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Anestesia Untuk Kraniotomi Tumor Supratentorial (Anesthesia For Craniotomy Supra Tentorial Tumor)
The common supratentorial tumors in adults are glioma (36%), meningioma (32.1%), and adenoma pituitary (8.4%). Approximately half of these tumors are malignant. The majority of them (> 80%) are supratentorial. For the entire primary tumor, the average age when a brain tumor was detected is 57 years old. The exact number of metastatic brain tumor incidence is unknown, but it is assumed quite low. The existence of metastatic tumor of the central nervous system (SSP) is found at the autopsy of around 25% of patients who died of cancer. There are five sources of malignancy which often cause metastasis to the brain, namely breast cancer, colorectal cancer, lung cancer, and melanoma. In six percent of patients, these complications appeared within a year after the primary tumor is de tected. These five cancers frequently cause the brain metastases in approximately 37.000 cases in the United States.
It is reported the successful handling of anesthesia on a woman 56 years old, weighing 65 kg. This patient was diagnosed with Space Occupying Lession . (SOL) right DD / Meningioma. Craniotomy surgery was performed for tumor expenditure. At the time she entered the operating room, her blood pressure was 176/100 mmHg, pulse rate beats / minuie, respiratory rate 20 times/minute, body temperature of 3r C, and GCS E4V5M6. She was induced with Fentanyl 100 mg, 100 mg Propofol; intubation facilities are Rocuronium 40 mg, Lidocaine 70 mg, maintenance with Inhalan Sevoflurane and Oxygen, along with continuous Propofol, the addition of Fentanyl and intermittent Rocuronium. Infusion was attached in two pathways. The surgery lasted seven hours and twenty minutes. With nasa I cannula and oxygen 3 liters/minute attached, the patient was transferred to ICU. She was treated for one day in ICU, before moved into a ward. After stay in the ward for five days, she was discharged and became an outpatient of neurosurgeon.
Anesthesia for supratentorial tumor requires an understanding of pathophysiology of intracranial pressure (lCP) suppression locally and entirely; setting up and maintenance of intracerebral perfusion; how to avoid secondary effects of a systemic effect on the brain. Accurate and structured perioperative preparation is critical for handling of anesthesia for supratentorial tumors, which includes the preparation of the patient pre-surgery, completeness preparation of drugs, devices, and monitoring, as well as planning the implementation of the anesthesia until post-surgery tendance.
Keywords: Anesthesia, non-pharmacological neuroprotection, pharmacological neuroprotection, Supratentorial tumors.
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