Claim Missing Document
Check
Articles

Manajemen Anestesi Stroke Perioperatif Permatasari, Endah; Bisri, Dewi Yulianti; Saleh, Siti Chasnak; Wargahadibrata, A. Hmendra
Jurnal Neuroanestesi Indonesia Vol 7, No 1 (2018)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (321.857 KB) | DOI: 10.24244/jni.vol7i1.29

Abstract

Stroke perioperatif merupakan suatu kejadian katastropik yang meningkatkan mortalitas dan morbiditas, terutama pada usia di atas 65 tahun. Stroke perioperatif merupakan suatu momok (kejadian yang tidak diharapkan) bagi keluarga dan rekan sejawat yang merawat. Stroke perioperatif dapat bersifat iskemik atau hemoragik yang terjadi selama masa intraoperatif hingga 30 hari pascaoperasi. Faktor risiko terjadinya stroke perioperatif diantaranya adalah: usia lanjut, riwayat stroke dan Transient Ischemic Attack (TIA) sebelumnya, atrial fibrilasi, kelainan pembuluh darah dan metabolik. Umumnya stroke perioperatif tidak terjadi selama masa pembedahan atau saat pulih sadar, tetapi terjadi dalam 24 jam pertama pascabedah. Penanganan stroke perioperatif membutuhkan manajemen yang menyeluruh dan suatu kerjasama tim yang baik. Walaupun kejadiannya tidak banyak namun membutuhkan penanganan tepat karena tingkat morbiditas dan mortalitas yang tinggi serta mengakibatkan lama perawatan memanjang. Identifikasi awal pasien dan manajemen terpadu lintas keilmuan harus dilakukan untuk mencegah luaran yang buruk setelah terjadinya stroke perioperatif.Anesthetic Management of Perioperative StrokePerioperative stroke can be a catastrophic outcome for surgical patients and is associated with increased morbidity and mortality, especially in the age above 65. A perioperative stroke is an unexpected event for families and caring colleagues. A perioperative stroke may be an ischemic or haemorrhagic disorder that occurs intraoperatively or up to 30 days postoperatively. Risk factors for perioperative stroke include elderly, history of previous stroke and transient ischemic attack (TIA), atrial fibrillation, vascular and metabolic disorder. Most perioperative stroke generally does not occur during the intraoperative period or soon after recovering period but within the first 24 hours. Handling perioperative stroke requires a thorough management and a good teamwork. Perioperative stroke can be devastating, as they not only result in death but also prolong the length of hospital stay, increasing cost and greater likelihood of discharge to long term care facilities. Although the incidence is not much but this requires appropriate treatment because of high morbidity and mortality and also result in prolong length of hospital stay. Early identification and expeditious management involving a multidisciplinary approach is the key to avoid a poor outcome following perioperative stroke.
Penatalaksanaan Anestesi pada Pasien Spondilitis Tuberkulosis Torakalis dan Tumor Esktramedular (Meningioma Torakalis) T711 Adriman, Silmi; Bisri, Dewi Yulianti; Rahardjo, Sri; Wargahadibrata, A Himendra
Jurnal Neuroanestesi Indonesia Vol 4, No 2 (2015)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2662.638 KB) | DOI: 10.24244/jni.vol4i2.111

Abstract

Spondilitis tuberkulosis dan tumor spinal merupakan dua dari banyak penyakit yang dapat menyebabkan kompresi dan lesi pada medula spinalis. Gejala klinis muncul sesuai dengan lokasi kompresi atau lesi, seperti kelemahan anggota gerak bawah, gangguan miksi dan gangguan neurologis lainnya. Pada hampir semua kasus, gejala-gejala yang muncul ini menjadi dasar dilakukannya tindakan pembedahan. Pada kasus seperti ini, pemilihan pengaturan posisi pasien saat dilakukan pembedahan, selain untuk mendapatkan akses yang optimal untuk ahli bedah, juga dapat mempengaruhi waktu pulih, morbiditas dan mortalitas. Pada kasus ini dilaporkan laki-laki, 16 tahun, dengan skor Glasgow Coma Scale (GCS) 15, berat badan 50 kg dan hemodinamik stabil, datang dengan keluhan kelemahan pada kedua kaki. Hasil magnetic resonance imaging (MRI) menunjukkan adanya abses pada vertebra torakal 78 dan tumor ekstramedular pada vertebra torakal 7-11. Pada pasien dilakukan tindakan laminektomi, pengangkatan tumor, drainase abses dan pemasangan stabilisasi posterior dengan anestesi umum. Tindakan pembedahan dilakukan pada posisi prone.Anesthetic Management of Tuberculous Spondylitis and Extramedullary Tumor (Thoracalis Meningioma) T711Tuberculous spondylitis and tumors of the spine are two of many commonly cause of multiple lesions and spinal cord compression. The location of the lesion often determines the clinical manifestation. Mild to severe limb weakness, urinary disturbance and other abnormality due to posterior column compression are the common clinical manifestations. In most cases, these symptoms were used as guidance for surgical treatment. In a case like this, patients position during surgery, in addition to gain optimal access for the surgeon, could affect recovery time, morbidity and mortality. This case reported a 16 years old male, with Glasgow Coma Scale (GCS) score 15, bodyweight 50 kgs with stable haemodynamic, admitted to hospital due to paresthesian both legs. Magnetic Resonance Imaging (MRI) revealed paravertebral abscess at vertebral body T7T8 and coincidencewith extramedullary tumor of the vertebrae T7T11. Laminectomy, tumor removal, abscess drainage and posterior fixation were performed under general anesthesia. Surgical intervention was done in prone position.
Ambang Hemoglobin pada Cedera Otak Traumatik Bisri, Dewi Yulianti; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 5, No 3 (2016)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2059.871 KB) | DOI: 10.24244/jni.vol5i3.73

Abstract

WHO mendefinisikan anemia bila konsentrasi Hb12g/dL pada wanita dan 13 g/dL pada laki-laki. Anemia merupakan salah satu komplikasi medikal yang paling sering pada pasien sakit kritis, termasuk pasien dengan kelainan neurologik. Kira-kira 2/3 pasien mempunyai kadar Hb12 g/dL pada saat masuk ke ICU, dan kemudian terjadi penurunan 0,5 g/dl/hari. Transfusi PRC memelihara hematokrit dan kapasitas pembawa oksigen, tapi dihubungkan dengan peningkatan resiko infeksi, gagal multiorgan termasuk gagal nafas, kejadian tromboembolik, dan kematian. Penelitian telah menunjukkan bahwa untuk kebanyakan pasien sakit kritis, tidak ada keuntungan untuk mempertahankan konsentrasi hemogloblin yang lebih tinggi.Disamping penemuan pada pasien sakit kritis, diketahui bahwa konsentrasi Hb serendah 7 g/dL tidak dapat ditolerir pada pasien dengan cedera otak traumatik berat maka indikasi transfusi bila Hb7g/dL. Penelitian telah menunjukkan tidak ada perbedaan dalam mortalitas atau mendukung suatu hubungan antara transfusi dengan lebih buruknya outcome. Mempertahankan konsentrasi Hb sekitar 9-10g/dL adalah suatu strategi terapi yang telah lama dilakukan untuk memperbaiki oksigenasi otak pada pasien dengan cedera otak traumatik. Kemungkinan efek menguntungkan lain dari mempertahankan konsentrasi Hb yang lebih tinggi adalah untuk menghindari peningkatan tekanan intrakranial yang dipicu oleh anemia dan untuk memberikan tekanan darah yang lebih tinggi serta tekanan perfusi otak yang lebih baik. Simpulan adalah anemia berat dan transfusi RBC bisa mempunyai pengaruh pada outcome klinis, transfusi restriksif aman dan sering dianjurkan, indikasi transfusi bukan dari kadar Hb tapi dari sinyal otak misalnya brain tissue oxygen tension dan regional cerebral oxygen saturation.Hemogloblin Treshold in Traumatic Brain InjuryWHO defined anemia as a Hb concentration 12 gr/dL in women and 13 g/dL in men. Anemia is one of the most common medical complication in critically ill patient, including patient with neurologic disorder. About 2/3 patient have Hb concentration 12 g/dL at the time of ICU admission with subsequent decrement of about 0.5 g/dL per day. PRC transfusion improve hematocrit and oxygen carrying capacity, but have correlation with increase infection risk, multiorgan failure including respiratory failure, thromboembolic event and death. The study show that for common critically ill patient, no benefit to keep Hb concentration in higher level. Beside in critically ill patient, Hb concentratrion as low as 7 g/dL can be tolerir in severe traumatic brain injury and indication for transfusion if Hb7g/dL. Study show that no different in mortality or support a relation between transfusion and worst outcome. Keeping Hb concentration arround 910g/dL is a strategy therapy to improve brain oxygenation in traumatic brain injury patient. The possibility othe advantageus in higher Hb concentration is to avoid increase ICP cause by anemia and to increase blood pressure and better cerebral perfusion pressure.The conclusion is severe anemia and RBC transfusion have some effect in clinical outcome, restrictive transfusion safe and advisable, transfusion indication not only from Hb level but from brain signaling ec brain tissue oxygen tension and regional cerebral oxygen saturation.
Penatalaksanaan Anestesi pada Reseksi Tumor Batang Otak Krisna J. Sutawan, Ida Bagus; Bisri, Dewi Yulianti; Saleh, Siti Chasnak; Wargahadibrata, A. Himendra
Jurnal Neuroanestesi Indonesia Vol 6, No 2 (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 (337.765 KB) | DOI: 10.24244/jni.vol6i2.44

Abstract

Batang otak adalah komponen dari fossa posterior, oleh karena itu penatalaksanaan anestesi pada reseksi tumor di batang otak tentunya mengikuti prinsip-prinsip umum penatalaksanaan anestesi pada fossa posterior ditambah dengan perhatian khusus terhadap komplikasi yang mungkin terjadi pada saat melakukan manipulasi pada batang otak. Seorang laki-laki 41 tahun dengan tumor batang otak mengeluh adanya pengelihatan ganda, rasa tebal dan nyeri pada wajah serta gangguan menelan, pada MRI ditemukan lesi difus batas tidak tegas di daerah pons sampai mid brain, curiga tumor otak primer (low grade tumor), nervus optikus dan kiasma optikum kanan kiri tampak normal. Pasien berhasil dianestesi dengan baik digunakan TCI- propofol monitoring standar ditambah monitoring invasif artery line dan pemasangan kateter vena sentral, intraoperatif pasien mengalami episode hipotensi tekanan darah (70/40 mmHg) dan bradikardia, (laju nadi 35 x/menit), oksigen 50%, fentanyl sevofluran dan rekuronium, digunakan akibat manipulasi pada batang otak. Postoperatif pasien dirawat di ICU dan diextubasi 12 jam kemudian.Anesthesia Management in Brain Steam Tumor ResectionBrain steam is a component of fossa posterior, ther fore anesthesia management for brain steam tumor resection should follow the general rule for anesthesia management of fossa posterior and a special concern for complication that could happen when brain steam is manipulated. Forty one year old male with a brain steam tumor complain a double vision, numbness and pain on the face, and swallowing problem, MRI show diffuse lesion on the pons to mid brain, suspect primary brain tumor (low grade tumor), nervus opticus and chiasma opticum are normal. Patient has been anesthesied well using TCI propofol, oxygen 50%, fentanyl, sevoflurane and rocuronium using invasive monitoring artery line and central venous catheter (CVC) in addition to standart monitoring. Intraoperatifly patient going through a hypotensive episode (blood pressure 70/40 mmHg) and bradycardia (heart rate 35x/minute that caused by manipulation on the brain steam. Postoperatifly patient is in the ICU and extubated on next 12 hours.
Penanganan Anestesi pada Operasi Olfactory Groove Meningioma Adriman, Silmi; Bisri, Dewi Yulianti; Rahardjo, Sri; Wargahadibrata, A Himendra
Jurnal Neuroanestesi Indonesia Vol 4, No 1 (2015)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2708.602 KB) | DOI: 10.24244/jni.vol4i1.108

Abstract

Angka kejadian Olfactory Groove Meningioma adalah 1015% dari total meningioma yang terjadi di intrakranial, dimana tumor ini berasal dari basis cranii anterior. Manifestasi klinis berupa penurunan penciuman akibat terjepitnya saraf olfaktori dan apabila tumor cukup besar dan menekan saraf optikus, pasien akan mengalami penurunan penglihatan, bahkan buta. Pada kasus ini dilaporkan seorang wanita berusia 38 tahun, GCS 15 dengan diagnosis olfactory groove meningioma akan dilakukan operasi kraniotomi untuk pengangkatan tumor. Pasien datang dengan keluhan tidak bisa melihat dan tidak bisa mencium bebauan. Hasil CT Scan menunjukkan gambaran hiperdens berbentuk enhancing lesion pada regio frontal. Pasien dilakukan tindakan anestesi umum dengan intubasi. Induksi dengan propofol, fentanyl, lidokain dan vecuronium. Pengelolaan cairan perioperatif dengan ringerfundin, manitol dan furosemid. Pembedahan dilakukan selama 6 jam. Pasca bedah, pasien dirawat di Unit Perawatan Intensif (Intensive Care Unit/ ICU) selama 2 hari sebelum pindah ruangan.Anesthesia Management for Olfactory Groove Meningioma RemovalOlfactory Groove Meningioma, a type of meningioma is primarily derived from anterior cranial base, manifest in approximatelly 10-15% of meningioma cases. Clinical manifestations include smelling disorder and blurred vision or even cause blindness due to compression of the tumor to the optic nerve. This case reported a 38 years old woman with GCS 15 and diagnosed with olfactory groove meningioma, planned for a craniotomy tumor removal under general anesthesia. She was admitted to hospital due to blurred vision and smelling disorder. Computed Tomography (CT) scan showed a enhancing lesion in the frontal region. Induction of anesthesia was done using propofol, fentanyl, lidocaine and vecuronium. Ringerfundin, manitol and furosemide were used for perioperative fluid management. The surgery was conducted for 6 hours. Patient was managed in the Intensive Care Unit post operatively for 2 days prior to ward transfer
Mannitol untuk Hipertensi Intrakranial pada Cedera Otak Traumatik: apakah masih diperlukan? Bisri, Dewi Yulianti
Jurnal Neuroanestesi Indonesia Vol 2, No 3 (2013)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (411.815 KB) | DOI: 10.24244/jni.vol2i3.157

Abstract

Angka kejadian cedera otak traumatika (COT) masih cukup tinggi berkisar 1,4 juta pertahun dengan angka kematian 1520%. Peningkatan tekanan intrakranial (TIK) sangat sering terjadi setelah COT yang dihubungkan dengan angka mortalitas dan morbiditas. Terapi hipertensi intrakranial harus dimulai bila tekanan intrakranial 20 mmHg atau lebih, karena makin tinggi kenaikan tekanan intrakranial makin tinggi mortalitas. Komplikasi peningkatan TIK adalah terjadinya iskemia dan herniasi otak. Pada guideline terapi hipertensi intrakranial dikenal first-tier therapy dan second-tier therapy. First-tier therapy adalah drenase cairan serebrospinalis, hiperventilasi sedang mencapai PaCO2 3035 mmHg, dan pemberian osmotik diuretik mannitol. Mannitol mampu menurunkan volume otak dan TIK, mengurangi viskositas darah, meningkatkan aliran darah otak, sehingga akan memperbaiki pasokan oksigen. Peningkatan deformabilitas eritrosit akan membantu menurunkan TIK. Akan tetapi, Cochrane systematic review menemukan tidak cukup data untuk membuat rekomendasi penggunaan mannitol untuk pengelolaan pasien cedera otak traumatik.Terapi diuretik dengan mannitol 0,251 g/kg diinfuskan dalam waktu lebih dari 10 menit sampai 20 menit dan diulang setiap 36 jam. Osmolaritas plasma harus dipantau dan tidak boleh lebih dari 320 mOsm/L. Efek akan dimulai pada menit ke 1530 setelah pemberian dan menetap 90 menit sampai 6 jam. Simpulannya adalah karena dari guideline Brain Trauma Foundation yang menyebutkan bahwa mannitol digunakan untuk first-tier therapy, maka pada pekerjaan sehari-hari dalam mengelola pasien cedera kepala berat dengan hipertensi intrakranial kita tetap memberikan terapi mannitol. Mannitol for Intracranial Hypertension in Traumatic Brain Injury: is it still needed? The incidence of traumatic brain injury (TBI) remains high, about 1.4 million per year with a mortality rate of 1520%. Increased intracranial pressure (ICP) is very common after TBI. Increased ICP is associated with incidence of mortality and morbidity. Intracranial hypertension therapy should be initiated when the ICP is 20 mmHg or more, as higher increase in ICP will increase mortality. Complications of elevated ICP include brain ischemia and brain herniation. Intracranial hypertension treatment guidelines include first-tier and second-tier therapy. First-tier therapy is cerebrospinal fluid drainage, hyperventilation, achieving PaCO2 3035 mmHg, and osmotic diuretic: mannitol administration. Mannitol can reduce brain volume and ICP, reduce blood viscosity, improve cerebral blood flow, therefore improving the supply of oxygen. Increased erythrocyte deformability will help to reduce ICP. However, the Cochrane systematic review found insufficient data to make recommendations on the use of mannitol for the management of TBI patients. Diuretic therapy with mannitol 0.25 to 1g/kg infused in just over 10 minutes to 20 minutes and repeated every 36 hours. Plasma osmolarity should be monitored and should not be more than 320 mOsm/L. Effect will begin 1530 minutes after administration and settled 90 minutes to 6 hours. Brain Trauma Foundation guidelines states that mannitol is used as first-tier therapy, therefore we administer manitol as part of management of patients with severe head injury with intracranial hypertension.
Gambaran Epidemiologi Pasien Stroke Dewasa Muda yang Dirawat di Bangsal Neurologi RSUP Dr.Hasan Sadikin Bandung Periode 20112016 Syifa, Nadia; Amalia, Lisda; Bisri, Dewi Yulianti
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 (265.975 KB) | DOI: 10.24244/jni.vol6i3.50

Abstract

Latar Belakang dan Tujuan: Kerugian akibat stroke lebih berat pada penderita yang berusia lebih muda dibandingkan usia tua. Insidensi stroke dewasa muda terus meningkat di berbagai negara. Pencegahan yang tepat dapat dilakukan dengan melakukan studi epidemiologi. Penelitian ini bertujuan untuk mengetahui gambaran epidemiologi pasien stroke dewasa muda.Subjek dan Metode: Penelitian ini merupakan studi kuantitatif dengan metode deskriptif. Data yang digunakan adalah resume rekam medis pasien stroke yang dirawat di bangsal neurologi Rumah Sakit Dr.Hasan Sadikin(RSHS) Bandung tahun 20112016. Data kemudian diklasifikasikan berdasarkan kelompok usia, jenis kelamin, tipe stroke, demografi, dan faktor risiko.Hasil: Sampel yang didapatkan sejumlah 450 buah. Jumlah kasus stroke terbanyak berada pada kelompok umur 4245 tahun (45,11%). Kejadian stroke iskemik (50,44%) lebih tinggi dibandingkan kejadian stroke perdarahan (49,56%). Kejadian pada perempuan (56,66%) lebih tinggi dibandingkan laki-laki (43,34%). Pendidikan terakhir penderita paling banyak adalah SMA (32,89%). Kelompok pekerjaan terbanyak adalah kelompok tidak bekerja (56,22%). Faktor risiko terbanyak adalah hipertensi (42,06%). Simpulan: Kejadian stroke dewasa muda di RSHS paling banyak terjadi pada kelompok usia 42-45 tahun, tipe stroke iskemik, jenis kelamin perempuan, pendidikan terakhir SMA, tidak bekerja, dan faktor risiko tertinggi adalah hipertensi.Epidemiological Picture of Young Adult Stroke Patients treated in Neurology Ward of RSUP Dr.Hasan Sadikin Bandung 20112016 PeriodBackground and Objectives: The stroke loss is higher in younger patients compared to the older patients. Stroke incidence is increasing year by year. Epidemiological study can be used as the basis of prevention and reduction of young adult stroke incidence. This study aims to determine the epidemiological picture of young adult stroke patientsSubjects and Method: This study is a quantitative study using descriptive method. The datas were taken from the resume of medical records of patients that are diagnosed as stroke and treated in the neurology ward Dr.Hasan Sadikin Hospital(RSHS) in 2011 - 2016. All samples were taken then classified by its age group, sex, stroke type, demographical characteristic and risk factor. Result: 452 samples were obtained. The highest number of cases are found in the 42-45 year old group (45,11%). Ischemic stroke (50,44%) cases are higher compared to the hemorrhagic stroke (49,56%). Stroke cases in women (56,66%) is higher than in men (43,34%). Most of the patients last education is high school (32,89%). Most of the patients who have stroke are unemployed (56,22%). The most risk factor is hypertension (42,06%). Conclusion: Stroke cases in RSHS happen to be higher in older age group, ischemic stroke type, women, high school as the last education, unemployment and the highest risk factor is hypertension.
Diagnosis and Management of Cerebral Vasospasm Following Aneurysmal SAH Oktavian, Mirza; Bisri, Dewi Yulianti; Rachman, Iwan Abdul
Jurnal Neuroanestesi Indonesia Vol 14, No 3 (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.v14i3.657

Abstract

Cerebral Vasospasm, characterized by the progressive constriction of cerebral arteries, often occurs following a subarachnoid hemorrhage (SAH) and is a leading cause of morbidity and mortality in affected patients. This condition can be resulted in cerebral ischemia, the severity of which correlates with the degree of vasospasm. The underlying pathophysiology involves the encasement of arteries by blood clots, although the intricate interactions between the hematoma and adjacent structures remain incompletely understood. The delayed onset of vasospasm offers a potential window for preventive interventions. However, recent randomized controlled trials have been discouraging, as they failed to demonstrate any significant improvement in patient outcomes with the use of clazosentan (an endothelin antagonist), simvastatin (a cholesterol-lowering agent), or magnesium sulfate (a vasodilator). Current best practices for managing vasospasm include minimizing ischemia by maintaining adequate blood volume and pressure, administering nimodipine (a calcium channel blocker), and, when necessary, performing balloon angioplasty. Over the past two decades, advancements in the management of vasospasm have significantly reduced associated morbidity and mortality rates. Nevertheless, vasospasm remains a critical determinant of clinical outcomes following aneurysmal rupture.
Pengelolaan Perioperatif Cedera Medula Spinalis Servikal karena Trauma dengan Tetraparesis Frankle C Asia Basuki, Wahyu Sunaryo; Bisri, Dewi Yulianti; Saleh, Siti Chasnak; Wargahadibrata, A. Hmendra
Jurnal Neuroanestesi Indonesia Vol 7, No 1 (2018)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (375.426 KB) | DOI: 10.24244/jni.vol7i1.24

Abstract

Cedera medula spinalis akut relatif jarang namun menjadi salah satu kejadian trauma yang berakibat fatal. Kejadian ini sering terjadi pada laki-laki dewasa muda. Kecelakaan lalu lintas merupakan penyebab utama dari kejadian ini, disusul oleh kejadian trauma di rumah, industri dan olahraga. Tujuan utama dari pengelolaan cedera medula spinalis akut adalah mencegah medula spinalis dari cedera sekunder dan memperbaiki fungsi neurologis, mencegah perubahan alignment dan menjaga stabilitas columna vertebralis untuk mendapatkan hasil pemulihan neurologis dan rehabilitasi yang maksimal. Ahli anestesi berperan besar mulai awal pengelolaan secara optimal cedera medula spinalis akut ini. Seorang laki-laki, 57 tahun, dibawa kerumah sakit karena kecelakaan sepeda motor. Pada pemeriksaan fisis, didapatkan laju nafas 24x/menit, nadi 70x/menit, tekanan darah 110/61 mmHg, perfusi baik, GCS 15, dan tetraparesis. Dalam perawatan selanjutnya, terjadi bradikardia (nadi 50-61 x/menit) dan hipotensi (tekanan darah 80-90/40-60 mmHg). Dilakukan laminoplasti dekompresi stabilisasi segera.Perioperative Management Traumatic Cervical Spinal Cord Injury with Tetraparesis Frankle C AsiaAcute spinalis cord injury (SCI) is relatively rare but can be a fatal trauma event. Young adult men are most commonly affected. Traffic accident is a frequent cause, followed by accidents at homes, industries, and in sports. The primary goals of the management of acute SCI are to prevent secondary injury of the spinal cord, improve neurological functions, prevent disruption in alignment, and maintain the stability of the vertebral columns. These serve to achieve neurological recovery and maximal rehabilitation. Anesthesiologists play an important role in the optimal management of acute SCI. A 57-year-old man was brought to the hospital due to a motorcycle accident. Physical examination revealed respiratory rate 24 x/minutes, heart rate 70 x/minutes, blood pressure 110/61 mmHg, good perfusion, GCS 15, and tetraparesis. During hospitalization, the patient developed bradycardia (heart rate 50-61 x/minutes) and hypotension (blood pressure 80-90/40-60 mmHg). Immediate decompressive laminoplasty stabilisation was performed.
Hubungan Parameter Koagulasi dengan Tipe, Ukuran, dan Jumlah Perdarahan pada Operasi Tumor Otak Supratentorial Sugiyanto, Endy; Bisri, Dewi Yulianti
Jurnal Neuroanestesi Indonesia Vol 8, No 2 (2019)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2271.938 KB) | DOI: 10.24244/jni.v8i2.201

Abstract

Latar Belakang dan Tujuan: Tumor otak memiliki angka kejadian 3,8-5,5% dari semua kasus tumor di Indonesia. Kebanyakan kasus tumor otak mengalami hiperkoagulasi, meskipun terdapat pengecualian pada beberapa kasus. Tujuan penelitian untuk mengetahui hubungan koagulopati dengan tipe, ukuran, dan jumlah perdarahan pada operasi tumor otak supratentorialSubyek dan Metode: Penelitian observasional analitik pada 30 pasien dengan rancangan cross-sectional pengukuran berulang untuk menganalisis hubungan antara koagulopati dengan tipe, ukuran, dan perdarahan tumor otak. Pengambilan sampel penelitian dilakukan secara consecutive samplingHasil: Terdapat 17 orang pasien dengan meningioma, 2 orang pasien dengan oligodendroglioma, 3 orang pasien dengan metastase dan 8 orang dengan tumor lain. Rata-rata bleeding time, clotting time, protrombin time (PT), dan activated partial thromboplastin time (APTT) preoperatif, 2 jam dan 6 jam post operatif berada dalam rentang nilai normal. Ditemukan penurunan yang konstan pada data APTT. Terdapat hubungan negatif yang signifikan antara ukuran tumor dengan bleeding time preoperatif serta hubungan yang signifikan antara jumlah pendarahan dengan APTT preoperatif.Simpulan: Pasien tumor otak mungkin mengalami kondisi hiperkoagulasi dari hasil pemeriksaan faktor koagulasi sederhana, terdapat hubungan negatif antara ukuran tumor dan bleeding time sehingga semakin besar ukuran tumor semakin besar juga risiko hiperkoagulasi yang mungkin dialami pasien.Correlation between Coagulation Parameter and Type, Size, and Blood Loss in Supratentorial Brain Tumor SurgeryAbstractBackground and Objective: The incidence rate of brain tumor 3.8-5.5% of all tumor cases in Indonesia. Most of brain tumor patients experience hypercoagulation, although there are exception in some cases. The purpose of this study to know the relationship between coagulopathy and brain tumor supratentorial type, size, and number of bleeding on operation.Subject and Methods: This is an observational analytical cross-sectional design for 30 patient to analyze correlation between coagulopathy and brain tumor type, size, and bleeding. The sampling methods were consecutive samplingResult: There were 17 patients with meningioma, 2 patients with oligodendroglioma, 3 patients with metastasis and 8 patients with other type of tumor. The average of bleeding time, clotting time, protrombin time (PT), dan activated partial thromboplastin time (APTT) in preoperative, 2 hours and 6 hours were normal. There were constant decline of APTT. Negative correlation between tumor size and preoperative bleeding time and significant correlation between amount of bleeding and preoperative APTT were also found.Conclusion: From simple coagulation factor test result, it is very like for a brain tumor patient to experience hypercoagulative state, a negative correlation between tumor size and bleeding time, meaning the bigger the tumor size, the higer hypercoagulation risk possesed by the patient.
Co-Authors A Himendra Wargahadibrata A. Himendra Wargahadibrata A. Hmendra Wargahadibrata Achmad Adam, Achmad Adriman, Silmi Adriman, Silmi Ahmado Oktaria Alifahna, Muhammad Rezanda Alifan Wijaya Andy Hutariyus Anwar, Tabihul Arief Cahyadi Arif, Izhar Muhammad Arif, Izhar Muhammad Arna Fransisca Arshad, Muhammad Ayu Rosema Sari Bangun, Chrismas Gideon Basuki, Wahyu Sunaryo Basuki, Wahyu Sunaryo Boesoirie, M. Adli Boesoirie, M. Adli Cecep Eli Kosasih Cobis, Albinus Yunus Daneswara, Andika Deni Nugraha Dhany Budipratama Doddy Tavianto Emas, Bagas Eri Surahman Firdaus, Riyadh Firdaus, Riyadh Fitri Sepviyanti Sumardi Fitri Sepviyanti Sumardi Gaus, Syaruddin Giovanni, Cindy Giovanni, Cindy Hana Nur Ramila Harahap, M Sofyan Hermin Aminah Usman Ida Bagus Krisna Jaya Sutawan Ike Sri Redjeki Indrayani, Ratih Rizki Indria Sari Iqbal Pramukti Irina, Rr. Sinta Iwan Abdul Rachman Iwan Fuadi Jasa, Zafrullah Khany Krisna J. Sutawan, Ida Bagus Lalenoh, Diana C Limawan, Michaela Arshanty Lira Panduwaty Lisda Amalia Longdong, Djefri Frederik M, Mutivanya Inez M, Mutivanya Inez M. Sofyan Harahap Maharani, Mutivanya Inez Maharani, Nurmala Dewi Mangastuti, Rebecca Sidhapramudita Mangastuti, Rebecca Sidhapramudita Michaela Arshanty Limawan Mirza Oktavian Muhammad Habibi Nataputra, Mario Nopian Hidayat Nuryanda, Dian Oetoro, Bambang J. Oetoro, Bambang J. Okky Harsono Oktaria, Ahmado Permatasari, Endah Permatasari, Endah Putri, Dini Handayani Putri, Dini Handayani Radian Ahmad Halimi Rasman, Marsudi Rasman, Marsudi Renaldy Sobarna Riki Punisada Riyadh Firdaus Robert Sihombing Ruli Herman Sitanggang Saleh, Siti Chasnak Saleh, Siti Chasnak Saputra, Tengku Addi Saputra, Tengku Addi SATRIYAS ILYAS Septiani, Gusti Ayu Pitria Sihombing, Robert Siti Chasnak Saleh Soefviana, Stefi Berlian Sri Rahardjo Sugiyanto, Endy Susanto, Yunita Susanto, Yunita Sutaniyasa, I Gede Sutanto, Sigit Sutanto, Sigit Syafruddin Gaus Syahpikal Sahana Syifa, Nadia Syifa, Nadia Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Tatang Bisri Uhud, Akhyar Nur Umar, Nazaruddin Utama, M Lucky Wargahadibrata, A. Hmendra Wargahadibrata, A. Hmendra Widiastuti, Monika Winarso, Achmad Wahib Wahju Wullur, Caroline Wullur, Caroline Yuanda Rizawan Putra Yusmein Uyun Zaka Anwary, Army