Jurnal Neuroanestesi Indonesia
Vol 7, No 3 (2018)

Pengelolaan Anestesi untuk Eksisi Tumor Intradura Intramedula (IDIM) Setinggi Vertebra Cervical 5-6 dengan Panduan Intraoperative Neurophysiological Monitoring


Santosa, Dhania Anindita, Harijono, Bambang, Hamzah, Hamzah, Jasa, Zafrullah Kany, Rehatta, Nancy Margareta



Article Info

Publish Date
30 Oct 2018

Abstract

Eksisi tumor intradura intramedula (IDIM) dengan bantuan intraoperative neurophysiological monitoring (IOM) merupakan suatu teknik pembedahan yang bertujuan agar eksisi tumor dilakukan semaksimal mungkin, dengan meminimalkan defisit neurologis akibat pembedahan. Penanganan anestesi pada eksisi tumor IDIM dengan bantuan IOM ini, seorang ahli anestesi perlu menguasai ilmu dan keterampilan neuroanestesi untuk pembedahan tulang belakang, selain itu juga pemilihan teknik, jenis dan dosis obat yang mendukung pelaksanaan pembedahan dengan IOM ini. Seorang laki-laki usia 52 tahun dengan tumor IDIM setinggi vertebra cervical 5–6 menjalani pembedahan eksisi tumor dengan bantuan IOM. Pembedahan dilakukan di bawah pengaruh anestesi umum dengan induksi intravena. Laringoskopi dilakukan dengan video laryngoscope. Pembedahan dilakukan dengan panduan IOM, selama anestesi diberikan total intravenous anesthesia tanpa pemberian pelumpuh otot tambahan setelah intubasi. Pembedahan berlangsung selama enam jam dan tumor dapat terangkat seluruhnya. Tantangan selama periode perioperatif adalah penilaian dan persiapan prabedah yang teliti, posisi pasien dan pemilihan teknik anestesi yang tepat.Anesthesia Management for Cervical 5-6 Intradural Intramedullary (IDIM) Tumor under Intraoperative Neurophysiological Monitoring GuidanceExcision of intradural intramedullary (IDIM) tumor using intraoperative neurophysiological monitoring (IOM) is one surgical technique aiming to excise tumor as maximum as possible, with minimum neurological deficit. In anesthesia management for IDIM tumor excision under IOM guidance, an anesthesiologist is required to master neuroanesthesia knowledge and skill, especially for spine surgery. Moreover, understanding the art of anesthesia technique, drug and dose supporting surgery with IOM. A male patient, 52 years old, with IDIM tumor at the level of cervical 5-6th underwent surgery for tumor excision using IOM. Surgery was done under general anesthesia, started with intravenous induction, and intubation was done using video laryngoscope. Surgery was done under IOM guidance, total intravenous anesthesia was implemented and no additional muscle relaxant was given after intubation. Surgery lasted for six hours and tumor was resected completely. Challenges during perioperative period are meticulous preoperative assessment and preparation, patient positioning and appropriate anesthesia technique.


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Original Source : http://ojs.inasnacc.org/ojs/index.php/jni/article/view/26
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Journal Info

Abbrev

jni

Publisher

Subject

Library & Information Science Medicine & Pharmacology Neuroscience Public Health Social Sciences

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 ...