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All Journal BALI MEDICAL JOURNAL (BMJ) E-Jurnal Medika Udayana MNJ (Malang Neurology Journal) Bali Journal of Anesthesiology Syntax Literate: Jurnal Ilmiah Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research PREPOTIF : Jurnal Kesehatan Masyarakat Neurologico Spinale Medico Chirurgico Journal of Anaesthesia and Pain Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Anesthesiology and Clinical Research Sehat Rakyat: Jurnal Kesehatan Masyarakat Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif
I Gusti Ngurah Mahaalit Aribawa
Department Of Anesthesiology, Pain Management, And Intensive Care, Faculty Of Medicine, Udayana University, Sanglah General Hospital, Denpasar-Bali, Indonesia
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

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Manajemen Perioperatif Pembedahan Video-Assisted Thoracoscopy (VATS) Dekortikasi dan Biopsi Pada Pasien dengan Kecurigaan Keganasan Paru Kiri dengan Atrial Septal Defect Yuliana, Astrid; Dewi, Dewa Ayu Mas Shintya; Aribawa, I Gusti Ngurah Mahaalit
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i7.60745

Abstract

Video-Assisted Thoracoscopy (VATS) is a minimally invasive procedure that can reduce postoperative pain, shorter hospitalizations, and faster recovery. The use of Double Lumen Tube (DLT) in this procedure is with the aim of optimizing the visualization of the surgical field. However, patients with cardiac disorders, such as Atrial Septal Defect (ASD) that can lead to shunt disorders, require adjustments to anesthesia management in terms of ventilation, especially in preventing shunts from right to left. Case Report. The male patient, 30 years old, came in with massive exudative pleural effusion and a history of ASD Secundum. The patient showed significant weight loss and spirometry results showed pulmonary restriction. Preoperative evaluation showed ASA III, with a risk of respiratory and cardiovascular impairment. Anesthesia is performed with left DLT for OLV and thoracic epidural for multimodal analgesation. Postoperatively, the patient is admitted to the ICU on a ventilator and given analgesia via an epidural. Postoperative monitoring showed stable hemodynamics. Discussion. VATS allows thoracic surgery with minimal incision, reducing postoperative pain and speeding up recovery. DLT selection is important for OLVs that require single-lung ventilation, taking into account risk factors such as ASD that can lead to hemodynamic disorders. Anesthesia management in patients with ASD needs to consider cardiac shunt and pulmonary and systemic blood vessel resistance. The anesthesia technique in VATS can be general anesthesia with ventilation of one lung, accompanied by an epidural block for analgesia. Conclusion. Anesthesia management in patients with ASD undergoing VATS requires special attention to ventilation in order to prevent shunts in the heart and pulmonary and systemic blood vessel resistance.
Co-Authors Adi, Made Septyana Parama Adinda Putra Pradhana Anak Agung Gde Adistaya Christopher Ryalino Dewi, Dewa Ayu Mas Shintya Dewi, Putu Utami Doddy Setiawan Eka Nantha Kusuma, Putu Elisma Nainggolan, Elisma Emkel Perangin Angin, Emkel Faridatun Hasanah Gede Semarawima, Gede Gusti Agung Made Wibisana Kurniajaya Hengky Hengky, Hengky I Gede Budiarta I Gede Prima Julianto I Gusti Agung Gede Utara Hartawan I Gusti Agung Made Wibisana Kurniajaya I Ketut Sinardja I Ketut Wibawa Nada I Made Gede Widnyana I Made Prema Putra I Putu Agus Surya Panji I Putu Fajar Narakusuma I Wayan Aryabiantara, I Wayan I Wayan Suranadi Ida Ayu Sri Wijayanti Ida Bagus Krisna Jaya Sutawan IGNA Putra Arimbawa, IGNA Putra Indah, Carolin Tiara Lestari Kadek Agus Heryana Putra Kadek Agus Heryana Putra, Kadek Agus Kadek Agus Putra Udayana Ketut Semara Jaya, Ketut Semara Komang Ady Widayana Komang Alit Artha Wiguna Komang Alit Artha Wiguna Krisnawardhani Kumbara, Cokorda Istri Yuliandari Kurniajaya, I Gusti Agung Made Wibisana Leton, Yohanes PT Made Agus Kresna Sucandra, Made Agus Kresna Made Bagus Cahya Maha Putra Made Septyana Parama Adi Made Wiryana Mahadewi, Ni Putu Ayu Putri Merry Ni Made Ayu Candrayuni Pande Nyoman Kurniasari, Pande Parama Adi, Made Septyana Pontisomaya Parami Pramaswari, Anak Ayu Agung Putu Gede Ary Sanjaya Ra Ratumasa, Marilaeta Cindryani Riko Riko Saputra, Darmawan Jaya Sidemen, I Gusti Ayu Eka Para Santi Siska Permanasari Sinardja Sonni Soetjipto, Sonni Susilawathi, Ni Made Syamsuddin, Johanis Bosco Troy Tini, Kumara Tjokorda Gde Agung Senapathi Togi Stanislaus Patrick Wiranata, Jeremia Alvian Yuliana, Astrid