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All Journal JURNAL PENELITIAN PERAWAT PROFESIONAL Jurnal Peduli Masyarakat Kolaborasi Jurnal Pengabdian Masyarakat JURNAL PENELITIAN TERAPAN KESEHATAN Jurnal Pengabdian Masyarakat Bhinneka ASJN (Aisyiyah Surakarta Journal of Nursing) Al-DYAS : Jurnal Inovasi dan Pengabdian kepada Masyarakat Madani: Multidisciplinary Scientific Journal Jurnal Pengabdian Harapan Ibu (JPHI) Jurnal Pustaka Keperawatan Jurnal Ilmu Kedokteran dan Kesehatan Indonesia
Yudha, Magenda Bisma
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Manajemen Perianestesi dengan Subarachnoid Block dan Sedasi pada Pasien Sectio Caesarea Emergency dengan Plasenta Previa dan Hipertiroid: Studi Kasus Dani, Dwi Darmawan; Agepho, Al Farouk Ozan; Wibowo, Ratu Laraswati Sekar; Yudha, Magenda Bisma; Muti, Refa Teja
Jurnal Pustaka Keperawatan (Pusat Akses kajian Keperawatan) Vol 5 No 1 (2026): Jurnal Pustaka Keperawatan
Publisher : Pustaka Galeri Mandiri

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Abstract

Emergency cesarean section in patients with placenta previa and hyperthyroidism presents significant anesthetic challenges due to the risk of massive hemorrhage and thyroid crisis. This case report describes the perioperative anesthetic management of a 31-year-old woman, G3P2A0, with complete placenta previa and uncontrolled hyperthyroidism who underwent emergency cesarean section. The patient presented with active vaginal bleeding at 39 weeks gestation. Laboratory findings revealed anemia (Hb 11.6 g/dL) and hyperthyroid state (TSH 0.10 mIU/L, FT4 3.24 ng/dL). Subarachnoid block was performed at L4-L5 level using levobupivacaine 12.5 mg combined with intrathecal morphine 70 mcg, achieving sensory block up to T6 dermatome. Light sedation with midazolam 3 mg and propofol 4 mg was administered intravenously after delivery. Intraoperative hypotension (90/61 mmHg) was managed with fluid resuscitation and ephedrine 10 mg IV, resulting in stable hemodynamics. The procedure was completed successfully without major complications. Postoperatively, the patient recovered well with Bromage score improving from 3 to 2 and Aldrete score reaching 9. This case demonstrates that subarachnoid block combined with light sedation provides safe and effective anesthetic management for emergency cesarean section in patients with placenta previa and uncontrolled hyperthyroidism, avoiding the risk of thyroid storm associated with general anesthesia
Co-Authors Agepho, Al Farouk Ozan Amalia, Cindy Amelia Andini Andini, Amelia Auliya, Khidmatul Cantika, Virginia Raida Chaerunisa, Siti Bakhittah Dani, Dwi Darmawan Didik Iman Margatot Dwi Novitasari Dzuhuri, Muh Adnan Fajirin, Muhammad Aldi Giffari, Aidil Hidayanti, Fadila Indri Heri Susanti, Indri Heri Jerau, Emiliani Elsi Khoirul Anam, Ahmad Made Suandika Maitsa, Hilvi Mulina, Napa Muti, Refa Teja Nailli, Yuris Tri Nashya, Jhea Aqilla Nuranggreni, Maricha Nurhadi, Muhammad Zidan Putra Rahayu, Mella Budi Rahmaya Nova Handayani Ratri, Hong Nuring Madyo Setyawati, Martyarini Budi Suhendro, Anton Suryani, Roro Lintang Tanjung, Ar-Rahman Triana, Noor Yunida Tumbey, Chrynscialdy Wibowo, Ratu Laraswati Sekar Wilis Sukmaningtyas Yudono, Danang Tri Zulita, Nabila Ulfa