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Jurnal Neuroanestesi Indonesia

jni
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Published by Indonesian Society of Neuroanesthesia & Critical Care

ISSN : 20889674 EISSN : 24602302 DOI : https://doi.org/10.24244/jni

Core Subject : Health, Science, Education,

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

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 full text of article which has not been published in other national magazines. The manuscript which has been published in proceedings of scientific meetings is acceptable with written permission from the organizers. Our motto as written in orphanet: www.orpha.net is that medicine in progress, perhaps new knowledge, every patient is unique, perhaps the diagnostic is wrong, so that by reading JNI we will be faced with appropriate knowledge of the above motto. This journal is published every 4 months with 8-10 articles (February, June, October) by Indonesian Society of Neuroanesthesia & Critical Care (INA-SNACC). INA-SNACC is associtation of Neuroanesthesia Consultant Anesthesiology and Critical Care (SpAnKNA) and trainees who are following the NACC education. After becoming a Specialist Anesthesiology (SpAn), a SpAn will take another (two) years for NACC education and training in addition to learning from teachers in Indonesia KNA trainee receive education of teachers/ experts in the field of NACC from Singapore.

Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine

Articles 8 Documents

Search results for , issue "Vol 11, No 2 (2022)" : 8 Documents clear

Konsep GHOST- CAP untuk Proteksi Otak Perioperatif pada Cedera Otak Traumatik Bisri, Dewi Yulianti; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 11, No 2 (2022)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Kerusakan otak adalah cedera yang menyebabkan rusak atau memburuknya sel otak yang disebabkan oleh berbagai kondisi seperti trauma kepala, pasokan oksigen yang tidak memadai, infeksi atau perdarahan intrakranial. Proteksi otak adalah intervensi terapeutik preemptif untuk memperbaiki outcome neurologik pada pasien yang berisiko terjadinya iskemi serebral, sedangkan resusitasi otak merujuk ke intervensi terapeutik yang dimulai setelah terjadinya iskemi. Targetnya adalah terapi iskemi dan mengurangi cedera neuron. Kerusakan otak perioperatif adalah salah satu komplikasi merugikan yang paling serius dari operasi dan anestesi, mengakibatkan defisit neurologis baru pasca operasi. Konsep GHOST-CAP, yang merupakan akronim dari Glycemia, Hemoglobin, Oxygen, Sodium, Temperature, Comfort, Arterial Pressure dan PaCO2, digunakan pada periode pascaoperatif. G: target level glukosa antara 80 dan 180?mg/dL. H: hemoglobin, ambang batas 79g/dL. O: oksigen, targetkan SpO2 antara 94 dan 97%. S: konsentrasi sodium mempengaruhi volume otak, kadar sodium hingga 155?mEq/L dapat ditoleransi. T: temperatur diatur untuk mengoptimalkan fungsi seluler, tetapi suhu inti ?38,0C harus dihindari. C: kenyamanan pasien (comfort), termasuk kontrol nyeri, agitasi, kecemasan, dan menggigil. A: tekanan darah arteri adalah penentu utama aliran darah otak (CBF), pertahankan tekanan arteri rata-rata (MAP) 80?mmHg dan tekanan perfusi otak (CPP) 60?mmHg. P: perubahan akut PaCO2 menyebabkan perubahan CBF, maka PaCO2 tidak boleh kurang dari 35 mmHg. Tulisan ini mengkaji konsep GHOST-CAP untuk proteksi otak perioperatif, apakah cukup memadai atau harus ditambah.GHOST-CAP Concept for Perioperative Brain Protection in Traumatic Brain InjuryAbstractBrain damage is an injury that causes damage or worsening of brain cells caused by various conditions such as head trauma, inadequate oxygen supply, infection or intracranial hemorrhage. Brain protection is a preemptive measure of therapeutic interventions to improve neurological outcomes in patients at risk of cerebral ischemic, while brain resuscitation refers to therapeutic interventions that begin after the occurrence of ischemic. The target is ischemic therapy and reducing neuronal injury. Perioperative brain damage is one of the most serious adverse complications of surgery and anesthesia, resulting in new postoperative neurological deficits. The concept of GHOST-CAP, an acronym for Glycemia, Hemoglobin, Oxygen, Sodium, Temperature, Comfort, Arterial Pressure and PaCO2, can be used in the postoperative period. G: The target level of glucose is between 80 and 180 mg/dL. H: hemoglobin threshold is 7-9 g/dL. O: oxygen, target SpO2 between 94 and 97%. S: Sodium concentration affects brain volume, sodium levels up to 155 mEq/L are tolerable. T: temperatures regulated to optimize cellular function, but core temperatures 38.0C should be avoided. C: patient comfort, including pain control, agitation, anxiety, and chills. A: Arterial blood pressure is the main determinant of cerebral blood flow (CBF), maintaining an mean arterial pressure (MAP) of 80 mmHg and cerebral perfusion pressure (CPP) of 60 mmHg. P: Acute changes in PaCO2 cause CBF changes, PaCO2 not to be less than 35 mmHg. This paper examines the GHOST-CAP concept for perioperative brain protection, whether adequate or should be supplemented

Tatalaksana Anestesi pada Pasien Geriatri dengan Hematoma Subdural, Intraserebral, dan Subarahnoid yang Menjalani Kraniotomi Evakuasi Hematoma Widiastuti, Monika; Rachman, Iwan Abdul; Umar, Nazaruddin
Jurnal Neuroanestesi Indonesia Vol 11, No 2 (2022)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Cedera otak traumatik pada geriatri memiliki insiden 734% dengan penyebab utama adalah jatuh. Perdarahan subdural merupakan jenis cedera yang paling sering terjadi pada populasi geriatri. Hal ini sesuai dengan proses penuaan yang terjadi pada jaringan otak sehingga menyebabkan populasi ini sering mengalami perdarahan subdural jika mengalami cedera. Pasien perempuan berusia 72 tahun datang dengan keluhan nyeri kepala pasca terjatuh 6 hari sebelum masuk rumah sakit. Dari pemeriksaan fisik ditemukan kesadaran E3M5V6, tanpa adanya kelainan dan defisit neurologis dan hemodinamika stabil. Dari pemeriksaan penunjang Computed Tomography (CT) scan ditemukan subdural hematoma di regio frontotemporoparietalis dextra dan regio frontalis et temporalis sinistra yang menyebabkan midline shift ke arah sinistra, perdarahan subarahnoid di regio frontalis sinistra, perdarahan intraserebral di lobus temporalis sinistra. Operasi kraniotomi evakuasi hematoma dilakukan selama 3 jam dengan anestesi umum. Pertimbangan anestesi pada pasien ini adalah neuroanestesi dan anestesi geriatri dengan memperhatikan proses penuaan yang mempengaruhi perubahan fisiologi dan farmakologi pada pasien geriatri, riwayat komorbiditas dan polifarmasi. Tatalaksana perioperatif yang baik penting untuk mencegah cedera sekunder pada jaringan otak.Anesthetic Management of Geriatri Patient with Subdural, Intracerebral, and Subarachnoid Hemorrhage Underwent Craniotomy for Hematoma EvacuationAbstractWorldwide, the incidence of traumatic brain injury in geriatrics is 734%, with falls as the most common cause. Subdural hemorrhage is the most common injury that occur and is associated with the aging process of the brain, making geriatric patients prone developing subdural hemorrhage. A 72-years-old female came with a headache after fell to the ground 6 days before hospital admission. Physical examination revealed E3M5V6 without neurologic deficits and hemodynamically stable. A computed tomography scan resulted in subdural hematoma in right frontotemporoparietal region causing midline shifting to the left, subarachnoid hemorrhage in the left frontal region, intracerebral hemorrhage in the left temporal lobe. The patient underwent craniotomy evacuation of hematoma and lasted for 3 hours under general anesthesia. Anesthetic concerns are neuroanesthesia and geriatric patient considering the aging process affects physiologic and pharmacologic changes, comorbidities and polypharmacy. Comprehensive perioperative management is essential to prevent secondary brain injury and improve the outcome.

Manajemen Anestesi Reseksi Tumor Cerebello-pontine Angle Vestibular Schwannoma dengan Posisi Lateral Suarjaya, I Putu Pramana; Paramartha, Bagus; J Sutawan, Ida Bagus Krisna; Panji, I Putu Agus Surya
Jurnal Neuroanestesi Indonesia Vol 11, No 2 (2022)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Tumor Cerebello-pontine angle (CPA) adalah tumor yang paling sering terjadi di daerah fossa posterior, dan berkisar 5-10 % dari seluruh kasus tumor intrakranial. Sebagian besar tumor CPA adalah tumor jinak, 85% diantaranya merupakan vestibular schwannoma (neuroma akustik). Terapi pilihan untuk tumor CPA vestibular schwannoma dengan gejala adalah tindakan pembedahan. Kraniotomi dengan posisi lateral penuh pada reseksi vestibular schwannoma yang berlangsung lama memberikan tantangan karena potensi terjadinya ketidaksesuaian ventilasi-perfusi dan atelektasis paru sisi bawah. Seorang pasien perempuan, usia 25 tahun, dengan gangguan pendengaran, gangguan keseimbangan, kelemahan separuh badan kiri, mengalami kesulitan menelan dan pada pemeriksaan magnetic resonance imaging (MRI) didapatkan lesi padat di cerebelo-pontine angle dengan ukuran 5,6 x 5 x 4.5 cm yang meluas hingga internal auditory canal dan didiagnosa sebagai tumor cerebro-pontine angle vestibular schwannoma sinistra. Pasien menjalani pembedahan dengan anestesi umum intubasi endotrakeal, posisi lateral kanan penuh, yang berlangsung selama 6 jam 40 menit. Target dari pengelolaan anestesi pada tindakan pembedahan tumor vestibular schwannoma adalah memfasilitasi lapangan pembedahan yang ideal dan melakukan proteksi serebral untuk mencegah cedera sekunder dengan mempertahankan tekanan perfusi serebral, menghindari instabilitas hemodinamik, memungkinkan dilakukannya pemantauan neurologi intraoperatif, deteksi dini dan pengelolaan segera bila terjadi komplikasi pembedahan.Anesthesia Management of Cerebello-pontine Angle Tumor Vestibular Schwannoma Resection in Lateral PositionAbstractCerebellopontine angle (CPA) tumors are the most common neoplasms in the posterior fossa, accounting for 5-10% of intracranial tumors. Most CPA tumors are benign, with over 85% being vestibular schwannoma (acoustic neuromas). The preferred treatment for symptomatic vestibular schwannoma has been surgical excision. Craniotomy for vestibular schwannoma resections in lateral position gave better surgical field exposure, but also posed increased risk of ventilation-perfusion mismatch and atelectasis of the dependent lung in lengthy surgery. A 25 years old woman, with loss of hearing function, disturbed sense of balance, left hemiplegia, difficulties to swallow, on magnetic resonance imaging (MRI) examination had solid lesion in the cerebello-pontine angle size 5,6 cm x 5 cm x 4.5 cm which is diagnosed as Cerebello-pontine angle vestibular schwannoma sinistra. Patient underwent surgical resection in right lateral position under general anesthesia and the surgical resection performed in 6 hour 40 minutes. The goals of anesthetic management in vestibular schwannoma tumor resection are to facilitate ideal surgical condition and provide brain protection by maintaining cerebral perfusion pressure, avoid hemodynamic instability, enable intraoperative neuro-monitoring and ensure the early detection and prompt management of potential complications.

Profil Kadar Natrium Serum pada Pemberian Manitol 20% dan Natrium Laktat Hipertonik Intravena pada Tikus Jantan Wistar Pamillian, Niko; Sudadi, Sudadi
Jurnal Neuroanestesi Indonesia Vol 11, No 2 (2022)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Latar Belakang dan Tujuan: Penggunaan cairan hiperosmoler dalam waktu lama berpengaruh terhadap peningkatan natrium serum. Natrium laktat hipertonik sebagai cairan baru berbasis natrium belum memiliki evidence base yang menyatakan bahwa penggunaan jangka panjang aman pada peningkatan tekanan intrakranial (TIK).Tujuan penelitian ini adalah untuk mengetahui pengaruh pemberian natrium laktat hipertonik terhadap perubahan natrium pada tikus wistar jantan dibandingkan dengan manitolSubjek dan Metode: Penelitian ini adalah penelitian laboratorik eksperimental pada hewan coba menggunakan rancangan simple random sampling. Didapatkan 36 tikus wistar jantan dengan usia dan berat badan 14,220,43 minggu dan 301,5625,10gr pada kelompok A dan 14,170,38 minggu dan 277,6118,85gr pada kelompok B. Manitol atau natrium laktat hipertonik diberikan selama 5 hari dan dinilai perubahan kadar natrium pasca pemberianHasil: Perubahan kadar natrium tertinggi pada kelompok natrium laktat hipertonik dibandingkan manitol terjadi pada hari pertama dibandingkan kadar natrium sebelum perlakuan, sebelum perlakuan 5,064,25 dan setelah perlakuan 5,672,96 mEq/L ( p= 0,222) dan perubahan terendah didapatkan pada hari ketiga dibandingkan hari kedua (0,223,51 vs 0,222,29 mEq/L) (p=0,568). Rerata tertinggi pada kelompok natrium laktat hipertonik dibandingkan manitol adalah 147,833,35 vs 147,833,35 mEq/L dan rerata terendah adalah 145,83 2,07 vs 146,06 2,92. Simpulan: Pada penelitian hewan coba ini pemberian natrium laktat hipertonik dan manitol akan meningkatkan kadar natrium secara bermakna dibandingkan sebelum perlakuan, tetapi tidak diikuti dengan perubahan yang bermakna pada hari pertama sampai dengan hari kelima.Profile of Serum Sodium Levels on Intravenous Administrations of 20% Mannitol and Hypertonic Sodium Lactate in Male Wistar RatsAbstractBackground and Objective: Prolonged use of hyperosmolar solution associated with mortality. Hypertonic sodium lactate as a new sodium-based solution does not yet have an evidence base that states that long-term use is safe in increasing ICP. Knowing the effect of hypertonic sodium lactate on alterations sodium level in male wistar rats compared to mannitolSubject and Method: This research is an animal experimental laboratory study using a simple random sampling design.Thirtysix male wistar rats were obtained with age and body weight 14.220.43 weeks and 301.5625.10gr in the group A and 14.170.38 weeks and 277.6118.85gr in the group B. Both groups were given hypertonic sodium lactate or mannitol for 5 days and assessed on changes sodium level after administration.Results: The highest alterations sodium levels in the hypertonic sodium lactate group compared to mannitol occurred on the first day 5.064.25 compared to sodium levels before treatment 5.672.96 mEq / L (p = 0.222) and the lowest changes were obtained at the third day compared to the second day (0.223.51 vs 0.222.29 mEq / L) (p = 0.568). The highest mean in the hypertonic sodium lactate group compared to mannitol was 147.833.35 vs 147.833.35 mEq / L and the lowest mean was 145.832.07 vs 146.062.92.Conclusion: In this experimental animal study, hypertonic sodium lactate and mannitol increased sodium levels significantly compared to before treatment, but were not followed by significant changes on the first day to the fifth day.

Penatalaksanaan Anestesi Tindakan Bedah Endoskopi Evakuasi Perdarahan Intraserebral karena Stroke Hemoragik Suarjaya, I Putu Pramana; J Sutawan, Ida Bagus Krisna; Sugiharso, Muhammad Aris
Jurnal Neuroanestesi Indonesia Vol 11, No 2 (2022)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Penatalaksanaan utama perdarahan intraserebral di daerah supratentorial adalah manajemen konservatif dengan penatalaksanaan optimal tekanan darah, penatalaksanaan komplikasi seperti pencegahan kejang, tromboemboli dan peningkatan tekanan intrakranial. Pembedahan untuk evakuasi perdarahan dilakukan bila terjadi penambahan bermakna volume perdarahan intraserebral yang meningkatkan morbiditas dan mortalitas. Prosedur neuroendoskopi saat ini menjadi pilihan karena pendekatan yang invasif minimal dan tingkat keberhasilan yang tinggi, insiden komplikasi lebih rendah, proteksi jaringan otak lebih baik, dan cedera yang berhubungan dengan teknik pembedahan lebih rendah dibanding kraniotomi terbuka. Pasien laki-laki, 44 tahun, obesitas dengan indeks massa tubuh 36,73 kg/m2, riwayat hipertensi, mengalami penurunan kesadaran dan lumpuh separo badan yang terjadi secara tiba-tiba. Pasien dirawat secara konservatif dan mengalami perbaikan sampai kesadaran pulih penuh, dengan gejala sisa hemiparese sinistra dan paresis nervus VII supranuklear sinistra. Pada hari keempatbelas perawatan, pasien didapatkan mengalami penambahan volume perdarahan intraserebral yang bermakna dan dilakukan operasi endoskopi evakuasi perdarahan intraserebral. Manajemen anestesi untuk pasien stroke hemoragik dengan riwayat hipertensi yang menjalani pembedahan neuroendoskopi merupakan tantangan untuk dokter anestesi selama periode perioperatif untuk mampu menyediakan kondisi operasi yang optimal, melakukan upaya proteksi jaringan otak dan menjamin pasien pulih segera dengan baik.Anesthetics Management for Endoscopic Evacuation of Intracerebral Hemorrhage due to Hemorrhagic StrokeAbstractMedical conservative treatment is a mainstay of supratentorial intracerebral hemorrhage management, which include blood pressure and increased intracranial pressure management, as well as seizure and thromboembolic prevention. Surgical intervention is an option if the intracerebral hematoma is expanding significantly and increase morbidity and mortality. Neuroendoscopic procedure is an attractive option which is less invasive and also provides high hemorrhage evacuation rate, low incidence of complication, better protection of brain tissue, and fever surgery-related injuries compared to open craniotomy. In this report, we presented a case of a man 44 years old, obese with body mass index of 36.73 kg/m2, hypertensive, who suffered from intracerebral hemorrhage and underwent endoscopic intracerebral blood clot evacuation. Medical management was done and the patient regained full consciousness, with left hemiparesis and the left supranuclear nerve VII sequelae. Due to the expanding volume of the hematoma, the patient underwent endoscopic surgical blood clot evacuation. Minimally invasive intracerebral blood clot evacuation of expanding hemorrhagic stroke in patient gives the anesthesiologist enormous challenge during the perioperative periods to provide optimal surgical conditions, performing brain protection, and ensure patients have early excellent recovery.

Perbandingan Pemberian Dexmedetomidine dengan Fentanyl Intraoperatif terhadap Kedalaman Anestesia dan Kecepatan Pemulihan pada Operasi Bedah Saraf Jasa, Zafrullah Kany; Heriansyah, Teuku; Muttaqin, Muttaqin
Jurnal Neuroanestesi Indonesia Vol 11, No 2 (2022)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Latar Belakang dan Tujuan: Anestesi bebas opioid merupakan diskusi baru dalam dunia anestesi. Bukti menunjukkan bahwa opioid memiliki efek samping yang tidak diinginkan. Dexmedetomidine merupakan suatu reseptor agonis a2-adrenergik selektif yang memiliki efek sparing opioid serta kecepatan pulih sadar anestesi yang lebih baik. Penelitian ini bertujuan membandingkan efektifitas dexmedetomidine dan fentanyl terhadap kedalaman anestesi dan pemulihan pasca anestesi pada operasi bedah saraf supratentorialSubjek dan Metode: Total 40 sampel penelitian dibagi menjadi 2 grup: A (Dexmedetomidine) dan B (Fentanyl) dengan total sampel 20 pada tiap grup. Kedua grup dilakukan pemasangan alat bispectral index (BIS) selama pembedahan. Kedua grup akan dinilai kecepatan pemulihan pasca anestesi sejak obat anestesi dihentikan.Hasil: Berdasarkan uji statistik didapatkan hasil bahwa penggunaan dexmedetomidine dan fentanyl memiliki efek anestesi optimal, dimana tidak terdapat perbedaan signifikan di antara keduanya dalam hal mencapai level anestesi optimal berdasar indeks BIS. Didapatkan pula hasil waktu pulih pasca anestesi dexmedetomidine lebih cepat dibandingkan pemberian fentanyl, dengan perbedaan waktu 5,10 menit (p0,05), dengan terdapat perbedaan signifikan kecepatan pulih pasca anestesi antara penggunaan dexmedetomidine dan fentanyl.Simpulan: Penggunaan dexmedetomidine pada operasi bedah saraf supratentorial memiliki kecepatan waktu pulih pasca anestesi yang lebih baik dibandingkan fentanylComparison of Dexmedetomidine Administration with Intraoperative Fentanyl to The Depth of Anesthesia and Recovery Speed in NeurosurgeryAbstractBackground and Objective: Opioid free anesthesia is a new discussion in the world of anesthesia. The available evidence suggests that opioids also have unintended effects. Dexmedetomidine is a selective 2-adrenergic receptor (?2-AR) agonist drug, that this drug has an opioid-sparing effect, and a faster recovery rate after anesthesia. To compare the effectiveness of dexmedetomidine and fentanyl on the depth of anesthesia and post-anesthesia recovery in supratentorial neurosurgery operations.Subject and Methods: A total of 40 research samples was divided into 2 groups, namely group A (Dexmedetomidine) and group B (Fentanyl). The number of research samples in each group was 20 people. Both groups of patients will be fitted with a bispectral index (BIS) during surgery. Both groups will measure the post-anesthesia recovery time since the anesthetic drug was discontinuedResults: Based on statistical tests, it was found that the use of dexmedetomidine and fentanyl had an optimal anesthetic effect, where there was no significant difference between these two anesthetic agents in achieving optimal anesthetic levels based on the BIS Index. From statistical analysis was found that post-anesthesia recovery time on dexmedetomidine was faster than the administration of fentanyl, with a difference of 5.10 minutes (p0.05) with statistically significant difference in the speed of post-anesthesia recovery between the use of dexmedetomidine and fentanyl.Conclusion: The use of dexmedetomidine in supratentorial neurosurgical surgery anesthesia has a faster post- anesthesia recovery time than the use of fentanyl.

Tatalaksana Anestesi Pasien Adenoma Hipofisis dengan Riwayat Hipotiroid Maharani, Nurmala Dewi; Bisri, Dewi Yulianti; Umar, Nazaruddin
Jurnal Neuroanestesi Indonesia Vol 11, No 2 (2022)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Adenoma hipofisis merupakan tumor otak dengan gejala klinis tergantung hormon yang dihasilkan oleh sel tumor, ukuran, dan invasi lokal. Perempuan 50 tahun dengan adenoma hipofisis dengan riwayat hipotiroid. Pada pemeriksaan prabedah GCS E4M6V5, tekanan darah 114/76 mmHg, denyut nadi 81x/menit, pernafasan 18x/menit, dan saturasi 99%. Pada pemeriksaan fisik berat badan dan visus mata kanan menurun. Pemeriksaan fungsi tiroid kesan hipotiroid, lalu pasien diterapi levotiroksin natrium 100 g perhari tablet selama 14 hari sampai dengan eutiroid. Tatalaksana lanjutan yang dilakukan adalah kraniotomi reseksi adenoma hipofisis. Premedikasi hidrokortison 100 mg dan midazolam 0,1mg/kgbb intravena. Induksi propofol 1 mg/kgbb, fentanyl 2g/kgbb, rocuronium 1 mg/kgbb, lidokain 1 mg/kgbb dan propofol pengulangan dosis 0,5 mg/kgbb. Manitol diberikan 0,5 mg/kgbb dan dexamethason 10 mg. Rumatan anestesi sevoflurane 0,5% dan propofol 50100 g/kgbb/menit. Pasca operasi pasien di ICU diberikan dexmedetomidine 0,2 g/kgbb/jam dan suplemen steroid H-1 diberikan 25 mg hidrokortison setiap 12 jam. Pada H-2 diberikan 20 mg hidrokortison pagi hari dan 10 mg sore hari kemudian dapat dihentikan. Pasien dirawat di ICU 3 hari sebelum pindah ruang rawat biasa. Manajemen perioperatif adenoma hipofisis dengan riwayat hipotiroid adalah mengoptimalkan pra operasi pasien sehingga pasien mencapai eutiroid, menjaga stabilitas hemodinamik, mengoptimalkan oksigenasi serebral, mencegah serta mengatasi komplikasi.Anesthesia Management of Patient with Pituitary Adenoma with Hystory of HypothyroidismAbstractPituitary adenoma is a brain tumor has clinical symptoms depending on hormones produced by tumor cells, size, and local invasion. A 50-year-old woman with pituitary adenoma with history of hypothyroidism. On preoperative, GCS E4M6V5, blood pressure was 114/76 mmHg, pulse was 81x/minute, respiration was 18x/minute, and saturation was 99%. On physical examination, body weight and the visual acuity in the right eye decreased. Examination of thyroid function suggests hypothyroidism before surgery, patient was treated with levothyroxine sodium 100 g per day tablets for 14 days until euthyroid. The next treatment was resection craniotomy of the pituitary adenoma. Premedicated with hydrocortisone 100 mg and midazolam 0.1 mg/kg body weight. Induction propofol 1 mg/kg body weight, fentanyl 2 g/kg body weight, rocuronium 1 mg/kg body weight, lidocaine 1 mg/kg body weight and repeated doses of 0.5 mg/kg body weight propofol. Mannitol was given 0.5 mg/kgbw and dexamethasone 10 mg. Maintenance anesthesia with sevoflurane 0.5% and propofol 50-100 g/kgbw/min. Postoperative the patient in the ICU was given dexmedetomidine 0.2 g/kgbw/hour and steroid supplement day-1 was given 25 mg hydrocortisone every 12 hours. On day-2, 20 mg of hydrocortisone in the morning and 10 mg in the evening, then can be discontinued. The patient was admitted to the ICU for 3 days before moving to the ward. Perioperative management of pituitary adenoma with a history of hypothyroidism is optimizing preoperatively the patient reaches euthyroid, maintaining hemodynamics, optimizing cerebral oxygenation, preventing and treatment if there are complications.

Penggunaan Lidokain Intravena untuk Adjuvan Obat Analgesik pada Operasi Bedah Saraf Firdaus, Riyadh; Tantri, Aida Rosita; Kurniawan, Teddy; Agusta, Laksmi Senja; Fadhila, Fulki; Sukoco, Gunawan; Reza, Harris Putra
Jurnal Neuroanestesi Indonesia Vol 11, No 2 (2022)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Nyeri merupakan suatu perasaan atau pengalaman yang bersifat subjektif yang melibatkan sensoris, emosional, dan tingkah laku yang tidak menyenangkan yang disebabkan oleh kerusakan jaringan. Manajemen nyeri pascaoperasi dinilai esensial karena akan memberikan hasil luaran yang baik pada pasien serta meningkatkan kualitas hidup pascaoperasi. Opioid merupakan obat analgesik intravena yang paling sering digunakan sebagai terapi nyeri perioperatif, namun memiliki efek samping yang kurang menyenangkan. Pengembangan dalam penggunaan obat analgesik yang lebih efektif diperlukan, salah satu adalah lidokain intravena yang memiliki efek samping yang lebih kecil dibandingkan opioid. Beberapa studi menunjukkan bahwa penggunaan lidokain sebagai obat analgesik intraoperatif memiliki efek samping minimal dan pemulihan lebih cepat. Penelitian lain juga menunjukkan penggunaan lidokain sebagai analgesik pada operasi bedah saraf memiliki efek yang cukup baik. Maka dari itu, tinjauan pustaka ini akan membahas mengenai penggunaan lidokain sebagai terapi adjuvan obat analgesik, khususnya pada operasi bedah saraf.The Use of Intravenous Lidocaine as Adjuvant Analgesia in NeurosurgeryAbstractPain is a subjective feeling or experience involving sensory, emotional, and unpleasant behavior caused by tissue damage. Postoperative management is considered essential because it will provide excellent results for patients and improve postoperative quality of life. Opioids are intravenous analgesic drugs that are most often used as perioperative pain therapy but have unpleasant side effects. Developments in using more effective analgesic drugs are needed, one of which is intravenous lidocaine which has fewer side effects than opioids. Several studies have shown that lidocaine as an intraoperative analgesic drug has minimal side effects and faster recovery. Other studies have also shown lidocaine as an analgesic in neurosurgery surgery to have a fairly good effect. Therefore, this literature will discuss lidocaine as an adjuvant therapy, especially in neurosurgery operations.

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name
Agni Susanti

Contact Email
jurnalneuroanestesi@gmail.com

Phone
+6287722631615

Journal Mail Official
jni@inasnacc.org

Editorial Address
Jl. Prof. Eijkman No. 38 Bandung 40161, Indonesia Lt 4 Ruang JNI

Location
,

INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Agni Susanti

Contact Email jurnalneuroanestesi@gmail.com

Phone +6287722631615

Journal Mail Official jni@inasnacc.org

Editorial Address Jl. Prof. Eijkman No. 38 Bandung 40161, Indonesia Lt 4 Ruang JNI

Location , INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Agni Susanti

Contact Email
jurnalneuroanestesi@gmail.com

Phone
+6287722631615

Journal Mail Official
jni@inasnacc.org

Editorial Address
Jl. Prof. Eijkman No. 38 Bandung 40161, Indonesia Lt 4 Ruang JNI

Location
,

INDONESIA