NEUROPHYSIOLOGY INTRAOPERATIVE MONITORING (NIOM) PADA OPERASI DEFORMITIY CORRECTION AT ADOLESENT SCOLIOSIS

The use of neurophysiological intraoperative monitoring (NIOM) during spinal orthopaedic and neurosurgical procedures provides a challenge to the attending anaesthesiologist. Since all anaesthetic agents affect synaptic function, the choice of agent will be determined by the type of surgery and the NIOM modality employed. Had been performed surgery for scoliosis correction of spinal abnormalities in children aged 15 years with using of sensory and motoric NIOM. The surgery going under general anesthesia with the installation monitor invasive arterial line and central venous pressure during surgery for hemodynamic monitoring. Drugs used during anesthesia using balanced anesthesia technique with a combination of opioids, propofol and sevo urane as inhalation. Muscle relaxants given intermittently for operator leisure and ventilation controls. Postoperative hospitalization in ICU with the aim of assessing the function of the respiratory and neurological of the patients and pain management.

Penggunaan neurophysiological intraoperative monitoring (NIOM) selama prosedur ortopedi dan bedah saraf pada tulang belakang memberikan tantangan kepada para ahli anestesi. Karena semua agen anestesi mempengaruhi fungsi sinaptik saraf, pilihan agen akan ditentukan oleh jenis operasi dan modalitas NIOM digunakan. Dilakukan operasi bedah untuk koreksi kelainan skoliosis tulang belakang pada anak umur 15 tahun dengan penggunaan NIOM sensorik dan motorik. Pasien dilakukan operasi dengan anestesi umum dengan pemasangan monitor invasif arteri line dan central venous pressure selama operasi untuk memantau hemodinamik. Obat yang digunakan selama pembiusan menggunakan teknik balanced anesthesia yakni dengan kombinasi opioid, propofol, dan inhalasi sevo urane. Pelumpuh otot diberikan intermitten untuk kenyamaan operator dan kontrol ventilasi. Pasca operasi dilakukan perawatan di ICU dengan tujuan menilai fungsi respiratorik dan neurologis pasien serta manajemen nyeri pasien.