Manajemen Anestesi pada Pasien Sindroma Kauda Equina e.c. SOL Ekstrameduler Intradural dengan Kehamilan

Ferra Mayasari, Tubagus Yuli R, Iwan Fuadi

Abstract


Manajemen anestesi untuk pasien hamil untuk operasi non-obstetrik jarang dilakukan, dan menimbulkan sejumlah tantangan bagi spesialis anestesiologi karena manajemen anestesi harus mempertimbangkan kehidupan ibu dan janin. Pertimbangan anestesi untuk wanita hamil dengan operasi non obstetri meliputi perubahan kardiovaskular dan hematologi, sistem respiratori, sistem gastrointestinal, dan sistem saraf pusat serta perifer serta pada kasus ini adalah posisi yang ekstrim. Seorang wanita berusia 26 tahun dengan sindroma kauda equina e.c. SOL ekstramedula intradural dengan G3P2A0 gravida 25‒26 minggu yang dilakukan tindakan laminektomi pengangkatan tumor dalam anestesi umum dengan posisi miring kekiri. Operasi dapat dilaksanakan tanpa adanya komplikasi, pascaoperasi baik ibu maupun janin dalam keadaan sehat. Keberhasilan manajemen anestesi pada operasi non-obstetrik selama kehamilan tergantung kepada kerjasama multidisiplin, penilaian preoperatif yang komprehensif, perhatian terhadap fisiologi maternal dan fetus, serta perawatan suportif periode postoperatif. Mempertahankan stabilitas maternal, waktu optimal melakukan tindakan, dan pemilihan obat serta teknik anestesi yang tepat merupakan hal yang sangat penting diperhatikan untuk keamanan ibu dan fetus.

 

Anesthesia Management of Pregnant Patient with Cauda Equine Syndrome e.c. Extramedulary Intradural SOL

Anesthesia management for non-obstetric surgery during pregnancy is relatively uncommon and challenges the anesthesiologist since anesthesia management must consider both mother and fetal safety. Anesthesia management for non-obstetric pregnant women is considered covering difference in cardiovascular and hematologic changes, respiratory system, gastrointestinal system, central nervous system and peripheral nervous system, and in this case extreme position for operation. For this case, a 26 year old woman with Cauda Equina Syndrome e.c. Extramedullary Intradural SOL with G3P2A0 25‒26 weeks pregnancy underwent Laminectomy for Tumor Removal under general anesthesia. The surgery was preceded without any complication, both mother and fetal recovered uneventfully. The successful of anesthesia management for non-obstetric surgery during pregnancy depends on multidisciplines coordination, comprehensive preoperative management, careful monitoring on maternal and fetal physiology, and supportive postoperative care. Maintaining maternal stability, determination of the optimal time for surgery, and selection of proper medication and anesthesia technique are the most important things to be considered for mother and fetal safety.


Keywords


Kehamilan; operasi non-obstetrik; sindroma kauda equina; cauda equina syndrom; non-obstetric surgery; pregnancy

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References


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DOI: https://doi.org/10.24244/jni.vol3i1.133

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