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Pengelolaan Perioperatif Pediatri dengan Patent Ductus Arteriosus dan Trikuspid Regurgitasi Mild Pro Transanal Endorectal Pull-Through

1Departemen Anestesi dan Terapi Intensif RSUD Dr. Moewardi, Fakultas Kedokteran, Universitas Sebelas Maret, Surakarta, Indonesia

2Fakultas Kedokteran, Universitas Sebelas Maret, Indonesia

Revised: 30 Nov 2021; Accepted: 30 Nov 2021; Available online: 30 Nov 2021.

Citation Format:
Abstract

Latar belakang: Megacolon congenital atau hirschprung disease merupakan penyebab umum obstruksi usus neonatal di mana segmen dari saluran usus bagian distal tidak memiliki elemen sistem saraf enterik yang normal. Transanal endorecral pull-through (TAERPT) merupakan salah satu prosedur operasi sebagai tatalaksana megacolon congenital yang sering dipakai karena metodenya yang invasif minimal dan memberikan efek kosmetik yang lebih baik daripada metode transabdominal.

Kasus: Kami melaporkan seorang anak perempuan usia 1 tahun dengan berat badan 9,2 kg dengan megacolon congenital, patent ductus arteriosus (PDA) 0,3 cm dan TR mild yang akan menjalani prosedur TAERPT. Pemeriksaan fisik preoperatif didapatkan pasien sadar dan aktif, tanda vital lain dalam batas normal, SpO2 95-97% dalam posisi supine. Pemeriksaan fisik lain dan laboratorium dalam batas normal.

Pembahasan: Tujuan anestesi selama tindakan pada pasien dengan kelainan jantung bawaan asianotik PDA adalah menjaga keseimbangan aliran agar tidak terjadi peningkatan aliran darah pulmonal yang menyebabkan hipertensi pulmonal. Pilihan obat dan tindakan anestesi pada pediatri didasarkan pada anatomi, fisiologi, dan farmakologi pada anak yang berbeda dengan pasien dewasa.

Kesimpulan: Pengelolaan perioperatif pasien dengan PDA yang menjalani TAERPT pada anak perempuan usia 1 tahun dalam laporan ini menuliskan pentingnya pemahaman terkait patofisiologis penyakit dan pendekatan anestesi pediatri untuk mendapat hasil yang baik.

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Subject PDA, TAERPT, pediatri, Megacolon congenital
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Keywords: megacolon congenital; PDA; pediatrik; regurgitasi tricuspid; TAERPT
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