Penatalaksanaan Anestesi untuk Tumor Neuroendokrin

Syafruddin Gaus, Tatang Bisri

Abstract


Tumor neuroendokrin sering ditemukan pada orang dewasa dengan angka kejadian 10%-15% dari seluruh neoplasma intrakranial dan tertinggi pada dekade ke 4 sampai ke 6 kehidupan. Penderita dengan tumor neuroendokrin mempunyai tantangan yang unik untuk dokter ahli anestesi karena peranan yang penting kelenjar hipofise pada sistem endokrin.Tantangan ini mulai saat pemeriksaan prabedah dan berlanjut selama operasi serta periode pascabedah. Banyak teknik anestesi dan obat anestesi yang dapat diberikan pada pembedahan tumor neuroendokrin. Pemilihan obat anestesi tergantung pada penyakit komorbititas penderita dan riwayat anestesi sebelumnya. Apabila diinginkan penderita cepat sadar untuk segera dilakukan pemeriksaan neurologik maka dapat digunakan obat-obat yang cepat dieliminasi (misalnya propofol dan remifentanil) atau anestetika inhalasi dengan kelarutan dalam darah yang rendah (misalnya sevofluran) merupakan pilihan yang rasional. Keberhasilan pembedahan dan penatalaksaan anestesi pada penderita tumor neuroendokrin memerlukan pendekatan multidisiplin dan sangat tergantung pada kualitas perawatan perioperatif.

 

Anesthesia Management for Neuroendocrine Tumor

Neuroendocrine tumor is commonly in adult patient with incidence 10-15% in all of intracranial neoplasm and highest at 4th-6th of life decade. Patients with neuroendocrine tumor have an unique challange for anesthesiologist because the important role of pituitary gland in endocrine system. The challange came during preoperative, intraoperative and postoperative periode. Many of anesthesia technique and anesthetics can use for neuroendocrine tumors surgery. The choice of anesthetics depend on comorbid diseases and history of anesthesia previously. If needed fast emergens for neurological evaluation, it can be use drug with fast elimination (ex propofol and remifentanil) or inhalation anesthetic with low coefficient partition (ex sevoflurane) is rational choice. The successful surgery and anesthesia management for neuroendocrine patient need multidisipline approach and depend on the quality of postoperative care.


Keywords


Kelenjar hipofise; sistem endokrin; tumor neuroendokrin; teknik anestesi; pitutary gland; endocrine system; neuroendocrine tumor; anesthesia technque

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References


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DOI: https://doi.org/10.24244/jni.vol1i3.172

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