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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 6, No 3 (2017)" : 8 Documents clear

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

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.

Penggunaan FOUR Skor dalam Manajemen Anestesi untuk Evakuasi Hematoma Epidural pada Pasien dengan Intoksikasi Alkohol Firdaus, Riyadh; Lalenoh, Diana C.; Rahardjo, Sri; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 6, No 3 (2017)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Manajemen neuroanestesia untuk cedera kepala bertujuan untuk mengoptimalkan perfusi otak, memfasilitasi pembedahan dan mencegah cedera otak sekunder. Bagi pasien cedera kepala yang mengalami toksisitas alkohol, diperlukan perhatian khusus dalam mengevaluasi dan menentukan dosis obat anestesia. Walaupun GCS dapat digunakan sebagai modalitas penilaian pasien dengan intoksikasi alkohol, penilaian menggunakan FOUR adalah alternatif yang lebih baik. FOUR lebih spesifik dalam menilai penurunan kesadaran bila ada defek neurologi, bahkan bagi pasien yang terintubasi. Selama pembiusan, dosis perlu diperhatikan karena konsumsi alkohol jangka panjang dapat meningkatkan kebutuhan dosis obat anestesia. Sebaliknya, intoksikasi alkohol memerlukan dosis obat induksi yang lebih kecil. Seorang laki-laki usia 38 tahun dibawa ke IGD dengan penurunan kesadaran pasca trauma kepala sejak 3 jam sebelum masuk rumah sakit. Pasien memiliki riwayat konsumsi alkohol. Berdasarkan anamnesis, pemeriksaan fisis dan pemeriksaan penunjang, ditegakkan diagnosis Hematom Epidural. Pasien menjalani kraniotomi evakuasi Hematom Epidural selama 4 jam. Pascaoperasi pasien tidak dilakukan ekstubasi dan dirawat di perawatan ICU selama 7 hari.Use of Four Score in Anesthesia Management for Epidural Hematoma Evacuation in Patient with Alcohol IntoxicationNeuroanesthetic management for brain trauma aims to maintain optimal cerebral perfusion and facilitate surgery while preventing secondary brain injury. For patients with brain trauma under alcohol toxicity, careful monitoring is needed to assess and determine drug dosing. Although GCS is reliable for assessing conciousness in patients with alcohol intoxication, evaluation using FOUR is a reasonable alternative. FOUR is more spesific in identifying level of conciousness in neurologic defects, even in intubated condition. Throughout anesthesia, special attention should be given, as long term alcohol consumption may increase the dose needed for general anesthesia. However, a smaller dose of induction agent is needed in alcohol intoxication. We describe a case of a 38 years old male, who was admitted to emergency department with loss of conciousness following head trauma for 3 hours prior to admission. There was history of alcohol consumption. History and physical findings were consistent with epidural hematoma. Patient underwent craniotomy for epidural hematoma evacuation. The surgery took four hours. Post surgery, patient remained intubated and stayed in ICU for seven days.

Angka Morbiditas Pascaoperasi Tulang Belakang akibat Posisi Prone di Rumah Sakit Dr. Hasan Sadikin Bandung Periode November 2015Desember 2016 Nugraha, Ade Aria; Sudjud, Reza Widianto; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 6, No 3 (2017)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Latar Belakang dan Tujuan: Operasi tulang belakang mengalami peningkatan secara signifikan selama dekade terakhir. Posisi prone dibutuhkan sebagai akses pada operasi tulang belakang melalui pendekatan posterior. Operasi tulang belakang dengan posisi prone memiliki risiko terjadi cedera yang dapat menyebabkan morbiditas serius.Tujuan penelitian ini adalah untuk mengetahui angka morbiditas pascaoperasi tulang belakang dengan posisi prone di Rumah Sakit Dr. Hasan Sadikin Bandung.Subjek dan Metode: Metode penelitian ini adalah deskriptif observasional dengan rancangan potong lintang pada pasien yang dirawat di Rumah Sakit Dr. Hasan Sadikin Bandung dan menjalani operasi tulang belakang dengan posisi prone dari bulan November 2015 sampai dengan bulan Desember 2016.Hasil: Hasil penelitian ini dari 99 subjek penelitian diperoleh 8 kasus (8,1%) cedera penekanan, 1 kasus (1%) cedera mata, dan 1 kasus (1%) cedera pada saraf tepi. Perubahan fisiologi dan efek penekanan akibat posisi prone serta keadaan selama operasi memengaruhi terjadinya morbiditas pada pasien yang menjalani operasi tulang belakang.Simpulan: Kesimpulan dari penelitian ini adalah angka morbiditas pascaoperasi tulang belakang akibat posisi prone di Rumah Sakit Dr. Hasan Sadikin Bandung periode November 2015Desember 2016 sebanyak 10 kasus (10%).The Incidence of Patients Morbidity After Spinal Surgery with Prone Position in Dr. Hasan Sadikin General Hospital During November 2015December 2016Background and Objective: The rate of spine surgeries has increased significantly over the past decade. Prone position is required as an access to spinal surgery through the posterior approach. Spinal surgery with prone surgery poses a risk of injury that can lead to serious morbidity. The purpose of this study was to determine the number of postoperative morbidity of the spine due to prone position in Dr. Hasan Sadikin Hospital Bandung Subjects and Methods: The methods of this research is descriptive observational with cross sectional design and subjects of this study is patient undergo spine surgery in prone position in Dr. Hasan Sadikin Hospital Bandung period November 2015 ? December 2016. Results: Results of this study had shown that among 99 subjects, 8 cases (8.1%) were diagnosed with pressure ulcer, 1 case (1%) with eye injury, and 1 case (1%) with peripheral nerve injury. The physiological changes in a prone position, pressure effect and conditions during surgery might lead to morbidity in patients undergoing spinal surgery.Conclusion: The conclusion of this study is the rate of postoperative morbidity of the spine due to prone position in Dr. Hasan Sadikin Hospital Bandung period November 2015December 2016 as many as 10 cases (10%).

Konsep Dasar Transcranial Doppler (TCD) untuk Neurocritical Care Ida Bagus Krisna J. Sutawan; Siti Chasnak Saleh; Tatang Bisri
Jurnal Neuroanestesi Indonesia Vol 6, No 3 (2017)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Transcranial Doppler merupakan salah satu aplikasi dari penggunaan ultrasonografi (USG) sehingga bersifat noninvasif dan mobile. Untuk dapat menggunakan TCD dengan baik maka diperlukan pemahaman mengenai doppler effect yang merupakan dasar perhitungan dari parameter TCD, acoustic window yang mana merupakan tempat dimana dilakukan isonasi sehingga menemukan arteri yang benar, anatomi dari arteri yang akan diisonasi dan tipe alat TCD yang digunakan untuk mengisonasi. Informasi mengenai keadaan sirkulasi darah otak menggunakan TCD didapatkan melalui parameter-parameter yang langsung dihitung oleh alat TCD diantaranya peak systolic velocity, end diastolic velocity, mean flow velocity, pulsatility index dan resistence index. Selanjutnya ada juga informasi-informasi lainnya yang didapatkan dengan memasukkan parameter-parameter tersebut ke sebuah rumus, seperti misalnya mean flow velocity, tekanan intrakranial, tekanan perfusi otak. Selain itu TCD juga dapat digunakan untuk menilai keutuhan autoregulasi, vasospasme, hiperemia, dan mati batang otak.Basic Concept of Transcranial Doppler (TCD) for Neuroanesthesia and Critical CareTranscranial Doppler (TCD) is one of the applicable use of ultrasonograhy (USG), so it is noninvasif and mobile. To use TCD properly, the understanding of Doppler effect as the basic to calculate the parameters of TCD, acoustic window which are the place where to isonate to find the correct arterie, the anatomy of arteries that will be isonated and type of TCD device that will be used to isonated are needed. Information about cerebral circulation using TCD can be achieved from parameters that are directly calculated by the TCD device such as peak systolic velocity, end diastolic velocity, mean flow velocity, pulsatility index and resistence index. Furthermore, there are also informations that can be archived by putting up those parameters to a formula such as mean flow velocity, intracranial pressure and cerebral perfusion pressure. Beside that TCD also can be used to evaluate autoregulation, vasospasme, hypermia, and brain death.

Pulih Sadar Pascaanestesi yang Tertunda Permatasari, Endah; Lalenoh, Diana C.; Rahardjo, Sri
Jurnal Neuroanestesi Indonesia Vol 6, No 3 (2017)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Dengan penggunaan obat-obatan anestesi dengan kerja singkat, umumnya pasien dapat segera dibangunkan pascaoperasi dan pembiusan. Namun dapat terjadi proses pulih sadar yang tertunda karena berbagai penyebab. Proses pulih sadar yang tertunda pascaanestesi masih merupakan suatu masalah bagi ahli bedah dan anestesi. Seharusnya pada akhir operasi dan pembiusan, pasien sudah kembali ke tingkat kesadaran penuh, mampu mempertahankan reflex jalan nafas dengan ventilasi yang adekuat dengan nyeri yang terkendali. Waktu proses pulih sadar pascaanestesi dapat bervariasi dan tergantung dari berbagai faktor risiko terkait kondisi pasien prapembedahan, jenis anestesi yang diberikan dan lama operasi. Pulih sadar pascaanestesi yang tertunda terutama disebabkan oleh medikasi dan obat-obatan anestesi pada waktu perioperatif. Penyebabnya multifaktor dan obat-obatan anestesi tidak selalu menjadi penyebab. Apabila faktor penyebab lain telah dapat disingkirkan maka wajib dipertimbangkan yang menjadi penyebab adalah kelaian intrakranial akut. Sembari mencari penyebab, tatalaksana awalnya adalah mempertahankan jalan nafas, pernafasan dan sirkulasi. Walaupun proses pulih sadar yang tertunda pascaanestesi jarang ditemukan, mengenali gejala dan penyebab menjadi wajib untuk dapat dilakukan tatalaksana proses pulih sadar yang tertunda pascaanestesi sehingga dapat mengurangi morbiditas dan mortalitasnya. Diagnosis yang akurat adalah kunci tatalaksana dan ahli anestesi memegang peran penting dalam mencegah terjadinya komplikasi anestesi ini.Delayed Emergence from AnaesthesiaThe use of fast acting general anaesthetic agents leads to patients awaken quickly in the post operative period. However sometimes recovery is protracted and the list of possible causes in long. Delayed emergence from anaesthesia remains a major cause of concern both for anaesthesiologist and surgeon. Ideally, on completion of surgery and anaesthesia, the patient should be awake or easily arousable, protecting the airay, maintaining adequate ventilation and with their pain under control. The time taken to emerge to fully consciousness is affected by patient factors, anaesthetic factors, duration of surgery and painfull stimulation. The principal factor for delayed awakening from anaesthesia assumed to be the medications and anaesthestic agents used in the perioperatif period. Delayed emergene from anaesthesia is often multifactorial and anaesthetic agent may not always be the culprit. When other causes are excluded, the possibility acute intracranial event should be considered. While the specific cause is being sought , primary management is always support of airway, breathing and circulation. Although delayed emergence from general anesthesia is not uncommon, recognizing the cause and instituting timely treatment is imperative in condition where delayed therapy can increase morbidity and mortality. Accurate diagnosis is the key of management and anesthesiologist play a key role in the prevention of this anesthetic complication.

Penatalaksanaan Perioperatif Epidural Hematoma karena Pijat Kepala pada Bayi Subekti, Bambang Eko; Lalenoh, Diana C.; Rahardjo, Sri
Jurnal Neuroanestesi Indonesia Vol 6, No 3 (2017)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Cedera kepala pada bayi merupakan merupakan kejadian yang sering terjadi. Sejak bayi dapat tengkurap, berguling, merangkak bisa terjadi kepala bayi membentur dinding saat berganti posisi. Kebiasaan pijat bayi tradisional yang salah juga berisiko terjadinya cedera kepala. Terdapat perbedaan anatomi, fisiologi dan fisikososial, di samping otak bayi yang sedang mengalami perkembangan/pertumbuhan menjadi problem khusus dalam neuroanestesi. Bila terjadi trauma akan menyebabkan angka mortalitas, morbiditas dan kecacatan yang tinggi, yang sangat berpengaruh pada perkembangannya. Seorang bayi laki-laki, 1 bulan, datang ke RS dengan mengalami penurunan kesadaran setelah dipijat oleh dukun bayi tradisional. 3 hari sebelum masuk Rumah Sakit, bayi dipijat kemudian hari berikutnya demam, mual dan muntah, kejang dan kesadarannya menurun. Dibawa ke puskesmas dan dirujuk ke Rumah Sakit Abdul Muluk. Pada pemeriksaan di dapat kondisi lemah, GCS 9, pupil isokor 2/2mm, reflek cahaya +/+, hemodinamik dalam batas normal, anemia (+). Setelah dilakukan pemeriksaan fisik dan pemeriksaan tambahan didiagnosa cedera otak traumatik (GCS 9) dengan epidural hemorrhage (EDH). Pada pasien dilakukan tindakan kraniotomi evakuasi hematom dengan memperhatikan prinsip neuroanestesi selama tindakan bedah berlangsung.Perioperative Management of Epidural Hematoma for a Head Massage in InfantsHead injury in infants is a common occurence. Infancy can stomach, roll over, crawl could happen babys head againts the wall when changing position. Custom baby masssage traditional one is also at risk of head injury. There are differences in anatomy, physiology and psychosocial, as well as infants who are experiencing brain development/growth particular problem in neuroanestesi In the event of trauma will cause mortality, morbidity and a higher rate, which is very influential in the development of infants. A boy,1 months, admitted to hospital with the experience a decrease in consciousness after a massage by masseur traditional. 3 days before entering the hospital, baby massage and then have fever, nausea and vomiting, seizures and decreased consciousness. The baby was brought to Puskesmas and refer to Abdul Muluk hospital. On examination 9 obtained GCS, pupillary light reflex isocoor 2/2mm + / +, hemodynamics in the normal range, anemia (+). After a physical examination and was diagnosed with an additional examination brain damage due to trauma (GCS 9) with epidural hemorraghe. Patient was managed with emergency hematoma evacuation under general anesthesia and with continues and comprehensive care using neuroanesthesia principles.

Penatalaksanaan Anestesi pada Pasien Cedera Kepala Berat akibat Hematoma Epidural Akut disertai Kehamilan Aulyan Syah, Bau Indah; Suarjaya, I Putu Pramana; Rahardjo, Sri; Saleh, Siti Chasnak
Jurnal Neuroanestesi Indonesia Vol 6, No 3 (2017)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Penanganan cedera kepala berat selalu bertujuan untuk mempertahankan tekanan perfusi otak (TPO) dan mencegah peningkatan tekanan intrakranial yang dapat menyebabkan cedera otak sekunder. Pada pasien dengan kehamilan, janin juga harus dipantau. Hiperventilasi harus dihindari karena berefek buruk terhadap perfusi otak dan aliran darah plasenta. Seorang wanita, 25 tahun, 60 kg, 160 cm datang ke rumah sakit akibat trauma kepala karena kecelakaan lalu lintas yang dialami kurang dari 1 jam sebelum masuk rumah sakit dengan GCS E4M6V4. Pasien dalam keadaan hamil G1P0A0 dengan usia kehamilan 2830 minggu. Di unit gawat darurat terjadi penurunan kesadaran mendadak hingga GCS E1M5V1 sehingga dilakukan intubasi endotrakhea disusul dengan pemeriksaan CT Scan dengan hasil hematoma epidural dekstra dan hematoma subarachnoid disertai midline shift. Pasien kemudian menjalani operasi evakuasi hematoma epidural dengan anestesi umum kemudian di rawat di unit perawatan intensif dengan pipa endotrakhea masih dipertahankan. Denyut jantung janin (DJJ) masih terdengar dan dilakukan observasi ketat DJJ selama perawatan di ICU. Namun setelah beberapa hari di ICU, janin dinyatakan meninggal. Ringkasan: Pasien cedera kepala berat dengan hematoma epidural dan subarachnoid disertai kehamilan telah menjalani operasi anestesi umum dengan tetap memperhatikan pemeliharaan tekanan perfusi otak (TPO) dan mempertahankan kondisi janin dalam batas normal. Meskipun pada akhirnya janin tidak bisa diselamatkan akibat lamanya perawatan ibu dengan ventilator.Anesthesia Management for Patients in Pregnancy with Severe Head Injury Due to Acute Epidural Hematoma Management of severe head injury cases, in any given situation, is targeted to maintain cerebral perfusion pressure (CPP), and preventing increase of intracranial pressure that possibly cause secondary brain injury. In a case of pregnancy, besides considering the maternal status, fetus condition is equally important to observe. Hyperventilation should be avoided due to its possible detrimental effect to both the brain perfusion and placental blood flow. A 25 year old female, 60 kg, 160 cm, was taken to the hospital due to head trauma caused by a traffic accident, roughly about an hour prior to hospitalization. GCS was E4M6V4. The patient was in her 28 30 week of pregnancy (G1P0A0). Sudden decrease in consciousness occurred and GCS lowered to E1M5V1. Endotracheal intubation was then prompted. Epidural haematoma subarachnoid haematoma with midline shift revealed in CT scan. The patient underwent epidural hematoma evacuation with general anesthesia then transferred to Intensive Care Unit (ICU) with ETT maintained. Fetal heart rate remains heard, followed with close monitoring of the fetal heart rate during treatment in the ICU. After 3 days in ICU, fetus died. Summary: A pregnant patient with severe head injury of epidural and subarachnoid bleeding, has undergone an operation with general anesthesia. The fetus was unfortunately cannot be saved due to the patient long ventilator treatment.

Penanganan Anestesi pada Ventriculo Peritoneal Shunt Cito e.c Hidrocephalus dengan Perdarahan Intraventricular Novitasari, Dian; Fuadi, Iwan; Saleh, Siti Chasnak; Wargahadibrata, A. Hmendra
Jurnal Neuroanestesi Indonesia Vol 6, No 3 (2017)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Perdarahan intraventrikular akibat perluasan perdarahan subarahnoid ke ruang intraventrikel atau akibat perdarahan intraserebral menyebabkan hidrosefalus merupakan prediktor independent prognosis yang buruk pada stroke hemoragik. Kondisi hidrosefalus dengan perdarahan intraventrikular membutuhkan Ventriculo Peritoneal (VP) Shunt segera untuk menghindari defisit neurologis permanen bahkan kematian. Pasien seorang laki-laki dewasa (56 tahun) dengan bb 75 kg, dengan hipertensi kronis dan penurunan kesadaran disertai hipertensi intrakranial dengan CT Scan menunjukkan adanya hidrosefalus disertai perdarahan intraventrikular luas. Dilakukan anestesi dengan kombinasi anestesia intravena menggunakan propofol, dexmedetomidine - sevofluran 1 MAC dapat menjadi pilihan dalam operasi bedah saraf. Tindakan VP Shunt segera pada pasien ini merupakan tindakan yang bersifat life saving dengan managemen anestesi yang baik memberikan outcome yang baik.Anesthesia Management for Emergency Ventriculo Peritoneal Shunt ec Hydrocephalus with Intraventricular HemorrhageIntraventricular hemorrhage due to the expansion of subarachnoid hemorrhage due to space intraventricular or intracerebral hemorrhage cause hydrocephalus is an independent predictor of poor prognosis in hemorrhagic stroke. Hydrocephalus condition with intraventricular hemorrhage requiring ventriculo peritoneal (VP) shunt immediately to avoid permanent neurological deficits and even death. In this case report will discuss the management of anaesthesia in emergency VP Shunt for a patient with chronic hypertension, history of loss of consciousness accompanied by intracranial hypertension and CT scan result showed the existence of intra-ventricular hemorrhage with hydrocephalus wide. The combination of intravenous anesthesia using propofol, dexmedetomidine - 1 MAC sevoflurane may be an option in the operation of neurosurgery. VP Shunt immediate action in these patients is an act that is life saving with good anesthetic management provides a good outcome.

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Contact Name Agni Susanti

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

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Agni Susanti

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

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INDONESIA