Perioperative Management and Anesthesia in Patients with Hemifacial Spasm Undergoing Microvascular Decompression: A Case Report

Introduction: Microvascular decompression (MVD) is an operation performed to treat a symptom of hemifacial spasm. Hemifacial spasm described as disorder neuromuscular movement characterized by repeated persistent involuntary contractions affecting the muscles innervated facial nerve.
 Case presentation: A 33-year-old woman came consciousness with complaints twitching on right side her face since 1 year ago. Initially, complaint was felt for first time 3 years ago, only upper eyelid, but it has been getting worse over past year. Magnetic resonance imaging (MRI) obtained vascular loop anterior inferior cerebellar artery (AICA) in level pontine angle (CPA). MVD unilateral neurosurgical procedure axial section posterior fossa. Positions that can be used are supine and modified lateral decubitus or park bench. The management anesthesia-related fossa surgery includes, first, effect drug ability lungs hold air from entering venous circulation. Intravenous administration anesthetics, example, fentanyl, maintain higher threshold retaining bubbles pulmonary circulation compared inhalational anesthetics.
 Conclusion: Optimal hemodynamic monitoring, good analgesia, adequate muscle relaxation principles anesthesia monitoring aim facilitate operator finding access disturbed nerve complex.