MULTIPLE CASE STUDY: GAMBARAN STATUS HEMODINAMIK PADA PASIEN OPERASI EKSTREMITAS BAWAH DENGAN SPINAL ANESTESI DI RSUD ULIN BANJARMASIN
Indonesia
Keywords:
Anestesi Spinal, Operasi Ekstremitas Bawah, Status HemodinamikAbstract
Anestesi spinal merupakan teknik anestesi regional yang sering digunakan pada operasi ekstremitas bawah karena menghasilkan blokade sensorik dan motorik yang efektif. Namun, blokade saraf simpatis akibat spinal anestesi dapat menyebabkan perubahan status hemodinamik sehingga diperlukan pemantauan selama periode intraoperatif. Penelitian ini bertujuan mengetahui gambaran status hemodinamik pasien yang menjalani operasi ekstremitas bawah dengan spinal anestesi di RSUD Ulin Banjarmasin. Penelitian ini menggunakan desain deskriptif dengan pendekatan multiple case study. Partisipan penelitian berjumlah tiga pasien yang menjalani operasi ekstremitas bawah dengan teknik spinal anestesi, yaitu dua pasien menjalani operasi Open Reduction Internal Fixation (ORIF) pada kasus Close Fracture Left Subtrochanter Femur dan Post Debridement, serta satu pasien menjalani operasi debridemen pada kasus Necrotic Wound At Anterior Aspect Of Right. Data dikumpulkan melalui observasi dan dokumentasi rekam medis berupa tekanan darah, frekuensi nadi, dan Mean Arterial Pressure (MAP) selama periode intraoperatif, kemudian dianalisis secara deskriptif. Hasil penelitian menunjukkan adanya perubahan status hemodinamik pada seluruh partisipan setelah pemberian spinal anestesi. Pasien pertama mengalami perubahan tekanan darah dari 132/73 mmHg menjadi 125/78 mmHg dengan frekuensi nadi dan MAP yang relatif stabil. Pasien kedua menunjukkan penurunan tekanan darah paling besar dari 143/96 mmHg menjadi 100/62 mmHg disertai penurunan frekuensi nadi hingga 48 kali/menit. Pasien ketiga mengalami perubahan tekanan darah dari 117/47 mmHg menjadi 102/55 mmHg dengan nilai MAP terendah sebesar 65 mmHg selama pengamatan. Perubahan status hemodinamik pada setiap pasien menunjukkan adanya variasi respons fisiologis individu terhadap pemberian spinal anestesi selama operasi ekstremitas bawah.
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