Abstract:
Meningocele is failure of the neural tube to close during first trimester pregnancy which is the most common
conditions in pediatrik patient. Correction is performed under prone position with carefull anesthestic procedure.
The physiology of neonates and infants are different from that of adults. Immaturity of their vital organ systems
narrows the safety margin of perioperative management including anesthesia. Remifentanil is becoming increasingly
popular for this purpose. Remifentanil has favorable characteristics for anesthesia in neonates such as rapid onset,
potent analgesic effect, and rapid elimination. A baby boy 7 months old, 7 kg, with meningocele lumbosacral
underwent meningocelectomy. The patient was given remifentanil 1 mcg/kgbw/iv in one minute and continuous
0.05-0.1 mcg/kgbw/mnt. Induction with propofol iv, atracurium before intubation. Stability hemodynamic
during the operation, no episode of bradycardia and patient extubated early after the operation. Remifentanil
is an ultra-short-acting opioid, with rapid onset, produces profound analgesia, rapid offset and good stability of
hemodynamic during the operation. The operations are carried out prone, careful positioning is paramount to avoid
complications like dislodging or kinking of the endotracheal tube, corneal abrasion or perioperative neuropathy.
Using remifentanyl in this case report given good hemodynamic stability dan rapid emergence.
Key words: meningocele, pediatrik, prone position, remifentanyl
