PENATALAKSANAAN HIPOTENSI INTRA OPERATIF PADA PASIEN SEKSIO SESAREA DENGAN ANESTESI SPINAL OLEH PENATA ANESTESI DI RUMAH SAKIT UMUM DAERAH BULELENG: MULTIPLE CASE STUDY Kadek Nanda Adiputra Fakultas Kesehatan Program Studi D IV Keperawatan Anestesiologi Institut Teknologi dan Kesehatan Bali Email: [email protected] ABSTRAK Latar Belakang: Kejadian hipotensi intra operatif masih banyak ditemukan. Hipotensi merupakan tantangan utama selama Tindakan anestesi spinal pada pasien seksio sesarea. Adanya tatalaksana yang tepat sangat diperlukan untuk dapat mencegah dampak buruk dari hipotensi intra operatif terhadap hasil pemulihan pasien. Tujuan: Mengetahui penatalaksanaan hipotensi intra operatif pada pasien seksio sesarea dengan anestesi spinal oleh penata anestesi di Rumah Sakit Umum Daerah Buleleng. Metode: Penelitian ini merupakan penelitian deskriptif kualitatif dengan pendekatan multiple case study. Penelitian ini melibatkan 5 (lima) partisipan dengan menggunakan teknik purposive sampling. Pengumpulan data, pedoman wawancara dilakukan dengan menggunakan lembar observasi. Analisa data dilakukan menggunakan individual case analysis dan cross case analysis. Hasil: Penelitian ini menemukan bahwa penatalaksanaan non farmakologi yang dilakukan penata anestesi untuk mengatasi hipotensi intra anestesi yakni pemberian posisi duduk 3 menit dan monitoring intra anestesi, penatalaksanaan farmakologi yang dilakukan penata anestesi untuk mengatasi hipotensi intra anestesi yakni pemberian loading cairan dan pemberian vasopresor evedrin. Kesimpulan: Penelitian ini menemukan bahwa penatalaksanaan farmakologi lebih banyak dilakukan oleh penata anestesi untuk mengatasi hipotensi intra anestesi pada pasien seksio sesares dengan anestesi spinal. Meskipun demikian tidak ditemukan adanya hambatan dalam penatalaksanaan hipotensi intra operatif pada pasien seksio sesarea dengan anestesi spinal oleh penata anestesi di Rumah Sakit Umum Daerah Buleleng. Kata Kunci: Anestesi spinal, hipotensi, intra operatif , seksio sesarea.

THE MANAGEMENT OF INTRAOPERATIVE HYPOTENSION IN CESAREAN SECTION PATIENTS WITH SPINAL ANESTHESIA PERFORMED BY NURSE ANETHESTISTS IN BULELENG REGIONAL GENERAL HOSPITAL: A MULTIPLE CASE STUDY Kadek Nanda Adiputra Faculty of Health Diploma IV of Nursing Anesthesiology Institute of Technology and Health Bali Email: [email protected] ABSTRACT Background: The incidence of intraoperative hypotension is widely found. Hypotension is a major challenge during spinal anesthesia in cesarean section patients. Appropriate management is required to prevent the adverse effects of intraoperative hypotension on patient recovery outcomes. Aim: To find out the management of intraoperative hypotension in cesarean section patients with spinal anesthesia, performed by nurse anesthetists in Buleleng Regional General Hospital. Methods: This research is descriptive qualitative research with multiple case study approach. 5 (five) participants involved in this study were selected through purposive sampling technique. The data were collected through interview using an interview guideline. The collected data were then analyzed using individual case and cross case analysis. Results: This study found that the non-pharmacological treatment performed by nurse anesthetists to overcome the intra-anesthesia hypotension was by allocating a 3-minute of time in the sitting position and intra-anesthesia monitoring. On the other hand, the pharmacological treatment performed by nurse anesthetists to overcome the intra-anesthesia hypotension was by providing fluid loading andvasopressor evedrin. Conclusion: The pharmacological treatment is mostly carried out by nurse anesthetists to overcome intra-anesthetic hypotension in cesarean section patients with spinal anesthesia; and there is no obstacles found in the management of intraoperative hypotension in cesarean section patients with spinal anesthesia by nurse anesthetists in Buleleng Regional General Hospital. Keywords: Spinal anesthesia, hypotension, intraoperative, cesarean section.