Penggunaan Ropivacaine Spinal untuk Kuretase pada Pasien Pasca Persalinan dengan Kompromi Kardiak

Achmad Hariyanto; Suparno Adi Santika; Haris Darmawan; Nurfaizah Titisari Sulihah; Umar Agusta Wijaya

doi:10.47507/obstetri.v8i3.227

Achmad Hariyanto Faculty of Medicine Universitas Jember
Suparno Adi Santika Faculty of Medicine Universitas Jember
Haris Darmawan Faculty of Medicine Universitas Jember
Nurfaizah Titisari Sulihah Universitas Jember
Umar Agusta Wijaya Faculty of Medicine Universitas Jember

DOI: https://doi.org/10.47507/obstetri.v8i3.227

Keywords: Spinal anestesi, ropivacaine isobarik, severe MS, RHD, ALO

Abstract

Manajemen anestesi pada pasien dengan komorbiditas kardiak multipel seperti Rheumatic Heart Disease (RHD), Severe Mitral Stenosis (MS), dan Acute Lung Edema (ALO) merupakan tantangan besar. Laporan kasus ini membahas penggunaan Ropivacaine isobarik intratekal pada seorang pasien perempuan usia 27 tahun, 21 hari pascapersalinan, dengan ketiga komorbiditas tersebut yang akan menjalani kuretase. Anestesi spinal dilakukan di interspace L3-L4 menggunakan 15 mg ropivacaine 0,75% isobarik tanpa glukosa. Pemilihan agen ini didasarkan pada profil hemodinamiknya yang stabil dan toksisitas jantung serta SSP yang lebih rendah. Dosis 15 mg menghasilkan blok sensorik adekuat untuk prosedur selama satu jam dengan durasi blok motorik yang lebih pendek. Pasien diposisikan head up 30° untuk meminimalkan sesak. Tanda vital intraoperatif tetap stabil tanpa episode hipotensi atau takikardia signifikan. Prosedur berhasil diselesaikan tanpa komplikasi kardiovaskular atau pernapasan akut. Ropivacaine 0,75% isobarik tanpa glukosa terbukti menjadi pilihan anestesi spinal yang efektif dan aman untuk pasien dengan komorbiditas kardiak kompleks ini, yang ditunjukkan oleh stabilitas hemodinamik yang terjaga, hasil prosedural yang baik, dan pemulihan fungsi motorik yang cepat

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Author Biographies

Achmad Hariyanto, Faculty of Medicine Universitas Jember

Department of Anesthesiology and Intensive Care dr. Soebandi General Hospital jember

Suparno Adi Santika, Faculty of Medicine Universitas Jember

Department of Anesthesiology and Intensive Care dr. Soebandi General Hospital Jember

Haris Darmawan, Faculty of Medicine Universitas Jember

Department of Anesthesiology and Intensive Care dr. Soebandi General Hospital Jember

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