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Total Intravenous Anesthesia (TIVA) pada Bedah Jantung Koroner

SMF Anestesi dan Perawatan Intensif Pascabedah, Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita, Jakarta, Indonesia

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Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)

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Abstract

Bedah jantung koroner merupakan jenis operasi jantung yang paling sering dilakukan pada pasien dewasa. Pada penelitian yang dilakukan tahun 2011-2014 angka mortalitas bedah jantung koroner pada pasien dengan multipel lesi pembuluh darah sebesar 27,8%.Pasien yang dipertimbangkan untuk dilakukan bedah jantung koroner memerlukan penilaian risiko operatif, pemeriksaan menyeluruh dan manajemen perioperatif yang baik oleh dokter anestesi. Pemilihan teknik dan agen anestesia pada bedah jantung koroner telah berkembang pesat dengan tersedianya obat intravena yang memiliki durasi singkat dan mudah dititrasi seperti propofol dan remifentanyl yang memberikan efek sinergis dibandingkan penggunaan opioid dosis tinggi. Oleh karena itu, teknik total intravenous anesthesia (TIVA) mulai banyak dipilih seiring dengan perkembangan obat dan tersedianya alat seperti smart-pump infusion yang memungkinkan obat intravena untuk mencapai efek klinis yang diharapkan dan memberikan angka harapan hidup dan luaran yang lebih baik hingga beberapa tahun pascabedah.

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Keywords: anestesi; bedah jantung koroner; propofol; remifentanil; TIVA

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