Annisa Isfandiary Ismandiya
Instalasi Bedah Sentral Rumah Sakit Gigi Dan Mulut, Rumah Sakit Umum Daerah Lembang, Jl. Parakan Arum No. 19, Bandung 40266

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Efek Ondansetron Intravena terhadap Tekanan Darah dan Laju Nadi pada Anestesi Spinal untuk Seksio Sesarea Ismandiya, Annisa Isfandiary; Maskoen, Tinni T.; Sitanggang, Ruli Herman
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1369.072 KB)

Abstract

Hipotensi merupakan komplikasi anestesi spinal yang sering ditemukan pada seksio sesarea. Pencegahan hipotensi dapat dilakukan dengan pemberian cairan, vasopresor, dan memperbaiki posisi uterus ibu saat terlentang dengan mengganjal punggung. Penelitian ini bertujuan mengetahui pengaruh ondansetron 8 mg yang diberikan 5 menit sebelum spinal anestesi dalam menjaga kestabilan hemodinamik. Penelitian ini dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada Januari–Maret 2014 dengan desain eksperimental secara acak klinis terkontrol tersamar ganda yang mengikutsertakan 46 ibu hamil dengan status fisik American Society of Anesthesiologist (ASA) I−II yang menjalani seksio sesarea menggunakan anestesi spinal. Setelah randomisasi secara blok permutasi, subjek penelitian dikelompokkan menjadi 2, yaitu 23 subjek kelompok kontrol mendapat NaCl 0,9% dan 23 subjek kelompok perlakuan mendapat ondansetron intravena 8 mg. Tekanan darah dan laju nadi diperiksa setiap 1–15 menit setelah anestesia spinal, kemudian diperiksa tiap 3 menit sampai operasi selesai. Data hasil penelitian dianalisis dengan uji-t, Uji Mann-Whitney, dan Uji Kolmogorov-Smirnov. Analisis statistik menunjukkan perbedaan bermakna tekanan darah sistol, tekanan darah rata-rata, dan jumlah pemakaian efedrin antara kelompok kontrol dan kelompok ondansetron (p<0,05). Simpulan, pemberian ondansetron 8 mg dapat mengurangi hipotensi dan menurunkan jumlah pemberian efedrin pasca-anestesi spinal pada operasi seksio sesarea.Kata kunci: Anestesi spinal, hipotensi, ondansetron, seksio sesareaIntravenous Ondansetron Effect on Blood Pressure and Heart Rate in Caesarean Section under Spinal AnesthesiaHypotension is the most common complication in spinal anesthesia during cesarean sections. One of the prevention efforts includes administering a fluid vasopressor or placing a wedge under the right hip for left uterine displacement. This study aimed to determine the effect of ondansetron 8 mg, 5 minutes before spinal anesthesia, to maintain maternal hemodynamic stability. This double-blind randomized control experimental study was conducted in Dr. Hasan Sadikin General Hospital Bandung during the period of January to March 2014 on 46 pregnant women, American Society of Anesthesiologist (ASA) II, who underwent cesarean section with spinal anesthesia. After randomization, the subjects were grouped into two groups: 23 subjects were included in the control group receiving Nacl 0.9% and 23 subjects were included in the ondansetron group receiving 8 mg of ondansetro. Blood pressure and pulse rate were examined every minute until 15 minutes after spinal anesthesia and then every 3 minutes until the operation was complete. Data were analyzed statistically using t test, Mann Whitney Test, and Kolmogorov-Smirnov Test. The results show that there were significant differences in systol presure, average blood pressure, and use of ephedrine between the control and ondansetron group (p<0.05). In conclusion, the provision of 8 mg ondansetron can prevent hypotension and reduce ephedrine use after spinal anesthesia in caesarean section.Key words:  Spinal anesthesia, caesarean section, hypotension, ondansetron, sectio sesareaspinal anesthesia  DOI: 10.15851/jap.v3n2.572
Efek Ondansetron Intravena terhadap Tekanan Darah dan Laju Nadi pada Anestesi Spinal untuk Seksio Sesarea Annisa Isfandiary Ismandiya; Tinni T. Maskoen; Ruli Herman Sitanggang
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1369.072 KB)

Abstract

Hipotensi merupakan komplikasi anestesi spinal yang sering ditemukan pada seksio sesarea. Pencegahan hipotensi dapat dilakukan dengan pemberian cairan, vasopresor, dan memperbaiki posisi uterus ibu saat terlentang dengan mengganjal punggung. Penelitian ini bertujuan mengetahui pengaruh ondansetron 8 mg yang diberikan 5 menit sebelum spinal anestesi dalam menjaga kestabilan hemodinamik. Penelitian ini dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada Januari–Maret 2014 dengan desain eksperimental secara acak klinis terkontrol tersamar ganda yang mengikutsertakan 46 ibu hamil dengan status fisik American Society of Anesthesiologist (ASA) I−II yang menjalani seksio sesarea menggunakan anestesi spinal. Setelah randomisasi secara blok permutasi, subjek penelitian dikelompokkan menjadi 2, yaitu 23 subjek kelompok kontrol mendapat NaCl 0,9% dan 23 subjek kelompok perlakuan mendapat ondansetron intravena 8 mg. Tekanan darah dan laju nadi diperiksa setiap 1–15 menit setelah anestesia spinal, kemudian diperiksa tiap 3 menit sampai operasi selesai. Data hasil penelitian dianalisis dengan uji-t, Uji Mann-Whitney, dan Uji Kolmogorov-Smirnov. Analisis statistik menunjukkan perbedaan bermakna tekanan darah sistol, tekanan darah rata-rata, dan jumlah pemakaian efedrin antara kelompok kontrol dan kelompok ondansetron (p<0,05). Simpulan, pemberian ondansetron 8 mg dapat mengurangi hipotensi dan menurunkan jumlah pemberian efedrin pasca-anestesi spinal pada operasi seksio sesarea.Kata kunci: Anestesi spinal, hipotensi, ondansetron, seksio sesareaIntravenous Ondansetron Effect on Blood Pressure and Heart Rate in Caesarean Section under Spinal AnesthesiaHypotension is the most common complication in spinal anesthesia during cesarean sections. One of the prevention efforts includes administering a fluid vasopressor or placing a wedge under the right hip for left uterine displacement. This study aimed to determine the effect of ondansetron 8 mg, 5 minutes before spinal anesthesia, to maintain maternal hemodynamic stability. This double-blind randomized control experimental study was conducted in Dr. Hasan Sadikin General Hospital Bandung during the period of January to March 2014 on 46 pregnant women, American Society of Anesthesiologist (ASA) II, who underwent cesarean section with spinal anesthesia. After randomization, the subjects were grouped into two groups: 23 subjects were included in the control group receiving Nacl 0.9% and 23 subjects were included in the ondansetron group receiving 8 mg of ondansetro. Blood pressure and pulse rate were examined every minute until 15 minutes after spinal anesthesia and then every 3 minutes until the operation was complete. Data were analyzed statistically using t test, Mann Whitney Test, and Kolmogorov-Smirnov Test. The results show that there were significant differences in systol presure, average blood pressure, and use of ephedrine between the control and ondansetron group (p<0.05). In conclusion, the provision of 8 mg ondansetron can prevent hypotension and reduce ephedrine use after spinal anesthesia in caesarean section.Key words:  Spinal anesthesia, caesarean section, hypotension, ondansetron, sectio sesareaspinal anesthesia  DOI: 10.15851/jap.v3n2.572
Comprehensive Management of Septic Shock Secondary to Intra-Abdominal Infection Complicated by Acute Respiratory Distress Syndrome: A Case Report Sahat , David; Kestriani , Nurita Dian; Ismandiya, Annisa Isfandiary
Journal of Society Medicine Vol. 5 No. 2 (2026): February
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i2.263

Abstract

Introduction: Septic shock is a life-threatening complication frequently encountered after major abdominal surgery and is associated with substantial morbidity and mortality in the intensive care unit (ICU). Intra-abdominal infection following laparotomy is a common precipitating source of sepsis that may rapidly progress to circulatory failure. The development of acute respiratory distress syndrome (ARDS) further exacerbates disease severity and necessitates early recognition and coordinated multidisciplinary management. Case Description: We report the case of a 65-year-old man who developed septic shock secondary to postoperative peritonitis following a laparotomy. The patient had previously undergone low anterior resection for rectal carcinoma. On intensive care unit (ICU) admission, the patient presented with severe hemodynamic instability requiring aggressive fluid resuscitation, vasopressor support, and invasive mechanical ventilation. On ICU day three, the patient developed ARDS, characterized by persistent fever, marked leukocytosis, worsening hypoxemia, and bilateral pulmonary infiltrates on chest radiography. Management included early goal-directed resuscitation, vasopressor therapy, and empiric broad-spectrum antibiotics (meropenem and levofloxacin). Lung-protective ventilation strategies were implemented in close collaboration with intensivists, surgeons, and anesthesiologists. The patient showed gradual clinical improvement and was successfully extubated on ICU day ten. Conclusion: This case underscores the critical importance of rapid recognition and meticulous management of septic shock secondary to intra-abdominal infection complicated by ARDS. Optimal outcomes depend on timely resuscitation, appropriate empiric antimicrobial therapy, early identification of ARDS, implementation of lung-protective ventilation, and a coordinated multidisciplinary approach to critical care management.