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Asuhan Keperawatan Anestesi Ambulatory Pada Bedah THT

This document discusses various ear, nose, and throat (ENT) surgical procedures including myringotomy, micro-laryngoscopy, polypectomy, and colon polypectomy. Myringotomy involves making a small incision in the eardrum to drain fluid buildup. Micro-laryngoscopy is used to remove vocal fold lesions through the mouth without external incisions. Polypectomy surgically removes polyps, usually in the colon, cervix, or nasal cavity, often using an endoscope and snare or wire lasso. Potential complications include bleeding, infection, perforation, and reactions to anesthesia.

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Ayu Sintiad
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58 views16 pages

Asuhan Keperawatan Anestesi Ambulatory Pada Bedah THT

This document discusses various ear, nose, and throat (ENT) surgical procedures including myringotomy, micro-laryngoscopy, polypectomy, and colon polypectomy. Myringotomy involves making a small incision in the eardrum to drain fluid buildup. Micro-laryngoscopy is used to remove vocal fold lesions through the mouth without external incisions. Polypectomy surgically removes polyps, usually in the colon, cervix, or nasal cavity, often using an endoscope and snare or wire lasso. Potential complications include bleeding, infection, perforation, and reactions to anesthesia.

Uploaded by

Ayu Sintiad
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Asuhan keperawatan anestesi

ambulatory pada bedah THT


Miringotomi
Merupakan pembedahan yang dilakukan dengan
memberikan sayatan kecil pada gendang telinga.

Tujuan: menurunkan tekanan akibat penumpukan


cairan yang berlebihan, atau untuk drainase cairan
telinga tengah.
Indikasi
Infeksi telinga yang tidak berespon pada terapi antibiotik atau
obat-obatan
Infeksi telinga tengah yang menyebabkan gangguan
pendengaran dan keterlambatan berbicara
Otitis media akut berulang (3 episode dalam 6 bulan atau 4
episode dalam 12 bulan)
Barotrauma : Kerusakan akibat tekanan
Komplikasi
Bleeding
Infection
Chronic scarring
Failure of the myringotomy incision in the eardrum to heal as
expected, which may result in frequent drainage
Hearing loss
Injury to ear structures other than the eardrum
Need for repeat surgery
Anestesia
General anesthesia is most often used. You will be asleep. In some cases, a local anesthetic will
be used to numb the ear.
Lidocaine ear drops may also be given to decrease pain.
Prosedur
A small microscope is placed in position to give the doctor a better view. A tiny incision will be
made in the eardrum. Fluid from the middle ear will then be drained. In most cases, a small tube
will be inserted and left in place. This will allow the drainage to continue.
No stitches will be used to close the incision. The incision will heal itself. The procedure is often
done on both ears. Some doctors may use a laser beam to make the opening in the eardrum.
The surgery will last about 15–20 minutes
Mikrolaringoskopi
a surgical procedure performed through a surgical
instrument called a laryngoscope that is placed through
the mouth to expose the vocal folds.
Using this technique, vocal fold lesions (such as cysts,
polyps, papilloma, nodules or cancer) are removed
without making any external incisions
The operation is performed with you asleep under a
general anaesthetic for approximately 15 - 45 minutes
Komplikasi
Nausea
Vomiting
sore throat and drowsiness may occur as a result of the anaesthetic
Serious drug reactions related to the anaesthetic are very rare.
Persiapan
Strictly rest your voice for 3 days. This means small amounts of normal talking only
Keep well hydrated (6 extra glasses of water per day unless you are on a fluid restriction for
another reason)
Rest adequately & avoid excessive exertion - Attend your review appointment
Hal yang perlu diperhatikan pada post op
Smoking :Please do not smoke after the operation.
Diet: a light meal is recommended after the operation. It is important to drink plenty of water, as
good hydration is beneficial for the vocal folds. Avoid caffeinated drinks (tea, coffee, coke) and
alcohol.
Voice Rest
◦ Voice rest is important after surgery on the vocal folds.
◦ Total voice rest is recommended for the first 2 days following surgery, and is followed by 5 days
of limited voice rest. Longer periods of voice rest may be required in some cases.
◦ Total voice rest means that no sound should be produced at all - no speaking, singing, whispering,
humming, whistling, coughing or throat clearing.
◦ Limited voice rest means using a normal conversational voice, and minimizing the amount of time you
use it. Limit your voice use to approximately 15 minutes per hour. You should only speak to someone
who is within arm's reach so that you avoid raising your voice. You should also avoid using the
telephone.
Hal yang perlu diperhatikan pada post op
Coughing & Throat Clearing: It is important to avoid coughing and throat clearing as these can
be harmful to the vocal folds, especially when they are healing after surgery. If you have the
sensation of mucus in the throat take a sip of water to clear the mucus. If the sensation persists
you can use an air cough or singer's cough. To clear mucus using this technique take a deep
breathe in, and then rapidly and forcefully breathe out without making any sound. This sounds
like a huff.
Medications: You may require anti-reflux medications (eg. omeprazole) or steroid medications
(eg. prednisone) after the surgery. Dr Vokes will advise you about this.
Polipektomi
the surgical removal of a polyp (an abnormal mass of tissue that develops on the inner wall of a
hollow organ), usually in the colon or large intestine, cervix, uterus, and nasal cavity.
Prosedur
To perform colon or rectal polypectomy, a long, flexible tube with a camera at the end, called an
endoscope, is inserted through the anus so the surgeon can locate the polyp without making
large incisions. In some cases, a special type of liquid is used in the lining of the bowel to lift off
the polyps and make them easier to locate. A snare or a wire lasso is then looped around the
base of the polyp and an electric current is passed through the snare to cauterize the polyp as
well as any blood vessel connected to it to avoid bleeding.
The same technique is applied in performing nasal polypectomy, except for the use of cautery. A
great deal of care is taken not to harm any nearby blood vessels, orbit, or the skull base.
Komplikasi
Adverse reactions to the anesthesia used
Heavy bleeding, for those who have undergone cervical polypectomy and those who had
polyps removed from the colon or stomach
Damage or perforation to the large intestine wall (for polypectomy in the colon), possibly
leading to bleeding or infection.

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