cover
Article Per Year (5 Year)
All
Home Page
OAI Link
Editorial Team
Contact
Reviewer
Google Scholar
Contact Name
Agni Susanti
Contact Email
agniesusanti2204@gmail.com
Phone
+6287722631615
Journal Mail Official
obstetrianestesi@gmail.com
Editorial Address
Department of Anesthesiology and Intensive Care Dr. Sardjito General Hospital Yogyakarta Jl.Jl. Kesehatan No.1, Senolowo, Sinduadi, Yogyakarta
Location
Unknown,
Unknown
INDONESIA
Jurnal Anestesi Obstetri Indonesia
Published by Indonesian Society of Obstetric Anesthesia and Critical Care
ISSN : -     EISSN : 2615370X     DOI : https://doi.org/10.47507/obstetri.v3i2
Core Subject : Health, Science,
Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health
We accept manuscripts in the form of Original Articles, Case Reports, Literature Reviews, both from clinical or biomolecular fields, as well as letters to editors in regards to Obstetric Anesthesia and Critical Care. Manuscripts that are considered for publication are complete manuscripts that have not been published in other national journals. Manuscripts that have been published in the proceedings of the scientific meeting can still be accepted provided they have written permission from the organizing committee. This journal is published every 6 months with 8-10 articles (March, September) by Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC).
Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine
Articles 94 Documents
 1   2   3   4   5 
Perbandingan Efek 10 Mg dengan 12,5 Mg Levobupivacain 0,5% Isobarik terhadap Onset, Durasi, dan Hemodinamik pada Spinal Anestesi untuk Seksio Sesarea Rachmad Ismail; Muh Ramli Ahmad; A. Muh. Takdir Musba
Jurnal Anestesi Obstetri Indonesia Vol 2 No 2 (2019): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i2.9

Abstract

Latar Belakang: Tujuan utama spinal anestesi pada seksio sesarea adalah meminimalkan efek samping pada ibu dan bayi baru lahir. Levobupivacain memiliki mekanisme aksi yang sama dengan anestesi lokal lainnya, akan tetapi memiliki efek toksik pada jantung dan saraf yang lebih kecil. Tujuan: Membandingkan onset/durasi blok sensorik, motorik serta hemodinamik antara 10 Mg dengan 12,5 Mg Levobupivacain 0,5% Isobarik + fentanyl 25 μg pada seksio sesarea dengan anestesi spinal.Metode: Sampel terdiri dari dua kelompok, kelompok pertama menerima 10 Mg Levobupivacain 0,5% Isobarik + fentanyl 25 μg dan kelompok kedua menerima 12,5 Mg Levobupivacain 0,5% Isobarik + fentanyl 25 μg dengan sampel masing-masing kelompok 23 orang. Analisis data menggunakan uji statistik uji T independen.Hasil: Onset blok sensorik lebih cepat pada kelompok 12,5 Mg Levobupivacain (2,30 menit) dibandingkan kelompok 10 Mg Levobupivacain (3,70 menit), hal ini secara statistik menunjukkan perbedaan yang signifikan. Durasi blok sensorik kelompok 12,5 Mg Levobupivacain (187,39 menit), durasi blok motorik (194,57 menit) lebih lama dibandingkan kelompok 10 Mg Levobupivacain durasi blok sensorik (153,48 menit) dan durasi blok motorik (157,83 menit). Tidak ada perbedaan yang signifikan pada perubahan hemodinamik untuk kedua kelompokSimpulan: Onset blok sensorik kelompok 12,5 Mg Levobupivacain lebih cepat dibandingkan kelompok 10 Mg Levobupivacain, durasi blok sensorik dan blok motorik kelompok 12,5 Mg Levobupivacain lebih lama dibandingkan kelompok 10 Mg Levobupivacain. Comparison Effects 10 Mg with 12.5 Mg Levobupivacain 0.5% Isobaric Against Onset, Duration, and Hemodynamics in Spinal Anesthesia of Caesarean Section Abstract Background: The main purpose of spinal anesthesia in cesarean section is to minimize side effects on the mother and newborn baby. Levobupivacaine has the same mechanism of action as other local anesthetics, but has a smaller toxic effect on the heart and nerves.Objective: Comparing the onset / duration of sensory, motor and hemodynamic blocks between 10 Mg and 12.5 Mg Levobupivacain 0.5% Isobaric + 25 μg fentanyl in cesarean section with spinal anesthesia.Methods: The sample consisted of two groups, the first group received 10 Mg Levobupivacain 0.5% Isobaric + fentanyl 25 μg and the second group received 12.5 Mg Levobupivacain 0.5% Isobaric + fentanyl 25 μg with a sample of 23 people each group. Data analysis using independent T test statistical tests.Results: Sensory block onset was faster in the 12.5 Mg Levobupivacain group (2.30 minutes) than the 10 Mg Levobupivacain group (3.70 minutes), this statistically showed a significant difference. The sensory block duration of the 12.5 Mg Levobupivacain group (187.39 minutes), the motor block duration (194.57 minutes) is longer than the 10 Mg Levobupivacain group the duration of the sensory block (153.48 minutes) and the duration of the motor block (157.83 minutes). There were no significant differences in hemodynamic changes for the two groups.Conclusion: The onset of the 12.5 Mg Levobupivacain sensory block was faster than the 10 Mg Levobupivacain group, the duration of the sensory block and motor block of the 12.5 Mg Levobupivacain group was longer than the 10 Mg Levobupivacain group
Anestesia Spinal untuk Seksio Sesarea pada Pasien Hipotiroid Rizqi Adhelia; Sri Rahardjo; Yusmein Uyun
Jurnal Anestesi Obstetri Indonesia Vol 2 No 2 (2019): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i2.11

Abstract

Disfungsi tiroid sering dijumpai pada populasi perempuan usia masa reproduksi. Efek disfungsi tiroid bermanifestasi pada berbagai organ dan mungkin menimbulkan komplikasi pembedahan dan kehamilan. Seorang perempuan 37 tahun dengan hipotiroid akan menjalani seksio sesarea. Kadar tiroid timulating hormone (TSH): dan tiroksin (T4) adalah 14,87 µUI/mL dan 71 nmol/L. Pasien mendapat terapi levotiroksin selama 6 minggu. Pada pemeriksaan fisik, pasien dalam keadaan umum baik. Anestesia spinal dilakukan dengan bupivakain 0,5% 7,5 mg dan fentanyl 25 µg. Bayi lahir dengan skor Apgar 8/9, hemodinamik stabil selama operasi. Pasien pulang dari rumah sakit setelah hari ke tiga operasi. Pasien hipotiroid dapat mengalami komplikasi koma miksedema, gangguan respirasi, maupun hipotensi selama pembedahan. Pembedahan elektif sebaiknya ditunda sampai kondisi eutiroid. Anestesia spinal dosis rendah, monitoring adekuat, pencegahan hipotermia, pengurangan opioid, dan terapi levotiroksin perioperatif dibutuhkan untuk mencegah komplikasi jika kondisi eutiroid belum tercapai. Sebagai kesimpulan anestesia spinal dapat dilakukan pada pasien hipotiroid yang menjalani seksio sesarea. Anesthesia for Cesarean Section in Hypothyroid Patient Abstract Thyroid disfunction is common in woman of child-bearing age population. Multiple organ are influenced with thyroid dysfunction and may contribute to complication during surgery and pregnancy. A 37-years-old female with hypothyroid was scheduled for cesarean section. Thyroid stimulating hormone (TSH) and thyroxine (T4) level was 14,87 µUI/mL and 71 nmol/L. The patient had levothyroxine therapy for 6 weeks. On physical examination, the general condition was good. She underwent spinal anesthesia with bupivacaine 0,5% 7,5 mg and fentanyl 25 µg. The baby was born with Apgar score 8/9 and the surgery was done without any complication. The patient was discharged from the hospital on the 3rd day after surgery. The hypothyroid patient may experience complication of myxedema comatous, respiratory disorder and hypotension during surgery. The elective surgery was best postponed until a euthyroid state was achieved. Low dose spinal anesthesia, adequate monitoring, hypothermia prevention, reducing opioid dose and continuing levothyroxine therapy was needed to prevent the complication if the euthyroid state was able not able to achieve. As conclusion : spinal anesthesia may be done for cesarean section in hypothyroid patient.
Manajemen Anestesi pada Wanita Hamil dengan Eklampsia dan Asma Akut Berat yang Menjalani Seksio Sesarea Erna Fitriana A; Ratih Kumala Fajar Apsari; Yusmein Uyun
Jurnal Anestesi Obstetri Indonesia Vol 2 No 2 (2019): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i2.12

Abstract

Eklampsia dengan asma merupakan kondisi medis yang paling sering terjadi dalam kehamilan. Eklampsia dengan asma akut berat dalam kehamilan merupakan problem yang sulit. Kejadian eklampsia sekitar 2–8% diseluruh dunia dan merupakan penyebab kematian tertinggi kedua setelah perdarahan. Prevalensi terjadinya 0,3%–0,7% pada negara berkembang. Asma merupakan penyakit inflamasi kronis saluran nafas yang melibatkan banyak sel dan elemen seluler yang mengakibatkan terjadinya hiperresponsif jalan nafas yang dapat menimbulkan gejala episodik berulang berupa wheezing, sesak nafas, dada berat dan batuk. Di Indonesia prevalensi berkisar 5-6% dari populasi penduduk, dimana serangan asma biasanya timbul pada usia kehamilan 24–36 minggu. Seorang wanita 28 tahun G1P0A0 datang hamil 35 minggu dengan keluhan sesak, nyeri kepala, kejang tiga kali, kaki bengkak. Dilakukan seksio sesarea dengan anestesi umum. Ventilator mekanik selama seksio sesarea harus disesuaikan untuk menjaga PCO2 30–32 mmHg. Intubasi dilakukan dengan rapid sequence induction dan setelah pipa endotrakheal masuk dijaga tekanan darah supaya tidak meningkat. Setelah operasi selesai dilakukan ekstubasi dalam untuk mencegah gejolak hemodinamik dan mengurangi iritasi saluran nafas. Pasca operasi pasien masuk intensive care unit untuk pemantauan lebih lanjut. Penanganan anestesi yang efektif pada pasien ini akan meningkatkan survival serta memberikan prognosis yang lebih baik Management of Anesthesia in Caesarean Section for Patient with Eclampsia and SevereAcute Asthma Abstract Eclampsia with asthma is the most common medical condition in pregnancy. Eclampsia with severe acute asthma in pregnancy is a difficult problem. The incidence of eckampsia is around 2–8% worldwide and is the second highest cause of death after bleeding. The prevalence of occurrence is 0.3% –0.7% in developing countries. Asthma is a chronic inflammatory airway disease that involves many cells and cellular elements that cause airway hyperresponsiveness which can cause recurrent episodic symptoms such as wheezing, shortness of breath, heavy chest and coughing. In Indonesia the prevalence ranges from 5–6% of the population, where asthma attacks usually occur at 24–36 weeks' gestation. A 28-year-old woman G1P0A0 comes 35 weeks pregnant with complaints of tightness, headache, seizures three times, swollen feet. Caesarean section was performed under general anesthesia. Mechanical ventilator during cesarean section must be adjusted to maintain PCO2 30–32 mmHg. Intubation was done by rapid sequence induction and after the endotracheal tube has been entered, the intracranial pressure is maintained so it did not increase. After the operation was complete, extubation was done to prevent hemodynamic fluctuations and reduce airway irritation. Postoperatively the patient was admitted to the intensive care unit for further monitoring. Effective anesthetic treatment in these patients will increase survival and provide a better prognosis
Edema Paru Akut pada Pasien Eklampsia: Perlukah Penanganan di Ruang Perawatan Intensif? Roni Kartapraja; Suwarman Suwarman
Jurnal Anestesi Obstetri Indonesia Vol 2 No 2 (2019): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i2.13

Abstract

Eklampsia adalah kelainan pada kehamilan yang ditandai dengan peningkatan tekanan darah disertai dengan proteinuria positif dan kejang yang muncul setelah minggu ke-20 kehamilan. Eklampsia dapat menimbulkan komplikasi terhadap ibu dan janin. Diantara komplikasi terhadap ibu yang muncul akibat eklampsia adalah edema paru akut. Edema paru akut terjadi pada 0,08% hingga 1,5% kehamilan dan merupakan salah satu penyebab kematian ibu hamil sehingga tergolong suatu keadaan darurat dan memerlukan penanganan segera. Faktor sirkulasi angiogenik, penurunan tekanan onkotik koloid, disfungsi sel endotel, atau peningkatan tekanan intravaskular disertai dengan peningkatan beban jantung diduga menjadi faktor penyebab terjadinya edema paru akut pada eklampsia. Penegakan diagnosa serta pemberian terapi yang tepat pada edema paru akut harus dilakukan sesegera mungkin untuk menurunkan angka mortalitas dan morbiditasnya. Terapi yang diberikan meliputi pemberian obat -obatan dan atau bantuan ventilasi mekanik. Penggunaan bantuan ventilasi mekanik dilakukan dengan pendekatan strategi lung recruitment yang bertujuan untuk memperbaiki oksigenasi paru dan mampu meningkatkan kemampuan penyapihan ventilator serta mencegah kerusakan paru iatrogenik. Disamping pemantauan hemodinamik secara berkesinambungan, penggunaan ventilasi mekanik merupakan indikasi bagi pasien eklampsia dengan edema paru akut untuk menjalani perawatan di ruang rawat intensif. Acute Pulmonary Edema in Patient with Eclampsia: are Really Need a Intensive Care Unit Treatment? Abstract Eclampsia is a disorder in pregnancy which is characterized by an increase in blood pressure accompanied by positive proteinuria and seizures that appear after the 20th week of pregnancy. Eclampsia can cause complications for the mother and fetus. Among the complications of the mother that arise due to eclampsia are acute pulmonary edema. Acute pulmonary edema occurs in 0.08% to 1.5% of pregnancy and is one of the causes of death of pregnant women so it is classified as an emergency and requires immediate treatment. Angiogenic circulation factors, a decrease in colloid oncotic pressure, endothelial cell dysfunction, or an increase in intravascular pressure accompanied by an increase in cardiac load are thought to be factors causing the occurrence of acute pulmonary edema in eclampsia. The diagnosis and the provision of appropriate therapy in acute pulmonary edema must be done as soon as possible to reduce its mortality and morbidity. The therapy provided includes the administration of medicines and or mechanical ventilation assistance. The use of mechanical ventilation assistance is carried out with a lung recruitment strategy approach that aims to improve lung oxygenation and be able to improve ventilator weaning capabilities and prevent iatrogenic lung damage. In addition to continuous hemodynamic monitoring, the use of mechanical ventilation is an indication for eclampsia patients with acute pulmonary edema to undergo treatment in the intensive care unit.
Anestesia Spinal Dosis Rendah untuk Seksio Sesarea pada Pasien Mitral Stenosis Berat Nopian Hidayat; Yusmein Uyun; Dewi Yulianti Bisri
Jurnal Anestesi Obstetri Indonesia Vol 2 No 2 (2019): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i2.14

Abstract

Penyakit jantung pada kehamilan meningkatkan angka morbiditas dan mortalitas ibu dan janin. Mitral stenosis adalah lesi katup jantung yang paling sering didapatkan pada wanita hamil dan hampir selalu disebabkan oleh penyakit jantung rematik. Perubahan fisiologis yang terjadi selama kehamilan dan periode peripartum dapat memperburuk gejala dan derajat penyakit jantung. Akibatnya, banyak wanita pertama kali didiagnosis penyakit jantung selama kehamilan. Seorang wanita berusia 24 tahun gravida 32–33 minggu dengan kongesti gagal jantung fungsional kelas III, mitral stenosis berat, ejection fraction (EF) 59%, regurgitasi trikuspid sedang, dan dilatasi atrium kiri menjalani seksio sesarea dengan anestesi spinal dosis rendah menggunakan bupivakaine 0,5% hiperbarik 7,5 mg ditambah fentanyl 50 mcg secara intratekal. Blok sensoris dicapai setinggi torakal 6 dalam waktu 4 menit 20 detik. Hemodinamik pasien stabil selama operasi maupun pasca operasi. Tidak diperlukan pemberian vasopresor. Pasca operasi pasien dirawat di intensive care unit (ICU) selama 3 hari dengan hemodinamik yang stabil. Laporan ini menyoroti bahwa anestesi spinal dosis rendah dapat menjadi pilihan yang baik dalam manajemen anestesi untuk seksio sesarea yang disertai dengan mitral stenosis berat. Low Dose Spinal Anesthesia for Cesarean Section with Severe Mitral Stenosis Abstract Heart disease in pregnancy increases maternal and fetal morbidity and mortality. Mitral stenosis is the most common heart valve lesion in parturient and is almost always caused by rheumatic heart disease. Physiological changes that occur during pregnancy and the peripartum period can worsen symptoms and the degree of the heart disease. As a result, many women are first diagnosed with heart disease during pregnancy. Twenty four year old woman gravida 32–33 weeks with congestive heart failure class III, severe mitral stenosis, EF 59%, moderate tricuspid regurgitation, and left atrial dilatation undergoing cesarean section with low-dose spinal anesthesia using bupivacaine 0,5% hyperbaric 7.5 mg plus fentanyl 50 mcg intrathecally. Sensory blocks were reached as high as thoracic 6th in 4 minutes and 20 seconds. The patient's hemodynamics are stable during both surgery and post surgery. Vasopressors were not needed. After surgery the patient was transferred to ICU for 3 days with stable hemodynamics. This report highlights that low-dose spinal anesthesia can be a good choice in the management of anesthesia for cesarean section accompanied by severe mitral stenosis.
Low Dose Spinal Anesthesia Bupivakain 0,5% 5 mg dengan Adjuvan Fentanyl 50 mcg untuk Pasien dengan Uncorrected Tetralogy of Fallot yang Menjalani Seksio Sesarea Ruddi Hartono; Sri Rahardjo; Yusmein Uyun
Jurnal Anestesi Obstetri Indonesia Vol 2 No 2 (2019): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i2.15

Abstract

Pasien hamil dengan uncorrected tetralogy of fallot yang menjalani seksio sesarea merupakan tantangan tersendiri bagi dokter anestesi. Tetralogy of Fallot terdiri dari ventricular septal defect, hipertrofi ventrikel kanan, overriding aorta dan stenosis pulmonal. Prinsip anestesi pada pasien ini adalah mempertahankan systemic vascular resistence (SVR) dan menghindari peningkatan pulmonary vascular resistance (PVR). Pasien Ibu hamil, 19 tahun dengan berat badan 50 kg, tinggi badan 150 cm, G3P000Ab200 Gravida 36–37 minggu, tunggal hidup, fetal distress dan tali pusat menumbung dengan tetralogy of fallot, akan dilakukan seksio sesarea cito. Penatalaksanaan anestesi pasien ini dengan low dose spinal anesthesia bupivakain 0,5% 5 mg dan adjuvan fentanyl 50 mcg. Hemodinamik stabil setelah tindakan spinal. Tekanan darah sebelum dilakukan spinal 100/60 mmHg dengan laju nadi 67 kali per menit dan saturasi oksigen 80% menggunakan non rebreathing mask (NRBM) 10 liter per menit. Tekanan darah pada saat operasi dimulai adalah 96/57 mmHg dan laju nadi 77 kali per menit serta saturasi 78% menggunakan NRBM 10 liter per menit. Setelah bayi dilahirkan, hemodinamik stabil hingga akhir operasi, tidak ditemukan periode hipotensi yang berat dan tidak digunakan obat vasopressor selama operasi. Pasien dipindahkan ke ICU untuk observasi pasca operasi selama 2 hari. Selama perawatan di ICU, kondisi pasien tetap stabil dan kemudian dipindahkan ke ruang perawatan biasa. Low dose spinal anesthesia mencegah risiko hipotensi karena intensitas blok simpatis yang lebih minimal sehingga penurunan SVR dapat dihindari. Teknik ini dapat digunakan sebagai alternatif pembiusan pada pasien dengan tetralogy of fallot tetapi tergantung kondisi pasien saat akan dilakukan pembiusan. Low Dose Spinal Anesthesia Bupivacaine 0,5% 5 mg with Adjuvant Fentanyl 50 mcg for Cesarean Section Patient with Uncorrected Tetralogy of Fallot AbstractCesarean delivery in parturient with uncorrected tetralogy of fallot poses significant challenge for anesthesiologist. Tetralogy of Fallot consists of ventricular septal defect, right ventricular hypertrophy, overriding aorta and stenosis pulmonum. Main principle of anesthesia for tetralogy of fallot is maintenance of systemic vascular resistance dan avoidance of increasing pulmonary vascular resistance. Parturient, 19 years old, body weigt 50 kg, height 150 cm, G3P000Ab200 36 – 37 weeks, fetal distress and umbilical cord prolapse with tetralogy of fallot will perform cesarean section. Patient anesthesized with low dose spinal anesthesia using bupivacaine 0,5% 5cmg with adjuvant fentanyl 50 mcg. Haemodynamic before spinal with blood pressure is 100/60 mmHg, heart rate 67 beat per minute (BPM), saturation is 80% using 10 liter of oxygen non rebreathing mask (NRBM) . Blood pressure during incision 96/57 mmHg heart rate 77 BPM with saturation 78% using 10 liter of NRBM. Haemodynamic is stable after baby is born until the operation is done, without any episode of severe hypotension and there is no using of vasopressor drugs. Patient is moved to ICU after the operation for further observation and for 2 days periode the haemodynamic is stable and then patient is moved to regular ward. Low dose spinal anesthesia avoid the incidence of hypotension by causing less intense blocked sympathetic system than traditional dose and thus providing a stable SVR. This technique could be an alternative for anesthesizing for parturient with tetralogy of fallot but its depend on patient condition before operation.
Patofisiologi dan Penanganan Kardiomiopati Peripartum Dwiana Sulistyanti; Bambang Suryono
Jurnal Anestesi Obstetri Indonesia Vol 2 No 2 (2019): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i2.16

Abstract

Kardiomiopati peripartum adalah salah satu penyebab dari kardiomiopati dilatasi yang timbul pada waktu akhir trimester tiga kehamilan sampai 5 bulan kelahiran. Tanda karakteristik kardiomiopati peripatum adalah berkurangnya fraksi ejeksi ventrikel kiri dan berhubungan dengan gagal jantung kongesti, yang dapat meningkatkan resiko aritmia, tromboemboli dan henti jantung mendadak. Pengertian mendalam tentang fisiologi selama kehamilan dan patofisiologi penyakit jantung pada ibu sangat penting untuk dokter anestesi, dokter kandungan dan dokter jantung yang terlibat pada penanganan pasien PPCM selama periode kehamilan dan persalinan (perawatan peripartum). Penatalaksanaan kardiomiopati peripartum sebagian besar bersifat suportif. Tujuan terapi pada pasien dengan kardiomiopati peripartum adalah optimalisasi hemodinamik, mengoptimalkan preload, menurunkan afterload dan meningkatkan kontraktilitas. Keputusan jenis persalinan pasien dengan kardiomiopati peripartum harus dibuat berdasarkan indikasi obstetri. Pilihan tehnik anestesi yang akan digunakan disesuaikan dengan kondisi klinis ibu pada saat itu dengan memperhatikan efek obat terhadap ibu maupun janin. Baik tehnik anestesi umum maupun tehnik anestesi regional dapat digunakan untuk parturien dengan kardiomiopati peripartum. Pathophysiology and Management of Peripartum Cardiomyopathy Abstract Peripartum cardiomyopathy (PPCM) is a number of cause of dilated cardiomyopathy which occured during the end third trimester of pregnancy until the fifth months of birth. The characteristic sign of peripartum cardiomyopathy is reduced the ejection fraction of left ventricle and associated to congestive heart failure, increased risk of arrhythmia, thromboemboli and sudden cardiac arrest. A comprehensive understanding of the physiology of pregnancy and pathophysiology of maternal cardiac disease is importance for anesthesiologist, gynecologists and cardiologists involved in peripartum care in patients with peripartum cardiomyopathy during the pregnancy and childbirth periods. Management of peripartum cardiomyopathy is mostly supportive therapy. The goal of therapy in patients with peripartum cardiomyopathy is hemodynamic optimization, such as maintaining preload, reducing afterload and improving contractility. Decision of the mode of delivery of patient with peripartum cardiomyopathy hould be based on obstetric indication. The choice of anesthesia technique should consider the current clinical condition of parturient and the effect of the drug for the mother and fetus. Both general anesthesia and regional anesthesia techniques can be an option for parturients with peripartum cardiomyopathy.
Perbandingan Ringer Laktat 40° C dengan Ringer Laktat pada Suhu Kamar dalam Mencegah Shivering pada Seksio Sesarea dengan Anestesi Spinal Adi Hidayat; Yusmein Uyun; Sri Rahardjo
Jurnal Anestesi Obstetri Indonesia Vol 1 No 1 (2018): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v1i1.17

Abstract

Latar Belakang: Shivering perioperatif selama anestesi spinal merupakan komplikasi yang sering terjadi seksio sesarea karena vasodilatasi perifer akibat blok simpatis dan irigasi cairan dingin. Meningkatnya tonus otot yang tampak sebagai shivering akan meningkatkan kebutuhan oksigen antara 200-800% dan produksi karbondioksida meningkat antara 300-500% diatas nilai dasarnya. Hal ini akan dapat berbahaya bagi pasien dengan kondisi fisik tidak optimal. Karena itu shivering harus segera dicegah atau diatasi.Tujuan: Mengetahui perbandingan kejadian shivering antara pemberian cairan ringer laktat 1000 cc suhu 40° C dengan Ringer laktat 1000 cc dengan suhu kamar pada operasi seksio sesarea yang dilakukan spinal anestesi.Metode:Subjek penelitian ini sebanyak 102 pasien yang memenuhi kriteria inklusi dan dilakukan secara double blind randomized control trial. Sebelum dilakukan spinal anestesi, kelompok A diberikan pemberian ringer laktat 1000 cc dengan menggunakan penghangat infus 3 lumen pada suhu 40° C, kelompok B diberikan pemberian ringer laktat 1000 cc pada suhu kamar. Dilakukan pengukuran suhu tubuh setelah dilakukan pemberian cairan dan dinilai adanya shivering atau tidak di ruang pemulihan. Hasil: Didapatkan kejadian shivering pada kelompok A yaitu sebanyak 2 pasien (3,9 %) dan kejadian shivering pada kelompok B yaitu sebanyak 8 pasien (15,7 %). Di dapatkan perbedaan yang bermakna antara kedua kelompok (P <0,05). Kesimpulan: Terdapat perbedaan bermakna kejadian shivering pada kelompok yang diberikan ringer laktat 1000 cc dengan suhu40° C dibandingkankelompok yang diberikan ringer laktat 1000 cc pada suhu kamar. The Comparison of Ringer’s Lactate 40 °C and Ringer's Laktat at Room Temperature To Prevent Shivering in Cesarean Section with Spinal Anesthesia Background: Perioperative shivering during spinal anesthesia is a common complication in cesarean surgery caused by peripheral vasodilatation due to sympathetic block and fluid cold irrigation. Increased muscle tone which seemed as shivering will increase 200-800% oxygen requirement and carbon dioxide production increased of 300-500% above the baseline. This will be dangerous for patients with not optimal physical condition. Therefore, shivering should be prevented immediately.Objective: To comparing shivering incident between 1000 cc ringer's lactate administration at 40 ° C and 1000 cc ringer's lactate administration at room temperature in cesarean surgery with spinal anesthesia. .Methods: The study subject was 102 patients who met the inclusion criteria and conducted a double-blind randomized control trial. Before spinal anesthesia, group A was given 1000 cc ringer's lactate at 40 ° C, group B was given 1000 cc ringer's lactate at room temperature. After fluid administration the body temperature was measured and shivering was assessed in the recovery room.Results: The shivering incidence in group A of 2 patients (3.9%) and the shivering incidence in group B of 8 patients (15.7%). There was a significant difference between the two groups (P <0.05).Conclusions: There are significant differences in the incidence of shivering in the 1000 cc ringer's lactate at 40°C administration group compared to the room temperature group.
Manajemen Anestesi pada Pasien Seksio Sesarea Primigravida 35 Minggu dengan Sindroma Nefrotik Roni Kartapraja; Bambang Suryono Suwondo
Jurnal Anestesi Obstetri Indonesia Vol 1 No 1 (2018): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v1i1.19

Abstract

Sindroma nefrotik adalah sekumpulan gejala berupa proteinuria, hipoalbuminemia, edema, hiperkolesterolemia, dan lipiduria yang ditandai peningkatan permeabilitas dinding kapiler terhadap protein serum. Sindroma nefrotik pada kehamilan jarang terjadi namun bila tidak dikelola dengan baik akan meningkatkan morbiditas. Sindroma anefrotik dapat muncul sebelum umur kehamilan 20 minggu dan sering disebabkan oleh glomerulonephritis, sedangkan yang muncul sesudah umur kehamilan 20 minggu patut diduga disebabkan atau disertai suatu preeklampsia. Dilaporkan pasien 35 minggu dengan diagnosis preeklamsia, sindroma nefrotik dan suspek edema pulmo. Pasien di diagnosis sindroma nefrotik sejak kehamilan 12 minggu dan mendapat terapi metilprednisolone 16 mg 1-0-0 hingga sekarang. Pada usia kehamilan 28 minggu pasien didiagnosis preeklamsia. Datang karena kontraksi yang semakin kencang. Pasien dilakukan seksio sesarea dengan tehnik regional anestesi epidural Levobupivacain 0.5% isobarik 11 ml, janin cukup viable dilahirkan. Pasca operasi pasien dirawat di high care unit dan pulang ke rumah setelah perawatan 8 hari dalam kondisi baik. Manajemen anestesia pada ibu hamil dengan sindroma nefrotik antara lain sering disertai tekanan darah tinggi atau preeklampsia, malnutrisi dan hilangnya zat-zat yang diperlukan tubuh bersamaan dengan hilangnya protein melalui urine. Pasien seharusnya ditangani melalui pendekatan multidisipliner dengan spesialis perinatologi, nefrologi, dan neonatologi, dengan pemahaman terhadap pentingnya menjaga keseimbangan agar sesuai dengan perubahan fisiologis wanita hamil normal akan memberikan prognosis yang baik dalam menurunkan tingkat morbiditas. Anesthesia Management of Caesarean Section in 35 Weeks Primigravida Patients with Nephrotic Syndrome Abstract Nephrotic syndrome is a set of symptoms in the form of proteinuria, hypoalbuminemia, edema, hypercholesterolemia, and lipiduria which are characterized by an increase in capillary wall permeability to serum proteins. Nephrotic syndrome in pregnancy is rare but if not managed properly, it will increase a morbidity. Nephrotic syndrome can occur before 20 weeks of gestation and is often caused by glomerulonephritis, whereas if appears after 20 weeks' gestation is thought to be due to or accompanied by preeclampsia. A 35-week patient was reported with preeclampsia, nephrotic syndrome and suspected pulmonary edema. Patients were diagnosed with nephrotic syndrome since 12 weeks' gestation and were treated with methylprednisolone 16 mg 1-0-0 until now. At 28 weeks' gestation the patient was diagnosed with preeclampsia. she came to hospital due to primature contraction. Patient underwent SC with a 11 ml Levobupivacaine 0.5% drug isobaric epidural anesthesia regional technique, the fetus was viable enough to be born. After surgery the patient was treated at HCU and returned home after 8 days of treatment in good condition. Management of anesthesia in pregnant women with nephrotic syndrome is often accompanied by high blood pressure or preeclampsia, malnutrition and loss of substances needed by the body along with loss of protein through urine. Patients should be treated through a multidisciplinary approach, along with specialists in perinatology, nephrology, and neonatology. With an understanding of the importance of maintaining balance in accordance with the physiological changes of normal pregnant women will provide a good prognosis in reducing morbidity.
Perbandingan antara Tramadol 100 mg dan Natrium Diklofenak 100 mg Suppositoria untuk Penanganan Nyeri Pasca Seksio Sesarea dengan Blok Subarakhnoid Arief Hariyadi Santoso; Yusmein Uyun; Sri Rahardjo
Jurnal Anestesi Obstetri Indonesia Vol 1 No 1 (2018): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v1i1.20

Abstract

Latar Belakang: Seksio sesarea menyebabkan nyeri pasca operasi yang signifikan. Tidak ada standar pengelolaan nyeri pasca seksio sesarea. Obat antiinflamasi nonsteroid, natrium diklofenak berkerja meng-inhibisi sintesis prostaglandin (PG) dengan menghambat enzim cyclooxygenase. Tramadol, aktivitas mu-agonis, tidak hanya bekerja pada reseptor opioid, tetapi juga menghambat serotonin (5-HT) dan reuptake noradrenalin.Tujuan: Mengetahui daya guna analgesi 24 jam pasca seksio sesarea antara penggunaan suppositoria rektal tramadol dengan natrium diklofenakMetode:Prospektif, uji klinis acak terkontrol pada 70 pasien status fisik ASA I-II, berusia 19-40 tahun, hamil aterm 37-42 minggu. Indeks Massa Tubuh < 35 kg/m2. Pasien dibagi acak 2 kelompok: kelompok suppositoria rektal natrium diklofenak (D) dan tramadol (T) dengan teknik single blind. Dilakukan penilaian VAS pada kedua kelompok, jumlah penambahan rescue jika VAS ≥3, dan efek samping pada masing-masing kelompok.Hasil: Selama 24 jam pasca operasi, rata-rata frekuensi pemberian tambahan fentanyl kelompok T sebanyak 3,13 kali dan kelompok D 1,7 kali, rata-rata dosis tambahan fentanyl kelompok T sebanyak 155,71 mcg dan kelompok D 67,65 mcg (p=0,000). Rata-rata VAS 24 jam pasca operasi pada kelompok T 2,14 dan pada kelompok D 1,74 (p<0,05). Efek samping, kelompok T terdapat 4 kejadian (11,4%) mual muntah, pada kelompok D tidak ada. Simpulan :Daya guna analgesi natrium diklofenak 100 mg suppositoria rektal lebih baik dibanding tramadol 100 mg suppositoria rektal, dengan efek samping yang lebih kecil pada 24 jam pasca operasi sesar. The Comparison between 100 mg Tramadol and 100 mg Diclofenac Sodium - Suppository for Handling Pain After Cesarean Section Using Subarachnoid Block Abstract Background: Cesarean section inflicts significant postoperative pain. There is no standard for pain management after cesarean section. Non-steroidal anti-inflammatory drugs, diclofenac sodium, work to inhibit the prostaglandin (PG) synthesis, by obstructing the cyclooxygenase enzyme. Tramadol alongside mu-agonist activity, does not only act on opioid receptors, but also inhibits serotonin (5-HT) and noradrenaline reuptake.Objective: To determine the efficacy of 24-hour postoperative cesarean section between of rectal suppositori tramadol and diclofenac sodium.Methods: Prospective, randomized controlled clinical trial to 70 patients with ASA I-II physical status, aged 19-40 years old, pregnancy aterm 37-42 weeks, Body Mass Index <35 kg / m2. The patients were randomly assigned into 2 groups: rectal diclofenac sodium suppository (D) and tramadol (T) groups using single blind technique. VAS assessment was performed in both groups. The amount of rescue was added if the VAS ≥3, and there were side effects in each group.Results: During the 24 hour postoperative period, the mean frequency of supplemental fentanyl to group T was 3.13 times, and group D was 1.7 times. The mean additional dose of fentanyl group T was 155.71 mcg, and group D was 67.65 mcg (p = 0.000 ). The average VAS was 24 hours postoperative in the T group of 2.14, and 1.74 in the D group (p <0.05). For the side effects, T group had 4 occurrences (11.4%) nausea vomiting, and zero in group D. Conclusion: The efficacy of 100 mg diclofenac sodium analgesia of rectal suppository is better than 100 mg tramadol rectal suppository, with smaller side effects within 24 hours after surgery.

Page 1 of 10 | Total Record : 94

 1   2   3   4   5 

Filter by Year

2018 2023


Reset
Filter By Issues
All Issue Vol 6 No 2 (2023): Juli Vol 6 No 1 (2023): Maret Vol 5 No 3 (2022): November Vol 5 No 2 (2022): Juli Vol 5 No 1 (2022): Maret Vol 4 No 2 (2021): September Vol 4 No 1 (2021): Maret Vol 3 No 2 (2020): September Vol 3 No 1 (2020): Maret Vol 2 No 2 (2019): September Vol 2 No 1 (2019): Maret Vol 1 No 1 (2018): September More Issue