Manajemen Perioperatif untuk Pemulihan Dini Pascaoperasi pada Kraniotomi Evakuasi Tumor Supratentorial: Sebuah Laporan Kasus

Abstract

Early Recovery After Surgery (ERAS) merupakan suatu upaya pemulihan dini pascaoperasi yang masih terus dikembangkan untuk operasi bedah saraf. Upaya ERAS pada tumor otak supratentorial akan memberi keuntungan pemulihan fungsional pascaoperasi lebih cepat dan masa perawatan yang lebih singkat. Pasien wanita 45 tahun, dengan tumor ekstraaksial regio fronto-temporal kiri dengan diagnosa meningioma parasagital sinistra menjalani operasi kraniotomi evakuasi tumor. Pasien sadar penuh, mengeluh sakit kepala hilang timbul, pandangan kabur dan memiliki riwayat kraniotomi evakuasi tumor sebelumnya. Pasien menjalani kraniotomi dengan anestesi umum dan tambahan blok scalp. Operasi berlangsung selama 3 jam 20 menit dengan hemodinamik yang stabil selama anestesi dan pembedahan. Pascaoperasi, pasien segera diekstubasi dan dirawat di ruangan intensif selama 2 hari. Pasien pulang pada hari kelima dan kontrol rawat jalan. Penatalaksanaan perioperatif pada pasien tumor supratentorial yang menjalani kraniotomi pengangkatan tumor dapat dilakukan untuk memfasilitasi pemulihan dini pascaoperasi. Manajemen multidisiplin yang tepat pada tahap praoperasi, intraoperasi dan pascaoperasi, dengan mempertimbangkan penyakit penyerta pasien, penting untuk keberhasilan melakukan pemulihan dini pascaoperasi.

Perioperative Management to Facilitate Early Recovery After Surgery for Supratentorial Tumor Resection: A Case Report

Abstract

Early Recovery After Surgery (ERAS) in neurosurgery is a promising and developing concept directed to enhance postoperative recovery for neurosurgical patient. ERAS application to supratentorial brain tumor patient’s will provide advantage of early functional recovery and shorter length of stay. We reported a successful anesthetic management for a 45-year-old woman, diagnosed with a left frontotemporal extra axial tumor, suspected left parasagittal meningioma. Preoperative, patient was fully conscious but complained occasional headache and blurred vision with normal hemodynamic parameters. We performed general anesthesia with additional scalp block for this patient to facilitate the surgery, which lasted 3 hours 20 minutes. The surgery went uneventful with a stable hemodynamic, patient was extubated in the operating theatre and monitored in the Intensive Care Unit (ICU). After two days in the ICU, we transferred the patient to the ward. She was discharged on the fifth day and controlled as an outpatient care. Perioperative management of patients with supratentorial tumor whom undergo craniotomy for tumor removal could be performed to facilitate early recovery. Appropriate multidisciplinary management in the preoperative, intraoperative and postoperative periods, with regard to the underlying disease, is important to successfully perform the ERAS