Pertimbangan Anestesia untuk Pasien dengan Deep Brain Stimulator Tertanam yang Menjalani Prosedur Diagnostik dan Pembedahan

Dhania A Santosa, Marsudi Rasman, Hamzah Hamzah, Siti Chasnak Saleh

Abstract


Deep brain stimulation (DBS) akhir-akhir ini sering digunakan untuk penyakit Parkinson dan kelainan pergerakan lainnya. DBS sendiri merupakan suatu stimulator yang ditanam pada nukleus dalam di otak dan disambungkan dengan pembangkit pulsasi yang ditanam di bawah klavikula. Sebagai konsekuensinya, ahli anestesiologi akan lebih sering menghadapi pasien dengan sistem DBS tertanam dalam tubuh mereka untuk menjalani prosedur diagnostik dan pembedahan. Anestesia pada pasien-pasien ini memerlukan perhatian khusus karena adanya potensi interferensi antara neurostimulator dan alat-alat lainnya yang dapat menbahayakan pasien. Oleh karenanya penting bagi ahli anestesi untuk memahami hal-hal khusus pada pasien dengan deep brain stimulator tertanam yang menjalani tindakan diagnostic maupun pembedahan. Panduan mengenai hal-hal yang perlu diperhatikan oleh ahli anestesi pada pasien seperti ini masih sangat kurang dan masih sangat bergantung pada laporan kasus atau panduan yang berasal dari pabrik pembuatnya. Tujuan penulisan artikel ini adalah untuk memberikan gambaran singkat mengenai sistem DBS dan penanganan anestesi pada pasien dengan alat DBS tertanam.

 

Anesthesia Considerations in Patients with Implanted Deep Brain Stimulator undergoing Diagnostic and Surgery Procedures

Deep brain stimulation (DBS) has become an increasingly common treatment for Parkinson’s disease and other movement disorders. DBS consist of implanted stimulator at deep nuclei of the brain and, connected to a pulse generated which is implanted under clavicle. Consequently, anesthesiologists will increasingly encounter patients with implanted DBS system facing diagnostic and surgery procedures. Anesthesia management in such patients requires specific considerations due to the possible interference between neurostimulator and other devices which are potentially harmful to the patient. Therefore, it is important for anesthesiologists to understand specific issues in patients with implanted deep brain stimulator undergoing surgery and other diagnostic procedures. Guideline on these specific issues is very limited and highly relies on case report and manufacturer’s manual. The purpose of this review is to provide brief overview on DBS system and anesthesia considerations in patients with implanted DBS


Keywords


deep brain stimulation; pertimbangan anestesia; pembedahan; anesthesia considerations; deep brain stimulation; surgery

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References


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DOI: https://doi.org/10.24244/jni.vol8i1.205

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