Perbandingan Low Dose Spinal Anesthesia dan Non-Low Dose Spinal Anesthesia Terhadap Hemodinamik dan Penggunaan Efedrin Sectio Caesarea
Abstract
Latar belakang: Gangguan hemodinamik yang disebabkan oleh anestesi spinal pada operasi sectio caesarea (SC) memiliki prevalensi yang tinggi, pemberian efedrin dan penggunaan low dose spinal anesthesia (LDSA) diharapkan mampu meminimalisir efek gangguan hemodinamik selama SC. Tujuan: menganalisis perbedaan pemberian efedrin dan hemodinamik pada LDSA dan non low dose spinal anesthesia (NLDSA) pada SC. Metode: Jenis penelitian ini adalah analitik observasional dengan desain case control. Pengambilan sampel dari rekam medis dengan metode total sampling yaitu pasien yang menjalani SC dengan kondisi sesuai (American Society of Anesthesiologist) ASA I dan ASA II, kemudian dilakukan uji statistik Kruskal wallis dan Fisher’s Exact Test. Hasil: Diperoleh 84 sampel yang terdiri dari 42 dan 42 NLDSA. Analisis uji Fisher’s Exact Test untuk membandingkan pemberian efedrin pada LDSA dan NLDSA didapatkan p value 0.026. Uji Kruskal wallis untuk membandingkan LDSA dan NLDSA pada kondisi hemodinamik nadi (p value=0.001), tekanan darah sistolik (p value<0.001), tekanan darah diastolik (p value<0.001), dan mean arterial pressure (p value<0.001). Simpulan: Pasien dengan pemberian LDSA menunjukkan hemodinamik yang lebih stabil dibandingkan dengan pasien dengan NLDSA yang memerlukan efedrin untuk menstabilkan hemodinamiknya.
Keywords
Full Text:
PDFReferences
Mylonas I, Friese K. Indications for and Risks of Elective Cesarean Section. Dtsch Arztebl Int. 2015 Jul;112(29–30):489–95.
Saeed KBM, Greene RA, Corcoran P, O’Neill SM. Incidence of surgical site infection following caesarean section: a systematic review and meta-analysis protocol. BMJ Open. 2017 Jan;7(1):e013037.
Yogatama A, Budiarti W. Determinan persalinan sesar wanita tanpa komplikasi kehamilan di Indonesia 2017. Semin Nas Off Stat. 2020;2019(1):545–56.
Armstrong S. Spinal anesthesia for cesarean section. In: Capogna G, editor. Anesthesia for Cesarean Section. Cham: Springer International Publishing; 2017. p. 47–65.
Cenkowski MJ, Maguire D, Kowalski S, Al Gurashi FA, Funk D. Hemodynamic effects of low-dose bupivacaine spinal anesthesia for cesarean section: A randomized controlled trial. Saudi J Anaesth. 2019;13(3):208–14.
Lee JE, George RB, Habib AS. Spinal-induced hypotension: Incidence, mechanisms, prophylaxis, and management: Summarizing 20 years of research. Best Pract Res Clin Anaesthesiol. 2017 Mar;31(1):57–68.
Xu C, Liu S, Huang Y, Guo X, Xiao H, Qi D. Phenylephrine vs ephedrine in cesarean delivery under spinal anesthesia: A systematic literature review and meta-analysis. Int J Surg. 2018 Dec;60:48–59.
Van de Velde M. Low-dose spinal anesthesia for cesarean section to prevent spinal-induced hypotension. Curr Opin Anaesthesiol. 2019 Jun;32(3):268–70.
Kern MJ, Lim MJ, Goldstein JA. Hemodynamic Rounds: Interpretation of Cardiac Pathophysiology from Pressure Waveform Analysis, 4th Edition. Kern MJ, Lim MJ, Goldstein JA, editors. Wiley-Blackwell; 2018.
American Society of Anesthesiologists. ASA Classification. 2014.
Butterworth JF, Mackey DC, Wasnick JD. Chapter 45. Spinal, Epidural, Caudal Blocks. In: Morgan Mikhail’s Clinical Anesthesiology, 5e [Internet]. New York, NY: The McGraw-Hill Companies; 2013. Available from: http://accessmedicine.mhmedical.com/content.aspx?aid=57237547
Fulda GJ, Sciscione A. Obstetric Critical Care. In: Surgical Critical Care and Emergency Surgery [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2018. p. 219–26. Available from: https://onlinelibrary.wiley.com/doi/10.1002/9781119317913.ch23
Dyer RA, Emmanuel A, Adams SC, Lombard CJ, Arcache MJ, Vorster A, et al. A randomised comparison of bolus phenylephrine and ephedrine for the management of spinal hypotension in patients with severe preeclampsia and fetal compromise. Int J Obstet Anesth. 2018 Feb;33:23–31.
Shitemaw T, Aregawi A, Fentie F, Jemal B. Prophylactic ephedrine to prevent postspinal hypotension following spinal anesthesia in elective cesarean section: A prospective cohort study in ethiopia. J Obstet Anaesth Crit Care [Internet]. 2019 Jul 1;9(2):75–80. Available from: https://www.joacc.com/article.asp?issn=2249-4472
Ahmed HO, Hossam M, Adel A. Volume Preload versus Ephedrine Infusion for Prevention of Hypotension Due to Spinal Anesthesia for Cesarean Section. Open J Anesthesiol. 2016;06(03):37–44.
Ge M, Wang S, Dai Z, Li Y, Xie L, Liu X, et al. Effect of ephedrine combined with bupivacaine on maternal hemodynamic and spinal nerve block in cesarean delivery. Biomed reports. 2017 Mar;6(3):295–9.
Almeida C, Vieira L, Cunha P, Gomes A. Low-dose spinal block combined with epidural volume extension in a high-risk cardiac patient: A case-based systematic literature review. Saudi J Anaesth [Internet]. 2022 Oct 1;16(4):383–9. Available from: https://www.saudija.org/article.asp?issn=1658-354X
Desai D, Bumiya P, Vashishtha A. Spinal anesthesia with low dose bupivacaine and fentanyl for femur surgeries in elderly patients. J Anesth Crit Care. 2019;11(2):60–4.
Sulistyawan V, Isngadi I, Laksono RM. Perbandingan Outcome Teknik Spinal Anestesi Dosis Rendah Dibandingkan Dosis Biasa pada Sectio Caesarea Darurat di Rumah Sakit dr. Saiful Anwar. J Anaesth Pain. 2020;1(2):37–44.
Klimek M, Rossaint R, van de Velde M, Heesen M. Combined spinal-epidural vs. spinal anaesthesia for caesarean section: meta-analysis and trial-sequential analysis. Anaesthesia. 2018 Jul;73(7):875–88.
DOI: https://doi.org/10.24853/myjm.3.1.37-43
Refbacks
- There are currently no refbacks.
Indexed by:
17.jpg)
Ciptaan disebarluaskan di bawah Lisensi Creative Commons Atribusi-NonKomersial 4.0 Internasional.
Copyright of Muhammadiyah Journal of Midwifery (e issn: 2722-8088)