Lalenoh, Alfonsius Paulus and Lalenoh, Diana Christine
(2013)
ANAESTHETIC MANAGEMENT IN SEVERE TRAUMATIC BRAIN INJURY.
Proceeding-Free Paper International 4th Congress of Asian Society for Neuroanesthesia and Critical Care (ASNACC) and 22nd Annual Meeting of Korean Society for Neuroscience in Anesthesiology and Critical Care (KSNACC) at Busan, Korea.
Abstract
Traumatic brain injury (TBI) is a major health problem in the world due to its mortality and morbidity. In general, the brain injury is caused by several accidents involving the vehicles and the human factor.
A young male 19 years old, 54lbs consulted by a neurosurgeon for craniotomy. The indication for craniotomy is the epidural hematomas in left front parietal according to the result of CT-Scan. The vital signs consist of blood pressure 110/70 mmHg; heart rate 98 x/min; respiratory rate 24 x/min; body temperature 37,5oC GCS E1V1M3. Patients were induced with 100 mg Fentanyl, Propofol 100 mg, intubation with rocuronium 40 mg, 70 mg lidocaine, and maintenance with isoflurane and oxygen Inhalants and continuous propofol and fentanyl and rokuronium intermittent additions. Infusion is attached in two lanes. The operation lasted for four hours. With attached nasal oxygen cannula and 3 liters / min, the patient was transferred to the ICU. After being treated for 2 days in the ICU, the patient was then transferred to ward with a GCS postoperative E3V5M6. Anesthesia for traumatic head injury requires an understanding of the pathophysiology of emphasis intracranial pressure (ICP) local and overall; setting and maintenance of intra cerebral perfusion; how to avoid the consequences of systemic secondary effect on the brain.
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