Laporan Kasus: Tatalaksana Anestesi Penyakit Hirschsprung dengan Sindrom Aspirasi Mekoneum dan Pneumomediastinum pada Neonatus
ABSTRACT: We report one female
newborn baby suffered from moderate asphyxia, meconium aspiration syndrome, and
Hirschsprung disease. The
patient admitted in
Neonatal Intensive Care
Unit (NICU) and
ventilated with Pressure
Controlled Mandatory Ventilation (PCMV) mode ventilator. Patient suffered from
pneumodiastinum and therefore mediastinotomy was performed. Sepsis and
Necrotizing Enterocolitis (NEC) made the case more complicated.
On further examination,
abdominal was distended
and perforated and
therefore we decided to
perform exploration laparatomy
and sigmoidoctomy. Anaesthesia
management with general anaesthesia had
been performed. Premedication
was not given.
We used oxygen
and Sevofluran for induction; Oxygen, Sevofluran,
Atracurium, Fentanyl, and Morphin for maintenance; and Morphin for post operative
analgesic. On follow up examination, we found wound disruption and therefore
relaparotomy was performed. Types and doses of anesthesia drugs were chosen
according to newborn immature organ noticely. Providing adequate oxygenation,
preventing hypotermi, and balancing electrolytes and acid base states still be
the most considerations in management of this patient. Anesthetic management
and intensive care of this patient gained a satisfying outcome. The prognosis
was good.
Penulis: Karmini Yupono, Ruddi
Hartono
Kode Jurnal: jpkedokterandd090150
