Anestesi pada Obstetri

Ardi Pramono
Kegawatan Termasuk
apa yg bisa orang sakit
muncul ? kah aku?

Hmm..biar
melahirkan tdk
nyeri, coba saya
sarankan LEA. Sy
hrs jelaskan
komplikasinya
 Physiological changes

Vol. (40-50%), dilutional

anemia (hmt 31.9-
36.5%). CO (30-50%),
decreased SVR (35%), minute vent.(50%),
HR (15-20 bpm) decreased. FRC
(20%), airway
edema, dec
PaCO2 and PaO2

Gastrointestinal:
prolonged emptying,
dec. lower
esophageal spinc.
Tone
 Stage of Labor
pain is
carried by
visceral aff.
fibers (T10-
L1)

Pain from stretching birth canal,

vulva, perineum (S2-S4)
Many changes in Pregnancy
 Fetal heart monitoring
“Be Careful for Fetal Distress”

Beat: Normal
110-160
bpm

Caused by umbilical cord

compression
Aortocaval compression syndrome
Caused by
impaired
Symptoms: nausea,
venous
vomiting, hypotension,
return
tachycardia, sweating

Prevented by laterally position

Medication during labor

Vasopressors:
ephedrin,
phenylephrine

Oxytocin

Tocolytics:
terbutalin
MgSO4
Anestesi pada persalinan

Meperidin
Fentanyl
Lumbal epidural
blockade
Spinal anestesia
(saddle block)
Intratecal opioid
 Other Methode

Combined spinal and epidural labor

Paracervical block  at fornix of vagina
Pudendal block
General anesthesia (rare)
Ibu hamil perlu ketenangan menghadapi pemberian analgesi epidural
Salah satu posisi pemberian analgesi lumbal
 Anesthesia for cesarean

General anesthesia
Regional anesthesia (spinal or epidural)
 Anesthesia for curretage
Case:
Ab. Inkompletus
Molla hidatidosa
Blighted ovum
PUD (perdarahan uterus disfungsional)
Prinsip: Sedasi dan anlegetik ketamin,
petidin, midazolam
Ibu hamil memerlukan ketenangan seperti air yang jernih
 Alhamdulillah..

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