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All Journal Jurnal Anestesi Perioperatif Abdimas Talenta : Jurnal Pengabdian Kepada Masyarakat Jurnal SAGO Gizi dan Kesehatan Majalah Anestesia & Critical Care (MACC)

Andriamuri Primaputra Lubis

Departemen Anestesiologi Dan Terapi Intensif, Fakultas Kedokteran, Universitas Sumatera Utara, Medan, Indonesia

Author-ID : 4419778

Agriculture, Biological Sciences & Forestry Dentistry Education Environmental Science Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Nursing Public Health Social Sciences

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Intubasi dengan Menggunakan Laringoskop McCoy dan Macintosh Andriamuri Primaputra Lubis
Majalah Anestesia & Critical Care Vol 39 No 3 (2021): Oktober
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Tindakan intubasi endotrakeal memiliki tingkat kesuksesan yang sangat tinggi pada pasien-pasien yang akan dilakukan tindakan anestesi secara elektif. Sedangkan, pada kasus-kasus emergensi ataupun kasus-kasus sulit intubasi, tindakan intubasi endotrakeal menjadi tantangan dan membuka perspektif berbeda. Laringoskop merupakan suatu instrumen yang digunakan untuk memeriksa regio laring dan memfasilitasi tindakan intubasi endotrakeal. Berbagai macam penelitian dilakukan di berbagai negara untuk menilai penggunaan blade laringoskop termasuk diantaranya untuk menilai tanggapan kardiovaskular dan kemudahan tindakan intubasi intubasi. Di Indonesia sendiri, penelitian yang serupa pernah dilakukan dengan penduduk dengan ras Melayu.

A Case Report Total Intravenous Anesthesia Combined with Peribulbar Block in Vitrectomy Operation with Heart Disorder Andriamuri Primaputra Lubis; Adhika Syaputra Lubis
Majalah Anestesia & Critical Care Vol 40 No 2 (2022): Juni
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Introduction: Vitrectomy is eye surgery to evaluate the retina by removing the vitreous gel which is principally carried out in three stages, namely retinal detachment repair, membrane peeling, and crystalline lens. In this operation, the anesthetic technique that needs to be emphasized is not increasing intraocular pressure and avoiding the oculocardiac reflex. This operation can be performed with a peribulbar or retrobulbar block, however, total intravenous anesthesia may also be considered in patients with other comorbidities.Case Presentation: Male, 55 years old, 96 kgs, with the chief complaint of blurred vision in the last 3 weeks ago. There were no other complaints but the patient has a history of hypertension, diabetes mellitus type II, congestive heart failure with a history of mitral valve replacement (MVR), and permanent pacemaker (PPM) usage from 2015. The patient had a history of warfarin and novamox usage 7 days ago. From the exam, the patient was diagnosed with ablatio retina + post-MVR and scheduled to have a vitrectomy. The patient was positioned supine with 300 heads up. The patient was given 3 liters of oxygen via nasal cannula, premedicated with fentanyl 50 mcg, then induced with propofol 100 mg bolus intravenously until sleep nonapnea before continuing with continuous propofol via syringe pump. The patient was maintained by propofol 0.5 mg/kg BW/hour. Next, the patient was given a peribulbar block with 2mL Lidocaine 2% and 2mL Bupivacaine 0.5%. During operation, there was no significant hemodynamic fluctuation until finished. Conclusion: The patient thus will undergo vitrectomy can be performed with peripheral nerve blocks such as retrobulbar anesthesia or peribulbar anesthesia. However, after knowing about the patient’s medical history, in this case, with a history of cardiac events and also undergone open-heart surgery, total intravenous anesthesia combined with a peribulbar block was considered the most suitable technique.

Pengaruh Pemberian Tiamin Intravena terhadap Kadar Tumor Necrosis Factor Alpha (TNF- α) pada Pasien COVID-19 di Ruang Isolasi Andriamuri Primaputra Lubis; Annisa Syifanurhati; Muhammad Ihsan
Majalah Anestesia & Critical Care Vol 40 No 2 (2022): Juni
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Introduction : Many cytokines and inflammatory mediators play a role in the progression of COVID-19 disease, including the interleukins, interferons, and tumor necrosis factor-α (TNF-α.) groups. An intervention is needed to reduce the levels of this cytokine. Thiamine has the potential to reduce levels of proinflammatory cytokines, especially TNF-α. Objective: To determine the effect of intravenous thiamine administration on TNF-α levels in COVID-19 patients in the isolation room of RSUP H Adam Malik. Methods: This study used an analytical design of one group pre test - post test in the isolation room of Haji Adam Malik General Hospital Medan with a sample size of 16 people. Samples were given thiamine IV 200 mg/12 hours and then the levels of TNF-α were measured by ELISA method. Results: Characteristics of the sample obtained were equal in number of males and females (1:1), the mean age was 43 ±14.78 years, the mean BMI was 23.31 ± 6.55, the mean systolic was 122.50 ± 5.77 mmHg and diastolic 88.88 ± 6.55 mmHg. The majority of the sample (50%) had no comorbidities. Before administration of thiamine, the median TNF-α was 186.5 pg/mL with a minimum and maximum value (171-420 pg/mL) and after administration of thiamine, the median TNF-α was 180.50 pg/mL with a minimum and maximum value (122-200 pg/mL) obtained a p value of 0.001 < 0.05 (there is a significant effect). Conclusion: In this study, the mean TNF-α level was lower when given intravenous thiamine. This decrease in TNF-α levels was also found to be significant after intravenous thiamine administration.

Plasmapheresis in Myasthenia Gravis Crisis Alegra Rifani Masharto; Bastian Lubis; Andriamuri Primaputra Lubis; Rommy Nadeak
Majalah Anestesia & Critical Care Vol 41 No 3 (2023): Oktober
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v41i3.290

Introduction: Myasthenic crisis is the most lethal complication of myasthenia gravis. Referral to an intensive care unit is crucial in managing the myasthenic crisis. Hereby, we report a case of a myasthenic crisis in a 30-year-old female who underwent plasmapheresis. The patient underwent a 12-hour procedure for plasmapheresis and was discharged to a normal ward the next day. Although plasmapheresis is costly, its efficacy should be considered as the main treatment for myasthenic crisis. Case Illustration: Female, 30 years old, weighed 60 kgs, with myasthenia crisis. The patient came to an emergency department and was then intubated before being admitted to the intensive care unit. The physical diagnostic was normal and laboratory findings were leukocytosis. The patient was treated with normal saline, antibiotics, high-dose corticosteroids, and pyridostigmine. The patient was done plasmapheresis with synchronized intermittent mandatory ventilator mode. The patient was examined every 30 minutes. The physical examinations were relatively normal. The plasmapheresis procedure was ended in 12 hours. From the literature, plasmapheresis was found to have significant results for myasthenia gravis compared to conventional therapy because of its blood separation technique to remove autoantibodies. The next day patient was extubated with normal physical examinations and normal laboratory findings. The patient then moved from the intensive care unit to the normal ward and outpatient on the third day of hospital stay. The patient was given oral medicine that included antibiotics, corticosteroids, and pyridostigmine. Conclusion: From this case, we can see that plasmapheresis therapy has a really good outcome compared to other conventional therapy. However this therapy is expensive, so most healthcare providers don’t cover the payment. Hopefully, most hospitals and healthcare providers can cover up for this treatment to save many myasthenia gravis crisis. Keyword: Intensive Care Unit; myasthenic crisis; myasthenia gravis; plasmapheresis; treatment efficacy

Co-Authors Adhika Syaputra Lubis Alegra Rifani Masharto Alegra Rifani Masharto Ananta Septriandra Ginting Annisa Syifanurhati Bastian Lubis Mitra Khairani Muhammad Ihsan Rian Army Rina Amelia Rommy Nadeak Rr Sinta Irina Rr. Sinta Irina Yutu Solihat

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