AIRWAY AND ANESTHETIC MANAGEMENT IN ROBINOW SYNDROME PATIENT WITH SEVERE AORTIC STENOSIS FOR DENTAL SURGERY : A CASE REPORT
DOI:
https://doi.org/10.31004/prepotif.v8i3.31221Keywords:
Anesthetic Management, Aortic Stenosis, Difficult Airway, Intubation, Robinow SyndromeAbstract
Robinow Syndrome (RS) adalah kelainan genetik langka yang ditandai dengan fitur kraniofasial dan abnormalitas skeletal yang khas, sering disertai dengan kelainan jantung, yang mempersulit manajemen anestesi. Pasien dengan RS sering mengalami tantangan signifikan dalam manajemen jalan napas karena karakteristik wajah dan skeletal, yang membuat manajemen jalan napas menjadi kompleks. Anomali vertebral juga mempersulit pemberian anestesi neuraksial, dan pemilihan agen induksi harus mempertimbangkan risiko jantung. Laporan ini membahas manajemen jalan napas dan anestesi yang berhasil pada seorang pasien RS berusia 13 tahun yang menjalani ekstraksi gigi akibat kerusakan gigi parah dan stenosis aorta. Pemeriksaan fisik pasien menunjukkan Mallampati IV dan Cormack-Lehane IV pada jalan napas, sehingga diperlukan teknik intubasi khusus seperti penggunaan gum elastic bougie untuk akses jalan napas yang berhasil. Fitur kraniofasial dan skeletal yang terkait dengan RS menimbulkan tantangan dalam manajemen perioperatif, sering kali membutuhkan pembedahan. Intubasi yang efektif pada pasien RS membutuhkan evaluasi praoperatif yang cermat, terutama pada kasus dengan micrognathia dan asimetri wajah. Evaluasi praoperatif yang komprehensif, termasuk penilaian fungsi jantung, ginjal, dan pernapasan, sangat penting untuk mengurangi komplikasi dan meningkatkan hasil. Manajemen anestesi harus memperhitungkan kesulitan jalan napas dan masalah jantung yang unik pada RS, dengan kesiapan menghadapi potensi tantangan intraoperatif. Kasus ini menyoroti pentingnya perencanaan yang teliti dan teknik khusus dalam mengelola anestesi pada pasien RS, khususnya mereka dengan kondisi jantung yang mempersulitReferences
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