Kombinasi Blok Pleksus Servikal Superfisial – Interskalenus untuk Operasi Fiksasi Klavikula pada Pasien dengan Pneumothoraks
Abstract
Latar belakang: Operasi klavikula lebih sering dilakukan dalam anestesi umum. Fraktur klavikula dengan cedera penyerta pneumothoraks yang berukuran kecil dan tidak bergejala dapat menjadi tension pneumothoraks ketika mendapat ventilasi tekanan positif pada paru-paru setelah induksi anestesi umum. Kombinasi blok pleksus servikal superfisial–interskalenus diharapkan dapat memberi analgesia yang cukup dan menghindarkan pasien dari komplikasi paru yang lebih berat akibat anestesi umum.
Kasus : Pasien pria 54 tahun mengalami nyeri dan bengkak pada bahu kiri akibat terjatuh. Pemeriksaan rontgen menunjukan adanya fraktur sepertiga tengah klavikula kiri. Pemeriksaan computed tomography (CT) scan dada menunjukan adanya kontusio paru, fraktur iga VIII-IX dan pneumothoraks minimal pada paru kiri. Dokter spesialis paru menatalaksana pneumothoraks secara konservatif karena berukuran kecil dan tidak bergejala. Pasien direncanakan menjalani operasi reduksi terbuka dan fiksasi internal klavikula kiri. Kami melakukan kombinasi blok pleksus servikal superfisial - interskalenus dengan panduan ultrasound untuk mendapatkan analgesia intra dan pasca operasi yang adekuat.
Kesimpulan : Kombinasi blok pleksus servikal superfisial – interskalenus dengan panduan ultrasound dapat menjadi anestesi tunggal pada operasi fraktur klavikula. Metode ini menjadi alternatif anestesi umum terutama bagi pasien yang berisiko tinggi.
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DOI: http://dx.doi.org/10.21776/ub.jap.2021.002.01.04
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