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Journal : Jurnal Neuroanestesi Indonesia

Diabetes Insipidus pada Pasien Pascaoperasi Tumor Hipofisis Cahyanti G, Ramadina Putri; Nofiyanto, Eko; Laksono, Buyung Hartiyo
Jurnal Neuroanestesi Indonesia Vol 12, No 3 (2023)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v12i3.553

Abstract

Pembedahan pada tumor hipofisis dapat menyebabkan penurunan fungsi hipofisis, salah satunya adalah defisiensi antidiuretic hormone (ADH) yang dapat menyebabkan diabetes insipidus. Laporan kasus: Pasien perempuan 48 tahun, dengan diagnosis tumor sella-suprasella disertai visual loss, hipotiroid, hipoprolaktin, dan hipokortisol. Operasi berjalan 4 jam dengan tatalaksana general anestesi teknik proteksi otak. Pasca operasi pasien mengalami diabetes insipidus dengan klinis poliuriaa sampai lebih dari 6000 cc perhari. Dilakukan perawatan intensif dengan pemantauan ketat di Intensive Care Unit (ICU). Penggantian cairan dan pemberian desmopressin acetate kombinasi dengan vasopressin dilakukan sebagai terapi. Setelah perawatan 12 hari terjadi perbaikan klinis dan laboratoris. Tatalaksana dan monitoring yang tepat akan kejadian diabetes insipidus yang dapat mencegah terjadinya perburukan kondisi pada pasien.Diabetes Insipidus in Patient with Postoperative Pituitary TumorAbstractSurgery on a pituitary tumor can cause a decrease in pituitary function,: like deficiency antidiuretic hormone which cause diabetes insipidus. Case report: A 48-year-old female patient, with a diagnosis of sella-suprasella tumor accompanied by visual loss, hypothyroidism, hypoprolactin, and hypocortisol. The operation lasted 4 hours under general anesthesia with brain protection techniques. Postoperatively the patient had diabetes insipidus with clinical poliuriaa up to more than 6000 cc per day. Intensive care is carried out with close monitoring in the Intensive Care Unit. Fluid replacement and administration of desmopressin acetate in combination with vasopressin is performed as therapy. After 12 days of treatment, there was clinical and laboratory improvement. Appropriate management and monitoring of the incidence of diabetes insipidus can prevent the worsening of the patient's condition.
Dexmedetomidine as an Adjunct in Anesthesia for Adolescent Idiopathic Scoliosis (AIS) Surgery: A Case Series Nofiyanto, Eko; Halimi, Radian Ahmad; Fuadi, Iwan; Abdul rachman, Iwan
Jurnal Neuroanestesi Indonesia Vol 14, No 2 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i2.682

Abstract

Scoliosis is a spinal curvature deformity 10, with Adolescent Idiopathic Scoliosis (AIS) affecting those aged 10-18 years. The global prevalence of AIS is between 1%-2%, while in Indonesia, it stands at 2,93%, with a female-to-male ratio of 4.7:1. Perioperative challenges include nerve damage, bleeding, and postoperative pain. Neuromonitoring (MEP and SSEP) helps prevent injury, while careful drug selection supports spinal protection. Three female patients scoliosis reconstructions were performed under general anesthesia. All received target- controlled infusion (TCI) propofol, dexmedetomidine, and fentanyl, with stable hemodynamics and no neurological changes post-surgery. Epidemiological data showed that AIS predominantly affects females. The study included patients with curve progression impacting activity, with no motor or sensory abnormalities observed. Anesthesia was induced with propofol TCI (4 ?g/mL) and dexmedetomidine (0.3-0.7 mcg/kg/hr), reducing propofol and opioid use. Dexmedetomidine targets ?2-adrenergic receptors, reducing sympathetic outflow, stabilizing hemodynamics, blocking pain transmission, and improving recovery by reducing blood loss and inflammation. Dexmedetomidine provides sedation, analgesia, and stable hemodynamics in scoliosis surgery, minimizing blood loss and transfusion needs. It supports neurophysiological monitoring, reduces postoperative pain, and enhances recovery.