Darmojo, Bagas Dyakso and dr. Isngadi, M.Kes., Sp An-TI., Subsp.An.O (K) and dr. Ruddi Hartono, SpAn-TI, FCTA, Subsp. An. O(K) (2023) Efek Pemberian Fenilefrin Bolus Dengan Dosis Berbeda (25μg, 50μg, Dan 75μg) Untuk Mencegah Hipotensi Akibat Anestesi Spinal Pada Seksio Sesarea Di Rumah Sakit Umum Daerah Dr. Saiful Anwar Malang. Magister thesis, Universitas Brawijaya.
Abstract
Latar Belakang : Operasi seksio sesarea merupakan tindakan untuk mengeluarkan hasil konsepsi melalui abdomen ibu yang membutuhkan tindakan anestesi. Anestesi yang efektif digunakan adalah dengan penggunaan anestesi spinal, namun efek samping paling sering terjadi adalah hipotensi akibat anestesi spinal / Spinal Anesthesia-induced Hypotension (SAIH). Pendekatan untuk pencegahan dan pengobatan hipotensi salah satunya adalah dengan pemberian vasopressor. Vasopressor yang biasa digunakan di Amerika Serikat dan Eropa adalah fenilefrin. Tujuan : Mengetahui efek fenilefrin yang diberikan secara bolus untuk mencegah hipotensi akibat anestesi spinal pada seksio sesarea di Rumah Sakit Umum Daerah dr. Saiful Anwar Malang. Metode : Penelitian dilakukan dari 4 September sampai 3 November 2023 dengan sumber data dari Kamar Bedah Sentral maupun di Kamar Operasi Instalasi Gawat Darurat di Rumah Sakit Umum Daerah dr. Saiful Anwar Malang. Penelitian ini dibagi dalam 4 kelompok yaitu kelompok kontrol (tanpa fenilefrin) (n=10), kelompok mendapat fenilefrin 25 μg (n=9), kelompok mendapat fenilefrin 50 μg (n=11),dan kelompok mendapat fenilefrin 75 μg (n=9). Sebelum dilakukan anestesi spinal, diukur tekanan darah pasien. Selanjutnya dilakukan anestesi spinal. Sesaat setelah anestesi spinal pasien diberi perlakuan dengan pemberian fenilefrin dengan dosis sesuai masing-masing kelompok. Setelah itu diukur kembali tekanan darahnya sesaat setelah pasien mendapat perlakuan pemberian fenilefrin. Tekanan darah diukur sesaat setelah pemberian fenilefrin dan diukur ulang setiap menit sampai menit ke-20. Hasil : Penelitian ini menggunakan 39 subyek yang memenuhi kriteria inklusi. Dari subjek penelitian tersebut, pada kelompok kontrol (n=10) didapatkan 100% pasien mengalami hipotensi. Pada kelompok fenileprin 25 μg (n=9) juga terjadi hipotensi pada seluruh subjek penelitian. Pada kelompok pemberian dosis fenilefrin 50 μg (n=11) juga didapatkan hasil angka hipotensi pada ibu sebesar 100%. Sedangkan pada kelompok pemberian dosis fenilefrin 75 μg (n=9) didapatkan kejadian hipotensi sebesar 55,5%. Kesimpulan : Dosis fenilefrin 25 μg maupun 50 μg, tidak dapat mencegah kejadian hipotensi pasca pemberian anestesi spinal pada operasi seksio sesarea. Pemberian dosis fenilefrin 75 μg dapat mencegah kejadian hipotensi pasca pemberian anestesi spinal pada operasi seksio sesarea.
English Abstract
Background : Section caesarean operation is an action to deliver the product of conception through the mother’s abdomen which requires anesthesia. An effective anesthesia in this operation use of spinal anesthesia, but the most common side effect is Spinal Anesthesia Induced Hypotension (SAIH). One of approach in preventing and treating hypotension is by administered vasopressors. The vasopressor commonly used in American and Europe is phenylephrine. Objective : to determine the effect dose of phenylephrine given as a bolus to prevent hypotension due to spinal anesthesia during section caesarean operation at dr. Saiful Anwar Malang Hospital Method : The research was conducted from 4 September to 3 November 2023 with data sources from the Central Operating Room and Emergency Room Operating Room at General Hospital dr. Saiful Anwar Malang. This study was divided into 4 groups, namely the control group (without phenylephrine) (n=10), the group receiving 25 μg phenylephrine (n=9), the group receiving 50 μg phenylephrine (n=11), and the group receiving 75 μg phenylephrine (n= 9). Before spinal anesthesia is performed, the patient's blood pressure is measured. Next, spinal anesthesia is performed. Immediately after spinal anesthesia, patients were treated with phenylephrine at doses according to each group. After that, the blood pressure was measured again shortly after the patient received phenylephrine treatment. Blood pressure was measured immediately after administration of phenylephrine and re-measured every minute until 20 minute. Results : This study used 39 subjects who inclusion criteria. The research subjects, in the control group (n=10) it was found that 100% of patients experienced hypotension. In the 25 μg phenylephrine group (n=9) hypotension also occurred in all study subjects. In the group given a dose of 50 μg phenylephrine (n=11), the hypotension rate in mothers was also found to be 100%. Meanwhile, in the group given a dose of phenylephrine 75 μg (n=9), the incidence of hypotension was 55.5%. Conclusion : Phenylephrine doses of 25 μg or 50 μg cannot prevent hypotension after administering spinal anesthesia during caesarean section operations. Giving a dose of phenylephrine 75 μg can prevent hypotension after administering spinal anesthesia during caesarean section operations.
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | 0423060119 |
| Uncontrolled Keywords: | Seksio sesarea, anestesi spinal, hipotensi, fenilefrin |
| Divisions: | Profesi Kedokteran > Spesialis Anestesiologi dan Terapi Intensif, Fakultas Kedokteran |
| Depositing User: | Endang Susworini |
| Date Deposited: | 05 Feb 2024 06:20 |
| Last Modified: | 05 Feb 2024 06:20 |
| URI: | http://repository.ub.ac.id/id/eprint/215239 |
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