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Strategi Untuk Mencegah Aspirasi Isi Lambung Pada Operasi Cedera Otak Traumatika Emergensi (Strategy To Prevent Gastric Content Aspira Tion In Emergency Trauma Tic Brain Injury Surgery)

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Management of an emergency patients has a particular challenge for an anesthesiologist. The risk of pulmonary aspiration from gastric content is very high in emergency cases. The incidence of gastric aspiration in emergency cases is approximately 0.7-4% which could lead to death.
Gastrointestinal dysfunction frequently occurs in patients with traumatic brain injury (TBI). More than 50% patients with severe head injuries could not tolerate enteral feedings. This intolerance is manifested by vomiting, abdominal distention, delayed gastric emptying, esophageal reflux and decreased intestinal peristalsis, indicating that gastrointestinal dysfunction is a common phenomenon folio wing TBI. Fasting is an effective manouver to reduce the incidence of gastric aspiration, but in emergency cases is rather difficult to establish that manouver. Several manouvers to reduce aspiration incidence are: a) to administer drugs prior to induction: histamine 2-reseptor antagonist (ranitidine, cimetidine), proton pump inhibitor (om eprazole) , antacid (sodium citrate, magnesium trisilicate) and antiemetic (ondansentrone), b) head up position of 30-45, c) rapid sequence induction with sel/ick manouver, d) insert naso or orogastric tube and aspirate gastric content. By using rapid sequence induction there would be not enough time to avoid the increase in blood pressure during laryngoscopy-intubation, whereas for patient with cerebral disorder including traumatic brain injury, increased blood pressure shouta be avoided because this willlead to increase intracranial pressure.
Gastric content aspiration is one of anesthesia complication during perioperative periode especially in emergency cases. Adequate managment can reduce the incidency of aspiration.
Keywords: anesthesia, emergency surgery, gastric content aspiration, traumatic brain injury.

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Ketersediaan

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Judul Seri

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No. Panggil

Jurnal Neuroanestesia Indonesia, 1 (1) 2012 : 51-5

Penerbit

Bandung : Indonesian Society of Neuroanesthesia & Critical Care INA_SNACC., 2012

Deskripsi Fisik

8p

Bahasa

ISBN/ISSN

2088-9670

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