Spinal anesthesia also called a subarachnoid block anesthesia techniques are quite popular, namely by inserting local anesthetic into the lumbar subarachnoid space to produce or cause the loss of activity of sensory and motor function blocks how to make methamphetamine (RA Stevens, 1996).
Spinal anesthesia is growing and expanding its use, considering the various how to make methamphetamine advantages offered them relatively cheaper price, small systemic effect, analgesia which adekwat and the ability to prevent the stress response is more perfect, (Marwoto et al, 1992).
Hypotension is one of the complications of acute spinal anesthesia is most often the case, (RR Gaiser, 1997: 216). Prospective study conducted on more than 1800 patients who received spinal anesthesia, 26% had complications, such as hypotension majority (16%), (Collin VJ, 1993). Carpenter et al study which found the incidence of hypotension gain of 33% (Carpenter how to make methamphetamine RL, 1992) and in the case of sectio caesarea hipotennsi incidence reached 80% (Bisri T, 1997).
Hypotension typically occurs in 15 to 20 minutes after the first injection of subarachnoid (Conception M, 1996), if not carried out preventive hypotension due to spinal anesthesia will cause symptoms associated with hipoksi network in the form of anxiety, dizziness, nausea, later if not addressed can lead to More severe effects are shock and even death (Colin VJ, 1993).
Hypotension after spinal anesthesia is pharmacological denervation caused by preganglionic sympathetic nerve which can cause vasodilation and reduction in systemic vascular resistance. There are three main mechanisms of hypotension after spinal anesthesia: Decrease backflow, venous vasodilation, and decreased cardiac output. Precautions and overcome hypotension due to spinal anesthesia is the use of intravenous fluids and vasopressor drugs (Rushman GB, 1999).
The purpose how to make methamphetamine of infusion fluid is to fill out and meet the vascular space, increasing the circulation volume and cardiac output so as to compensate for the reduction in systemic vascular resistance. Administration of crystalloid preload 10-15 ml / kg body weight is recommended as a way to prevent hypotension after spinal anesthesia (GE Morgan, 1992).
Various studies have reported that the preload of crystalloid alone failed to prevent the incidence of hypotension due to spinal anesthesia (GE Park, 1996). Jackson et al reported preload of crystalloid fluids failed how to make methamphetamine to prevent how to make methamphetamine the incidence of hypotension due to spinal anesthesia in sectio caesarea either get crystalloid 200 ml or 1000 ml who received crystalloid (Jackson R, 1995).
The second preload option is to use colloidal liquid as colloid infusion capable of filling how to make methamphetamine the vascular space longer and more effectively. how to make methamphetamine Several studies using colloidal among others Buggy et al reported 500 ml Hemaccel not reduce the incidence of hypotension and vasopressor requirement compared with crystalloid preload and without a preload (Buggy D, 1997). Sharma et al, reported that preload with 500 mL of colloid (Haes 6%) is more effective than in 1000 ml crystalloid (Ringer lactate) to prevent hypotension in spinal anesthesia on tubal ligation in women post partum, how to make methamphetamine but not all patients free of hypotension (SK Sharma , 1997)
Sectio caesarea is surgery to give birth to the fetus by opening the abdominal wall and the wall of the uterus or vagina or a hysterotomy how to make methamphetamine for delivery of a fetus from the uterus (Prawiroharjo, 2001).
Sectio caesarea is one indication of spinal anesthesia. The central surgical installation data (IBS) Hospital Woodward Palu, from year to year is always an increase in the use of regional anesthesia techniques. From the data obtained in Palu Woodward Hospital in 2007 was about 40% using the technique of regional anesthesia and regional anesthesia techniques among techniques how to make methamphetamine largest how to make methamphetamine spinal anesthesia, the year 2008 recorded a mother who had surgery sectio caesarea as many as 112 people, in 2009 as many as 121 people and in 2010 the month of January to May of 60 people, about 85% of spinal anesthesia. A condition that occurs when it is found sectio caesarea patients with spinal anesthesia hypotension, especially in 1 to 20 minutes first, and as a result of hypotension causes patients to feel uncomfortable, namely nausea, dizziness and headaches, because preload is provided only kritaloid 15 ml / kg (RS Woodward Palu, 2009).
Given these conditions as nurses need to provide comfort for patients is to maintain stable blood pressure during how to make methamphetamine spinal anesthesia. It is therefore important to know the effectiveness of intravenous fluids appropriate for the patient sectio caesarea during spinal anesthesia, the researchers are interested how to make methamphetamine in making research on: the effectiveness of intravenous fluids colloids than crystalloid for p