Cardiac Arrest Intra Operatif Pada Neuroanestesi Pediatrik

Abstract

Henti jantung (cardiac arrest) intra operatif merupakan penyulit yang paling menakutkan selama pembedahan berlangsung, terutama pada kasus-kasus bedah saraf pediatrik, dikarenakan akan berpengaruh pada luaran operasi dan dampak jangka panjang yang ditimbulkannya. Resiko yang lebih berat adalah kematian di meja operasi. Seorang anak perempuan 10 bulan dibawa ke RSUD Prof. Dr. Margono Soekarjo oleh orangtuanya dengan keluhan kelemahan anggota gerak sebelah kiri sejak 1 bulan sebelumnya. Pasien rujukan dari salahsatu rumahsakit daerah. Setelah dilakukan tindakan pemeriksaan penunjang, maka disimpulkan dengan diagnosa sementara primitive neuroectoderm tumor (PNET). Pasien direncanakan untuk dilakukan tindakan opeasi bedah saraf elektif. Tindakan anestesi bedah saraf berlangsung selama 180 menit. Selama berlangsungnya operasi pasien mengalami henti jantung (cardiac arrest) pada menit ke-120. Kemudian dilakukan tindakan resusitasi kardiopulmoner. Pasien merespon resusitasi dengan baik. Pasien pasca operasi dibawa ke ruang perawatan intensif. Pasien dirawat di ruang perawatan intensif selama 6 hari, dirawat di ruang bedah saraf selama 4 hari, dan dipulangkan pada hari ke-10 pasca operasi.

Intraoperative Cardiac Arrest in Pediatric Neuroanesthesia

Intra-operative cardiac arrest is the most frightening complication during surgery, especially in cases of pediatric neurosurgery, because it will affect the outcome of the operation and the long-term effects it causes. A more severe risk is death at the operating table. A 10-month-old girl was brought to the RSUD Prof. Dr. Margono Soekarjo by his parents with complaints of weakness in the left limb since 1 month before. Patient referral from one regional hospital. After carrying out investigative actions, it is concluded with a provisional diagnosis of primitive neuroectoderm tumor (PNET). Patients are planned for elective neurosurgery surgery. The neurosurgical anesthetic procedure lasts 180 minutes. During the operation, the patient experiences cardiac arrest (cardiac arrest) in the 120th minute. Then cardiopulmonary resuscitation is performed. Patients respond to resuscitation. Postoperative taken to intensive care. The patient was treated in the intensive care room for 6 days, was admitted to the neurosurgical room for 4 days, and sent home on the 10th day postoperatively.