Efetivitas Variasi Sudut Elevasi Tungkai terhadap Tekanan Darah dan Nadi Pasca Spinal Anestesi pada Pasien Sectio Caesarea
Keywords:
elevasi tungkai, hemodinamik, sectio caesarea, spinal anestesi, tekanan darahAbstract
Hipotensi merupakan komplikasi yang sering terjadi setelah spinal anestesi pada pasien sectio caesarea akibat blokade saraf simpatis yang menyebabkan penurunan aliran balik vena, curah jantung, dan tekanan darah. Elevasi tungkai merupakan salah satu intervensi nonfarmakologis yang berpotensi mempertahankan stabilitas hemodinamik melalui peningkatan aliran balik vena. Penelitian ini bertujuan menganalisis efektivitas variasi sudut elevasi tungkai terhadap tekanan darah dan frekuensi nadi pasca spinal anestesi pada pasien sectio caesarea. Penelitian menggunakan desain quasi eksperimental dengan rancangan pretest–posttest pada tiga kelompok perlakuan, yaitu elevasi tungkai 20°, 30°, dan 45°. Populasi penelitian berjumlah 95 pasien, dengan sampel sebanyak 45 responden yang dipilih menggunakan consecutive sampling dan dibagi menjadi tiga kelompok masing-masing 15 responden. Pengukuran tekanan darah dan frekuensi nadi dilakukan sebelum spinal anestesi dan 15 menit setelah pemberian intervensi. Data dianalisis menggunakan uji normalitas, homogenitas, one-way analysis of variance, dan uji lanjut Tukey. Hasil penelitian menunjukkan terdapat perbedaan yang bermakna pada perubahan tekanan darah sistolik, tekanan darah diastolik, tekanan arteri rata-rata, dan frekuensi nadi antar kelompok perlakuan (p<0,05). Elevasi tungkai 45° menghasilkan perubahan hemodinamik terbesar dibandingkan elevasi 20° dan 30°. Variasi sudut elevasi tungkai efektif meningkatkan stabilitas hemodinamik pasca spinal anestesi pada pasien sectio caesarea, dengan sudut 45° menunjukkan hasil paling optimal. Elevasi tungkai 45° dapat dipertimbangkan sebagai intervensi nonfarmakologis sederhana untuk membantu mencegah hipotensi pasca spinal anestesi.
References
Anesth, J., Crit, A., Herbosa, G. A. B., Tho, N. N., Gapay, A. A., & Lorsomradee, S. (2022). Consensus on the Southeast Asian management of hypotension using vasopressors and adjunct modalities during cesarean section under spinal anesthesia. Journal of Anesthesia, Analgesia and Critical Care, 1–16. https://doi.org/10.1186/s44158-022-00084-1
Bhat, A. D., Singh, P. M., & Palanisamy, A. (2024). Neuraxial anaesthesia-induced hypotension during Caesarean section. BJA Education, 24(4), 113–120. https://doi.org/10.1016/j.bjae.2024.01.003
Butterworth, J., Mackey, D., & Wasnick, J. (2022). Morgan and Mikhail’s Clinical Anesthesiology, 7th Edition (7th ed.). McGraw Hill LLC.
Chestnut, D. H., Wong, C. A., Tsen, L. C., Ngan Kee, W. D., Beilin, Y., Mhyre, J. M., & Bateman, B. T. (2020). Obstetric Anesthesia Principles and Practice (6 ed.). London: Elsevier Health Sciences.
Cunningham, F. G., Leveno, K. J., Bloom, S. L., Dashe, J. S., Hoffman, B. L., Casey, B. M., & Spong, C. Y. (2018). Williams Obstetrics (25 ed.; A. Moyer & R. Y. Brown, Ed.). New York: McGraw-Hill.
Daniel DeMers, D. W. (2023). Physiology, Mean Arterial Pressure. In National Library of Medicine. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK53 8226
Desta, A. B., Alemu, B., Mossie, A., Abebe, M., Shiferaw, A., Girma, B., et al. (2023). Effectiveness of Leg-Elevation to Prevent Post-Spinal Hypotension in Elective Cesarean Section: A Systematic Literature Review of Randomized Controlled Trial. Open Access Surgery 2023(16), 61-68.
Girma, B., Ilala, T. T., Yilma, K. T., & Mohamed, K. (2023). Effectiveness of Leg-Elevation to Prevent Post-Spinal Hypotension in Elective Cesarean Section : A Systematic Literature Review of Randomized Controlled Trial. July.
Helmy, M. A., Naguib, N. N., Helmy, K. A., & Milad, L. M. (2025). The influence of thirty ‑ degree leg elevation on noradrenaline requirements administered as a prophylactic variable infusion during cesarean delivery , an open ‑ label randomized controlled trial.
Kumar, A., Kurdi, M., Harshitha, H., & Theerth, K. (2025). Comparison of Passive Leg Raising and Intravenous Phenylephrine as Prophylaxis in the Prevention of Hypotension After Spinal Anaesthesia in Elective Caesarean Section : A Randomized Controlled Trial. 17(3). https://doi.org/10.7759/cureus.80311
Mathew, M., Manah, Y. M., Ahuja, P., Shetty, A. R., & Taye, T. E. (n.d.). Managing spinal anesthesia-induced hypotension in cesarean section : emerging techniques and evidence-based strategies – a narrative review. 7338–7346.
Park, H., & Choi, W. (2024). Use of vasopressors to manage spinal anesthesia-induced hypotension during cesarean delivery. 85–93.
Patel, S., & Ninave, S. (2024). Postspinal Anesthesia Hypotension in Caesarean Delivery : A Narrative Review. 16(4). https://doi.org/10.7759/cureus.59232
Radhitya I.G.A.N and Pratama R.A. (2023). Preventing Hypotension Caused By Spinal Anesthesia In Non Preeclapmtic Pregnancies With Caesarean Section. 2(3), 190–200.
Silwal, S., Subedi, A., Bhattarai, B., & Ghimire, A. (2024). Association between preoperative shock index and hypotension after spinal anesthesia for non-elective cesarean section : a prospective cohort study. BMC Anesthesiology. https://doi.org/10.1186/s12871-024-02766-5
Zhang, J., Che, J., Sun, X., Li, Y., & Ren, W. (2025). Analysis of the risk difference in post-spinal anesthesia hypotension between primiparas and multiparas in cesarean section. June. https://doi.org/10.3389/fsurg.2025.1617342
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Ratih Kusuma Dewi, Anita Setyowati, Astika Nur Rohmah
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
