasi, dilakukan blok pleksus servikalis superfisialis dengan menggunakan ropivakain 0.75% sebanyak 10 cc dengan teknik mengipas dan anestesi lokal diberikan sepanjang batas posterior muskulus sternokleidomastoideus. Selama operasi berlangung, tanda-tanda vital dalam batas normal. Simpulan: Blok pleksus servikalis superfisialis adalah teknik anestesi regional yang mudah aplikasikan dan secara efektif dapat menjadi adjuvant pada pembedahan tiroidektomi serta dapat mengurangi penggunaan opioid selama operasi.