Anestesi Spinal untuk Seksio Sesarea Pasien dengan Tinggi Badan Ekstrim Pendek
Abstract
Anestesi untuk seksio sesarea dapat dilakukan dengan anestesi spinal, epidural, combined spinal-epidural atau anestesi umum. Akan tetapi, pilihan utama anestesi untuk seksio sesarea adalah anestesi spinal karena murah, mudah dilakukan, cepat bekerja dan risiko aspirasi tidak ada serta tidak ada masalah pengelolaan jalan nafas. Masalah utama spinal anestesi adalah adanya hipotensi, mual muntah intraoperatif, postdural puncture headache (PDPH), dan merupakan kontraindikasi bila dilakukan pada orang dengan ekstrim pendek karena ketakutan terjadi hipotensi berat. Dua orang wanita gravida aterm ekstrim pendek, dilakukan seksio sesarea (SC) dengan anestesi spinal di Rumah Sakit Melinda Bandung. Pasien pertama dengan berat badan 61 kg, tinggi badan 145 cm, pasien kedua dengan berat badan 64 kg, tinggi badan 146 cm. Keduanya dilakukan spinal anestesi dengan bupivacain hiperbarik 0,5%, ditambah fentanyl dan morfin. Pengaturan dosis bupivacain berdasarkan kombinasi berat badan dan tinggi badan. Tidak ada kejadian penurunan tekanan darah >20% dari tekanan darah awal pada kedua pasien tersebut.
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Jurnal Anestesi Obstetri Indonesia
