Pengaruh Posisi Head Up 30o Terhadap Post Operative Nausea and Vomiting Pada Pasien Post Spinal Anestesi di Recovery Room RSUD Mardi Waluyo Blitar

Bahrudin; Taufan Arif; Maria Diah Ciptaningtyas; Nurul Hidayah

doi:10.30651/jkm.v10i4.27996

Authors

Bahrudin Poltekkes Kemenkes Malang
Taufan Arif Program Studi Sarjana Terapan Keperawatan, Politeknik Kesehatan Kemenkes Malang
Maria Diah Ciptaningtyas Program Studi Sarjana Terapan Keperawatan, Politeknik Kesehatan Kemenkes Malang
Nurul Hidayah Poltekkes Kemenkes Malang, Kota Malang, Indonesia

DOI:

https://doi.org/10.30651/jkm.v10i4.27996

Keywords:

spinal anestesi, head up 30 derajat, post-operative nausea and vomiting

Abstract

Objective: Postoperative Nausea and Vomiting (PONV) is a common complication in patients undergoing spinal anesthesia. One of the interventions to reduce PONV is the application of a 30° head-up position, while maintaining patients in the supine position after spinal anesthesia may lead to high spinal block. The head-up position utilizes gravity to suppress the gastroesophageal reflex that triggers PONV. This study aims to analyze the effect of a 30° head-up position on the reduction of PONV.

Methods: The study employed a quasi-experimental design with a two-group pretest–posttest control group approach. The sample was obtained using a non-probability purposive sampling technique, involving 32 respondents divided into three groups. The inclusion criteria were postoperative spinal anesthesia patients experiencing moderate to severe PONV. The independent variable in this study was the 30° head-up position, while the dependent variable was the level of PONV. Data were collected using the RINVR observation sheet and analyzed with a paired-sample t-test. Ethical approval for this study was obtained from Mardi Waluyo General Hospital, Blitar.

Results: The results of the paired t-test showed a decrease in the mean PONV scores between the pretest and posttest in the control group, from 3.55 to 1.88. In the 30° head-up intervention group, the mean PONV scores decreased from 6.13 to 1.25 between the pretest and posttest.

Conclusion: The paired t-test analysis revealed that both groups demonstrated a significant difference between pretest and posttest PONV scores. The control group showed a reduction in mean PONV scores from 3.55 to 1.88, while the 30° head-up intervention group demonstrated a greater reduction, from 6.13 to 1.25. Both groups obtained a Sig. (2-tailed) value of 0.000 (p < 0.05), indicating a statistically significant effect of the intervention. Accordingly, the research hypothesis (H1) was accepted.

References

Abdulquadri et al. (2022). Spinal Anesthesia. NCBI Bookshelf. A Service of the National Library of Medicine, National Institutes of Health, 2.

Arif, T., Ciptaningtyas, M. D., Mudviyanti, N. N., & Solikhah, F. K. (2024). Reduction of Postoperative Nausea and Vomiting Induced by Spinal Anesthesia: Peppermint and Lavender Aromatherapies as Complementary Therapies. Folia Medica Indonesiana, 60(4), 281–287.

Asriani, N. S., Yuswanto, T. J. A. A., & Arif, T. (2023). Aromaterapi Jahe Efektif menurunkan Post Operative Nausea and Vomiting pada Pasien Post General Anestesi di RSUD Kanjuruhan. Jurnal Penelitian Kesehatan" SUARA FORIKES"(Journal of Health Research" Forikes Voice"), 14(4), 694–699.

Bisri et al. (2022). Abdul. Jurnal Neuroanestesia Indonesia.

Cing, M. T. G. C., Hardiyani, T., & Hardini, D. S. (2022). Faktor Yang Mempengaruhi Kejadian Mual Muntah Post Operasi. Poltekita : Jurnal Ilmu Kesehatan, 16(1), 16–21. https://doi.org/10.33860/jik.v16i1.537

Dixit, A., Chauhan, S., Sumita Bhargava, D. A. B., & Jibhakate, R. (2021). Scholars Journal of Medical Case Reports ISSN 2347-6559 (Online). ©Scholars Academic and Scientific Publishers (SAS Publishers) (An International Publisher for Academic and Scientific Resources), 4. https://doi.org/DOI: 10.36347/sjmcr.2017.v05i03.023

Dwiputra, A. G. (2023). Komplikasi Pasca Anestesia Spinal: Apa saja yang harus kita waspadai? Majalah Anestesia & Critical Care, 41(1), 1–3. https://doi.org/10.55497/majanestcricar.v41i1.316

Fransisca et,al. (2023). Beban Kerja Perawat dan Kepatuhan Pelaksanaan Surgical Safety Checklist di Rumah Sakit. Jurnal Penelitian Kesehatan Suara Forikes, Volume 14 Nomor Khusus, 3. https://doi.org/DOI: http://dx.doi.org/10.33846/sf14nk202

Hayati, F. K. (2019). Pengaruh Pemberian Aromaterapi Peppermint terhadap Nausea pada Pasien Post Operasi Sectio Caesarea dengan Anestesi Spinal.

Karnina. (2021). Hubungan Usia, Jenis Kelamin, Lama Operasi dan Status ASA dengan Kejadian PONV pada Pasien Pasca Operasi Laparatomi Bedah Digestif. Health and Medical Journal, 4(1), 16–22. https://doi.org/10.33854/heme.v4i1.867

Lee, M. H., Kim, E. M., Bae, J. H., Park, S. H., Chung, M. H., Choi, Y. R., & Choi, E. M. (2020). Head Elevation in Spinal-Epidural Anesthesia Provides Improved Hemodynamics and Appropriate Sensory Block Height at Caesarean Section. Yonsei Medical Journal, 56(4), 1122. https://doi.org/10.3349/ymj.2015.56.4.1122

Lekatompessy, P. G., Devi, C. I. A., Siahaya, P. G., & Hataul, I. I. (2022). FAKTOR RISIKO DENGAN ANGKA KEJADIAN POST OPERATIVE NAUSEA AND VOMITING PADA PASIEN YANG DILAKUKAN ANESTESI SPINAL DI RSUD DR. M. HAULUSSY AMBON DAN RS BHAYANGKARA AMBON TAHUN 2022. PAMERI: Pattimura Medical Review, 4(1), 8–16. https://doi.org/10.30598/pamerivol4issue1page8-16

Miller. (2019). MILLER’S ANESTHESIA (Vol. 2). Library of congress control. https://books.google.com/books?hl=id&lr=&id=cHK0DwAAQBAJ&oi=fnd&pg=PP1&dq=Miller%27s+Anesthesia&ots=vSOl125jyw&sig=aAHna-gXyvQMemwyXGcWusSnyyE

Pertami, S. B., Sulastyawati, S., & Anami, P. (2017). EFFECT OF 30° HEAD-UP POSITION ON INTRACRANIAL PRESSURE CHANGE IN PATIENTS WITH HEAD INJURY IN SURGICAL WARD OF GENERAL HOSPITAL OF Dr. R. SOEDARSONO PASURUAN. Public Health of Indonesia, 3(3), 89–95. https://doi.org/10.36685/phi.v3i3.131

Pierre, S., & Whelan, R. (2013). Nausea and vomiting after surgery. Critical Care, 13(1).

Saputra, L. O. A., Hafid, Muh. A., & Jamaluddin, A. (2024). Intervensi Head Up 15-30 Derajat Terhadap Perfusi Serebral Pasien Traumatic Brain Injury: Studi Kasus. Alauddin Scientific Journal of Nursing, 5(1), 8–14. https://doi.org/10.24252/asjn.v5i1.44451

Stoops, S., & Kovac, A. (2020). New insights into the pathophysiology and risk factors for PONV. Best Practice & Research Clinical Anaesthesiology, 34(4), 667–679.

Suhartomo, Punawan, & Iwan. (2024). Perlakuan posisi elevasi kepala dalam upaya membuka jalan napas: A systematic literature review. Holistik Jurnal Kesehatan, 18(1), 10–17. https://doi.org/10.33024/hjk.v18i1.221

Wahyuda, I., & Pujiastuti, R. S. E. (2023). Implementasi Komplementer Sujok Terhadap Tekanan Darah, Nadi, Respirasi, Dan PONV Pada Pasien Pasca Bedah Dengan Spinal Anestesi. 6(1).

Wulandari, I. S., Megasari, A. L., Cahyanto, E. B., Mulyani, S., & Musfiroh, M. (2024). OPTIMALISASI KEPATUHAN PUASA PRA OPERASI MELALUI ASPIRATION SIMULATION DEVICES DALAM UPAYA PENCEGAHAN RESIKO ASPIRASI OPERATIVE. JMM (Jurnal Masyarakat Mandiri), 8(5), 4571–4581.