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.

8

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)

Alat Pendukung
-

Laringoscope
Opt, npt, bantal
Meja operasi

PREMEDIKASI

Menimbulkan rasa nyaman bagi

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