Manajemen Ansietas Preoperatif pada Pasien Seksio Sesarea dengan Diabetes Gestasional dan Preeklampsia Berat: Studi Kasus
Abstract
Diabetes gestasional dan preeklampsia berat adalah komplikasi kehamilan dengan risiko tinggi bagi ibu dan bayi. Kehadiran gangguan ansietas-depresi campuran semakin menyulitkan manajemen perioperatif, memengaruhi stabilitas anestesi, hemodinamik, dan pemulihan pascaoperasi. Penelitian dilakukan pada manajemen anestesi wanita hamil berusia 32 tahun dengan preeklampsia berat, diabetes gestasional, keterlambatan pertumbuhan intrauterin (IUGR), dan gangguan ansietas-depresi campuran yang menjalani seksio sesarea elektif. Ansietas preoperatif dinilai dengan Amsterdam Preoperative Anxiety and Information Scale (APAIS) dan menunjukkan ansietas sedang. Anestesi regional blokade subaraknoid (RA–BSA) dipilih bersama manajemen ansietas multidisiplin serta premedikasi midazolam, ketamin, dan ondansetron. Hasil menunjukkan pasien tetap stabil secara hemodinamik selama operasi. Bayi lahir dengan berat 1850 gram dan skor APGAR 8–9, sementara nyeri pascaoperatif dikelola secara multimodal dan tidak ditemukan komplikasi intraoperatif maupun pascaoperatif mayor. Penerapan pendekatan anestesi yang mengintegrasikan aspek medis dan psikologis dapat dijadikan standar dalam manajemen perioperatif kehamilan berisiko tinggi, karena terbukti membantu menjaga stabilitas hemodinamik, meningkatkan kenyamanan pasien, serta mendukung luaran neonatal yang lebih baik.
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