<![CDATA[Latar Belakang dan Tujuan: Perdarahan intraserebral (PIS) mempunyai angka morbiditas dan mortalitas yang tinggi. Hanya 20% individu yang bertahan dari penyakit ini dapat hidup dalam 6 bulan. Masih terdapat kontroversi dalam tatalaksana PIS, seperti meregulasi tekanan darah, mencegah perluasan hematoma, edema otak, dan mempertahankan perfusi serebral. Tujuan penelitian ini adalah untuk membahas prosedur tatalaksana perioperatif PIS dengan hipertensi emergensi. Subjek dan Metode: Penelitian serial kasus dari 3 kasus dengan gangguan kesadaran (skor GCS ≤14), didiagnosa PIS, akan dilakukan kraniotomi evakuasi hematoma. Dilakukan pengelolaan tekanan darah prabedah dengan target tekanan darah rata-rata (TAR) 125–130 mmHg. Induksi dengan fentanyl 3 ug/kg, propofol 2,5 mg/kg, vecuronium 0,1 mg/kg, lidokain 1,5 mg/kg dan rumatan anestesi dengan O2, air, isoflurane 1–1,5 vol%. Hasil: Pascabedah 2 kasus dirawat di ICU selama 2–3 hari dan satu kasus dirawat di neurocritical care unit (NCCU) selama 3 hari dan terdapat perbaikan GCS menjadi 15. Setelah itu dipindahkan ke ruangan dan mendapat perawatan selama 5–7 hari, dan dipulangkan setelah 7–15 hari. Simpulan: Masih ada kontroversi tentang terapi PIS yang optimal terutama dalam pengendalian tekanan darah. Tekanan darah yang tinggi dapat menimbulkan hematoma, tapi penurunan tekanan darah dapat menimbulkan penurunan perfusi otak. The Intensive Blood Pressure Reduction of Acute Cerebral Hemorrhage Trial (INTERACT) menemukan bahwa penurunan tekanan darah yang segera akan mengurangi resiko perluasan perdarahan tapi tidak mempunyai efek pada outcome, akan tetapi, pada ke 3 kasus tersebut menurunkan tekanan darah dalam waktu kurang dari 24 jam memberikan hasil yang baik. Perioperative Anesthesia Management in Patients with Spontaneous Intracerebral Haemorrhage (ICH) et causa Hypertensive Emergency: A Case Series Background and Objectives: Intracerebral hemorrhage (ICH) have a high rate of morbidity and mortality. Only 20% of individuals who survive ICH are independent at 6 months. Many issues need to be considered for the optimal management of ICH, such as blood pressure (BP) control, prevention of hematoma growth, containing brain edema, and preserving cerebral perfusion. The objective of this case series is to report perioperative management procedure for ICH with hypertensive emergency.Subject and Methods: A serial case study of three patients with decrease consciousness (score GCS ≤14), ICH, were planned for craniotomy evacuation. Perioperative management of BP has been done to a targetted mean arterial pressure (TAR) of 125–130 mmHg. Induction with fentanyl 3 ug/kg, propofol 2.5 mg/kg, vecuronium 0.1 mg/kg, lidocaine 1.5 mg/kg and maintain of anesthesia with O2, air, isoflurane 1–1.5 vol%. Results: Two patients were admitted to the ICU post-operatively for 2–3 days, one patient were admitted to the Neuro Critical Care Unit (NCCU) for three days, and had improvements of consciousness (GCS 15), then transferred to the ward for another 5–7 days, and finally discharged after 7–15 days. Conclusion: There are still controversies in the treatment of ICH, especially in the control of BP. High BP can lead to hematoma, but decrease in BP can reduce cerebral perfusion. The Intensive Blood Pressure Reduction of Acute Cerebral Hemorrhage Trial (INTERACT) found that early intensive BP management reduced the risk of hematoma expansion but had no effect on outcomes. However in all three cases above, a reduction in BP within 24 hours have provided good results. ]]>
