Penatalaksanaan Anestesi pada Operasi Splenektomi Ruptur Lien dengan ORIF Humerus Sinsitra
Keywords:
syok hemoragik, general anesthesia, manajemen perioperatifAbstract
Latar Belakang
Syok hipovolemik (hemoragik) yang tidak terkontrol merupakan penyebab mortalitas yang paling sering terjadi pada pasien dengan multipel trauma. Diperkirakan 25% kematian akibat trauma dapat dicegah dengan onset penanganan trauma yang tepat dan intervensi yang tepat untuk menghentikan perdarahan.
Laporan Kasus
Dilaporkan seorang pasien laki-laki usia 31 tahun, mengalami kecelakaan lalu lintas, terdiagnosis ruptur lien derajat V disertai fraktur humerus sinistra. Pasien dilakukan Tindakan operasi cito splenektomi dan ORIF humerus. Anestesi dilakukan dengan general anesthesia (GA). Operasi berlangsung selama 3.5 jam dengan lama anestesi 4 jam. Durante operasi hemodinamik relatif stabil, dengan perdarahan 1500 mL dan urine output 400 mL. Post operasi pasien dirawat di ICU.
Kesimpulan
Manajemen perioperatif, yang meliputi: pemilihan farmakologi sebelum operasi, kombinasi terapi cairan, tranfusi darah dan penggunaan vasopresor sangat penting dalam tatalaksana anestesi operasi splenektomi ruptur lien dengan ORIF humerus.
References
American Society of Anesthesiologists. (2025). American Society of Anesthesiologists Statement on ASA Physical Status Classification System. Anesthesiology Open, 1(1), e0002. https://doi.org/10.1097/ao9.0000000000000002
ATLS COMMITTEE ON TRAUMA. (2025). Advanced Trauma Life Support Course Manual. In Circulation Assessment and Volume Resuscitation (11th ed., pp. 80–81).
Badan Penelitian dan Pengembangan Kementerian Kesehatan. (2018). Hasil Utama Riskesdas 2018 (Kementerian Kesehatan Republik Indonesia, Ed.). Kementerian Kesehatan Republik Indonesia.
Bu, F., Zhang, D., & Chi, Y. (2025). Effects of ondansetron applied before the induction of anaesthesia on postoperative nausea and vomiting in high-risk patients: Protocol for a randomised controlled trial. BMJ Open , 15(6). https://doi.org/10.1136/bmjopen-2024-093633
Butterworth, J., Mackey, D., & Wasnick, J. (2022). Morgan and Mikhail’s Clinical Anesthesiology, 7th Edition (22nd ed.). Mc Graw Hill.
Desousa, K. A. (2016). Pain on propofol injection: Causes and remedies. In Indian Journal of Pharmacology (Vol. 48, Number 6, pp. 617–623). Medknow Publications. https://doi.org/10.4103/0253-7613.194845
George, S. (2025). Anesthesia: Principles, Clinical Practice, and Recent Advances. Journal of Society Medicine, 4(12), 401–408. https://doi.org/10.71197/jsocmed.v4i12.254
Hines, R., & Jones, S. (2022). STOELTING’S ANESTHESIA AND CO-EXISTING DISEASE (Eighth). Elsevier.
Kementerian Kesehatan RI. (2022). Pedoman nasional pelayanan kedokteran tata laksana anestesiologi dan terapi intensif. Keputusan Menteri Kesehatan Republik Indonesia, 123.
Lema, G. F., Tesema, H. G., Fentie, D. Y., & Arefayne, N. R. (2019). Evidence-based perioperative management of patients with high serum potassium level in resource-limited areas: A systematic review. In International Journal of Surgery Open (Vol. 21, pp. 21–29). Elsevier Ltd. https://doi.org/10.1016/j.ijso.2019.10.006
Obeidat, M., Bashmaf, O., Alrwashdeh, S., Ababneh, F., & Sharadgah, S. (2024). Tranexamic acid with vitamin K mixture decreases bleeding of total hip arthroplasty in a Jordanian population. International Journal of Research in Orthopaedics, 10(6), 1148–1152. https://doi.org/10.18203/issn.2455-4510.intjresorthop20243107
PERDATIN. (2019). Anestesiologi dan Terapi Intensif (Rehatta et al, Ed.). Gramedia Pustaka Utama.
Puppo Moreno, A. M., Abella Alvarez, A., Morales Conde, S., Pérez Flecha, M., & García Ureña, M. Á. (2019). The intensive care unit in the postoperative period of major abdominal surgery. Medicina Intensiva (English Edition), 43(9), 569–577. https://doi.org/10.1016/j.medine.2019.05.011
Ramesh, G. H., Uma, J. C., & Farhath, S. (2019). Fluid resuscitation in trauma: What are the best strategies and fluids? In International Journal of Emergency Medicine (Vol. 12, Number 1). BioMed Central Ltd. https://doi.org/10.1186/s12245-019-0253-8
Sander, M. A. (2018). Kasus Serial Ruptur Lien Akibat Trauma Abdomen: Bagaimana Pendekatan Diagnosis dan Penatalaksanaannya. Fakultas Kedokteran Universitas Muhammadiyah Malang, 14.
Uemura, Y., Kinoshita, M., Sakai, Y., & Tanaka, K. (2023). Hemodynamic impact of ephedrine on hypotension during general anesthesia: a prospective cohort study on middle-aged and older patients. BMC Anesthesiology, 23(1). https://doi.org/10.1186/s12871-023-02244-4
Vishwanathan, K., Chhajwani, S., Gupta, A., & Vaishya, R. (2021a). Evaluation and management of haemorrhagic shock in polytrauma: Clinical practice guidelines. Journal of Clinical Orthopaedics and Trauma, 13, 106–115. https://doi.org/10.1016/j.jcot.2020.12.003
Vishwanathan, K., Chhajwani, S., Gupta, A., & Vaishya, R. (2021b). Evaluation and management of haemorrhagic shock in polytrauma: Clinical practice guidelines. Journal of Clinical Orthopaedics and Trauma, 13, 106–115. https://doi.org/10.1016/j.jcot.2020.12.003
Willmott, H. (2016). Trauma and Orthopaedics at a Glance (At a glance, 87). Wiley.
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