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All Journal Jurnal Anestesiologi Indonesia Mandala of Health : A Scientific Journal
Utami, Yulia Kartika
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Dentistry Health Professions Medicine & Pharmacology Public Health

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Role of Neuroprotective Agents in the Anesthetic Management of Brain Tumors for Patients with Recidive Cystic Tumor with Signs of Intracranial Hypertension Underwent Re-Craniotomy Decompression Tumor Resection: Case Report Utami, Yulia Kartika; Prihatno, Rudi; Suryani, Shila
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 2 (2025): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.66384

Abstract

Background: The management of brain tumor surgeries, particularly recurrent cystic tumors with cerebral edema, poses significant challenges. Elevated intracranial pressure (ICP) and the associated risk of ischemia necessitate a comprehensive neuroprotective approach during anesthesia to ensure optimal surgical and postoperative outcomes.Case: A 54-year-old male presented with two weeks history of headaches and dizziness. He had previously undergone a craniotomy six months ago for the removal of a metastatic right parieto-occipital adenocarcinoma. Imaging revealed tumor recurrence, and the patient was scheduled for a re-craniotomy. The anesthetic plan included neuroprotective strategies: thiopental for metabolic suppression, sufentanil for hemodynamic stability, and sevoflurane for neuroprotection. The surgery lasted 3.5 hours, with minimal intraoperative blood loss and stable perioperative hemodynamics. Postoperatively, the patient recovered without complications and was discharged in stable condition.Discussion: The anesthetic management prioritized maintaining ICP, cerebral perfusion pressure (CPP), and minimizing neuroinflammatory responses. Thiopental effectively reduced cerebral metabolic demands, sufentanil stabilized hemodynamics, and sevoflurane provided neuroprotective and anti-inflammatory benefits. hypothesis and principles. These strategies ensured cerebral autoregulation, controlled cerebral edema, and optimized recovery. The Monro-Kellie hypothesis and principles of neuroprotection were key guiding frameworks in this case.Conclusion: This case highlights the critical role of neuroprotective agents in the anesthetic management of brain tumor surgeries. The combination of thiopental, sufentanil, and sevoflurane contributed to a stable intraoperative course and uneventful recovery. Integrating these strategies ensures improved surgical outcomes and patient safety in challenging neurosurgical cases.
PERBANDINGAN ONSET DAN DURASI BLOK SENSORIK MOTORIK MENGGUNAKAN METODE KOMBINASI BUPIVAKAIN DAN BUPIVAKAIN MURNI PADA PASIEN SEKSIO SESARIA Utami, Yulia Kartika; Suryani, Shila; Setiawati, Setiawati
Mandala Of Health Vol 17 No 2 (2024): Mandala of Health: a Scientific Journal
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mandala.2024.17.2.13191

Abstract

Anesthesia plays as an important role in the caesarean section procedure. The use of multimodal analgesia regimen has been considered as the gold standard of anesthesia for patients undergoing cesarean section. This study examines the comparison between the onset and duration of motoric and sensoric nerve blocks in patients undergoing cesarean section with spinal anesthesia using Bupivacaine Combination and Bupivacaine Only at Margono Soekarjo Hospital, Purwokerto. This research was a randomized controlled trial with double blind. Inclusion criteria in this study were patients aged 20-45 years, ASA physical status II and BMI between 18.5-35. Exclusion criteria in this study were patients with anatomical abnormalities or severe congenital abnormalities, contraindications to spinal anesthesia, history of allergy to the anesthetic agents used and unconsciousness patients. Subjects were divided into two groups, each group consists of 15 patients, Bupivacaine Combination (spinal anesthesia with Bupivacaine 7.5 mg + Fentanyl 25 mcg + Morphine 100 mcg) and Bupivacaine Only (spinal anesthesia with Bupivacaine 15 mg). Data were analyzed using Independent Sample T Test with a significance level of α=0.05. There were differences in onset of motoric block (p=0.00), duration of motoric block (p=0.00), onset of sensoric block (p=0.00) and duration of sensoric block (p=0.00) between Bupivacaine Combination and Bupivacaine Only groups. The Bupivacaine Combination group has a slower onset and shorter duration of anesthesia than the Bupivacaine Only group.
Co-Authors Prihatno, Rudi Setiawati Setiawati Shila Suryani, Shila