Findings of Hypotension in Spinal Anesthesia Patients with Lumbar 3-4 And Lumbar 4-5
DOI:
https://doi.org/10.61716/jnj.v2i3.71Keywords:
spinal anesthesia, hypotension, hemodynamics lumbar 3-4, lumbar 4-5Abstract
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.
References
1. Chusnah L, Zainuri I, Soemah Eka N. Hubungan Usia Dengan Kejadian Hipotensi Pada Pasien Dengan Spinal Anestesi Di Instalasi Bedah Sentral Rsud Bangil. Angew Chem Int Ed 611 951–952. 2021;5–24.
2. Fitrianingsih, Rumantika, Burhan A. Efek Hypotermia Pasca General Anestesi: A Scoping Review. Viva Med J Kesehat Kebidanan Dan Keperawatan. 2021;11.
3. Sebayang Sm, Burhan A, Susanti I. Impact Of Anesthesia Type On Blood Glucose In Intraoperative Diabetic Patients: A Systematic Review And Meta-Analysis Randomized Control Trial. Java Nurs J. 2023;1(1):7–15.
4. Baroki Saragih Mn, Lintang Suryani R, Burhan A. Overview Of Spinal Anesthesia Injection Techniques At Rsi Fatimah Cikacap: English. Java Nurs J. 2023 Oct 16;1(2):97–102.
5. Kristanti Nma. Gambaran Perubahan Hemodinamik Saat Tindakan Spinal Anestesi Dengan Posisi Lateral Decubitus Pada Pembedahan Seksio Sesarea Di Rsud Buleleng. Repos Itekes Bali. 2021;
6. Fauzan R, Tavianto D, Sitanggang Rh. Pengaruh Duduk 5 Menit Dibanding Dengan Langsung Dibaringkan Pada Pasien Yang Dilakukan Anestesi Spinal Dengan Bupivakain Hiperbarik 0,5% 10 Mg Terhadap Perubahan Tekanan Arteri Rata-Rata Dan Blokade Sensorik. J Anestesi Perioper. 2021;4(4):519.
7. Nurhakiky Af. Hubungan Ketinggian Blok Spinal Anestesi Dengan Kejadian Hipotensi Intra Operatif Di Rs Tk Ii Udayana. 2022.
8. Budiarte M. Hubungan Lokasi Penyuntikan Dengan Hipotensi Pada Pasien Sectio Caesarea Dengan Anestesi Spinal Diruang Operasi Rumah Sakit Umum Daerah Karangasem Made. 2022.
9. Goyal A, Shankaranarayan P, Ganapathi P. A Randomized Clinical Study Comparing Spinal Anesthesia With Isobaric Levobupivacaine With Fentanyl And Hyperbaric Bupivacaine With Fentanyl In Elective Cesarean Sections. Anesth Essays Res. 2015;9(1):57–62.
10. Dinesh K, Talikoti Anand T, Raghavendra Rs, Somasekharam P. Continuous Spinal Aneshesia In A High Risk Eldery Patient Using Epidural Set. 2016;19(5):1–23.
11. Nika Fs, Sukmaningtyas W, Burhan A, Yantoro At. Kejadian Hipotensi Pada Pasien Dengan Anestesi Spinal Hypotension Occurence On Patients With Spinal. J Keperawatan Terap. 2023;09(02):102–8.
12. Sklebar I, Bujas T, Habek D. Spinal Anaesthesia-Induced Hypotension In Obstetrics: Prevention And Therapy. Acta Clin Croat. 2019;58:90–5.
13. Darmawan Pgc. Hubungan Status Fisik American Society Of Anestesiologist Dengan Bromage Score Pada Pasien Paska Spinal Anestesi Putu. Intitue Tekologi Dan Kesehatan Bali; 2022.
14. Nurdiamsyah P, Susanto A, Burhan A, Suandika M, Wijayanti I. Overview Of The Incidence Of Post Operative Nausea And Vomiting In Spinal Anesthesia For Sectio Caesarea Patients In The Recovery Room Of Fatimah Cilacap Islamic Hospital. Java Nurs J. 2024 Feb 1;2(1):50–6.
15. Susanti I, Mixrova Sebayang S, Burhan A. Impact Of Ondancentron In Intra-Anesthesia During Caesarean Section: A Meta-Analysis Of Randomized Trials. Java Nurs J. 2024 Feb 1;2(1):26–42.
16. Vika Andriyani, Roro Lintang Suryani, Asmat Burhan. The Relationship Of Family Support With The Level Of Pre-Anesthesian Sectio Patients In The Hospital Pekalongan Regional General. Java Nurs J. 2024 Feb 1;2(1):43–9.
17. Pramudya Gurensky G, Sukmaningtyas W, Burhan A. Overview Of Mean Arterial Pressure (Map) Changes In Patients After General Anesthesia At Juanda Kuningan Hospital West Java: English. Java Nurs J. 2023 Oct 16;1(2):88–96.
18. Alverina F, Suryani Rl, Burhan A. An Overview Caring Behavior Of Anesthesiologist In Spinal Anesthesia Patients At Rsud Cilacap. Java Nurs J. 2024 Jun 21;2(2):124–30.
19. Triyadi F, Mixrova Sebayang S, Burhan A, Dwi Agus Yulianto, Refa Teja Muti. The Relationship Between Age And Duration Of Surgery With The Incidence Of Post Anesthesia Shivering In Section Caesarean Patients At Bendan Hospital Pekalongan City. Java Nurs J. 2024 Feb 1;2(1):7–14.
20. Fauzan Dh, Sebayang Sm, Burhan A, Suhendro. Gambaran Kejadian Shivering Post Spinal Anestesi Pada Pasien Benign Prostatic Hyperplasia Di Rumah Sakit Umum Daerah Cilacap. 2024 May 10 [Cited 2024 Aug 22]; Available From: Https://Zenodo.Org/Doi/10.5281/Zenodo.11173343
21. Ayu Kartika Sari V, Suandika M, Burhan A, Tri Yudono D. Overview Of Induction Drug Dosage Types With The Eracs (Enhanced Recovery After Caesarean Surgery) Sectio Caesarean Method In Post Sectio Caesarean Patients At Hermina General. Java Nurs J. 2024 Jun 21;2(2):110–5.
22. Dewi Nkaps. Gambaran Tekanan Darah Intra Operasi Pada Pembedahan Orthopedi Dengan General Anestesi. Modul Biokimia Materi Metabolisme Lemak, Daur Asam Sitrat, Fosforilasi Oksidatif Dan Jalur Pentosa Fosfat. 2021.
23. Ayu Dm. Hubungan Ketinggian Block Spinal Anestesi Dengan Kejadian Hipotensi Intra Operatif Di Ibs Rsd Mangusada. 2020;15–7.
24. Angin Sep, Novitasari D, Burhan A. Volume 6 Number 1, Februari 2024 E-Issn 2715-1972; P-Issn 2714-9749 Http://Jurnal.Globalhealthsciencegroup.Com/Index.Php/Ijghr. 2024;6(1).
25. Afrilya To, Sukmaningtyas W, Burhan A. Overview Of Post-Operative Nausea And Vomiting (Ponv) In Patients Undergoing Caesarean Section With Spinal Anesthesia At Fatimah Islamic Hospital Cilacap. 2023;16.
26. Kurniadita A, Donsu Jd Tine, Induniasih. Corelations The Height Of The Block With Hemodynamic Intra Spinal Anesthesia In The Pku Muhammadiyah Yogyakarta Hospital. Anaesth Nurs J. 2022;1(January):24–31.
27. Zulfakhrizal, Sumarni T, Haniyah S. Hubungan Usia Dengan Kejadian Hipotensi Pada Pasien Pasca Spinal Anestesi Di Kamar Operasi Rumah Sakit Umum Tgk. Chik Ditiro Sigli Kabupaten Pidie Aceh. Viva Med. 2023;12:1–19.
28. Rustini R, Fuadi I, Surahman E. Insidensi Dan Faktor Risiko Hipotensi Pada Pasien Yang Menjalani Seksio Sesarea Dengan Anestesi Spinal Di Rumah Sakit Dr. Hasan Sadikin Bandung. J Anestesi Perioper. 2018;000(99):479–86.
29. Okanlawon Tf, Eyelade Or, Adebiyi Aa. Relationship Between Heart Rate Variability And Hypotension With Bradyacardia Following Spinal Anaesthesia In Patients Undergoing Elective Surgery. Ann Ib Postgrad Med. 2022;20(2):120–8.
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