DOI: https://doi.org/10.14710/jai.v0i0.66384

Rare Case of Neurosurgical Anesthesia in a Patient with Recidive Cystic Tumor and Cerebral Edema Re-craniotomy tumor excision and decompression: Case Report

Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Jendral Soedirman University- Prof. DR. Margono Soekarjo Hospital., Indonesia

Received: 1 Sep 2024; Revised: 24 Jan 2024; Accepted: 12 Mar 2024; Available online: 12 Mar 2024.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

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Abstract

Background: The existence of recurrent cystic tumors and cerebral edema is very rare with an estimated incidence of 0.5-1.0%. Anesthetic management for cases of recurrent cystic tumors and cerebral edema has several special things that are important to implement.

Case: In this case, a 54-year-old patient was reported with complaints of headaches and dizziness for 6 months before entering the hospital. The patient never experienced seizures or loss of consciousness. The patient was planned to undergo re-craniotomy surgery to remove the recurrent cystic tumor. ASA physical status 3. The patient was performed under general anesthesia with intubation. Induction with sufentanyl 20 mcg, Thiopental 200 mg, and rocuronium 50 mg. The operation lasted 3.5 hours. After surgery, the patient was treated in the Intensive Care Unit for 1 day before moving to the room.

Discussion: Anesthetic management is carried out with the target of not increasing intracranial pressure, with adequate analgesics, good brain relaxation techniques, and prevention of hypercapnia, hypocapnia, and hypoxia. Apart from that, blood pressure must be maintained by preventing hypotension or hypertension. Brain tissue is covered by the cranium. Because of the continuous relationship of blood flow and brain tissue volume, the risk of bleeding is very high. Without a proper anesthetic approach, the risk of brain hemorrhage due to surgical manipulation can increase.

Conclusion: Anesthetic treatment and regulation of physiological factors have a major impact on brain tissue. The anesthetist must know the effects of drugs and other manipulations to achieve good surgical results.

Keywords: recurrent cystic tumor, cerebral edema, general anesthesia, neurosurgery, intracranial pressure.

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Keywords: recurrent cystic tumor, cerebral edema, general anesthesia, neurosurgery, intracranial pressure.

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Section: Case Reports
Language : EN
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