Penanganan Anestesi pada Ventriculo Peritoneal Shunt Cito e.c Hidrocephalus dengan Perdarahan Intraventricular

Dian Novitasari, Iwan Fuadi, Siti Chasnak Saleh, A. Hmendra Wargahadibrata

Abstract


Perdarahan intraventrikular akibat perluasan perdarahan subarahnoid ke ruang intraventrikel atau akibat perdarahan intraserebral menyebabkan hidrosefalus merupakan prediktor independent prognosis yang buruk pada stroke hemoragik. Kondisi hidrosefalus dengan perdarahan intraventrikular membutuhkan Ventriculo Peritoneal (VP) Shunt segera untuk menghindari defisit neurologis permanen bahkan kematian. Pasien seorang laki-laki dewasa (56 tahun) dengan bb 75 kg, dengan hipertensi kronis dan penurunan kesadaran disertai hipertensi intrakranial dengan CT Scan menunjukkan adanya hidrosefalus disertai perdarahan intraventrikular luas. Dilakukan anestesi dengan kombinasi anestesia intravena menggunakan propofol, dexmedetomidine - sevofluran 1 MAC dapat menjadi pilihan dalam operasi bedah saraf. Tindakan VP Shunt segera pada pasien ini merupakan tindakan yang bersifat life saving dengan managemen anestesi yang baik memberikan outcome yang baik.

Anesthesia Management for Emergency Ventriculo Peritoneal Shunt ec Hydrocephalus with Intraventricular Hemorrhage

Intraventricular hemorrhage due to the expansion of subarachnoid hemorrhage due to space intraventricular or intracerebral hemorrhage cause hydrocephalus is an independent predictor of poor prognosis in hemorrhagic stroke. Hydrocephalus condition with intraventricular hemorrhage requiring ventriculo peritoneal (VP) shunt immediately to avoid permanent neurological deficits and even death. In this case report will discuss the management of anaesthesia in emergency VP Shunt for a patient with chronic hypertension, history of loss of consciousness accompanied by intracranial hypertension and CT scan result showed the existence of intra-ventricular hemorrhage with hydrocephalus wide. The combination of intravenous anesthesia using propofol, dexmedetomidine - 1 MAC sevoflurane may be an option in the operation of neurosurgery. VP Shunt immediate action in these patients is an act that is life saving with good anesthetic management provides a good outcome.


Keywords


Anestesia intravena; sevofluran; hidrosefalus; perdarahan intraventrikular; Ventriculo Peritoneal Shunt; intravenous anaesthesia; sevoflurane; hydrocephalus; Ventriculo Peritoneal Shunt; intraventricular hemorrhage

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DOI: https://doi.org/10.24244/jni.vol6i3.55

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