Efek Profilaksis Norepinefrin Kontinu pada Anestesi Spinal Pasien Seksio Sesarea terhadap Hemodinamik dan Kontraksi Uterus
Indonesia
Abstract
Latar Belakang: Hipotensi merupakan suatu komplikasi setelah anestesi spinal dan dapat mempengaruhi kontraksi uterus pada operasi seksio sesarea (SC). Profilaksis norepinefrin kontinu dapat diberikan untuk mengurangi kejadian hipotensi pascaspinal pada pasien yang menjalani SC. Norepinefrin menjadi kandidat yang baik sebagai alternatif pencegahan hipotensi.
Tujuan: Penelitian ini untuk mengetahui efek profilaksis norepinefrin kontinu terhadap pencegahan hipotensi akibat anestesi spinal dan pengaruhnya terhadap kontraksi uterus.
Subjek dan Metode: Penelitian ini dilakukan di RSUP Dr. Hasan Sadikin Bandung. Metode penelitian uji acak klinis tersamar ganda pada 36 pasien hamil cukup bulan berusia 18–35 tahun, status fisik ASA II ,menjalani SC dengan anestesi spinal. Subjek penelitian dibagi menjadi 2 kelompok yaitu kelompok kontrol (NaCl 0,9%) dan kelompok norepinefrin (norepinefrin intravena setelah tindakan anestesi spinal dengan injeksi sebanyak 5 μg, kemudian di titrasi sebanyak 0,05 μg/kgbb/menit). Data dianalisis dengan uji t test, uji Mann Whitney dan uji kolmogorov-smirnov, nilai p<0,05 dianggap bermakna.
Hasil: Penurunan tekanan darah pada kelompok kontrol (61.1%) lebih tinggi dari kelompok norepinefrin (11.1%) dengan perbedaan signifikan (p<0,05). Kontraksi uterus yang adekuat lebih cepat tercapai pada kelompok norepinefrin dibandingkan kelompok kontrol (p<0,05).
Simpulan: Profilaksis noreprinefrin kontinu dapat mencegah dan menurunkan angka kejadian hipotensi anestesi spinal dan meningkatkan kontraktilitas uterus pada pasien menjalani operasi
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References
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Jurnal Anestesi Obstetri Indonesia
