Jurnal Neuroanestesi Indonesia
Vol 2, No 2 (2013)

Tatalaksana Anestesi pada Laminektomi Komplek karena Hernia Nukleus Pulposus L15

Roosiati, Betty (Unknown)



Article Info

Publish Date
23 Jun 2013

Abstract

Hernia nukleus pulposus (HNP) lumbalis sering terjadi, dengan angka kejadian 2% dari populasi umum. Skiatika yang berasal HNP lumbal sering menimbulkan nyeri radikular dari kaki pada populasi pekerja dewasa. Pengaturan posisi pasien, posisi prone, selain untuk mendapatkan akses yang optimal untuk ahli bedah, dapat mempengaruhi waktu pulih, morbiditas dan mortalitas. Umumnya pasien geriatri lebih sensitif terhadap anestetika. Untuk mendapatkan efek klinik yang diharapkan pada orang tua diperlukan obat-obatan lebih sedikit, dan efeknya sering memanjang. Secara umum, operasi pada pasien geriatri, harus didapatkan pemulihan yang cepat dan hindari penurunan fungsi organ. Wanita 61 tahun mengalami nyeri punggung bawah dan parestesia. Kesadaran GCS 15, berat badan 50 kg, tekanan darah 120/80 mmHg, laju jantung 80x/menit. Foto torak: pembesaran jantung yang ringan, CTR50%, peningkatan sekret bronkovaskular. Monitor EKG didapatkan amplitudo QR yang rendah, QT memanjang, kemungkinan penyakit jantung iskemik. Laboratorium dalam batas normal. Pada MRI: HNP L12345. Operasi dilakukan dalam posisi prone selama 9 jam. Tidak ada kesulitan dalam tata laksana anestesi, selama operasi kardiovaskular stabil, tekanan darah antara 105/55130/70 mmHg dan laju jantung 7780 x/menit. Tidak terjadi komplikasi pascabedah.Anesthetic Management of Complex Laminectomy Due To Lumbar Disc Herniation L1 5 A lumbar disk herniation is very common, occuring in 2% of the general population. Sciatica, resulting from a herniated lumbar disk, is the most common cause of radicular leg pain in the adult working population. Important setting patient's position, prone position, in addition to gain optimal access for the surgeon, can affect recovery time, morbidity and mortality. Generally, geriatric patients are more sensitive to anesthetic. To obtain the expected clinical effect usually in elderly ussually need fewer drugs, and the effect is often prolonged. Generally in geriatric patients, have obtained a rapid recovery and avoid decreasing organs function decline. Women 61 years of experience lower back pain and paresthesias. GCS 15, weight 50 kgs, blood pressure 120/80 mmHg, heart rate 80x/menit. Thorax photo: mild cardiac enlargement, CTR50%, increase in bronchovascular. Secretions QR ECG reveal a low amplitude, QT prolonged, with the possibility of ischemic heart disease. Laboratories within normal limits. On MRI: HNP L12345. Surgery performed in prone position for 9 hours. Anesthesia was uneventful stable cardiovascular,with blood pressure between 105/55 - 130/70 mmHg and heart rate of 77-80x/ min. No postoperative complications occurred

Copyrights © 2013






Journal Info

Abbrev

jni

Publisher

Subject

Biochemistry, Genetics & Molecular Biology Education Medicine & Pharmacology Neuroscience Public Health

Description

Editor of the magazine Journal of Neuroanestesi Indonesia receives neuroscientific articles in the form of research reports, case reports, literature review, either clinically or to the biomolecular level, as well as letters to the editor. Manuscript under consideration that may be uploaded is a ...