Tatalaksana Peningkatan Tekanan Intra Kranial (TIK) pada Operasi Craniotomi Evakuasi Hematom yang disebabkan oleh Hematom Intracerebral

We reported management of anesthesia in a man 50 years old with diagnosis ICH in region dextra ec parietal hemorrhagic stroke who underwent craniotomy with hematoma evacuation, physical status ASA II. Prior to the surgery, patient were treated in a stroke unit for 10 days. GCS E4M5V5, left hemiparesis with a chief complaint of headache. At the stroke unit, patient was managed as stroke haemmoragic and prevent elevation of intracranial preassure.

The operation was performed under general anesthesia, the procedure maintained intracranial pressure remains in optimal condition. Hemodynamic maintained at MAP 80 mm Hg ranged. The operation lasted for 3 hours, and in the postoperative periode, the patient treated and evaluated in the ICU for 2 days, then moved to the ward. Management of intracranial pressure is very important in the perioperative, either before surgery, during and after surgery in patients undergone craniotomy hematoma evacuation.

Kami laporkan menejemen anestesi pada pasien seorang laki-laki 50 tahun dengan diagnosa ICH regio parietal dextra ec stroke hemoragik yang dilakukan craniotomi evakuasi hematom, dengan status fisik ASA II. Pasien sebelum dilakukan operasi dirawat di unit stroke selama 10 hari GCS E4M5V5dan hemiparesissinistra dengan keluhan utama nyeri kepala. Di Unit stroke telah dilakukan usaha-usaha penatalaksanaan stroke hemoragik dan penatalaksanaan peningkatan tekanan intrakranial.

Operasi dilakukan dengan general anestesi, prosedur menjaga keadaan stabil dan mempertahankan tekanan intrakranial tetap dalam kondisi yang optimal. Hemodinamik dijaga dengan mempertahankan MAP bekisar 80 mmHg. Operasi berlangsung selama 3 jam, post operasi dirawat dan dievaluasi di ICU selama 2 hari, kemudian pindah ke bangsal.Penatalaksanaan tekanan intrakranial sangat penting dalam perioperatif, baik sebelum dilakukan operasi, selama maupunsetelah operasi pada pasien craniotomi evakuasi hematom.