Anesthesia and Analgesia Management Profile for Airway Surgeries at Dr. Soetomo General Academic Hospital Surabaya
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Introduction: Ear, Nose, and Throat (ENT) surgeries are commonly performed and very often require the surgeon and anesthesiologist to share the same workspace. Over the years, ENT surgery techniques have evolved from conventional methods to computer-assisted intraoperative navigation. In contrast to the past, a minimally invasive approach to paranasal sinus and petrous bone surgery is now preferred. Bleeding, postoperative nausea, and vomiting are complications often encountered in ENT surgery. In addition, pain management during surgery and patient comfort after a surgical procedure is a challenge for anesthesiologists. Therefore, the choice of anesthetic drugs is important. Objective: This study aims to determine the action profile, anesthetic management, and pain management in ENT surgery at Dr. Soetomo General Academic Hospital Surabaya. Methods: This is a retrospective descriptive study. A total of 177 patients underwent airway surgery. Data were obtained from the Medical Records of the Integrated Surgery Center of Dr. Soetomo General Academic Hospital recorded from January to December 2021. Results: Most of the patients were in the age group of 45 - 65 years (40.1%) and a majority were men (65.5%). Most patients who were ≥ 20 years old had a normal nutritional status (54.2%). The most frequent diagnosis was laryngeal cancer (23%), with micro laryngeal surgery being the most frequently performed (35.8%). Most surgeries also needed less than 60 minutes followed by 60 to 119 minutes (27.1%). The most frequently used induction agents were a combination of propofol, fentanyl, and rocuronium (39.5%), with isoflurane as the most frequent inhalation agent (91.3%). Metamizole (70.1%) was the most postoperative analgesic. Conclusion: In general, intravenous agents were used for anesthesia induction. A combination of different induction agents brings synergistic benefits.
Lee S, Choi SJ, In CB, Sung T. Effects of tramadol on emergence agitation after general anesthesia for nasal surgery.
Singarelli S, Berni A, Coppo G, Fracchia P. Day-surgery , one-day surgery : the experience of an ENT Unit in a 250 bed Hospital. 2005;365–9.
George OOA. Anesthesia for ear, nose, and throat (ENT) surgery. Anesth Care Pediatr patient. 2014;Chapter 17. p(469-470).
Caversaccio M, Freysinger W. Computer assistance for intraoperative navigation in ENT surgery. Minim Invasive Ther Allied Technol. 2003;12(1–2):36–51.
Fuzi J, Budiono GR, Meller C, Jacobson I. Tranexamic acid in otorhinolaryngology – A contemporary review. World J Otorhinolaryngol - Head Neck Surg [Internet]. 2021;7(4):328–37. Available from: https://doi.org/10.1016/j.wjorl.2020.05.010
Myklejord DJ, Yao L, Liang H, Glurich I. Consensus Guideline Adoption for Managing Postoperative Nausea and Vomiting. 2003;111(5):207–15.
Arbor A, Lewis IH. Uma A. Pandit,. 1995;230–3.
Nocini R, Molteni G, Mattiuzzi C, Lippi G. Updates on larynx cancer epidemiology. 2020;32(1):18–25.
Chen WC, Chuang HC, Lin YT, Huang CC, Chien CY. Clinical impact of human papillomavirus in laryngeal squamous cell carcinoma: A retrospective study. PeerJ. 2017;2017(5):1–13.
Te Riele RJL., Dronkers EA., Van den Brink M., De Herdt M., Sewnaik A, Hardillo J., et al. Influence of anemia and BMI on prognosis of laryngeal squamous cell carcinoma: Development of an updated prognostic model. Oral Oncol. 2018;78:25–30.
Tambajong RN, Lalenoh DC, Kumaat L. Profil penderita sepsis di ICU RSUP Prof. Dr. R. D. Kandou Manadoperiode Desember 2014 – November 2015. e-CliniC. 2016;4(1).
Jaquet Y, Monnier P, Melle G Van, Ravussin P, Spahn DR, Chollet-rivier M. Complications of Different Ventilation Strategies in Endoscopic Laryngeal Surgery. 2006;(1):52–9.
Yosunkaya MT. Basic principles of microlaryngeal surgery in benign larynx lesions. 2020;6:12–5.
Croft R, Washington S. Induction of anaesthesia. Anaesth Intensive Care Med. 2012;13(9):401–6.
Jackson D., Forte P. Intravenous Induction Agents, in: Basic Clinical Anesthesia. New York: Springer New York; 2015.
Ferguson I, Bell A, Treston G, New L, Ding M, Holdgate A. Propofol or Ketofol for Procedural Sedation and Analgesia in Emergency Medicine”The POKER Study: A Randomized Double-Blind Clinical Trial. Ann Emerg Med. 2016;68(5):574-582.e1.
Aboeldahab H, Samir R, Hosny H, Omar A. Comparative study between propof, ketamine and their combination (ketofol) as an induction agent. Egypt J Anaesth. 2011;27(3):145–50.
Mitos G, Thoma G, Tsaousi G. Propofol / Fentanyl / Rocuronium or Sevoflurane Inhalational Induction for Intubation ? 2021;13(11).
Wan C, Hanson A., Schulte P., Dong Y, P.R B. Propofol, Ketamine, and Etomidate as Induction Agents for Intubation and Outcomes in Critically Ill Patients: A Retrospective Cohort Study. Crit Care Explor. 2021;21(1):52–61.
Butterworth, J. F., Mackey, D.C., & Wasnick JD. Analgesic agents. In: Clinical anesthesiology. 5 th. New York: Mc Graw hill education; 2013.
Wolf A, Selpien H, Haberl H, Unterberg M. Does a combined intravenous-volatile anesthesia offer advantages compared to an intravenous or volatile anesthesia alone : a systematic review and meta-analysis. 2021;1–10.
Chang J, Yang C. Propofol Combined with Fentanyl Is Superior to Propofol Alone in Sedation Protocols for Painless Gastrointestinal Endoscopy. J Nanomater. 2021;2021.
Azeem Y, Kanwal F, Kaneez M, Kumar S, Muhammad S, Zaidi J, et al. Comparison of hemodynamic changes in ketamine versus fentanyl as co-induction agent with propofol in elective surgical procedures In trodu ction. 2020;16(4):161–5.
Jell WS, Hall R, Lien A. The Comparative Effects of Sevoflurane Versus Propofol in the Induction and Maintenance of Anesthesia in Adult Patients. 1996;
Schraag S, Pradelli L, Jabbar A, Alsaleh O, Bellone M, Ghetti G, et al. Propofol vs . inhalational agents to maintain general anaesthesia in ambulatory and in- patient surgery : a systematic review and meta-analysis. 2018;1–9.
Talih G, Yüksek A, Ender Åž. Am J Otolaryngol Evaluation of emergence agitation after general anaesthesia in rhinoplasty patients : Inhalation anaesthesia versus total intravenous anaesthesia. Am J Otolaryngol. 2020;(December 2019):102387.
Ali Peirovifar EJ, Eydi M, Mirinejhad MM, Mahmoodpoor A, Mohammadi A, Golzari SEJ. Comparison of postoperative complication between Laryngeal Mask Airway and endotracheal tube during low-flow anesthesia with controlled ventilation. Pakistan J Med Sci. 2013;29(2):601–5.
Özkiris M, Kapusuz Z, Öztürk S, Bolat E, Saydam L. The Effects of Sevoflurane and Isoflurane in Nasal Septal Surgery. J Craniofac Surg. 2013;24(4):1376–9.
El Fawal S, Abdelaal A, Nofal WH. Comparative study between sevoflurane and isoflurane on the perioperative and postoperative bleeding of adenotonsillectomy patients. Ain-Shams J Anaesthesiol. 2017;10:1687–7934.
Doǧan IV, Ovali E, Eti Z, Yayci A, Göǧüş FY. The in vitro effects of isoflurane, sevoflurane, and propofol on platelet aggregation. Anesth Analg. 1999;88(2):432–6.
Hirakata H, Hatano Y, Ushikubi F, Narumiya S, Nakamura K, Mori K. The Effect of Inhaled Anesthetics on the Platelet Aggregation. 1995;114–8.
Bozdogan N, Madenoglu H, Dogru K. Effects of Isoflurane , Sevoflurane , and Desflurane on Platelet Function : A Prospective , Randomized , Single-Blind , In Vivo Study. 2005;66(4):375–84.
Becker SD, Becker DG. Review and update on postoperative opioid use after nasal and sinus surgery. 2017;1–5.
Finkensieper M, Poller K, Wittekindt C, Meissner W, Guntinas-Lichius O. Postoperative pain assessment after functional endoscopic sinus surgery (FESS) for chronic pansinusitis. Eur Arch Oto-Rhino-Laryngology. 2013;270(1):157–66.
Kemppainen TP, Tuomilehto H, Kokki H, Seppa J. Pain Treatment and Recovery
After Endoscopic Sinus Surgery. 2007;(August):1434–8.
Bianchini C, Malagò M, Crema L, Aimoni C, Matarazzo T, Bortolazzi S, et al. Post-operative pain management in head and neck cancer patients : predictive factors and efficacy of therapy. Acta Otorhinolaryngol Ital. 2016;36(2):91–6.
Gostian A., Loeser J, Tholen C, Wolber P, Otte M, Schwarz D, et al. Postoperative pain after tonsillectomy – the value of standardized analgesic treatment protocols. Auris Nasus Larynx. Auris Nasus Larynx. 2020;47(6):1009–17.
Gostian M, Loeser J, Gostian AO, Heindl L. Pain after External and Endonasal Septorhinoplasty ” A Propensity Score Matching Analysis. 2020;1(212):290–6.
Dahm V, Lui JT, Liepins R, Chen JM, Le TN, Arnoldner C, et al. Is otologic surgery contributing to the opioid epidemic? J Otolaryngol - Head Neck Surg. 2021;50(1):4–11.
MisioÅ‚ek H, ZajÄ…czkowska R, Daszkiewicz A, WoroÅ„ J, Dobrogowski J, Wordliczek J, et al. Postoperative pain management ” 2018 consensus statement of the Section of Regional Anaesthesia and Pain Therapy of the Polish Society of Anaesthesiology and Intensive Therapy , the Polish Society of Regional Anaesthesia and Pain Therapy , the Polish Asso. 2018;50(3):173–99.
Wu A., Walgama E., Genç E, Ting J., Illing E., Shipchandler T., et al. Multicenter study on the effect of nonsteroidal anti-inflammatory drugs on postoperative pain after endoscopic sinus and nasal surgery. Int Forum Allergy Rhinol. 2019;10(4):489–95.
Nguyen BK, Yuhan BT, Folbe E, Eloy JA, Zuliani GF, Hsueh WD, et al. Perioperative Analgesia for Patients Undergoing Septoplasty and Rhinoplasty : An Evidence-Based Review. 2018;1–13.
American Society of Anesthesiologists. Practice Guidelines for Acute Pain Management in the. Anesthesiology. 2012;116(2):248–73.
Gordon DB, De Leon-Casasola OA, Wu CL, Sluka KA, Brennan TJ, Chou R. Research gaps in practice guidelines for acute postoperative pain management in adults: Findings from a review of the evidence for an American pain society clinical practice guideline. J Pain. 2016;17(2):158–66.
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