Claim Missing Document
Check
Articles

Found 3 Documents
Search

Penatalaksanaan Perioperatif Epidural Hematoma karena Pijat Kepala pada Bayi Subekti, Bambang Eko; Lalenoh, Diana C.; Rahardjo, Sri
Jurnal Neuroanestesi Indonesia Vol 6, No 3 (2017)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (329.947 KB) | DOI: 10.24244/jni.vol6i3.53

Abstract

Cedera kepala pada bayi merupakan merupakan kejadian yang sering terjadi. Sejak bayi dapat tengkurap, berguling, merangkak bisa terjadi kepala bayi membentur dinding saat berganti posisi. Kebiasaan pijat bayi tradisional yang salah juga berisiko terjadinya cedera kepala. Terdapat perbedaan anatomi, fisiologi dan fisikososial, di samping otak bayi yang sedang mengalami perkembangan/pertumbuhan menjadi problem khusus dalam neuroanestesi. Bila terjadi trauma akan menyebabkan angka mortalitas, morbiditas dan kecacatan yang tinggi, yang sangat berpengaruh pada perkembangannya. Seorang bayi laki-laki, 1 bulan, datang ke RS dengan mengalami penurunan kesadaran setelah dipijat oleh dukun bayi tradisional. 3 hari sebelum masuk Rumah Sakit, bayi dipijat kemudian hari berikutnya demam, mual dan muntah, kejang dan kesadarannya menurun. Dibawa ke puskesmas dan dirujuk ke Rumah Sakit Abdul Muluk. Pada pemeriksaan di dapat kondisi lemah, GCS 9, pupil isokor 2/2mm, reflek cahaya +/+, hemodinamik dalam batas normal, anemia (+). Setelah dilakukan pemeriksaan fisik dan pemeriksaan tambahan didiagnosa cedera otak traumatik (GCS 9) dengan epidural hemorrhage (EDH). Pada pasien dilakukan tindakan kraniotomi evakuasi hematom dengan memperhatikan prinsip neuroanestesi selama tindakan bedah berlangsung.Perioperative Management of Epidural Hematoma for a Head Massage in InfantsHead injury in infants is a common occurence. Infancy can stomach, roll over, crawl could happen babys head againts the wall when changing position. Custom baby masssage traditional one is also at risk of head injury. There are differences in anatomy, physiology and psychosocial, as well as infants who are experiencing brain development/growth particular problem in neuroanestesi In the event of trauma will cause mortality, morbidity and a higher rate, which is very influential in the development of infants. A boy,1 months, admitted to hospital with the experience a decrease in consciousness after a massage by masseur traditional. 3 days before entering the hospital, baby massage and then have fever, nausea and vomiting, seizures and decreased consciousness. The baby was brought to Puskesmas and refer to Abdul Muluk hospital. On examination 9 obtained GCS, pupillary light reflex isocoor 2/2mm + / +, hemodynamics in the normal range, anemia (+). After a physical examination and was diagnosed with an additional examination brain damage due to trauma (GCS 9) with epidural hemorraghe. Patient was managed with emergency hematoma evacuation under general anesthesia and with continues and comprehensive care using neuroanesthesia principles.
Manajemen Anestesi untuk Evakuasi Epidural Hemorrhage bersama dengan Operasi Fraktur Cruris Terbuka Subekti, Bambang Eko; Oetoro, Bambang J.; Rasman, Marsudi; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 6, No 1 (2017)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2135.461 KB) | DOI: 10.24244/jni.vol6i1.38

Abstract

Cedera kepala merupakan masalah kesehatan utama, pemicu kecacatan dan kematian di seluruh dunia. Epidural Hemorrhage (EDH) adalah salah satu bentuk cedera kepala yang sering terjadi. Epidural Hemorrhage umumnya terjadi karena robeknya arteri dan menyebabkan perdarahan di ruangan antara duramater dan tulang tengkorak. Kejadian cedera kepala ini biasanya juga dikuti dengan cedera di bagian tubuh lain yang juga memerlukan tindakan operasi. Penatalaksanaan cedera kepala saat ini difokuskan pada stabilisasi pasien dan menghindari gangguan intrakranial ataupun sistemik sehingga dapat menghindari cedera sekunder yang lebih buruk. Seorang laki-laki, 20 tahun, dibawa ke rumah sakit dengan penurunan kesadaran, fraktur femur tertutup dan fraktur cruris terbuka karena kecelakan lalu lintas. Setelah resusitasi dan stabilisasi didapatkan jalan napas bebas, laju pernapasan 12 x/menit (reguler), tekanan darah 130/85 mmHg, laju nadi 78 x/menit (reguler). Pada pasien dilakukan tindakan kraniotomi evakuasi hematoma dan debridement pada luka yang terbuka dengan anestesi umum dan dengan memperhatikan prinsip neuroanestesi selama tindakan bedah berlangsung.Anesthetic Management for Evacuation of Epidural Hemorrhagealong with Surgery Open Fracture CrurisHead trauma is a major health problem and considered as the leading cause of disability and death worldwide. Epidural Hemorrhage (EDH) is commonly seen in head trauma. Epidural Hemorrhage usually occurs due to ripped artery that coursing the skull causing blood collection between the skull and dura. The incidence of head trauma is usually followed by injuries in other body parts that require surgery.Head trauma management is currently focusing on patients stability and prevention the intracranial and haemodynamic instability to prevent the secondary brain injury. A 20 years old male patient, admitted to the hospital with decreased level of consciousness, closed fracture femur and open fracture cruris after traffic accidents. On examination, no airway obstruction found, respiratory rate was 12 times/min (regular), blood pressure 130/85 mmHg, heart rate 78 bpm (regular). Patient was managed with emergency hematoma evacuation and debridement of wounds under general anesthesia and with continues and comprehensive care using neuroanesthesia principles.
Manajemen Perioperatif pada Pasien dengan Hipertensi: Tinjauan Pustaka Khoirul Basyar, Fragil; Subekti, Bambang Eko
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1725

Abstract

Hypertension is a chronic condition characterized by sustained elevation of blood pressure ≥130/80 mmHg and is one of the major risk factors for morbidity and mortality among patients undergoing elective surgery. Globally, hypertension affects more than 1.13 billion individuals and contributes to approximately 9 million deaths annually. Despite advancements in antihypertensive therapy, hypertension remains a significant clinical challenge in perioperative management. Meta-analyses indicate that hypertension increases the risk of postoperative cardiovascular complications by up to 35%, underscoring the importance of effective perioperative management. Blood pressure regulation involves baroreceptor reflex mechanisms and the Renin–Angiotensin–Aldosterone System (RAAS). Dysregulation of these systems influences hemodynamic responses during anesthesia, in which reduced sympathetic activity and increased RAAS activation may elevate the risk of intraoperative hypotension, particularly in patients receiving specific classes of antihypertensive medications. Perioperative management begins with a comprehensive blood pressure assessment. Surgical delay is recommended only in cases of severe hypertension, defined as diastolic pressure >110 mmHg, or when significant comorbidities are identified. Management of antihypertensive medications plays a crucial role. Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Blockers (ARBs) are generally recommended to be withheld 24 hours prior to surgery to prevent intraoperative hypotension, except in stable heart failure patients. Large cohort studies have demonstrated that discontinuing ACEIs/ARBs before surgery reduces the composite risk of mortality, stroke, and myocardial injury in non-cardiac procedures. In contrast, β-blockers should be continued until the day of surgery, as abrupt discontinuation may induce rebound hypertension, tachycardia, and an increased risk of myocardial ischemia. Meta-analyses show that β-blockers effectively reduce the incidence of postoperative myocardial infarction and arrhythmias. Perioperative management in hypertensive patients requires an individualized approach that considers clinical status, medication profile, and hemodynamic risks associated with anesthesia.