Anda di halaman 1dari 5

LEMBAR PENGESAHAN

Telah disetujui dan diterima oleh Penguji Laporan Kasus Fakultas Kedokteran
Universitas Cenderawasih Jayapura, sebagai syarat untuk kelulusan Kepaniteraan Klinik
Madia pada SMF Anestesi dan Perawatan Intensif Rumah Sakit Umum Daerah Jayapura.

Nama : Vera Fitria Egand M.


NIM : 007 084 0063

Pada,
Hari :
Tanggal :
Tempat : Ruangan Pertemuan SMF Anestesi dan
Perawatan Intensif RSU Jayapura

Mengetahui,
Dosen Penguji/Pembimbing

dr. Diah Widyanti, Sp An KIC

ii
DAFTAR ISI

Halaman
HALAMAN JUDUL ............................................................................................................. i
LEMBAR PENGESAHAN .................................................................................................. ii
DAFTAR ISI ......................................................................................................................... iii

BAB I PENDAHULUAN ..................................................................................................... 1

BAB II TINJAUAN PUSTAKA ........................................................................................... 2


2.1. Fraktur ...................................................................................................................... 2
2.1.1. Definisi Fraktur................................................................................................ 2
2.1.2. Klasifikasi Fraktur........................................................................................... 2
a) Klasifikasi Berdasarkan etiologi.................................................................... 2
b) Klasifikasi Klinis............................................................................................ 3
c) Klasifikasi Radiologi...................................................................................... 3
2.1.3. Perubahan Struktural Akibat Fraktur............................................................... 5
2.1.4. Deskripsi Fraktur............................................................................................. 5
2.1.5. Diagnosis Fraktur............................................................................................. 6
a) Anamnesis...................................................................................................... 6
b) Pemeriksaan Fisik.......................................................................................... 6
c) Pemeriksaan Penunjang.................................................................................. 7
2.1.6. Tatalaksana....................................................................................................... 8
2.1.6.1. Fraktur Tertutup....................................................................................... 8
2.1.6.2. Fraktur Terbuka....................................................................................... 8

2.2. Jenis-Jenis Fraktur ................................................................................................... 9


2.2.1.Fraktur Galeazzi............................................................................................... 9
2.2.1.1. Pengertian Fraktur Galeazzi.................................................................... 9
2.2.1.2. Etiologi Fraktur Galeazzi........................................................................ 9
2.2.1.3. Gambaran Klinis .................................................................................... 9
2.2.1.4. Pemeriksaan Radiologis.......................................................................... 9
2.2.1.5. Penatalaksaan Fraktur Galeazzi.............................................................. 10

iii
2.2.2.Neglected Fracture ........................................................................................... 10
2.2.2.1. Pengertian Neglected Fracture................................................................ 10
2.2.2.2. Klasifikasi............................................................................................... 10

2.3. Jenis Pembedahan .................................................................................................... 11


2.3.1.Tujuan Pengobatan Fraktur............................................................................... 11
2.3.1.1. Reposisi................................................................................................... 11
2.3.1.2. Imobilisasi / Fiksasi................................................................................. 11
2.3.2.Penatalaksaan Fraktur Melalui Tindakan Operasi............................................ 11
2.3.2.1. Internal ORIF.......................................................................................... 12
a) Definisi........................................................................................................... 12
b) Indikasi ORIF................................................................................................. 12
c) Kontraindikasi ORIF...................................................................................... 12
d) Keuntungan ORIF.......................................................................................... 13
e) Kerugian ORIF............................................................................................... 13

2.4. Anestesi Umum pada Operasi Neglegted Galleazi Fracture.................................... 13


2.4.1.Definisi Anestesi Umum................................................................................... 13
2.4.2.Metode Anestesi Umum................................................................................... 14
2.4.2.1. Parenteral................................................................................................. 14
2.4.2.2. Perektal.................................................................................................... 14
2.4.2.3. Inhalasi.................................................................................................... 14
2.4.3.Obat Anestesi.................................................................................................... 14
2.4.3.1. Golongan Obat Premedikasi................................................................... 14
2.4.3.2. Golongan Obat Anestesi Intravena.......................................................... 15
2.4.3.3. Golongan Obat Anestesi Inhalasi............................................................ 15
2.4.4.Faktor-Faktor yang Mempengaruhi Anestesi Umum....................................... 16
2.4.4.1. Faktor Respirasi...................................................................................... 16
2.4.4.2. Faktor Sirkulasi....................................................................................... 16
2.4.4.3. Faktor Jaringan........................................................................................ 16
2.4.4.4. Faktor Zat Anestesi................................................................................. 16
2.4.4.5. Faktor Lain.............................................................................................. 17
2.4.5.Keuntungan Anestesi Umum............................................................................ 17
2.4.6.Kekurangan Anestesi Umum............................................................................ 17
iv
2.4.7.Indikasi Anestesi Umum................................................................................... 17
2.5. Prosedur Anestesi Umum......................................................................................... 18
2.5.1.Persiapan Pra Anestesi Umum.......................................................................... 18
a) Persiapan Pasien................................................................................................... 18
b) Persiapan Peralatan Anestesi................................................................................ 21

2.6. Teknik Anestesia....................................................................................................... 24


2.6.1.Teknik anestesi napas spontan dengan sungkup muka..................................... 24
2.6.2.Teknik anestesi napas spontan dengan endotrakea........................................... 25
2.6.3.Teknik anestesi dengan pipa endotrakea dan napas kendali............................. 25
2.6.4.Ekstubasi........................................................................................................... 25

2.7. Anestesi pada Pembedahan Brakial......................................................................... 25


2.8. Anestesi Umum pada Pembedahan Ortopedi Khususnya ORIF.............................. 26

BAB III LAPORAN KASUS ............................................................................................... 27


3.1. Identitas Pasien ........................................................................................................ 27
3.2. Anamnesis ................................................................................................................ 27
3.3. Pemeriksaan Fisik .................................................................................................... 29
3.4. Pemeriksaan Penunjang ........................................................................................... 30
3.5. Konsultasi Bidang Yang terkait ............................................................................... 30
3.6. Status Anestesi ......................................................................................................... 31
3.6.1.Persiapan Anestesi............................................................................................ 31
3.6.2.Laporan Anestesi.............................................................................................. 31
3.7. Laporan Operasi ....................................................................................................... 33
3.8. Observasi Durante Operasi ...................................................................................... 34
3.8.1. Observasi Tekanan Darah dan Nadi................................................................. 34
3.8.2. Balance Cairan................................................................................................. 34
3.9. Terapi Cairan Perioperatif ........................................................................................ 34
3.9.1.Pre Operatif....................................................................................................... 34
3.9.2.Durante Operatif............................................................................................... 35
3.9.3.Post Operatif..................................................................................................... 34
3.10 Follow Up Post Operatif ....................................................................................... 35

v
BAB IV PEMBAHASAN ..................................................................................................... 37
BAB V PENUTUP ................................................................................................................ 41
Kesimpulan ............................................................................................................. 41
DAFTAR PUSTAKA ............................................................................................................ 42

vi