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Hemodynamic Picture After Spinal Anesthesia Sectio Caesarea Fredy, Fredy Marta; Triyudono, Danang; Sebayang, Septian; Suandika, Made
Java Nursing Journal Vol. 3 No. 1 (2025): November - February 2025
Publisher : Global Indonesia Health Care (GOICARE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61716/jnj.v3i1.95

Background: Sectio caesarea is a surgical procedure through an abdominal and uterine wall incision to remove the fetus, placenta and amniotic fluid. SC action with spinal anesthesia has an impact on body hemodynamics, such as changes in blood pressure, changes in pulse rate and changes in MAP. Purpose: The purpose of this research is to document the vital signs of patients undergoing post-spinal anesthesia for sectio secaria surgery at Sriwijaya Hospital Palembang. Methods: Research of this kind is known as descriptive research. This research used a purposeful sampling strategy to select 93 individuals who had spinal anesthesia for a caesarean delivery. Results: The frequency and percentages of blood pressure, pulse, and MAP of pregnant women having spinal acupuncture with anesthesia were determined by univariate data analysis. The majority of the 93 participants who had spinal anesthesia for caesarean section surgery had hypertension (60.2% of the total), asthma (72%) in 67 participants, systolic blood pressure below 90 mmHg in 45 participants (48.38%), and diastolic blood pressure below 60 mmHg in 46.2%. There were 52 cases of tachycardia (55.9% of the total), 33 cases of abnormal heartbeats (35.5% of the total), and 8 cases of brachycardias (8.6% of the total). In terms of population, 80 individuals (86.02%) reported normal levels, whereas 13 (13.98%) reported high levels. Conclusion: The majority of participants who had spinal anesthesia for section caesarian surgery reported abnormal MAP readings, pulse tachycardia, and hypotension.

Description of Pain Levels in Postoperative Sectio Caesarea Patients Using, The ERACS Method Wahyudi, Wahyudi Saputra; Triyudono, Danang; Sebayang, Septian
Java Nursing Journal Vol. 3 No. 1 (2025): November - February 2025
Publisher : Global Indonesia Health Care (GOICARE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61716/jnj.v3i1.96

Background: Postoperative pain management is an essential component of patient care after cesarean section (C-section) because inadequate pain management can negatively affect maternal recovery as well as the psychological well-being of mothers and overall surgical outcomes. Enhanced Recovery After Cesarean Section (ERACS) has been introduced to enhance the care patients receive in the perioperative period concerning reduced pain, improvement in recovery, and decreased opioid dependence. Despite growing adoption, very few studies have reported on the ability of the method to manage post-C-section pain. Purpose: To evaluate the pain experience of postoperative C-section patients managed with the ERACS method in Bunda Medika Jakabaring Hospital. Methods: A cross-sectional descriptive quantitative study was conducted among 66 Cesarean delivery patients treated by the ERACS method from July 20 to August 20, 2024. The purposive sampling method was used to select the subjects, and the pain levels were measured by using the Numerical Rating Scale (NRS). Pain levels were categorized as no pain (0), mild pain (1-3), moderate pain (4-6), or severe pain (7-8). Results: Of the patients, 16 (24.2%) had no pain; 43 (65.2%), had mild pain; 5 (7.6%), were moderate; and 2 (3.0%) had severe pain. Most of the patients (65.2%) noted only mild pain, indicating that ERACS contributes significantly to reducing postoperative pain. Conclusion: These findings indicate that the ERACS method greatly contributes toward minimizing postoperative pain in C-section patients, thus endorsing its use in the clinical setting. Further studies should also consider larger sample sizes and comparative analyses to substantiate these findings and look into other advantages of ERACS in enhancing

Impact of Visual and Aural Education on the Anxiety Level of Patients Under Spinal Anesthesia for Preoperative Caesarean Section Anggara, Ari; Triyudono, Danang; Lintang Suryani, Roro
Java Nursing Journal Vol. 2 No. 1 (2024): November - February 2024
Publisher : Global Indonesia Health Care (GOICARE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61716/jnj.v2i1.32

Background: The implementation of Sectio Caesarea (SC) requires anesthesia to relieve pain in patients who will undergo surgical procedures. SC action can cause anxiety in pregnant women who will undergo surgery. Purpose: Knowing the effect of audiovisual education on the anxiety level of preoperative ectio caesarea patients with spinal anesthesia at RSUD dr. H. Soemarno Sosroatmodjo Tanjung Selor. Method: This research design uses a pre-experimental design with a Pre and post-test without control approach. Accidental sampling technique. The number of samples obtained was 40 respondents. Measurement of anxiety using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) with audio visual education intervention. Findings: The age of the patients was mostly in the category of 20-35 years, 35 patients (87.5%) and the majority of parity with primiparous 24 patients (60%), Anxiety of preoperative cesarean section patients before giving audio visual education about cesarean section surgery with spinal anesthesia the majority with moderate anxiety 25 patients (62.5%), Anxiety of preoperative cesarean section patients after giving audio visual education about cesarean section surgery with spinal anesthesia the majority with not anxious or normal a total of 21 (52.5%). Conclusion: There is an effect of audio-visual education on the anxiety level of preoperative sectio caesarea patients with spinal anesthesia at RSUD dr. H. Soemarno Sosroatmodjo Tanjung.

Description of Hemodynamic Changes in Section Caesarea Patients with Spina; Anesthesia in Sijunjung Regional General Hospital Nofyanto, Deden; Sukmaningtyas, Wilis; Triyudono, Danang
Java Nursing Journal Vol. 2 No. 1 (2024): November - February 2024
Publisher : Global Indonesia Health Care (GOICARE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61716/jnj.v2i1.38

Background: Every anesthetic action must Background: Every anesthetic action must pay attention to the patient's condition because this anesthetic action causes effects on all body systems, including hemodynamic changes in the patient's body. To see if there are hemodynamic changes that occur, blood pressure and pulse monitoring can be done during the Sectio Caesarea surgery process. Purpose: to know the description of hemodynamic changes in Sectio Caesaria patients with spinal anesthesia at Sijunjung Regional General Hospital. Methods: The type of research used is observational research with descriptive research type. The population in this study were all patients with cesarean section with spinal anesthesia at the Sijunjung Regional General Hospital in July - August with a sample size of 20 patients. Research instruments used ECG monitors and observation sheets using descriptive data analysis. Findings: blood pressure and pulse of respondents before spinal anesthesia were seen entirely, namely 20 respondents (100%) with normal blood pressure and pulse and after spinal anesthesia as many as 14 people (70%) experienced hypotension and 6 respondents (30%) with normal blood pressure. While the pulse rate in respondents after spinal anesthesia was 11 people (50%) experiencing tachycardia and 9 people (45%) with a normal pulse. Conclusion: then it means that there is a picture of hemodynamic changes in sectio caesaria patients with spinal anesthesia at the Sijunjung Regional General Hospital.

Relationship Between Length of Surgery and Shivering in Postoperative Abdominal Surgery Patients Yuswanto, Subur; Triyudono, Danang; Kemal Firdaus, Eza
Java Nursing Journal Vol. 2 No. 2 (2024): March - June 2024
Publisher : Global Indonesia Health Care (GOICARE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61716/jnj.v2i2.47

Background: Abdominal surgery is a type of major surgical operation performed in the abdominal area with incision in the wall layer. The surgery has a risk, one of which is the incidence of shivering and the long period of surgery causes a continuous process of losing body heat. Objective: to know the relationship between the length of surgery and the incidence of shivering in postoperative abdominal surgery patients in the central surgical installation of RSUD Hj. Anna Lasmanah Banjarnegara. Methods: This research design uses cross sectional. Sampling technique with total sampling obtained 50 with abdominal surgery... Instruments include age, gender, BMI, type of anesthesia, length of surgery and incidence of shevering. Findings: age with the majority of the early adult category 26-35 years at 14 (28.0%) for the majority of female gender at 35 (70%) and the highest BMI with normal at 31 (62%).The length of operation of postoperative abdominal surgery patients with the majority in the fast category less than 1 hour at 29 (58%). Conclusion: there is a relationship between the length of surgery and the incidence of shivering in abdominal surgery patients in the Central Surgical Installation of Hj. Anna Lasmanah Banjarnegara Hospital with a p_value of 0.004 (<0.05) with a relationship in the moderate category with rho 0.416 with a relationship in the moderate category with rho 0.416

Overview of Thirst Level in Pre-Operative Patients Muhammad Pandu Wira Sena Isnantopo, Noor; Sukmaningtyas, Wilis; Triyudono, Danang
Java Nursing Journal Vol. 2 No. 2 (2024): March - June 2024
Publisher : Global Indonesia Health Care (GOICARE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61716/jnj.v2i2.48

Background: Fasting before surgery has the effect of reducing the acidity and volume of the stomach which affects the risk of nausea and vomiting leading to aspiration pnomonia and gastric regurgitation that may occur during anesthesia. Purpose: The study aims to determine the description of the level of thirst in preoperative patients at the Central Surgical Installation (IBS) of Dr. H. Moch. Ansari Saleh Banjarmasin Hospital. Methods: This study used descriptive method with cross sectional design. The sampling technique with total sampling obtained 35 respondents. Data analysis using descriptive analysis. Findings: The study showed 18 respondents (51.4%) had fasted for 5-8 hours before surgery, 13 respondents (37.1%) had a habit of drinking more than 2000 ml of water per day, this study showed that the level of thirst of respondents in the mild category was 31.4%, the level of moderate thirst was 42.9% and the level of severe thirst was 25.7%. Conclusion: That more respondents experienced moderate thirst.

Factors Associated with the Incidence of Hypotension in Patients With Spinal Anesthesia Gani, Evita; Triyudono, Danang; Lintang Suryani, Roro
Java Nursing Journal Vol. 2 No. 2 (2024): March - June 2024
Publisher : Global Indonesia Health Care (GOICARE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61716/jnj.v2i2.50

Background: Spinal anesthesia is a regional anesthetic that functions in inhibiting the spinal nerves in surgical attempts. Spinal anesthesia also has complications, one of which is hypotension. Purpose: to determine the factors of hypotension in patients with spinal anesthesia at Mayjend Hospital. H. M. Ryacudu North Lampung. Methods: using analytic correlation with a cross sectional approach. Sample technique with purposive sampling. The number of samples was 56 respondents. The study used observations containing post-anesthesia data including age, gender, BMI, and type of drug and the incidence of hypotension. Findings: The age of the respondents was mostly in the early adult category, 21 (37.5%). Male gender is 28 (50%) and female is 28 (50%), the majority of BMI with normal category is 24 (42.9%), the type of anesthesia is Bupivacaine 28 (50%) and Levobupivacain 28 (50%).There is no relationship between age, gender and type of drug with hypotension with p_value>0.05 Conclusion: there is a relationship between BMI and hypotension in post-spinal anesthesia patients at RSD Mayjend. H. M. Ryacudu North Lampung with a p-value of 0.00 (<0.05).

Description of The Incidence of Back Pain After Sectio Caesarea With Spinal Anesthesia M. Dirham, Nurul Rifah Ulmi; Triyudono, Danang; Apriliyani, Ita
Java Nursing Journal Vol. 2 No. 3 (2024): July - October 2024
Publisher : Global Indonesia Health Care (GOICARE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61716/jnj.v2i3.59

Background: Cesarean section (sectio caesarea) is a common surgical procedure for childbirth involving an incision in the uterine wall. Postoperative pain, particularly back pain associated with spinal anesthesia, is a prevalent concern. Previous research by Kurniawan (2022) indicated that 43.3% of patients experience moderate back pain postoperatively. However, comprehensive studies on the contributing factors to this back pain remain limited. Purpose: This study aims to analyze the incidence and determinants of back pain following cesarean section with spinal anesthesia at Siti Aminah Hospital, Bumiayu. Methods: A descriptive analytic study was conducted, employing a cross-sectional design with a survey method. The study population comprised 35 patients who underwent cesarean section with spinal anesthesia. Data were collected using structured observation sheets, focusing on variables such as patient age, needle size, anesthesia technique, patient positioning, and the severity of back pain. Findings: The majority of participants were aged 25-39 years (65.7%). A needle size of 25 gauge was used in 71.4% of cases. The median approach was the predominant anesthesia technique (82.9%), and 74.3% of procedures were performed with the patient in a sitting position. Notably, 51.4% of respondents reported mild back pain postoperatively. Conclusion: The findings suggest that patient age, needle size, anesthesia technique, and positioning during the procedure significantly influence the incidence of back pain following cesarean section with spinal anesthesia. Further research is recommended to develop strategies to minimize this complication and improve patient outcome.

Findings of Hypotension in Spinal Anesthesia Patients with Lumbar 3-4 And Lumbar 4-5 Amir, Melani Setiaputri; Triyudono, Danang; Suandika, Made
Java Nursing Journal Vol. 2 No. 3 (2024): July - October 2024
Publisher : Global Indonesia Health Care (GOICARE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61716/jnj.v2i3.71

Background: Hypotension is a common complication associated with spinal anesthesia, often resulting from sympathetic nerve block. Factors such as the type of drug, patient positioning, injection site, dosage, and age influence the incidence of hypotension. Purpose: This study aimed to evaluate the incidence of hypotension in patients receiving spinal anesthesia at the lumbar 3-4 (L3-L4) and lumbar 4-5 (L4-L5) injection sites. Methods: A quantitative descriptive study with a cross-sectional approach was conducted, involving 190 respondents selected via purposive sampling. Univariate data analysis was performed. Findings: Findings indicated that patients receiving spinal anesthesia at the L3-L4 site experienced an average systolic blood pressure decrease of 24.69% and a diastolic decrease of 16.17%. In contrast, patients with L4-L5 injections showed a lesser reduction, with systolic pressure dropping by 15.51% and diastolic pressure by 12.31%. Additionally, the pulse rate decreased progressively within the first 20 minutes following induction. The average pulse rate at the 20th minute was 75.06 for patients with L3-L4 injections and 75.65 for those with L4-L5 injections. Conclusion: The study highlights that the incidence of hypotension varies based on the spinal injection site, with more significant decreases in blood pressure observed in patients receiving injections at L3-L4 compared to L4-L5. These findings have important implications for anesthesia management in clinical practice.

Effect of Progressive Muscle and Autogenic Relaxation on Post-Spinal Pain and Anxiety: A Three-Group Randomized Controlled Trial Burhan, Asmat; Triyudono, Danang; Utami, Tin; Susanti, Indah; Atwood, Margaret
Jurnal Keperawatan Soedirman Vol 20 No 2 (2025): Jurnal Keperawatan Soedirman (JKS)
Publisher : Fakultas Ilmu-ilmu Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.jks.2025.20.2.14415

Patients undergoing cesarean sections (CS) under spinal anesthesia often experience pain, anxiety, and peripheral vasoconstriction. This study, a randomized, blinded, controlled trial, compared progressive muscle relaxation (PMR) and autogenic training (AOT) with standard treatment to alleviate the aforementioned symptoms. Sixty-six female patients who underwent CS aged 20-35 were randomized into three groups: PMR (n=22), AOT (n=24), or standard (n=20). Pain and anxiety were evaluated using standardized instruments: Hamilton Rating Scale for Anxiety (HARS) and Numeric Rating Scale (NRS). Both groups indicated a statistically significant decrease in pain and anxiety as compared to the control group (p = 0.001). Both the PMR (Mean difference; pain, 2.54) and anxiety (17.37) improved significantly more than the AOT (pain, 1.23; anxiety, 11.68) group, while the control group minimally improved (pain, 0.32; anxiety, 2.27) over their pre-intervention scores. Statistical tests, Mann-Whitney U and Kruskal-Wallis, showed statistically significant differences between the three groups, p <0.034; p <0.001, 95% CI. Thus, the PMR is more effective than AOT or standard care. Therefore, PMR should be included in the postoperative care of nurse anesthetists in their pragmatic collaborative effort to support non-pharmacological symptom self-management in cesarean patients.

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