Background: Mitral stenosis heart valve abnormalities in pregnant women is a complication of pregnancy that is quite common, accompanying rheumatic heart disease, endocarditis, and congenital abnormalities. In pregnancy, there have been changes in the cardiorespiratory system caused by increased cardiac output, which the presence of mitral valve stenosis can then exacerbate. Anesthesia management plays an essential role in the safety of the mother and baby during and after surgery. The choice of technique and anesthesia management depends on the abnormality’s severity. Case: We report the successful management of anesthesia with pure central neuraxial epidural block and combined spinal epidural (CSE) in two cases of a cesarean section of 3rd-trimester pregnant women with mitral stenosis and class II functional heart failure caused by rheumatic heart disease. Conclusion: Central neuraxial block epidural anesthesia and combined spinal epidural (CSE) anesthesia are safe anesthesia techniques for both mother and baby because they can maintain hemodynamic stability.
Craniopharyngiomas are benign histological brain tumors originating less frequently fromembryonic pituitary gland tissue that are seen most frequently in children between the ages of 5and 10 years. In this case report we present a 25-year-old patient with a craniopharyngiomatumor. Patients with decreased consciousness since 4 months before admission to the hospital,which started with memory loss that was getting worse and more difficult to communicate. Thepatient was diagnosed with a brain tumor and underwent surgery for tumor therapy in 2018. Theprocedure was performed using a transcranial approach. Considerations for preoperativeanesthesia should include evaluation of radiological features to identify tumor mass andpreoperative neurologic status. Other examinations of concern include examination of blood gasanalysis and examination of electrolytes. The goals of treatment can be to remove the tumor,reduce or control the size of the tumor.
Pendahuluan: Berbagai macam teknik anestesi regional sudah banyak dikembangkan guna memfasilitasi pengendalian nyeri selama operasi maupun paska operasi, blok pleksus servikalis superfisialis (BPSS) merupakan salah satunya. Penulis mempresentasikan kasus, pasien laki-laki berusia 53 tahun yang menjalankan operasi tiroidektomi. Dilakukan anestesi umum pada pasien dengan adjuvan BPSS guna mengendalikan nyeri intra maupun paska operasi. Dari laporan kasus ini dapat disimpulkan bahwa BPSS adalah teknik anestesi regional yang mudah aplikasikan dan secara efektif dapat menjadi adjuvant pada pembedahan tiroidektomi serta dapat mengurangi penggunaan opioid selama operasi.Ilustrasi Kasus: Pada laporan kasus ini, dilakukan pengamatan pada pasien laki-laki berusia 53 Ilustrasingan keluhan benjolan pada leher sejak 1 bulan yang lalu, yang menjalani pembedahan tiroidektomi. Pasien mendapatkan premedikasi dan setelah prosedur intubasi, dilakukan blok pleksus servikalis superfisialis dengan menggunakan ropivakain 0.75% sebanyak 10 cc dengan teknik mengipas dan anestesi lokal diberikan sepanjang batas posterior muskulus sternokleidomastoideus. Selama operasi berlangung, tanda-tanda vital dalam batas normal. Simpulan: Blok pleksus servikalis superfisialis adalah teknik anestesi regional yang mudah aplikasikan dan secara efektif dapat menjadi adjuvant pada pembedahan tiroidektomi serta dapat mengurangi penggunaan opioid selama operasi.
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