Manajemen Anestesi pada Pasien dengan Chiari Malformation dan Syringomyelia

Kasus: Pasien kami mengalami Chiari malformation tipe 2 dengan adanya syringomyelia. Gejala klinis yang muncul berupa nyeri kepala dan leher bagian belakang, disertai dengan kelemahan pada tangan kiri. Melalui tindakan operatif, dikerjakan dekompresi foramen magnum dan duroplasty. Anestesi dikerjakan dengan anestesi umum intravena, diberikan induksi dengan propofol dan fentanyl, pemeliharaan dengan propofol intravena dosis 100 mcg/kg/menit. Nyeri paska operasi pasien dikelola dengan epidural analgesia yang dipasang pada daerah setinggi vertebra cervical 3, dengan regimen bupivakain 0,1% dan morfin 0,5 mg dalam volume 5 ml.
Ringkasan: Chiari malformation adalah kelainan anatomi cerebellum yang memiliki potensi berbahaya. Kompresi yang terjadi pada foramen magnum dapat menyebabkan terjadinya bulbar palsy dan menyebabkan apnea. Tindakan dekompresi dikerjakan untuk mencegah terjadinya kelumpuhan tersebut. Pasien dengan Chiari malformation seringkali disertai dengan syringomyelia dan hidrosefalus. Manajemen anestesi yang direncanakan sebaiknya tidak menimbulkan peningkatan tekanan intra kranial.
Article Metrics:
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Last update: 2021-03-03 06:41:35
Last update: 2021-03-03 06:41:36
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