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Usamah U, Sumartono C, Fitriati M, Wirabuana B, Tjokroprawiro BA. Comparative analysis of lumbar quadratus lumborum block and epidural block for analgesia in uterine surgery at Dr. Soetomo Hospital, Surabaya. J Med Life 2023; 16:1707-1713. [PMID: 38406774 PMCID: PMC10893563 DOI: 10.25122/jml-2023-0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/13/2023] [Indexed: 02/27/2024] Open
Abstract
Over 80% of surgical patients experience postoperative pain, which, if inadequately managed, can lead to complications, prolonged rehabilitation, chronic pain, and decreased quality of life. Epidural block and quadratus lumborum block are techniques commonly used for postoperative pain management. This comparative analytic study aimed to analyze the differences in the analgesic effects of quadratus lumborum block and epidural block in uterine surgery at Dr. Soetomo General Hospital. The outcomes assessed were the numerical rating score (NRS) as a pain score and the administration of opioids as an adjuvant analgesic. Statistical analysis employed the Mann-Whitney test and Chi-square test. The study included 32 patients who underwent uterine surgery at Dr. Soetomo General Hospital and met the inclusion and exclusion criteria. Among the patients, 90.6% experienced mild pain, and 9.4% experienced moderate pain. Epidural blocks were performed in 50% of the patients, while quadratus lumborum blocks were performed in the other 50%. Additionally, 9.4% of the patients received opioids as adjuvant analgesics. The Mann-Whitney test revealed no significant difference in NRS between the epidural block and quadratus lumborum block groups (p-value>0.05). However, the Chi-square test indicated a significant difference in NRS between patients who received additional opioids as adjuvant analgesics and those who did not (p-value<0.00). There was no significant difference in NRS between patients who underwent epidural block and quadratus lumborum block as analgesic techniques.
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Affiliation(s)
- Usamah Usamah
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo Regional General Hospital, Surabaya, Indonesia
| | - Christrijogo Sumartono
- Faculty of Medicine, Universitas Airlangga, Dr. Soetomo Regional General Hospital, Surabaya, Indonesia
| | - Mariza Fitriati
- Faculty of Medicine, Universitas Airlangga, Dr. Soetomo Regional General Hospital, Surabaya, Indonesia
| | - Belindo Wirabuana
- Faculty of Medicine, Universitas Airlangga, Dr. Soetomo Regional General Hospital, Surabaya, Indonesia
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Lusianawati, Suhardi CJ, Sumartono C, Wungu CDK. Efficacy and safety of the serratus anterior block compared to thoracic epidural analgesia in surgery: Systematic review and meta-analysis. Tzu Chi Med J 2023; 35:329-337. [PMID: 38035055 PMCID: PMC10683523 DOI: 10.4103/tcmj.tcmj_36_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/15/2023] [Accepted: 04/03/2023] [Indexed: 12/02/2023] Open
Abstract
Objectives The objective of this study was to compare the efficacy and safety of serratus anterior plane block (SAPB) and thoracic epidural analgesia (TEA) in thoracic region surgery. Materials and Methods We implemented a systematic search of PubMed, ScienceDirect, SCOPUS, and Web of Science and through gray literature for all randomized controlled trials that compared SAPB, a novel thoracic wall nerve block, and TEA in surgery. The evaluated outcomes included the Visual Analog Scale (VAS), hypotension, and postoperative nausea and vomiting (PONV). Review Manager, version 5.4.1, was implemented for the analysis of statistics. Results The pooled analysis included six trials that fulfilled the inclusion criteria. In total 384, surgery had received regional blocks (162 - SAPB and 163 - TEA). VAS did not differ significantly between SAPB and TEA, with a mean difference of 0.71, P = 0.08. PONV incidence did not differ significantly between SAPB and TEA (odds ratio = 0.25, P = 0.07). Hypotension incidence was lower in SAPB compared to TEA (odds ratio = 0.10, P = 0.0001). Conclusion SAPB yielded comparable VAS with TEA in pain management of thoracic region surgery. The incidence of hypotension was lower in SAPB than in TEA. No difference in PONV incidence was observed. SAPB can be a viable alternative to TEA in thoracic region surgery.
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Affiliation(s)
- Lusianawati
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Christian Julio Suhardi
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Christrijogo Sumartono
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Citrawati Dyah Kencono Wungu
- Department of Physiology and Medical Biochemistry, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
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Rantam FA, Kharisma VD, Sumartono C, Nugraha J, Wijaya AY, Susilowati H, Kuncorojakti S, Nugraha AP. Molecular docking and dynamic simulation of conserved B cell epitope of SARS-CoV-2 glycoprotein Indonesian isolates: an immunoinformatic approach. F1000Res 2021; 10. [PMID: 34909175 PMCID: PMC8596179 DOI: 10.12688/f1000research.54258.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 11/20/2022] Open
Abstract
Background: An immunoinformatic approach may be useful to investigate the conserved region in the spike glycoprotein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Indonesia isolates. The aim of this study was to investigate Indonesian SARS-CoV-2 isolates based on B cell epitopes by targeting the conserved regions in the spike glycoprotein to trigger increased multi-variant virus neutralization and memory response for the development of vaccine seed candidates. Methods: SARS-CoV-2 spike glycoprotein gene sequences originating from Indonesia were compared with Wuhan (China), the United Kingdom, South Africa, India, the United States, and Brazil isolates obtained from the NCBI and GISAID databases. The recognition of antigens was carried out directly using B cells through the B cell receptor (BCR). An indirect B cell activation by Cluster of Differentiation (CD)4+ T cells and major histocompatibility complex (MHC)-II was predicted through the binding with human leukocyte antigen (HLA) based on IC 50 value. In addition, vaccine allergenicity and toxicity were investigated. During the molecular complex examination, the 3D peptide structure was investigated and the lowest amount of energy formed when the vaccine candidate peptide bound to BCR and MHC-II was calculated. Results: As a result, the spike glycoprotein sequences of Indonesian SARS-CoV-2 isolates had conserved regions which were very similar to reference countries such as China, the United Kingdom, South Africa, India, the United States, and Brazil. Conclusion: It was predicted that the conserved regions could be identified as the epitope of B and T CD4+ cells that produced the peptides for vaccine candidate with antigenic, non-allergen, and non-toxic properties.
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Affiliation(s)
- Fedik Abdul Rantam
- Research Center for Vaccine Technology and Development, Institute of Tropical Disease, Universitas Airlangga, Surabaya, East Java, Indonesia.,Virology and Immunology Laboratory, Department of Microbiology, Faculty of Veterinary Medicine, Airlangga University, Surabaya, East Java, 60132, Indonesia
| | - Viol Dhea Kharisma
- Biology Department, Faculty of Mathematic and Natural Sciences, Universitas Brawijaya, Malang, East Java, Indonesia
| | - Christrijogo Sumartono
- Anasthesiology and Reanimation Department, Dr. Soetomo Gerneral Hospital and Faculty of Medicine, Universitas Airlangga,, Surabaya, East Java, Indonesia
| | - Jusak Nugraha
- Clinical Pathology Department,, Dr. Soetomo Gerneral Hospital and Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Andi Yasmin Wijaya
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Helen Susilowati
- Research Center for Vaccine Technology and Development, Institute of Tropical Disease, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Suryo Kuncorojakti
- Department of Veterinary Anatomy, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
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Hamzah H, Darma Surya Bratha INY, Sumartono C, Utariani A, Semedi B, Avidar Y. Comparison of outcome between patients receiving general anesthesia combined with continuous epidural anesthesia and patients receiving general anesthesia combined with intermittent epidural anesthesia. Bali J Anaesthesiol 2020. [DOI: 10.4103/bjoa.bjoa_18_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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