TRIAL FIBRILASI SETELAH INFILTRASI EPINEFRIN PADA PEMBEDAHAN RINOTOMI : SEBUAH LAPORAN KASUS
DOI:
https://doi.org/10.31004/prepotif.v10i1.54234Keywords:
Atrial Fibrilasi, Rinotomi, Epinefrin, Anestesi Umum, Aritmia PerioperatifAbstract
Atrial fibrilasi merupakan salah satu aritmia supraventrikular yang paling sering ditemukan pada periode perioperatif. Penggunaan agen vasokonstriktor seperti epinefrin dalam pembedahan, khususnya pada pasien dengan riwayat penyakit kardiovaskular atau aritmia, dapat menimbulkan perubahan hemodinamik dan gangguan irama jantung yang bermakna. Laporan kasus ini bertujuan untuk menggambarkan kejadian atrial fibrilasi dengan respons ventrikel cepat setelah infiltrasi epinefrin pada tindakan rinotomi. Kami melaporkan seorang pria berusia 56 tahun dengan diagnosis karsinoma sinonasal bilateral stadium IVc dengan metastasis tulang yang menjalani pembedahan rinotomi bilateral. Pasien memiliki riwayat gagal jantung kelas fungsional II dan atrial fibrilasi normoventrikular pada EKG praoperasi. Anestesi umum dilakukan dengan teknik standar dan pemeliharaan menggunakan sevofluran. Selama pembedahan dilakukan infiltrasi submukosa epinefrin 1:200.000. Setelah infiltrasi epinefrin, irama jantung berubah menjadi atrial fibrilasi dengan respons ventrikel cepat dengan frekuensi 120–140 kali per menit. Pasien segera ditangani dengan pemberian amiodaron intravena bolus 150 mg sehingga irama kembali menjadi atrial fibrilasi normoventrikular. Operasi dapat diselesaikan tanpa komplikasi lanjutan dan pasien dirawat di HCU tanpa kejadian ulang. Infiltrasi epinefrin dapat memicu atrial fibrilasi dengan respons ventrikel cepat pada pasien berisiko. Kewaspadaan anestesiologis dan penatalaksanaan aritmia yang cepat sangat penting untuk mencegah komplikasi serius perioperatif.References
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