PERSIAPAN ANESTESI

dr. Imam Sudrajat SpAn MSi Med

PERSIAPAN PRE OPERATIF

Menentukan keberhasilan operasi Dimulai sejak persiapan psikologik Operasi elektif; 1-2 hr pre-op Selektif/cyto; beberapa saat pre-op

KUNJUNGAN PRA ANESTESI

Persiapan fisik & mental Perencanaan & pemilihan tehnik & obat komplikasi min Prognosis (ASA) - tentukan obat premed

Persiapan Fisik & Mental/Psi

Anamnesis
Identitas,RPS,RPD,R-obat,R-op/an,kebiasaan

Pemeriksaan fisik
rutin,psikis,gizi,KV,resp,kulit,SS,vena

Pemeriksaan penunjang
lab rutin-khusus,EKG,spirometer

The physical examination

should be thorough but focused Special attention is directed toward evaluation of the airway, heart, lungs, and neurologic status When a regional anesthetic technique is planned, there should be a detailed assessment of the extremities or back.

As a minimum, the physical examination should include:

Vital signs Head and neck. maximal mouth opening, the size of the
tongue, and Mallampati classification.

Precordium. Auscultation of the heart may reveal

murmurs, gallop rhythms, or a pericardial rub.

Lungs. Abdomen. Any evidence these might predispose to

regurgitation or compromise ventilation.

Extremities. Back. Note any deformity, bruising, or infection. Neurologic examination. Mental status, cranial nerve

function, cognition, and peripheral sensorimotor function.

Penampakan faring posterior pada tes Mallampati.

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Perencanaan Anestesi

Obat yg akan digunakan

DMketamin, ggn faal hatihalotan

Tehnik yg akan dipakai

GA, regional, kombinasi

Persiapan komplikasi pembedahanpasca

tirotoksikosis tyroid storm

Prognosis

ASA ASA ASA ASA

1 2 3 4

ASA 5 ASA 6

: Pasien sehat : Pasien kelainan sistemik ringan sedang : Pasien kelainan sistemik berat : Pasien kelainan sistemik berat mengancam hidup : Pasien tidak diharapkan hidup : Pasien donor organ

ASA Physical Status classes:

Class 1. A healthy patient (no physiologic, physical, or psychologic abnormalities). Class 2. A patient with mild systemic disease without limitation of daily activities. Class 3. A patient with severe systemic disease that limits activity but is not incapacitating. Class 4. A patient with incapacitating systemic disease that is a constant threat to life. Class 5. A moribund patient not expected to survive 24 hours with or without the operation. Class 6. A brain-dead patient whose organs are being removed for donor purposes. Note: If the procedure is performed as an emergency, an E is added to the previously defined ASA Physical Status.

PERSIAPAN HARI OPERASI

Pembersihan & pengosongan sal. Cerna Tanggalkan : gg pls, protese Lepas perhiasan, hapus kosmetik VU kosong Pakaian khusus Pakai label Informed concent PF ulang Premedikasi monitor

PERSIAPAN OBAT2AN

Obat2an yg akan dipakai Obat2an yg kemungkinan akan dipakai Obat2an emergensi

PERSIAPAN ALAT

Mesin Anestesi
-

Sumber gas, flowmeter, vaporizer Sirkuit nafas Alat penghubung (masker, ett)
Laringoscope Opt, npt, bantal Meja operasi

Alat Pendukung
-

PREMEDIKASI

Menimbulkan rasa nyaman bagi pasien Memudahkan/memperlancar induksi Mengurangi jumlah obat Menekan reflek2 yg tdk diinginkan Mengurangi sekresi kelenjar saluran nafas