Managemen Anestesia untuk Seksio Sesarea Wanita Hamil dengan Morbid Obesitas dan Varicella
Abstract
Seksio sesarea mempunyai berbagai masalah dengan harus mempertimbangkan keselamatan ibu dan bayi. Obesitas merupakan penyulit kehamilan. Varicella juga merupakan penyulit kehamilan. Penyulit varicella dan obesitas dapat mempengaruhi seluruh organ tubuh dan bukan saja pada masa kehamilan dan post partum, akan tetapi, juga setelah selesai masa nifas. Seorang perempuan umur 28 tahun dengan G3P0A2 mengalami varicella sejak umur kehamilan 35-36 minggu, berat badan 92 kg, tinggi badan 152 cm, BMI 39.1 kg/m2. Masuk ke RS Melinda 1 dan direncanakan dilakukan seksio sesarea. Obat yang diberikan preoperasi metochlopramide 10 mg intravena. Anestesi dilakukan dengan spinal anestesi, tusukan setinggi L4-L5 dengan jarum 29G, memakai obat bupivacain 0,5% hiperbarik 2cc, fentanyl 0,5 cc dan morfin 0,05 mg. Bayi lahir dengan berat badan 3050 gr, panjang badan 47cm. Apgar score 1 menit 9 dan 5 menit 10. Kontraksi uterus diukur dengan linear analog scale (LAS) dan hasilnya 8-9. Pascabedah pasien dirawat kembali di ruangan perawatan biasa. Analgetic pascabedah dengan fentanyl 25 ug/jam untuk 24 jam dengan hasil VAS 2.
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Jurnal Anestesi Obstetri Indonesia
