Suandika , Made
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Perbedaan Posisi Elevasi Kaki dan Posisi Trendelenburg terhadap Kestabilan Tekanan Darah Pasca Induksi Spinal Anestesi Febrianor , M; Suandika , Made; Yudono , Danang Tri
Bali Medika Jurnal Vol 10 No 2 (2023): Bali Medika Jurnal
Publisher : Stikes Wira Medika Bali

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36376/bmj.v10i2.356

Abstract

Salah satu komplikasi akut yang terjadi pada spinal anestesi ialah penurunan tekanan darah pasca induksi. Salah satu tindakan yang bisa dilakukan untuk mencegah hat tersebut adalah elevasi kaki atau posisi Trendelenburg dan terbukti dapat mempertahan kan kestabilan tekanan darah pada pasien spinal anestesi. Tujuan penelitian ini adalah untuk mengidentifikasi tekanan darah pasca induksi, pasca intervensi Elevasi Kaki 45º dan posisi 10º Trendelenburg. Metode penelitian ini menggunakan kuantitatif, desain two group pretest posttest. Sampel penelitian 54 responden pasca anestesi dengan teknik sample purposive sampling, uji normalitas dengan uji Shapiro-Wilk serta analisis data yang digunakan adalah uji paired t-test dan independent t-test. Hasil independent t test diperoleh kelompok TDS setelah intervensi yaitu nilai p = 0.000 < 0.05, lalu TDD setelah intervensi dengan nilai p = 0.036 < 0.05 maka disimpulkan bahwa terdapat perbedaan yang signifikan antara TDS dan TDD pada masing masing kelompok intervensi, nilai rata-rata menunjukkan posisi 10º T memiliki pengaruh dalam menstabilkan tekanan darah dari pada posisi EK 45º, dilihat dari rata-rata nilai pada 10º T ialah 136.96 (TDS) 75.30 (TDD), lalu pada EK 45º ialah 120.11 (TDS) dan 72.52 (TDD). Kesimpulannya, hasil penelitian pada kelompok 10º T dapat memberikan kestabilan tekanan darah dibandingkan posisi EK 45º.   One of the acute complications that occurs in spinal anesthesia is a decrease in blood pressure after induction. One of the actions that can be taken to prevent hat is leg elevation or Trendelenburg position and has been proven to maintain blood pressure stability in spinal anesthesia patients. The Objective is to identify post-induction blood pressure, post-intervention 45º leg elevation and 10º Trendelenburg position. This study uses quantitative, two group pretest posttest design. The research sample was 54 respondents after anesthesia with purposive sampling technique, normality test with Shapiro-Wilk test and data analysis used was paired t-test and independent t-test. The results of the independent t test obtained by the TDS group after the intervention are p value = 0.000 <0.05, then TDD after the intervention with a p value = 0.036 <0.05, it is concluded that there is a significant difference between TDS and TDD in each intervention group, the average value shows that the 10º T position has an influence in stabilizing blood pressure than the 45º EK position, this can be seen from the mean value at 10º T is 136.96 (TDS) 75.30 (TDD), then at 45º EK is 120.11 (TDS) and 72.52 (TDD). In Conclusion, the results of the study in the 10º T group can provide blood pressure stability compared to the 45º EK position.
GAMBARAN KEBUTUHAN CAIRAN DAN ELEKTROLIT PADA PEMBEDAHAN NEFROTOMI: NARRATIVE REVIEW Suandika , Made; Febriyani, Ceria; Handayani, Rahmaya Nova; Wardani , Ayu; Djafar , Anisa Dwiyanti
JURNAL PENELITIAN TERAPAN KESEHATAN Vol 12 No 2 (2025): JURNAL PENELITIAN TERAPAN KESEHATAN
Publisher : Poltekkes Kemenkes Bengkulu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33088/jptk.v12i2.1161

Abstract

ABSTRAK Nephrotomy procedures, whether elective such as Percutaneous Nephrolithotomy (PCNL) or emergency due to renal trauma, carry a significant risk of disrupting fluid and electrolyte homeostasis. Perioperative fluid imbalance increases the risk of complications including hypovolemia, hypervolemia, electrolyte disturbances (hyperkalemia, hyponatremia), metabolic acidosis, and Acute Kidney Injury (AKI), particularly in patients with Chronic Kidney Disease (CKD). This narrative review aims to analyze perioperative fluid management requirements in nephrotomy surgery based on recent scientific literature. Articles were identified through Google Scholar and PubMed, with 15 publications from 2011–2024 selected based on relevance to perioperative fluid therapy and nephrotomy. The synthesis indicates that optimal fluid strategies include preoperative hydration optimization through Enhanced Recovery After Surgery (ERAS) protocols, intraoperative hemodynamic-based fluid therapy such as Perioperative Goal-Directed Therapy (PGDT), preference of balanced crystalloid solutions (Lactated Ringer/Acetated Ringer) to prevent hyperchloremic metabolic acidosis, and strict postoperative fluid monitoring to prevent fluid overload, especially in CKD patients with CRRT indication. In conclusion, perioperative fluid management in nephrotomy must be individualized, carefully monitored, and evidence-based to prevent postoperative renal complications and improve patient outcomes.