Blok Aksilar dengan Panduan Ultrasonografi pada Operasi Debridement Lengan Bawah Pasien Systemic Lupus Erythematosus, Gagal Ginjal Kronik, Sirosis Hepatis, dan Gagal Jantung
Abstract
Blok aksilar sangat menguntungkan dilakukan pada operasi daerah lengan bawah. Pasien wanita berusia 28 tahun dengan diagnosis systemic lupus erithematosus (SLE), gagal ginjal kronik, sirosis hepatis dan gagal jantung, direncanakan operasi nekrotomi debridement di lengan bawah di Rumah Sakit Dr. Hasan Sadikin Bandung pada Maret 2012. Dilakukan anestesi blok aksilar dengan panduan ultrasound Sonosite M Turbo menggunakan high frequency probe linear, jarum stimulasi 50 mm dan nerve stimulator dengan obat anestesi lokal bupivakain 0,5% dengan adjuvan epinefrin 1:200.000. Keberhasilan blok aksiler dikonfirmasi dengan menstimulasi sensoris dan nervus motorik yang telah diblok. Blok tercapai secara sempurna dalam waktu ±15 menit. Operasi dilakukan setelah blok tercapai dan operasi berlangsung selama 1 jam. Simpulan, blok aksilar dengan panduan ultrasound memberikan hasil yang memuaskan dengan angka keberhasilan yang tinggi. Pada pasien ini sangat menguntungkan dilakukan anestesi regional blok saraf perifer dibandingkan dengan anestesi umum karena komplikasi penyakit yang banyak.
Kata kunci: Blok aksilar, systemic lupus eritematosus, ultrasounografi
Axillary Block with Ultrasound Guided for Debridement of the Forearm in Patient with Systemic Lupus Erythematous, Chronic Renal Failure, Hepatic Cirrhosis, and Congestive Heart Disease
Axillary block is beneficial when applied to a forearm operation. A 28-year-old female patient diagnosed with systemic lupus erythematosus, chronic renal failure, hepatic cirrhosis and heart failure, was planned for necrotomy debridement operation of the forearm in Dr. Hasan Sadikin Hospital-Bandung in March 2012. An axillary block anesthesia was done with Sonosite M Turbo ultrasound guidance that used high frequency linear probe, 50 mm stimulating needle, and nerve stimulator containing bupivacaine 0.5% and epinephrine adjuvant 1:200,000. The operation can be initiated after the block was achieved and the duration of operation was 1 hour. In conclusions, axillary block with ultrasound guidance gives satisfying result with higher success rate. Peripheral nerve block (regional anesthesia) is more beneficial to this patient than general anesthesia due to multiple complications.
Key words: Axillary block, systemic lupus erythematosus, ultrasound
DOI: 10.15851/jap.v1n2.124
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