Sri Rahardjo
Faculty of Medicine Universitas Gadjah Mada/Dr. Sardjito Yogyakarta, Indonesia

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Peranan Index of Consciousness (IoC) dalam Tatalaksana Total Intravenous Anesthesia pada Operasi Mikrovaskular Dekompresi Fitri Sepviyanti Sumardi; Iwan Fuadi; Sri Rahardjo; Tatang Bisri
Jurnal Neuroanestesi Indonesia Vol 6, No 2 (2017)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (436.902 KB) | DOI: 10.24244/jni.vol6i2.43

Abstract

Perkembangan ilmu pengetahuan dan tehnik operasi bedah saraf ini berbanding lurus dengan kemajuan keilmuan anestesi. Tatalaksana anestesi sangat mempengaruhi kualitas hidup dan kesehatan pasien pascabedah. Seorang laki-laki 58 tahun dengan diagnosis trigeminal neuralgia sinistra, berat badan 60 kg dan tinggi badan 165 cm. Pasien mengeluh nyeri wajah sebelah kiri yang terkadang disertai nyeri kepala. Riwayat hipertensi dan penyakit penyerta lain disangkal. Riwayat konsumsi obat-obatan seperti carbamazepine disangkal. Dilakukan induksi anestesi umum dengan tehnik total intravenous anesthesia (TIVA) menggunakan teknik target controlled infuse (TCI): propofol, dexmetomidine, fentanyl dan rocuronium, sebagai alat pantau/monitoring digunakan index of consciousness (IoC), lama operasi 2 jam dan lama pasien teranestesi 2 jam 30 menit. Pascabedah pasien dirawat di ICU selama 1 hari, lalu dipindahkan ke ruang rawat inap dan pulang ke rumah pada hari ke-6 perawatan. Mikrovaskular dekompresi merupakan operasi bedah otak yang minimal invasif menuntut para ahli anestesi untuk bertanggung jawab menyokong pascabedah yang lebih optimal, sehingga pasien cepat bangun dan penilaian neurokognitif dilakukan sedini mungkin. Penggunaan IoC sebagai alat pantau pasien/monitoring selama diberikan anestesi TIVA sangatlah berguna. Hal ini bertujuan untuk mencegah timbulnya pasien tetap sadar selama operasi berlangsung, dengan melihat kedalaman anestesi yang diberikan, agar tidak terjadi kekurangan atau kelebihan dosis obat-obatan anestesi yang diberikan.The role of index of consciousness (IoC) Total Intravenous Anesthesia Management for Microvascular Decompression SurgeryThe development of science and engineering neurosurgical operation is directly proportional to the scientific advancement of anesthesia. Management of anesthesia greatly affect quality of life and health of patients postoperatively. A man 58 years old with a diagnosis of the left trigeminal neuralgia, weighing 60 kg and height 165 cm. Patients complain of pain left face is sometimes accompanied by headache. A history of hypertension and other comorbidities denied. A history of consumption of drugs such as carbamazepine denied. Induction of general anesthesia with TIVA technique using TCI: propofol, dexmetomidine, fentanyl and rocuronium, as a means of monitoring / monitoring use IoC (index of consciousness), long operating time of 2 hours and anesthetized patients 2 hours 30 minutes. Postoperative patients admitted to the ICU for 1 day, and then transferred to the wards and go home on the 6th day of treatment. Microvascular decompression is a brain surgery less invasive and requires minimal bleeding anesthesiologists responsible for more optimal postoperative support, so patients quickly get up and neurocognitive assessment done as early as possible. The use IoC as a tool to monitor patients during anesthesia TIVA, it’s very useful. It aims to prevent the patient awareness during surgery, to see the depth of anesthesia is given, in order to avoid under- or overdosing anesthesia agents.