MANAJEMEN ANESTESI PADA PASIEN DENGAN ARTERIOVENOUS MALFORMATION SPINE

Authors

  • Beny Pratama Sidabutar Departemen Anestesi dan Terapi Intensif Universitas Udayana, Denpasar Bali
  • I Putu Pramana Suarjaya Departemen Anestesi dan Terapi Intensif Universitas Udayana, Denpasar Bali
  • Tjokorda GA Senapathi Departemen Anestesi dan Terapi Intensif Universitas Udayana, Denpasar Bali

DOI:

https://doi.org/10.31004/prepotif.v9i2.46810

Keywords:

arteriovenous malformation, anestesi umum, laminektomi, neuroanestesi

Abstract

Manajemen anestesi pada pasien dengan arteriovenous malformation (AVM) spinal yang menjalani operasi laminektomi memerlukan pendekatan multidisipliner dan pemantauan ketat untuk menghindari komplikasi neurologis dan hemodinamik. AVM spinal merupakan kelainan vaskular kompleks yang meningkatkan risiko perdarahan intraoperatif, hipotensi spinal, dan iskemia medula spinalis. Oleh karena itu, strategi anestesi harus difokuskan pada stabilitas hemodinamik, penghindaran perubahan tekanan intratekal yang mendadak. Penggunaan teknik anestesi umum yang seimbang, pemilihan agen anestesi yang minimal mengganggu pemantauan neurofisiologis, serta kolaborasi erat dengan tim bedah dan neurofisiologi menjadi kunci keberhasilan manajemen anestesi pada prosedur ini. Kami memaparkan kasus manajemen anestesi yang sukses pada pasien laki-laki usia 31 tahun dengan diagnosa Paraparese dan Tumor Intramedullary ec Suspek Intramedullary Spinal AVM dengan rencana tindakan laminektomi + Reseksi AVM + Stabilisasi Fusi dengan anestesi umum.

References

Akgun, M. Y., Kemerdere, R., Ulu, M. O., Alizada, O., Isler, C., Kizilkilic, O., et al. (2019). Spinal vascular malformations: Treatment and outcome. World Neurosurgery, 130, e953–e960. https://doi.org/10.1016/j.wneu.2019.07.043

Alkhaibary, A., Alharbi, A., Alnefaie, N., Alammar, H., Arishy, A. M., Alghanim, N., Aldhfyan, Y. M., Albaiahy, A., Khormi, Y. H., Alshaya, W., AlQahatani, S., Aloraidi, A., Alkhani, A., & Khairy, S. (2024). Spinal dural arteriovenous fistula: A comprehensive review of the history, classification systems, management, and prognosis. Chinese Neurosurgical Journal, 10(1), 2. https://doi.org/10.1186/s41016-023-00355-y

Arthur, A. S., Abecassis, I. J., Abi-Aad, K. R., Albuquerque, F. C., Almefty, R. O., & Aoun, R. J. N., et al. (2019). Vascular. Operative Neurosurgery, 17(Suppl 2), S76–S90. https://doi.org/10.1093/ons/opz088

Brinjikji, W., & Lanzino, G. (2017). Endovascular treatment of spinal arteriovenous malformations. Handbook of Clinical Neurology, 143, 161–174. https://doi.org/10.1016/B978-0-444-63640-9.00016-3

Kamimura, Y., Nakanishi, T., Sato, A., Kako, E., Tanaka, M., & Sobue, K. (2021). Anesthetic considerations for cesarean delivery in a parturient with hereditary hemorrhagic telangiectasia: A case report. JA Clinical Reports, 7(1). https://doi.org/10.1186/s40981-021-00420-4

Kannath, S., Mandapalu, S., Thomas, B., Rajan, J., & Kesavadas, C. (2019). Comparative analysis of volumetric high-resolution heavily T2-weighted MRI and time-resolved contrast-enhanced MRA in the evaluation of spinal vascular malformations. American Journal of Neuroradiology. https://doi.org/10.3174/ajnr.a6164

Koch, M., Stapleton, C., Agarwalla, P., Torok, C., Shin, J., Coumans, J., et al. (2017). Open and endovascular treatment of spinal dural arteriovenous fistulas: A 10-year experience. Journal of Neurosurgery: Spine, 26(4), 519–523. https://doi.org/10.3171/2016.9.spine16394

Ozpinar, A., Weiner, G. M., & Ducruet, A. F. (2017). Epidemiology, clinical presentation, diagnostic evaluation, and prognosis of spinal arteriovenous malformations. Handbook of Clinical Neurology, 143, 145–152. https://doi.org/10.1016/B978-0-444-63640-9.00014-X

Roldán, M., Téllez, M., Mora, F., Ghatan, S., Roonprapunt, C., & Ulkatan, S. (2020). Intraoperative neurophysiologic monitoring correlates with neurologic outcome after endovascular and surgical treatment of a cervical arteriovenous malformation. Journal of Neurological Surgery Part A: Central European Neurosurgery, 82(4), 381–386. https://doi.org/10.1055/s-0039-1700835

Ropper, A. H., Samuels, M. A., & Klein, J. P. (2019). Adams and Victor's principles of neurology (11th ed.). McGraw Hill.

Schimmel, K., Ali, M. K., Tan, S. Y., Teng, J., Do, H. M., Steinberg, G. K., Stevenson, D. A., & Spiekerkoetter, E. (2021). Arteriovenous malformations—Current understanding of the pathogenesis with implications for treatment. International Journal of Molecular Sciences, 22(16), 9037. https://doi.org/10.3390/ijms22169037

Downloads

Published

2025-07-11

How to Cite

Sidabutar, B. P., Suarjaya, I. P. P., & Senapathi, T. G. (2025). MANAJEMEN ANESTESI PADA PASIEN DENGAN ARTERIOVENOUS MALFORMATION SPINE. PREPOTIF : JURNAL KESEHATAN MASYARAKAT, 9(2), 3866–3874. https://doi.org/10.31004/prepotif.v9i2.46810

Issue

Vol. 9 No. 2 (2025): AGUSTUS 2025

Section

Articles

License

Copyright (c) 2025 Beny Pratama Sidabutar, I Putu Pramana Suarjaya, Tjokorda GA Senapathi

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Authors who publish with this journal agree to the following terms:

  • Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal.
  • Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  • Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).