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Anestesia perioperatif pada pasien obesitas morbid dengan gangguan tidur

  • Ferdi Yanto ,
  • IB Gde Sudjana ,

Abstract

 Obesitas menjadi perhatian kesehatan serius tidak hanya di negara maju namun juga di negara berkembang seperti Indonesia dengan peningkatan prevalensi di semua status ekonomi penduduk. Obesitas berhubungan dengan banyak gangguan organ. Sindrom hipoventilasi obesitas (SHO) merupakan kumpulan gejala berupa trias obesitas morbid, hipoventilasi dengan hiperkapnea, dan hipoksemia. Sindrom SHO berbeda dengan obstructive sleep apnea (OSA). Kami melaporkan kasus, lelaki, berusia 33 tahun dengan diagnosis tonsilitis kronis, hipertrofi adenoid, dan OSA, yang direncanakan mendapat tindakan adenotonsilektomi. Evaluasi pra-anestesi menunjukkan pasien status fisik ASA III dengan Mallampati III. Tindakan anestesi umum dengan teknik intubasi sadar. Kondisi pasien stabil selama operasi, pasca-operasi pasien dirawat di Ruang Terapi Intensif (RTI). Selama observasi di RTI menunjukkan adanya desaturasi dengan polisitemia sehingga diagnosis SHO dapat ditegakkan. Dua hari setelah perawatan dengan continuous positive airway pressure (CPAP), kondisi pasien mengalami pemulihan. Pemeriksaan fisik menyeluruh, laboratorium darah lengkap, analisis gas darah, dan tes fungsi paru penting untuk dilakukan. Sindrom SHO masih merupakan tantangan dalam tatakelola anestesi dan evaluasi peri-operatif.

 

 

Obesity is a major health concern not only in develop country but also in developing country such as Indonesia while its prevalence is still increasing in all economic status. Obesity is correlated with many illnesses form various organ. Obesity hypoventilation syndrome (OHS) is defined by the triad of morbid obesity, daytime hypoventilation with hypercapnia, and hypoxemia. Here in we reported a case of 33 years old male with chronic tonsillitis, adenoid hypertrophy and OSA, who came for a planned adenotonsilectommy. Pre-anesthesia evaluation showed patient with physical status of ASA III and Mallampati III. General anesthesia was performed with awake intubation technique. Intraoperative patient stable and safe with post operation care in Intensive Care Unit (ICU) after it. During observation in ICU show desaturation with polisitemia so the diagnosis of OHS can be established. Two days after treatment with CPAP, the patient’s condition is improved. Physical examination, full blood laboratory, blood gas analysis, and lung function tests are essential Obesity hypoventilation syndrome (OHS) remains a challenge in anesthesia management and peri-operative evaluation.

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How to Cite

Yanto, F., & Sudjana, I. G. (2019). Anestesia perioperatif pada pasien obesitas morbid dengan gangguan tidur. Medicina, 50(3). https://doi.org/10.15562/medicina.v50i3.628

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