Less Serious Risks

Nausea and vomiting

Bruising or superficial thrombophlebitis at the intravenous acces site
Sore throat
Dental injury
Corneal abrasion
Headache
More Serious Risks
Peripheral neuropathy (ulnar neuropathy most common)
Cardiac dysrhytmias
Myocardial iinfarction
Atelectasis/pneumonia
Renal or hepatic insufficiency
Stroke
Allergic drug reactions
Malignant hyperthermia
Blood reactions
Mortality
 SCOPE OF ANESTHESIA
Do the preoperative
evaluation
Operation Room
Manage patient’s care in
perioperative period
Intensive Care Unit

Scope of Evaluate postperative

condition
Anestehsia Resuscitation Team

Pain Management (Pain Clinic)

Respiratory Therapy Department

Others (lithotripsy, fluoroscopy,

endoscopy, electroconvulsive
therapy, cardiac catheterization)
 4

MONITORING
• Noninvasive BP monitoring with appropriate cuff size.
• Invasive BP monitoring (A-line) for elective hypotension,
anticipation of wide variations in BP, need for frequent
blood sampling.
• Common sites are femoral and radial sites.
• Don’t use Brachial artery.
 5

MONITORING
• EKG for detection of dysrhythmias,
myocardial ischemia, electrolyte
abnormalities.
• Leads V2 and V5 together detect 95% of
intraoperative ischemia, allowing for early
intervention.
• Pulse oximetry estimates level of oxygen
binding by hemoglobin
• SaO2 of 70%, 80%, and 90% correlates to
PaO2 of 40, 50, 60.
 6

MONITORING
• Temperature- Axilla, esophagus, pharynx,
bladder, tympani.
• Urine output- a measure of end-organ
perfusion; Foley for all cases over 2 hrs, to
decompress bladder (lap procedures).
• Swan-Ganz- for LVEDP, CO, SVR.
• Capnography- confirms adequacy of
ventilation, ETT placement, estimates PaCO2.
• Unexpected rise in CO2: Malignant
hyperthermia.
 TEAM UP, DISCUSS THIS :
• Akan menjadi apa saya nanti setelah lulus nanti ?

• Konsep balanced anestesi

• Komplikasi tindakan anestesi

• Ruang lingkup kerja penata anestesi

15 minutes
SEKIAN