Jurnal Anestesi Obstetri Indonesia最新文献

{"title":"Kejang Post Partum di Rumah Sakit Tipe B: sebuah Manajemen Kasus Multidisiplin","authors":"Ketut Mahendera Barata, Mariza Fitriati, Hisbullah Hisbullah, Faisal Faisal, Haizah Nurdin","doi":"10.47507/obstetri.v4i2.79","DOIUrl":"https://doi.org/10.47507/obstetri.v4i2.79","url":null,"abstract":"Kejang post partum masih merupakan kasus utama penyebab morbiditas dan mortalitas maternal diseluruh dunia. Diagnosis banding penyebab kejang antara lain kejang akut, gangguan metabolik, hipoglikemi dan hipo/hipernatremia, jejas otak traumatik, iskemia otak sesaat ataupun cerebrovasculair accident, perdarahan intrakranial, perdarahan subarachnoid, meningitis, ensefalitis, eklampsia, gejala akut kecanduan alkohol, gejala akut kecanduan benzodiazepine atau barbiturate, dural puncture, dan posterior reversible encephalopathy syndrome (PRES). Pada pasien ini terjadi kejang pada hari kedelapan post partum, dengan penyebab utama kejang berasal dari masalah kardiovaskular. Manajemen kejang pada pasien ini dimulai dengan upaya resusitasi cairan, dilanjutkan pengelolaan dukungan airway-breathing-circulation, dan kemudian penyingkiran kandidat diagnosis terhadap infeksi Covid-19, Mendelson syndrome, infeksi lain, gangguan keseimbangan elektrolit, dll. Kerjasama multidisiplin dokter spesialis sangat membantu pencapaian kesembuhan, meskipun masih perlu dilakukan pemeriksaan lanjutan terutama bila ada perencanaan kehamilan berikutnya. \u0000 ","PeriodicalId":203301,"journal":{"name":"Jurnal Anestesi Obstetri Indonesia","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127672742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efek Profilaksis Norepinefrin Kontinu pada Anestesi Spinal Pasien Seksio Sesarea terhadap Hemodinamik dan Kontraksi Uterus","authors":"Riki Punisada, Radian Ahmad Halimi, Dewi Yulianti Bisri","doi":"10.47507/obstetri.v4i2.71","DOIUrl":"https://doi.org/10.47507/obstetri.v4i2.71","url":null,"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 \u0000 ","PeriodicalId":203301,"journal":{"name":"Jurnal Anestesi Obstetri Indonesia","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115816961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mengenal Nyeri Neuropatik Akut Pasca Seksio Sesarea","authors":"Muhsin Ahmad, Rezki Hardiyanti","doi":"10.47507/obstetri.v4i2.75","DOIUrl":"https://doi.org/10.47507/obstetri.v4i2.75","url":null,"abstract":"Nyeri neuropatik akut pascabedah Seksio Sesarea (SS) ditandai dengan adanya tanda dan gejala nyeri neuropatik yang berbeda dari nyeri nosiseptif berupa alodinia dan hiperalgesia, yang ditemukan pada periode awal hingga 1 bulan pascabedah. Nyeri neuropatik akut dapat terjadi akibat cedera langsung pada saraf iliohipogastrika dan ilionguinal akibat pembedahan SS, yang selanjutnya memicu pelepasan ektopik dan perubahan kanal ion pada saraf perifer, serta memicu terjadinya sensitisasi sentral. Meskipun demikian, disfungsi saraf pascabedah biasanya merupakan kombinasi dengan nyeri nosiseptif akibat kerusakan jaringan dan peradangan. Skrining perioperatif dan faktor risiko dapat menggunakan alat skrining Douleur Neuropathique en 4 (DN4) atau DN2 untuk mencegah perkembangan menjadi nyeri persisten. Pendekatan saat ini untuk pencegahan nyeri neuropatik kronis bertujuan untuk mengoptimalkan analgesia dan mengurangi nosisepsi dari nyeri akut dengan memodifikasi teknik bedah dan memilih anestesi regional. Pengobatan nyeri neuropatik memerlukan kombinasi terapi farmakologis, fisik, dan terapi perilaku. Beberapa terapi lini pertama pada penanganan nyeri neuropati akut seperti gabapentinoid, opioid, antagonis reseptor NMDA, hingga terapi stimulasi listrik transkutan dan stimulasi medula spinalis menjadi pertimbangan untuk nyeri neuropatik akut.","PeriodicalId":203301,"journal":{"name":"Jurnal Anestesi Obstetri Indonesia","volume":"515 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132559635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efektivitas Blok Transversus Abdominis Plane Pasca Operasi Caesar","authors":"Gusti muhammad Fuad Suharto, Rory Denny Saputra","doi":"10.47507/OBSTETRI.V3I1.23","DOIUrl":"https://doi.org/10.47507/OBSTETRI.V3I1.23","url":null,"abstract":"Operasi caesar merupakan prosedur bedah yang paling umum dilakukan di seluruh dunia. Operasi ini menyebabkan nyeri pasca operatif sedang hingga berat sebagai akibat insisi pfannenstiel yang umumnya dikaitkan dengan rasa nyeri pada uterus dan somatik pada dinding abdomen. Analgesia pasca operasi yang memadai pada pasien obstetrik sangat penting karena mereka memiliki kebutuhan pemulihan bedah yang berbeda, yaitu meliputi menyusui dan perawatan bayi baru lahir, hal ini dapat terganggu jika analgesia yang diberikan tidak memuaskan. Rejimen analgesik pasca operasi yang ideal harus efektif tanpa mempengaruhi ibu untuk merawat neonates dan dengan efek transfer obat yang seminimal mungkin melalui ASI. Saat ini banyak cara yang paling aman dan efektif dari intervensi manajemen nyeri pasca operasi seperti anestesi lokal dengan infiltrasi kulit, analgesia epidural, dan blok bidang seperti blok transversus abdominis plane (TAP) dan blok ilioinguinal-iliohipogastrik (II-IH). Blok TAP merupakan teknik anestesi regional dimana serabut saraf aferen yang menginervasi dinding abdomen bagian anterolateral diblokir dengan mengguakan anestesi lokal di bidang transversus abdominalis. Potensinya dalam meningkatkan kualitas dan durasi analgesia setelah berbagai operasi abdomen bawah sudah tidak bisa dipungkiri lagi. Sekarang, dengan bantuan USG menjadikan blok TAP sebagai metode yang aman dan efektif untuk memberikan analgesia pasca operasi caesar dibandingkan dengan perawatan standar pasca operasi. Selain itu, blok TAP juga dikaitkan dengan pengurangan konsumsi opioid, peningkatan kepuasan pasien, dan efektif untuk mengurangi nyeri dibandingkan dengan teknik analgesia lainnya. \u0000Efficacy of Transversus Abdominis Plane Block After Post Caesarean Section Delivery \u0000Abstract \u0000Caesarean section is the most common surgical procedure performed worldwide. This operation causes moderate to severe postoperative pain as a result of pfannenstiel incision which is commonly associated with pain in the uterus and somatic in the abdominal wall. Adequate postoperative analgesia in obstetric patients is very important because they have different surgical recovery needs, which include breastfeeding and newborn care, this is can be disrupted if the analgesia given is not satisfactory. The ideal postoperative analgesic rejimen must be effective without affecting the mother to treat the neonate and with minimal effect of drug transfer through breast milk. There are currently many of the safest and effective ways of interventions for postoperative pain management such as local anesthetic skin infiltration, epidural analgesia, and field block like TAP and II-IH. TAP block is a regional anesthetic technique where afferent nerve fibers that innervate the anterolateral abdominal wall are blocked by using local anesthesia in the transverse abdominal plane area. Potential in improving the quality and duration of analgesia after various lower abdominal operations is inevitable. Now, with ultrasound","PeriodicalId":203301,"journal":{"name":"Jurnal Anestesi Obstetri Indonesia","volume":"108 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141205498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manajemen Nyeri Kronis pada Kehamilan","authors":"Budi Yulianto Sarim, Bambang Suryono","doi":"10.47507/obstetri.v2i1.34","DOIUrl":"https://doi.org/10.47507/obstetri.v2i1.34","url":null,"abstract":"Menurut IASP ( International Association of the Study of Pain) nyeri didefinisikan sebagai “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or describe interm of such damage”. Nyeri adalah rasa inderawi dan pengalaman emosional yang tidak menyenangkan akibat adanya kerusakan jaringan yang nyata atau yang berpotensi rusak atau sesuatu yang tergambarkan seperti itu.Kelainan muskuloskeletal yang sering dialami oleh wanita hamil adalah berupa nyeri lumbopelvis pada kehamilan (pelvic girdle pain) dan nyeri kronis lumbal (low back pain).Adapun yang menyebabnya adalah faktor hormonal, faktor mekanis dan vaskuler. Manajemen untuk nyeri kronis pada wanita hamil dapat dilakukan melalui manajemen non farmakologis dan manajemen farmakologis. Manajemen non farmakologis dapat dikerjakan dengan cara fisioterapi, terapi distraksi, terapi musik, guided imaginary dan relaksasi. Untuk manajemen farmakologis, obat – obatan yang dapat diberikan adalah asetaminofen, NSAID dan analgesik opioid. \u0000  \u0000Management Chronic Pain in Pregnancy \u0000Abstract \u0000According to the IASP (International Association of the Study of Pain) pain is defined as \"an unpleasant sensory and emotional experience associated with actual or potential tissue damage or describe the interim of such damage\". Pain is a sensation and or emotional experience unpleasant and disturbing as a result of tissue damage, or potential tissue damage. Musculoskeletal disorders are often experienced by pregnant women is pelvic girdle pain and chronic pain lumbar. The etiology of that is the hormonal factor, mechanical factors and vascular factors. Management of chronic pain in pregnancy can be done through non-pharmacological management and pharmacological management. Non pharmacological management can be done by means of physiotherapy, distraction therapy, music therapy, guided imaginary and relaxation. For pharmacological management can be given is acetaminophen, NSAIDs and opioid analgesics.","PeriodicalId":203301,"journal":{"name":"Jurnal Anestesi Obstetri Indonesia","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122136627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Dose Spinal dan Epidural untuk Seksio Sesarea Pasien dengan Patent Ductus Arteriosus","authors":"D. Ariani, Isngadi Isngadi","doi":"10.47507/obstetri.v2i1.30","DOIUrl":"https://doi.org/10.47507/obstetri.v2i1.30","url":null,"abstract":"Wanita hamil dengan penyakit jantung bawaan terjadi perubahan hemodinamik peningkatan kardiovaskular, perhatian dan terapi yang khusus dibutuhkan. Penambahan obat opioid meningkatkan dosis anestesi lokal, hemodinamik stabil, meningkatkan efek analgetik. Kasus: Satu, wanita 26 tahun gravida 30–32 minggu, PDA besar L-R shunt, hipertropi konsentrik ventrikel kiri, trivial atrium regurgitasi, pulmonal regurgitasi sedang, trikuspid regurgitasi sedang, pulmonal hipertensi berat, EF 57%. Dua, wanita 22 tahun gravida 37–38 minggu, preterm premature rupture of membrane, PDA besar L-R shunt, pulmonal hipertensi berat, penurunan fungsi sistolik ventrikel kiri, EF 54%, bekas seksio sesarea. Keduanya menggunakan teknik regional anestesi dosis rendah. Pembahasan: Teknik menggunakan combine spinal epidural (CSE) dengan spinal 5 mg bupivacain heavy 0,5% dan fentanyl 50 mcg, epidural bupivacain 0,125% dan fentanyl 30 mcg meningkatkan anestesi untuk seksio sesarea, dan hemodinamik stabil pada pasien kelainan katup. Opioid intratekal mereduksi anestesi lokal dan hipotensi, kemampuan anestesi terjaga. Simpulan: Dosis rendah CSE dengan 5 mg bupivacain heavy 0,5 % dan 50 mcg, dengan epidural bupivacain 0,125% dan fentanyl 30 mcg adekuat untuk pasien seksio sesarea dengan kelainan jantung. \u0000  \u0000Low-dose Spinal and Epidural Patients for Caesarean Section Patients with Patent Ductus Arteriosus \u0000Abstract \u0000Pregnant women with congenital heart diseases hemodynamic changes during pregnancy increasing cardiovascular, it’s need attention and special treatment. Opiod addition scan decrease the dose of local anesthetic drugs, prevent hemodynamic fluctuation, increase the analgesia effect. Case: First case, female 26 years with gravida 30-32 weeks with large PDA Left to Right shunt, consentrik left ventrikel hipertrophy, trivial atrium regurgitation, moderate pulmonal regurgitation, moderate tricuspid regurgitation, severe pulmonal hypertension, EF 57%. Second case, female 22 years with gravida 37-38 weeks, PPROM , large PDA Left to Right shunt, pulmonal hypertension severe, function systolic left ventrikel decreasing, EF 54%, former section caesaria. Both of them undergoing section caesaria with low dose regional anesthesia. Discussion: In this case with used CSE with Spinal 5 mg Bupivacaine heavy 0,5 % and fentanyl 50 mcg, Epidural bupivacain 0,125 % and fentanyl 30 mcg provided adequate anaesthesia for section cesarean delivery, and haemodynamic stability in patient with valvular cardiac disease. The synergism between intrathecal opioid sareductionin the dose of local anaesthetic and reduce hypotension, while still maintaining adequate anaesthesia. Conclussion: Low dose CSE with 5 mg bupivacaine heavy 0,5% and fentanyl 50 mcg, and epidural bupivacain 0,125% and fentanyl 30 mcg provided adequate for sectio cesarian patient with cardiac disease, with stable of haemodynamic.","PeriodicalId":203301,"journal":{"name":"Jurnal Anestesi Obstetri Indonesia","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125845034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pemberian Lidocain-Ketorolac sebagai Analgesi Lokal Infiltrasi dibandingkan dengan Parasetamol Intravena untuk Manajemen Nyeri Pascaoperasi Seksio Sesarea (SC) di RSUD Mgr. Gabriel Manek, SVD Atambua","authors":"Y. Permatasari, Willy Yant Kartolo","doi":"10.47507/obstetri.v2i1.28","DOIUrl":"https://doi.org/10.47507/obstetri.v2i1.28","url":null,"abstract":"Latar Belakang: Local Infiltration Analgesia (LIA) adalah teknik memberikan obat anestesi lokal yang diencerkan, dan diberikan adjuvant obat seperti anti-inflamasi nonsteroid (AINS), epinefrin, dan opioid. Tujuan: Untuk mengetahui apakah teknik LIA dapat menurunkan visual analoque scale (VAS) dan menurunkan kebutuhan analgetika dibandingkan pemberian parasetamol intravena dalam 24 jam pascaoperasi seksio sesarea (SC). Metode: Desain penelitian dengan studi intervensi pada populasi pasien wanita hamil yang akan dilakukan SC, dibagi dua kelompok yaitu menggunakan teknik LIA dan Parasetamol.Hasil: Chi-Square pada jam ke-0 menunjukkan nilai sebesar 3.354, dengan nilai p=0,340 ≥α 0,05, artinya pemberian parasetamol dan LIA belum memberikan pengaruh bermakna terhadap skala VAS, sedangkan pada uji Chi-Square jam ke-24 menunjukkan nilai sebesar 36.863, dengan nilai p=0,000 ≤α 0,05 memberikan pengaruh bermakna terhadap skala VAS pasien. Uji spearman pada jam ke-0 nilai koefisien korelasi sebesar -0.090 dengan nilai p= 0.459 ≥ α 0.05 disimpulkan tidak ada hubungan yang signifikan pemberian parasetamol dan LIA dengan skala VAS. Uji Spearman jam ke-24 menunjukkan ada hubungan bermakna antara pemberian parasetamol dan LIA dengan skala VAS dengan nilai koefisien korelasi sebesar -0.671 nilai p= 0.000 ≥α 0Simpulan: Pemberian LIA dapat menurunkan VAS dalam 24 jam pasca operasi SC dibandingkan dengan pemberian paracetamol intravena dan dapat mengurangi kebutuhan analgetik dalam 24 jam pasca-operasi SC dibandingkan dengan pemberian paracetamol intravena. \u0000  \u0000Lidocain-Ketorolac as Local Infiltration Analgesi Compared to Intravenous Paracetamol for Management Postoperative Pain in Caesarean Section in RSUD Mgr. Gabriel Manek, SVD Atambua \u0000Abstract \u0000Background: LIA (Local Infiltration Analgesia) is a technique that provides localized anesthetic drugs that are diluted, and given adjuvants drugs such as NSAIDs, epinephrine, and opioids. Objective: This study aims to determine the technique of LIA can decrease VAS and decrease analgesic requirements compared to intravenous administration of paracetamol within 24 hours postoperative SC. Method: The design of this study used an intervention study with a population of pregnant women which have been done by SC and divided into two group which use technique of LIA and paracetamol. Result:Chi-Square at hour 0 show value equal to 3,354, with value p = 0,340 ≥ α 0.05, which mean giving paracetamol and LIA have not significant influence to VAS scale, while in Chi-Square test 24 hour show the value of 36.863, with the value p = 0.000 ≤ α 0.05 which means to provide a significant effect on the VAS scale of patients. In spearman test at hour 0 shows the value of correlation coefficient of -0.090 with p = 0.459 ≥ α 0.05 there is no significant relationship giving paracetamol and LIA with VAS scale. Spearman correlation test clock 24 indicate there is significant relation between giving of paracetamol and LIA with scale of VAS have v","PeriodicalId":203301,"journal":{"name":"Jurnal Anestesi Obstetri Indonesia","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116493192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manajemen Anestesi pada Seksio Sesarea dengan Preeklamsia Berat dan Morbid Obese","authors":"R. Supraptomo, Yusmein Uyun","doi":"10.47507/obstetri.v2i1.33","DOIUrl":"https://doi.org/10.47507/obstetri.v2i1.33","url":null,"abstract":"Pendahuluan: Preeklampsia adalah terjadinya trias preeklampsia (hipertensi, hipoalbuminemia, dan edema) yang mendadak setelah 20 minggu kehamilan. Pasien obesitas memiliki banyak implikasi klinis dalam tatalaksana anestesi. Kasus: Wanita, 22 tahun G2P1A0 hamil 39 minggu dengan preeklampsia berat, KPD 12 jam, obesitas morbid akan dilakukan seksio sesarea emergency dengan status fisik ASA IIIE, dilakukan pembiusan dengan teknik regional anestesi subarachnoid block dengan puncture di L3–L4 median, menggunakan agen levobupivakain 15 mg dan fentanyl 25 mcg. Operasi berlangsung selama 1 jam 15 menit, dengan perdarahan 350 cc, hemodinamik stabil. Lahir bayi laki-laki, BB 3400 gr, APGAR Score 8–9–10. Diskusi: Preeklampsia adalah penyakit multiorgan yang spesifik terhadap kehamilan manusia, namun etiologi spesifik yang mendasari tetap belum diketahui. Tatalaksana bersifat suportif, melahirkan bayi dan plasenta tetap menjadi satu-satunya terapi definitif. Pasien obesitas memiliki banyak implikasi klinis untuk dipertimbangkan. Pemahaman mengenai patofisiologi akan membantu memberikan tatalaksana anestesi yang lebih baik. Simpulan: Pemilihan teknik neuraksial anestesi lebih direkomendasikan karena menghindari kemungkinan intubasi sulit pada kasus emergensi, perfusi uteroplasenta yang lebih baik, kualitas analgesi/anestesia yang baik, mengurangi obat yang masuk ke sirkulasi uteroplasenta, menurunkan stress operasi, dan psikologis ibu yang dapat melihat bayinya saat dilahirkan. \u0000  \u0000Anesthesia Management in Caesarean Section with Severe Preeclampsia and Morbid Obese \u0000Abstract \u0000Introduction: Preeclampsia is a sudden triad of preeclampsia (hypertension, hypoalbuminemia and edema) after 20 weeks of pregnancy, Obese patients have many clinical implications to consider. Case: Female, 22 years old with G2P1A0, 39 weeks pregnant with severe preeclampsia, 12 hours PROM, pro morbid obesity SCTP-E with ASA IIIE physical status. Labor pain management was carried out using regional subarachnoid block anesthesia technique with puncture in median L3-L4, clear CSF (+), blood (-) using levobupivacaine 15 mg + fentanyl 25 mcg. The operation lasted for 1 hour 15 minutes, with 350 cc bleeding, hemodynamically stable. Born a baby boy, BW 3400 gr, APGAR Score 8-9-10. Discussion: Preeclampsia is a multiorgan disease that is specific to human pregnancy, and the underlying specific etiology remains unknown. Management is supportive, giving birth to the baby and placenta remains the only definitive therapy. Obese patients have many clinical implications to consider. Understanding of pathophysiology will help provide better anesthesia management. Conclusion: The neuraxial anesthesia technique is recommended to avoids the possibility of difficult intubation, better uteroplacental perfusion, good analgesia / anesthesia quality, reducing drugs that enter the uteroplacental circulation, decreasing surgical stress, and maternal psychological to be able to see the baby at birth.","PeriodicalId":203301,"journal":{"name":"Jurnal Anestesi Obstetri Indonesia","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121743073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manajemen Anestesi pada Seksio Sesarea Pasien dengan HIV (Human Immunodeficiency Virus)","authors":"I. Nuryawan, Bambang Suryono, Sri Rahardjo","doi":"10.47507/obstetri.v2i1.31","DOIUrl":"https://doi.org/10.47507/obstetri.v2i1.31","url":null,"abstract":"Infeksi Human Immunodeficiency Virus (HIV) dan Acquired Immunodeficiency Syndrome (AIDS) adalah masalah utama dari kesehatan global. Menurut United Nations Programme on HIV/AIDS (UNAIDS), salah satu bagian dari WHO yang mengurus tentang AIDS menyebutkan, bahwa perkiraan jumlah penderita yang terinfeksi HIV/AIDS di seluruh dunia sampai dengan akhir tahun 2010 mencapai 34 juta. Kasus HIV pada anak paling sering ditemukan akibat transmisi dari ibu yang HIV positif ke anaknya. Pada laporan kasus ini dilaporkan penanganan anestesi pada penderita pasien wanita berusia 25 tahun berat badan 50 kg primigravida hamil aterm 38 minggu belum dalam persalinan dengan infeksi HIV belum mendapatkan terapi antiretroviral. Pasien diklasifikasikan ASA II dan dilakukan anestesi regional teknik blok subarakhnoid dengan obat bupivakin 0,5% hiperbarik 10 mg. Dilahirkan bayi perempuan berat lahir 2500 gram, dengan skor Apgar 9/10. Operasi berlangsung selama 1 jam dengan hemodinamik TD 90–120/60-80 mmHg, HR 65-100 x/mnt, SpO2 99–100%, perdarahan 400 cc, produksi urin 0,5 ml/kgBB/jam. Pasca operasi pasien diobservasi di ruang pemulihan hingga skor Bromage 0 sebelum dikembalikan ke bangsal. \u0000  \u0000Anesthesia Management in Cesarean Section Patients with HIV (Human Immunodeficiency Virus) \u0000Abstract \u0000Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) infections are the main problems of global health. According to United Nations Programme on HIV/AIDS (UNAIDS), one part of the WHO that deals with AIDS states that the estimated number of people infected with HIV/AIDS worldwide by the end of 2010 reached 34 million. HIV cases in children are most often found due to the transmission of HIV-positive mothers to their children. We reported a 25-year-old primigravida, 38 weeks, weighing 50 kg, not in delivery with HIV infection without antiretroviral therapy underwent caesarean section. Patient was classified as ASA II and performed subarachnoid blocks with hyperbaric 0.5 mg bupivacaine 10 mg. A baby girl was born, weighing 2500 grams, with Apgar score 9/10. The operation lasts for 1 hour with hemodynamics TD 90-120/60-80 mmHg, HR 65-100 x/min, SpO2 99-100%, bleeding 400 cc, urine production 0.5 ml/kgBW/hour. In postoperative period, patient was observed in the recovery room until the Bromage score was 0 before transferred to the ward.","PeriodicalId":203301,"journal":{"name":"Jurnal Anestesi Obstetri Indonesia","volume":"289 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120985610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manajemen anestesi pada pasien Seksio Sesarea Primigravida dengan Glioblastoma Multiforme","authors":"Ratih Kumala Fajar Apsari, Bambang Suryono, Shinta Shinta","doi":"10.47507/obstetri.v2i1.32","DOIUrl":"https://doi.org/10.47507/obstetri.v2i1.32","url":null,"abstract":"Tumor otak pada kehamilan jarang terjadi, Glioblastoma multiforme adalah tumor otak primer yang paling agresif dan biasanya membawa prognosis yang buruk. Tumor otak pada kehamilan berkorelasi dengan terjadinya peningkatan mortalitas maternal, kelahiran premature dan intra uterine growth restriction (IUGR). Adanya tumor otak pada kehamilan akan mempengaruhi penentuan waktu persalinan, jenis dan tehnik anestesi yang akan digunakan. Kasus: Dilaporkan pasien dengan G1P0A0 Hamil 33 minggu, mengeluh sakit kepala hilang timbul sejak 6 bulan yang lalu. Sakit kepala berdenyut terutama sebelah kanan, tidak disertai mual, muntah, pandangan kabur dan kejang. Sakit kepala berkurang dengan obat paracetamol. Awal Mei 2017 pasien merasakan sakit kepala hebat disertai muntah proyektil, dilakukan pemeriksaan MRI kepala, curiga glioblastoma multiforme regio temporoparietal dextra. Diagnosa ditegakkan berdasarkan anamnesa, pemeriksan fisik dan pemeriksaan penunjang. Pasien telah dilakukan SC dengan tehnik regional anestesi epidural obat Levobupivacain 0.5% isobaric 11 ml, janin cukup viable dilahirkan dan mencegah peningkatan tekanan intracranial lebih lanjut. Pasien pulang ke rumah setelah perawatan 5 hari dalam kondisi baik. Pembahasan: Pada wanita hamil dengan tumor otak yang akan dilakukan SC, selama tidak ada kontraindikasi neuroaxial anestesi dapat dilakukan. Tehnik ini pun dilakukan dengan menjaga hemodinamik tetap stabil, mencegah peningkatan tekanan intracranial, seperti saat dilakukan dengan general anestesi. Simpulan: Selama tidak didapati kontraindikasi untuk anestesi neuroaxial, wanita hamil dengan SOL yang tidak mempunyai efek massa, hidrosefalus, atau klinis kearah peningkatan TIK, dapat dilakukan tindakan dengan neuroaxial anestesi. \u0000  \u0000Anesthesia Management for Cesarean Section in Patient with Glioblastoma Multiforme \u0000Abstract \u0000A brain tumor in pregnancy is rare. Glioblastoma mutltiforme is the most aggressive tumor primary brain and usually have poor prognosis. A brain tumor in pregnancy are associated with increased mortalitas maternal, prematurity and intra uterine growth restriction. The presence of a brain tumor in pregnancy may affect the decision for timing of delivery, type and technique an anesthesia to be used. Case: Patients with G1P0A0 pregnant 33 weeks, complaining of recurrent headaches since 6 months ago. Headache pulsate especially on the right side, without nausea, vomiting, blurred vision or seizures. Headache is relieved with paracetamol. Patients felt a severe headache accompanied by projectile vomiting on May 2017. And performed head examination MRI, suspected glioblastoma multiforme temporoparietal dextra region based on anamnesis, physical examination and brain MRI. Patient has been performed caesarea section with regional anesthesia technique with epidural drug Levobupivacain 0.5% isobaric 11 ml. Patient returns home after 5 days in good condition. Discussion: A pregnant women with a brain tumor to be performed caesarea secti","PeriodicalId":203301,"journal":{"name":"Jurnal Anestesi Obstetri Indonesia","volume":"131 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114418242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}