Faktor-Faktor yang Mempengaruhi Migrasi Kateter Epidural

Abstract

Currently, continuous epidural anesthesia was one of the regional anesthesia technique used on daily anesthesia practice. It could be used for single anesthesia on surgery, adjuvant of general anesthesia, pain management of post surgery and chronic pain management of malignancy. One of the problems faced on continuous epidural procedure was migration of epidural catheter out from epidural space. In the beginning catheter was placed on epidural space and confirmed by Loss of Resistance (LOR) technique, hanging drop, or by ultrasonography. Due to many factors, epidural catheter could migrate from the place that should be. This surely affected the effectivity of anesthesia from epidural technique itself, and became fatal if a certain amount of local anesthesia regiment entered to other spaces through the catheter which previously moved to subarachnoidea space, intravascular, or subdural space. Migration of catheter could be caused by malposition on placement or patient's movement, and increased of epidural space pressure. Thus, it's important for anesthesiologist to know what factors that would increase the risk of epidural catheter migration and how to prevent and manage the complication that could happen. ABSTRAKEpidural kontinyu saat ini merupakan salah satu satu tekhnik regional anestesia yang mulai sering digunakan dalam praktek anesthesia sehari-hari. Dapat digunakan untuk anestesia tunggal dalam pembedahan, adjuvan anestesia umum, manajemen nyeri paska operasi serta menajemen nyeri kronis pada pasien keganasan. Salah satu permasalahan yang banyak dihadapi pada prosedur epidural kontinyu adalah kejadian migrasi kateter epidural keluar dari ruang epidural. Kateter pada awalnya telah berada di rongga epidural dan telah dikonfirmasi dengan teknik Loss of