ASRA Practice Advisory on Neurologic Complications in Regional-part2

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Journal reading ppt about neurological complication after regional anesthesia part 2

Transcript of ASRA Practice Advisory on Neurologic Complications in Regional-part2

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

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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

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