Jurnal Pustaka Keperawatan
Vol 5 No 1 (2026): Jurnal Pustaka Keperawatan

Manajemen Perianestesi dengan Subarachnoid Block dan Sedasi pada Pasien Sectio Caesarea Emergency dengan Plasenta Previa dan Hipertiroid: Studi Kasus

Dwi Darmawan Dani (Unknown)
Al Farouk Ozan Agepho (Unknown)
Ratu Laraswati Sekar Wibowo (Unknown)
Magenda Bisma Yudha (Unknown)
Refa Teja Muti (Unknown)



Article Info

Publish Date
29 Jun 2026

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

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Journal Info

Abbrev

pustakakeperawatan

Publisher

Subject

Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

Description

Jurnal Pustaka Keperawatan adalah sebuah jurnal Double blind peer-review yang didedikasikan untuk publikasi hasil penelitian yang berkualitas dalam bidang Keperawatan. Semua publikasi di Jurnal Pustaka Keperawatan bersifat akses terbuka yang memungkinkan artikel tersedia secara bebas online tanpa ...