DOI: https://doi.org/10.14710/jai.v11i1.23934

Anestesi Regional pada Pasien dengan Penyakit Jantung/ Hemodinamik Tidak Stabil

Bagian Anestesiologi dan Terapi Intensif; Fakultas Kedokteran; Universitas Diponegoro; Semarang, Indonesia

Published: 1 Mar 2019.

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Abstract

Pembiusan pasien dengan penyakit jantung sebelumnya merupakan tantangan yang menarik. Penyebab paling umum morbiditas dan mortalitas perioperatif pada pasien jantung adalah penyakit jantung iskemik (PJI). Goldman dkk. melaporkan bahwa 500.000 hingga 900.000 infark miokard terjadi setiap tahun di seluruh dunia dengan mortalitas 10-25%. Keputusan untuk menggunakan anestesi regional tergantung pada banyak faktor. Karakteristik pasien, jenis operasi yang direncanakan, dan potensi risiko anestesi semuanya akan berdampak pada pilihan anestesi dan manajemen perioperatif.

Kerugian dari anestesi regional termasuk hipotensi dari blokade simpatis yang tidak   terkendali dan kebutuhan untuk loading volume dapat menyebabkan iskemia. Pemberian anetesi lokal dalam dosis besar juga harus mempertimbangkan risiko toksisitas depresi miokard. Pada pasien dengan penyakit kardiovaskular, teknik anestesi regional (baik tunggal atau dengan anestesi umum) bermanfaat perioperatif dalam mengurangi respon stres, simpatektomi jantung, ekstubasi lebih awal, lama rawat di rumah sakit lebih pendek, dan analgesia pascaoperasi yang baik. Selain jenis operasi yang dilakukan, dalam pelaksanaannya juga harus mempertimbangkan masalah yang ada pada masing-masing pasien. Anestesi umum juga memberikan peranan penting karena bersifat kardioprotektif dan dapat meningkatkan suplai oksigen. Keputusan untuk menggunakan anestesi regional harus dilakukan dengan hati-hati dan dilakukan dengan pemantauan yang tepat.

 

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Keywords: anestesi; hemodinamik; jantung; regional; umum

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Section: Literature Reviews
Language : ID
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