Pengelolaan Perioperatif Cedera Medula Spinalis Servikal karena Trauma dengan Tetraparesis Frankle C Asia

Wahyu Sunaryo Basuki, Dewi Yulianti Bisri, Siti Chasnak Saleh, A. Hmendra Wargahadibrata

Abstract


Cedera medula spinalis akut relatif jarang namun menjadi salah satu kejadian trauma yang berakibat fatal. Kejadian ini sering terjadi pada laki-laki dewasa muda. Kecelakaan lalu lintas merupakan penyebab utama dari kejadian ini, disusul oleh kejadian trauma di rumah, industri dan olahraga. Tujuan utama dari pengelolaan cedera medula spinalis akut adalah mencegah medula spinalis dari cedera sekunder dan memperbaiki fungsi neurologis, mencegah perubahan alignment dan menjaga stabilitas columna vertebralis untuk mendapatkan hasil pemulihan neurologis dan rehabilitasi yang maksimal. Ahli anestesi berperan besar mulai awal pengelolaan secara optimal cedera medula spinalis akut ini. Seorang laki-laki, 57 tahun, dibawa kerumah sakit karena kecelakaan sepeda motor. Pada pemeriksaan fisis, didapatkan laju nafas 24x/menit, nadi 70x/menit, tekanan darah 110/61 mmHg, perfusi baik, GCS 15, dan tetraparesis. Dalam perawatan selanjutnya, terjadi bradikardia (nadi 50-61 x/menit) dan hipotensi (tekanan darah 80-90/40-60 mmHg). Dilakukan laminoplasti dekompresi stabilisasi segera.

Perioperative Management Traumatic Cervical Spinal Cord Injury with Tetraparesis Frankle C Asia

Acute spinalis cord injury (SCI) is relatively rare but can be a fatal trauma event. Young adult men are most commonly affected. Traffic accident is a frequent cause, followed by accidents at homes, industries, and in sports. The primary goals of the management of acute SCI are to prevent secondary injury of the spinal cord, improve neurological functions, prevent disruption in alignment, and maintain the stability of the vertebral columns. These serve to achieve neurological recovery and maximal rehabilitation. Anesthesiologists play an important role in the optimal management of acute SCI. A 57-year-old man was brought to the hospital due to a motorcycle accident. Physical examination revealed respiratory rate 24 x/minutes, heart rate 70 x/minutes, blood pressure 110/61 mmHg, good perfusion, GCS 15, and tetraparesis. During hospitalization, the patient developed bradycardia (heart rate 50-61 x/minutes) and hypotension (blood pressure 80-90/40-60 mmHg). Immediate decompressive laminoplasty stabilisation was performed.


Keywords


Bradikardia; cedera medula spinalis akut; hipotensi; laminoplasti dekompresi stabilisasi; Acute medula spinalis injury; bradycardia; decompressive laminoplasty stabilisation; hypotension;

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DOI: https://doi.org/10.24244/jni.vol7i1.24

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