asra practice advisory on neurologic complications in regional-part2
DESCRIPTION
Journal reading ppt about neurological complication after regional anesthesia part 2TRANSCRIPT
7/17/2019 ASRA Practice Advisory on Neurologic Complications in Regional-part2
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• Defsit sara penuh atau progresimemerlukan evaluasi dari ahli saraatau bedah sara perier
• Gejala ringan atau membaik tanpabukti objekti defsit saraprognosisnya baik
• Jika gejala tidak membaik dalam 2-3minggu diperlukan konsultasi lebihlanjut
• Konduksi sara dan elektromiograf
7/17/2019 ASRA Practice Advisory on Neurologic Complications in Regional-part2
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ekomendasi
"edera neura#ial
• Mengetahui anatomi pasien
• $dakah hematoma atau abses% penggunaan
anti&oagulan% teknik aseptik• 'umor
• (osisi bedah yang digunakan
• Dosis obat
• (enggunaan anestesi lokal dan atau opioidharus ada monitoring dan ketersediaanresusitasi
7/17/2019 ASRA Practice Advisory on Neurologic Complications in Regional-part2
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7/17/2019 ASRA Practice Advisory on Neurologic Complications in Regional-part2
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"edera sara perier
• )elum ada data yang mendukungkeunggunal teknik lokalisasi satusara% parestesia% stimulasi sara%*+G
• 'idak ada data yang mendukungeektiftas monitoring tekananinjeksi% ,at anestesi lokal yangmengurangi neurotoksisitas
7/17/2019 ASRA Practice Advisory on Neurologic Complications in Regional-part2
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• (asien dengan gangguan atau&edera sara sebelumnya DM% kemo%pykit vaskular perier berat. dapat
se&ara teori meningkatkan resiko
7/17/2019 ASRA Practice Advisory on Neurologic Complications in Regional-part2
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7/17/2019 ASRA Practice Advisory on Neurologic Complications in Regional-part2
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$ pd pasien dengan gangguan neurologis
• Ggn neurologis pada "/+ dan perierseperti M+% $0+% dan syndr postpolio
merupakan tantangan bagi ahli anestesi• (ertimbangkan alternati teknik anestesi
• 1pidural teknik pada pasien dengan
stenosis atau massa tidak dianjurkan
7/17/2019 ASRA Practice Advisory on Neurologic Complications in Regional-part2
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7/17/2019 ASRA Practice Advisory on Neurologic Complications in Regional-part2
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7/17/2019 ASRA Practice Advisory on Neurologic Complications in Regional-part2
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7/17/2019 ASRA Practice Advisory on Neurologic Complications in Regional-part2
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Kesimpulan
• Komplikasi neurologis terkait dengan anestesiregional dan pengobatan nyeri jarang terjadi
• (emahaman patofsiologi dan aktor risiko
yang terkait dengan &edera sara neuraksialdan perier memungkinkan ahli anestesiuntuk meminimalkan komplikasi
• +ayangnya% pasien yang dinyatakan sehat
bahkan dengan peraatan sempurna daridokter% komplikasi ini tidak sepenuhnya dapatdiprediksi atau di&egah
7/17/2019 ASRA Practice Advisory on Neurologic Complications in Regional-part2
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