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All Journal BALI MEDICAL JOURNAL (BMJ) E-Jurnal Medika Udayana Jurnal Anestesi Perioperatif Paediatrica Indonesiana Bali Journal of Anesthesiology Syntax Literate: Jurnal Ilmiah Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research PREPOTIF : Jurnal Kesehatan Masyarakat Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Anesthesiology and Clinical Research Jurnal Neuroanestesi Indonesia Majalah Anestesia & Critical Care (MACC) The International Journal of Medical Science and Health Research Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif
Ida Bagus Krisna Jaya Sutawan
Faculty Of Medicine Universitas Udayana Denpasar Bal
Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences Veterinary Other

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Journal : Syntax Literate: Jurnal Ilmiah Indonesia

 1 
Anesthesia Management of Space-Occupying Lesion in the Pontine Region due to Brainstem Glioma in a Pediatric Patient: a Case Report Yustisia, Putu Ngurah Krisna Denta; Sutawan, Ida Bagus Krisna Jaya; Senapathi, Tjokorda Gde Agung; Kurniyanta, I Putu
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v9i11.16937

Abstract

A space-occupying lesion (SOL) in the pontine region of the medulla oblongata, often suspected as a brainstem glioma, poses a complex diagnostic challenge. Brainstem gliomas, primarily diffuse intrinsic, afflict all age groups with a median survival of about 12 months, influenced by tumor characteristics. Comprehensive preoperative evaluation is essential to assess the patient's health status and identify potential complications, guiding optimal anesthesia management. This case report aimed to describe the author's anesthesia technique for managing patients with SOL in the pontine region of the medulla oblongata, focusing on those with suspected brainstem gliomas. A four-year-old girl weighing 20 kilograms presented with sudden left-sided weakness, difficulty swallowing, headaches, and speech difficulties. Examination revealed right cranial nerve paresis and decreased left extremity strength. MRI showed a pontine glioma. Surgery preparation included fasting, fluid calculation, and medication readiness. Anesthesia induction involved midazolam premedication, propofol induction, and remifentanil for intubation. Monitoring included EtCO2 and oxygen saturation maintenance. Intraoperatively, target-controlled infusion (TCI) propofol and compressed air sustained oxygenation. Paracetamol and tranexamic acid were administered. The surgery lasted five hours in the left lateral decubitus position. Postoperative analgesia included fentanyl and oral paracetamol. The patient spent seven days in the PICU on a ventilator before discharge on the eighth day. In summary, the case of the four-year-old girl with left-sided weakness and difficulty swallowing, diagnosed with pontine glioma, showcases the intricate multidisciplinary approach essential in pediatric neurosurgery.
Co-Authors Adhiwirawan, Christina Angelia Maharani Dewi Anak Agung Ngurah Aryawangsa Christopher Ryalino Cynthia Dewi Sinardja Dewi Yulianti Bisri Diana Lalenoh Eka Nantha Kusuma, Putu EM, Tjahya Aryasa Erwin Pradian Gde Agung Senapathi, Tjokorda Gede Semarawima, Gede Haithami, Guntur Mu Ammar Hartawan, I Gusti Agung G Utara Hendra Santoso Hendrikus Gede Surya Adhi Putra I Gede Catur Wira Natanagara I Gede Prima Julianto I Gusti Agung Gede Utara Hartawan I Gusti Ngurah Mahaalit I Gusti Ngurah Mahaalit Aribawa I Ketut Sinardja I Ketut Wibawa Nada I Made Gede Widnyana I Wayan Aryabiantara, I Wayan IGNA Putra Arimbawa, IGNA Putra Johanes, Kevin Paul Junaedi, Made Darma Kadek Agus Heryana Putra Kadek Agus Heryana Putra, Kadek Agus Ketut Dewi Kumara Wati Ketut Semara Jaya, Ketut Semara Ketut Yudi Arparitna, Ketut Yudi Komang Ayu Witarini Kurniyanta, I Putu Made Agus Kresna Sucandra, Made Agus Kresna Made Wiryana Martin Gabe Tua Sihotang Mulyadi, Win Oetoro, Bambang J Oetoro, Bambang J. Parami, Pontisomayaa Pontisomaya Parami Pragra, Maria Preicilia Putu Agus Surya Panji Putu Ayunda Trisnia Putu Herdita Sudiantara, Putu Herdita Putu Kurniyanta Putu Pramana Suarjaya Rasman, Marsudi Ratumasa, Marilaeta Cindryani Ra Richard Richard Saleh, Siti Chasnak Siti Chasnak Saleh Sri Rahardjo Sucandra, MA Kresna Supradnyana, I Nyoman Novi Syafruddin Gaus Tatang Bisri Tatang Bisri Tinni T. Maskoen Tinni T. Maskoen Tjahya Aryasa Tjokorda Gde Agung Senapathi Wanda, Aprilia Wargahadibrata, A. Hmendra Yustisia, Putu Ngurah Krisna Denta