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All Journal Jurnal Anestesiologi Indonesia Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Anestesi Perioperatif Mutiara Medika: Jurnal Kedokteran dan Kesehatan JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Jurnal Anestesi Obstetri Indonesia Jurnal Neuroanestesi Indonesia Jurnal Komplikasi Anestesi
Yusmein Uyun
Departemen Anestesiologi Dan Terapi Intensif; Fakultas Kedokteran; Universitas Gadjah Mada; Yogyakarta
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Comparison of giving ephedrine 30 μg/kgbw iv and lidocaine 2% 40 mg iv to educe pain induction propofol 2 mg/kgbw iv in general anesthesia Yusmein Uyun, Mujahidin Bambang Suryono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 01 (2013)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (402.446 KB) | DOI: 10.19106/JMedScie004501201303

Abstract

The administration of propofol often causes burning sensation in the area of injection. There have been efforts to reduce discomfort, but the result remains unsatisfactory. The main purpose of this study is to find objective evidence of whether the administration of ephedrine 30μg/kgBB IV is more effective than 40mg 2% lidocaine in order to reduce propofol 2mg/kgBB injection pain.This study was conducted in the double blind Randomized Controlled Trial (RCT) to 128 patients, with the range of age 18-60 years, physical status ASA I and II, BMI 17.5 – 24.5 kg/m2 which had been done elective surgery in the Intergrated Surgery Center of Dr. Sardjito Hospital Yogyakarta and other education network (Banyumas Hospital, Panembahan Senopati Bantul Hospital, Orthopedi Solo Hospital, Saras Husada Purworejo Hospital) and carried out in 2-4 months, general anaesthesia has been done with endotracheal intubation technic. Subjects have been divided into 2 groups, group A (lidokain 40 mg) and group B (efedrin 30μg/ kgBB). All of the patients have been given at the vena sefalikabasalika with 18G needle and RL. After one of the drugs has been given, the patient will be inducted with propofol 60 seconds later. The measurement of discomfort caused by propofol injection has been marked with discomfort scoring system (score 0-3), the blood pressure measurement has been taken before and after propofol administration. The results showed no statistically significant difference in the two study groups (2% lidocaine 40 mg IV vs ephedrine 30μg/kgbb IV) on pain response measured when patients received propofol 2mg/kgbb IV, p > 0.05 (P = 0.068) In group A there were 52 patients (81.3%), pain-free, while for group B there were 59 patients (92.2%). The pain response obtained was varies, in group A obtained a scale of 1-3, while in group B obtained a scale of 1-2. It can be concluded that administration of IV ephedrine 30μg/kgBB is not a significantly different effect compared with 2% lidocaine 40 mg IV to prevent response to pain during injection of propofol 2 mg / kg IV, P> 0.05 (P = 0.068), but clinically group B have the ability to eliminate pain in 59 patients (92.2%) compared with group A in 52 patients (81.3%), while the possibility of causing pain in group A were 12 patients (7.8%) and group B were 5 patients (18.7%).Keywords: Pain, injection, propofol, lidocaine, ephedrine.
The relationship between body mass index (BMI) with the distance of the skin-epidural space in 3rd and 4th lumbar epidural anesthesia in nonobstetric surgery of Indonesian patients Sri Rahardjo, Agung Sutrisno Yusmein Uyun
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 44, No 01 (2012)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (492.479 KB)

Abstract

Skin to epidural space distance varies in an insertion of epidural needle which can greatly affectthe identification of the epidural space and epidural anesthesia complications. Therefore, acareful prediction of skin to epidural space distance is needed in doing insertions. The purposeof this study was to evaluate the relationship between body mass index (BMI) and the distanceof skin to the epidural space in the 3rd – 4th lumbar epidural anesthesia in nonobstetric surgery ofIndonesian patients. This was a prospective observational study with cross sectional designinvolving patients of both sexes between the age 18-65 years with ASA physical status I-II whounderwent non obstetric surgery with 3rd-4th lumbar epidural anesthesia in Dr. Sardjito GeneralHospital, Yogyakarta and in Satellite Hospital. Weight, height and BMI were considered as theindependent variables, whereas skin to epidural space distance was considered as dependentvariable. Data were collected and analyzed using multiple regression analysis continued usingPearson’s correlation test to evaluate the relationship between BMI and skin to epidural spacedistance. One hundred patients selected from October to December 2011 were evaluated in thisstudy. The mean of weight, height and BMI were 57.35±11.59 kg, 155.98±5.88 cm and23.52±4.26 kg/m2, respectively. The mean of skin to epidural space distance of non obstetricsurgery of Indonesian patients was 40.89±9.95 mm. Multiple regression analysis showed thatBMI had a strongest relationship (r= 0.81; p<0.03) with skin to epidural space distance comparedto weight (r= 0.11; p=0.78) and height (r= 0.04; p<0.83). Further analysis using Pearsoncorrelation test showed that a significantly good correlation of BMI (r=0.92; p=0.001) andbody weight (r=0.87; p=0.001) with the skin to epidural space distance were observed. Inconclusion, BMI and body weight have a significant correlation with the skin to epidural spacedistance in non obstetric surgery patient. 
Dampak Anestesi Umum, Spinal dan Epidural Terhadap Tempat Rawat Pasca Operasi dan Skor Apgar pada Pasien Preeklampsia Berat yang Dilakukan Seksiosesaria di RSUP Dr Sardjito Tahun 2004-2006 Pramono, Ardi; Uyun, Yusmein; Suryono, Bambang
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 8, No 2 (2008)
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v8i2.1476

Abstract

The author want to know the place of post operative care and Apgar score of general and regional anesthesia in patients with severe preeclampsia who will be performed sectiosecaria in Sardjito Hospital Yogyakarta year 2004-2006. Data will be collected from medical record. The study will be conducted with cohort retrospective and sample method with consequtive sampling. The inclusion criteria of severe preeclampsia patients were systolic pressure e ” 160mmHg and or diastolic pressure e " llOmmHg before any medical intervention with one or more sign of protein-uria, visual disturbance during pregnancy, and cyanosis, without any disseminated intravascular coagulation (DIC), pulmonary edema, organ dysfunction, and HELLP (hemolytic, elevated liver enzyme, low platelet) syndrome. The recovery room of post operative care was divided into standard room, intensive care unit (ICU) with or without mechanical ventilator. General anesthesia will be limited using tiopenthal as induction agent, and regional anesthesia technique (spinal or epidural) with bupivacain. The result showed that there were no differences in recovery room of post operative care between general, spinal, and regional anesthesia (p 0.05). Apgar score in first 1 minute was significant lower in general compared with spinal and epidural anesthesia.
Anestesi Spinal pada Pasien Seksio Sesaria dengan Tuberkulosis Multidrug-resistant (TB MDR) Satrio Adi Wicaksono; Yusmein Uyun; Ratih Kumala Fajar Apsari
JAI (Jurnal Anestesiologi Indonesia) Vol 12, No 2 (2020): Jurnal Anestesiologi Indonesia
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v12i2.28761

Abstract

Latar belakang: Multi Drug Resistant Tuberculosis (MDR-TB) adalah adanya resistensi terhadap obat TB minimal 2 (dua) obat anti TB yang paling poten yaitu INH dan rifampisin secara bersama-sama atau disertai resistensi terhadap obat anti TB lini pertama lainnya seperti etambutol, streptomisin dan pirazinamid. Pemilihan anestesi spinal pada pasien ini merupakan bahan diskusi yang menarik.Kasus: Seorang wanita G2P1A0 dirujuk ke RSUP Dr Kariadi dengan diagnosa TB MDR. Pasien memiliki riwayat flek paru sejak usia 15 tahun. Pasien memiliki keluhan batuk lama saat kehamilan yang pertama dan sempat mengalami putus obat. Pada pemeriksaan fisik didapatkan keadaan umum pasien tampak sesak dengan kesadaran composmentis, BB 43kg, TB 160cm. Tekanan darah 130/80 mmHg, frekuensi nadi 112x/menit, laju napas 28 x/menit, dengan temperatur 37oC. Pada pemeriksaan mata didapatkan konjungtiva palpebra anemis. Pemeriksaan jantung normal dan paru terdengar suara ronki basah kasar di kedua lapang paru. Pada pemeriksaan laboratorium didapatkan anemia dan trombositopenia. Pasien menjalani operasi seksio sesaria dengan anestesi spinal dengan bupivakain 0,5% 10 mg dengan tekanan darah awal 130/80 mmHg. Selama operasi dan pascaoperasi seksio sesaria, hemodinamik pasien stabil, tidak ditemukan hipotensi yang berat maupun kenaikan tekanan darah. Pasien kemudian dirawat di ruangan dengan perawatan pascaoperasi.Pembahasan: Pada penderita TB MDR, hampir seluruh lapang paru diisi oleh infiltrat. Anestesi regional sering disukai pada pasien dengan penyakit paru-paru kronis seperti tuberkulosis daripada anestesi umum untuk menghindari risiko hipersensitivitas pada otot polos bronkhial dan penyempitan saluran udara akibat proses inflamasi, yang dapat berdampak pada morbiditas dan mortalitas selama persalinan operatif. Ketersediaan tes fungsi paru akan sangat membantu ahli anestesi.Kesimpulan: Keadaan paru yang kurang baik dapat menjadi kontra indikasi untuk dilakukan anestesi umum.
Pengaruh Diabetes Mellitus Gestasional Terhadap Sirkulasi Uteroplasenta Redhy Sindharta; Isngadi Isngadi; Yusmein Uyun; Sri Rahardjo
JAI (Jurnal Anestesiologi Indonesia) Vol 7, No 1 (2015): Jurnal Anestesiologi Indonesia
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (724.382 KB) | DOI: 10.14710/jai.v7i1.17277

Abstract

Diabetes mellitus pada kehamilan (Gestational diabetes mellitus/GDM) adalah intoleransi glukosa yang ditemukan pertama kali pada masa kehamilan dan sering menimbulkan komplikasi pada ibu yang mengandung maupun janin yang dikandung. Beberapa organ pada GDM mengalami perubahan struktur dan perubahan fungsi termasuk disfungsi endothel mikrosirkulasi dan makrosirkulasi fetoplasenta. Endothelium-derived Relaxing Factors (EDRF) khususnya prostasiklin dan nitrik oksid berperan penting dalam mengontrol sirkulasi fetoplasental. Endothel vaskuler pasien GDM mengalami disfungsi, sehingga sintesa dan pelepasan prostasiklin dan nitrik oksid (NO) mengalami gangguan sehingga tonus arteria meningkat. Peningkatan tonus arteri yang menuju uterus akan menurunkan aliran darah uteroplasenta dan akhirnya menurunkan umbilical blood flow (UmBF). Endothel pembuluh darah merupakan target utama dari stress oksidatif. Sintesa NO merupakan mekanisme penting yang mendasari perubahan pembuluh darah sistemik dan pembuluh darah uterine selama kehamilan. Beberapa evidensi penelitian membuktikan peranan NO dan ADMA pada kehamilan normal dan insufiensi plasenta. Dengan berkembangnya pengetahuan akan mekanisme gangguan jalur ADMA-NO, pilihan tambahan untuk intervensi terapetik akan dapat ditemukan. Tatalaksana GDM secara umum adalah dengan pengaturan diet, latihan fisik selama tidak ada kontraindikasi, pengawasan dan kontrol gula darah, dan terapi farmakologi Berbagai penelitian lain terus berusaha menemukan terapi-terapi baru untuk memperbaiki endothel dan sirkulasi uteroplasenta pada pasien GDM.
The relationship between body mass index (BMI) with the distance of the skin-epidural space in 3rd and 4th lumbar epidural anesthesia in nonobstetric surgery of Indonesian patients Agung Sutrisno Yusmein Uyun Sri Rahardjo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 44, No 01 (2012)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (492.479 KB)

Abstract

Skin to epidural space distance varies in an insertion of epidural needle which can greatly affectthe identification of the epidural space and epidural anesthesia complications. Therefore, acareful prediction of skin to epidural space distance is needed in doing insertions. The purposeof this study was to evaluate the relationship between body mass index (BMI) and the distanceof skin to the epidural space in the 3rd – 4th lumbar epidural anesthesia in nonobstetric surgery ofIndonesian patients. This was a prospective observational study with cross sectional designinvolving patients of both sexes between the age 18-65 years with ASA physical status I-II whounderwent non obstetric surgery with 3rd-4th lumbar epidural anesthesia in Dr. Sardjito GeneralHospital, Yogyakarta and in Satellite Hospital. Weight, height and BMI were considered as theindependent variables, whereas skin to epidural space distance was considered as dependentvariable. Data were collected and analyzed using multiple regression analysis continued usingPearson’s correlation test to evaluate the relationship between BMI and skin to epidural spacedistance. One hundred patients selected from October to December 2011 were evaluated in thisstudy. The mean of weight, height and BMI were 57.35±11.59 kg, 155.98±5.88 cm and23.52±4.26 kg/m2, respectively. The mean of skin to epidural space distance of non obstetricsurgery of Indonesian patients was 40.89±9.95 mm. Multiple regression analysis showed thatBMI had a strongest relationship (r= 0.81; p<0.03) with skin to epidural space distance comparedto weight (r= 0.11; p=0.78) and height (r= 0.04; p<0.83). Further analysis using Pearsoncorrelation test showed that a significantly good correlation of BMI (r=0.92; p=0.001) andbody weight (r=0.87; p=0.001) with the skin to epidural space distance were observed. Inconclusion, BMI and body weight have a significant correlation with the skin to epidural spacedistance in non obstetric surgery patient. 
Comparison of giving ephedrine 30 μg/kgbw iv and lidocaine 2% 40 mg iv to educe pain induction propofol 2 mg/kgbw iv in general anesthesia . Mujahidin; Bambang Suryono; Yusmein Uyun
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 01 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (402.446 KB) | DOI: 10.19106/JMedScie004501201303

Abstract

The administration of propofol often causes burning sensation in the area of injection. There have been efforts to reduce discomfort, but the result remains unsatisfactory. The main purpose of this study is to find objective evidence of whether the administration of ephedrine 30μg/kgBB IV is more effective than 40mg 2% lidocaine in order to reduce propofol 2mg/kgBB injection pain.This study was conducted in the double blind Randomized Controlled Trial (RCT) to 128 patients, with the range of age 18-60 years, physical status ASA I and II, BMI 17.5 – 24.5 kg/m2 which had been done elective surgery in the Intergrated Surgery Center of Dr. Sardjito Hospital Yogyakarta and other education network (Banyumas Hospital, Panembahan Senopati Bantul Hospital, Orthopedi Solo Hospital, Saras Husada Purworejo Hospital) and carried out in 2-4 months, general anaesthesia has been done with endotracheal intubation technic. Subjects have been divided into 2 groups, group A (lidokain 40 mg) and group B (efedrin 30μg/ kgBB). All of the patients have been given at the vena sefalikabasalika with 18G needle and RL. After one of the drugs has been given, the patient will be inducted with propofol 60 seconds later. The measurement of discomfort caused by propofol injection has been marked with discomfort scoring system (score 0-3), the blood pressure measurement has been taken before and after propofol administration. The results showed no statistically significant difference in the two study groups (2% lidocaine 40 mg IV vs ephedrine 30μg/kgbb IV) on pain response measured when patients received propofol 2mg/kgbb IV, p > 0.05 (P = 0.068) In group A there were 52 patients (81.3%), pain-free, while for group B there were 59 patients (92.2%). The pain response obtained was varies, in group A obtained a scale of 1-3, while in group B obtained a scale of 1-2. It can be concluded that administration of IV ephedrine 30μg/kgBB is not a significantly different effect compared with 2% lidocaine 40 mg IV to prevent response to pain during injection of propofol 2 mg / kg IV, P> 0.05 (P = 0.068), but clinically group B have the ability to eliminate pain in 59 patients (92.2%) compared with group A in 52 patients (81.3%), while the possibility of causing pain in group A were 12 patients (7.8%) and group B were 5 patients (18.7%).
THE PHARMACOKINETIC PROFILE OF BUPIVACAINE IN NORMOTENSIVE PREGNANT PATIENT DURING CAESAREAN SECTION Dita Ayulia Dwi Sandi; Djoko Wahyono; Farida Hayati; Yusmein Uyun
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 3, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.105

Abstract

Bupivacaine is used as a local anesthetic with Epidural Lumbal Anasthesia (ELA) for Caesarean Section (CS) in Indonesia. During pregnancy, there are changes in pharmacokinetic parameter values, as a result of changes in the physiology of the body. This study was designed to determine the pharmacokinetic parameters of isobaric bupivacaine 0.5% with non-compartment model and to monitor its effectiveness. The study was conducted on 7 normotensive pregnant patients who treated with 0.5% bupivacaine doses 75 mg at Integrated Central Surgery Building in Dr. Sardjito Hospital. Blood samples (3 mL) from each patients were drawn at the following intervals: 0, 15, 20, 25, 30, 45, 60, 75 and 90 minutes, then the plasma bupivacaine consentration were measured using HPLC and pharmacokinetic parameters were calculated with non-compartment models, i.e. AUC(0-~), AUMC(0-~) and the MRT. Monitoring the effectiveness was conducted by Pinprick test. Relationship of AUC(0-~) with maximum sensory block was analyzed by Pearson correlation. The results of pharmacokinetic parameters of isobaric bupivacaine 0.5% for 7 normotensive pregnant patients with non-compartment model were AUC(0-~) 101,25 ± 15,07 μg.mL-1.min; AUMC(0-~) 6.431,92 ± 2.212,96 μg.mL-1.min2 and MRT 63,74 ± 20,52 minutes. Bupivacaine 0,5% doses 75 mg as an anesthetic for CS with ELA in 7 normotensive pregnant patients was effective for pain blockade, with maximum sensory block was T6. There was no correlation between AUC(0-~) and sensory block (p>0,05).Keywords: Bupivacaine 0.5%, Sectio Caesarea, Pharmacokinetics, Sensory bloc
PHARMACOKINETIC PROFILE OF LUMBAR EPIDURAL BUPIVACAINE INJECTION IN PREECLAMPSIA PATIENTS DURING CESAREAN SECTION: CASE STUDY IN DR. SARDJITO HOSPITAL YOGYAKARTA Helmina Wati; Djoko Wahyono; Farida Hayati; Yusmein Uyun
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 3, No 1
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.102

Abstract

Preeclamsia patient experienced deterioration of glomerolus filtration and plasma protein concentration. Bupivakain is bound strongly with the plasma protein that is 95%. This research was aimed to know the pharmacokinetics profiles of isobaric bupivacaine with the noncompartemen model in preeclampsia patients who underwent Sectio Caesarea (SC) with lumbar epidural technique in RSUP Dr. Sardjito and to know correlation between protein levels and pharmacokinetics profiles of isobaric bupivacaine in preeclampsia patients. Firstly, albumin concentration of patients was checked in the laboratory and then isobaric bupivacaine 0.5% in 15ml (75mg) was given by lumbar epidural technique. The samples of blood were taken through veins vessels at 0; 15; 20; 25; 30; 45; 60 and 90 minutes. The concentration of 0.5% isobaric bupivacaine in those samples of blood was determined with High Performance Liquid Chromatography (HPLC) methods. Furthermore, pinprick test was taken to measure block sensoric effect in T10-T6 areas. Pharmacokinetics parameters of bupivacaine (AUC, AUMC, MRT) were calculated based on data of bupivakain concentration in the blood versus time. The results of this research showed that the AUC0-∞ (total AUC) was 116±37,6 (μg/ml) minutes; AUMC0-∞ (total AUMC) was 9187,5 (μg/ml) minutes2; and MRT0-∞ was 102,5 minutes. Average block sensoric effect was at T8. There was no linear correlation between the protein levels and pharmacokinetics profiles of bupivacaine (p>0,05). The conclusion was that there was no linear correlation between the protein levels and pharmacokinetics profiles of bupivacaine that was given by lumbar epidural in preeclampsia patientswho underwent section caesarea.Keywords : bupivakaine, pharmacokinetic profile, lumbar epidural, section caesarea.
Anestesia Spinal untuk Seksio Sesarea pada Pasien Hipotiroid Rizqi Adhelia; Sri Rahardjo; Yusmein Uyun
Jurnal Anestesi Obstetri Indonesia Vol 2 No 2 (2019): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i2.11

Abstract

Disfungsi tiroid sering dijumpai pada populasi perempuan usia masa reproduksi. Efek disfungsi tiroid bermanifestasi pada berbagai organ dan mungkin menimbulkan komplikasi pembedahan dan kehamilan. Seorang perempuan 37 tahun dengan hipotiroid akan menjalani seksio sesarea. Kadar tiroid timulating hormone (TSH): dan tiroksin (T4) adalah 14,87 µUI/mL dan 71 nmol/L. Pasien mendapat terapi levotiroksin selama 6 minggu. Pada pemeriksaan fisik, pasien dalam keadaan umum baik. Anestesia spinal dilakukan dengan bupivakain 0,5% 7,5 mg dan fentanyl 25 µg. Bayi lahir dengan skor Apgar 8/9, hemodinamik stabil selama operasi. Pasien pulang dari rumah sakit setelah hari ke tiga operasi. Pasien hipotiroid dapat mengalami komplikasi koma miksedema, gangguan respirasi, maupun hipotensi selama pembedahan. Pembedahan elektif sebaiknya ditunda sampai kondisi eutiroid. Anestesia spinal dosis rendah, monitoring adekuat, pencegahan hipotermia, pengurangan opioid, dan terapi levotiroksin perioperatif dibutuhkan untuk mencegah komplikasi jika kondisi eutiroid belum tercapai. Sebagai kesimpulan anestesia spinal dapat dilakukan pada pasien hipotiroid yang menjalani seksio sesarea. Anesthesia for Cesarean Section in Hypothyroid Patient Abstract Thyroid disfunction is common in woman of child-bearing age population. Multiple organ are influenced with thyroid dysfunction and may contribute to complication during surgery and pregnancy. A 37-years-old female with hypothyroid was scheduled for cesarean section. Thyroid stimulating hormone (TSH) and thyroxine (T4) level was 14,87 µUI/mL and 71 nmol/L. The patient had levothyroxine therapy for 6 weeks. On physical examination, the general condition was good. She underwent spinal anesthesia with bupivacaine 0,5% 7,5 mg and fentanyl 25 µg. The baby was born with Apgar score 8/9 and the surgery was done without any complication. The patient was discharged from the hospital on the 3rd day after surgery. The hypothyroid patient may experience complication of myxedema comatous, respiratory disorder and hypotension during surgery. The elective surgery was best postponed until a euthyroid state was achieved. Low dose spinal anesthesia, adequate monitoring, hypothermia prevention, reducing opioid dose and continuing levothyroxine therapy was needed to prevent the complication if the euthyroid state was able not able to achieve. As conclusion : spinal anesthesia may be done for cesarean section in hypothyroid patient.
Co-Authors . Mujahidin Adi Hidayat Adi, Danis Woro Kuncoro Adrin, Olga Elenska Akhmad Yun Jufan Annemarie Chrysantia Melati Ardi Pramono Arief Hariyadi Santoso Arif Ikhwandi Arif Supriyono Artika, I Gusti Ngurah Rai Ayu Rosema Sari Bambang Suryono Bambang Suryono Bambang Suryono Bambang Suryono, Bambang Bhirowo Yudo Pratomo Budianti, Nugrahaeni Calcarina Fitriani Retno Wisudarti Dadik Wahyu Wijaya Daniswara Dewi Yulianti Bisri Djoko Wahyono Djoko Wahyono Djoko Wahyono Dwiana Sulistyanti Ekuarianto, Donny Erna Fitriana A Fadinie, Wulan Fitri Hapsari Dewi Fitri, Lillah Fitriana A, Erna Gutama, Bayu Satria Hartono, Pinter Hayati, Farida Helmina Wati Hendra, Maijoni Hernawan, Agung Diky Hidayat, Nopian Isngadi Isngadi Isngadi Juni Kurniawaty Muhdar Abubakar Djayanti Sari Liza, Helda Mahisa, Orizanov Mahmud Mahmud Muhammad Iqbal Noegroho, Wahyu Nopian Hidayat Nova Maryani Nugroho, Alfan Mahdi Nurul Ulfah Hayatunnisa Perbatasari, Inggita Dyah Perwira, Rendra Prakosa, Nur Hamam Prihatna, Hendi Purnomo, Dedi Pujo Rafidya Indah Septica Rahma, Aulia Zuhria Ratih Kumala Fajar Apsari Redhy Sindharta Rizqi Adhelia Rose Mafiana RTH Supraptomo Ruddi Hartono Sandi, Dita Ayulia Dwi Sandi, Dita Ayulia Dwi Santoso, Arief Hariyadi Satrio Adi Wicaksono SATRIYAS ILYAS Septica, Rafidya Indah Septica, Rafidya Indah Septika, Rafidya Indah Siti Helmyati Sri Rahardjo Sri Rahardjo Sri Rahardjo Sudadi Suharso, Pamungkas Hary Sunartejo, Bayu Supraptomo Suryasaputra, Wahyu Untung Widodo Untung Widodo, Untung Utomo, F uad Cipto Wicaksono, Galih Sahid Wirawan, Angga Aditya Yunita Widyastuti Yusmalinda Yusmalinda