DAFTAR ISI

DAFTAR ISI ........................................................................................................ i

DAFTAR GAMBAR ............................................................................................ iv
DAFTAR TABEL ................................................................................................. v
DAFTAR SINGKATAN ...................................................................................... v
BAB 1 PENDAHULUAN ................................................................................... 1
1.1 LATAR BELAKANG ................................................................................. 1
1.2 RUMUSAN MASALAH ............................................................................. 5
1.3 HIPOTESA .................................................................................................. 5
1.4 TUJUAN PENELITIAN............................................................................. 5
1.4.1 TujuanUmum..................................................................................... 5
1.4.2 TujuanKhusus.................................................................................... 5
1.5 MANFAAT PENELITIAN.............................................................. 5
1.5.1 Manfaat dalam bidang akademik...................................................... 5
1.5.2 Manfaat dalam bidang penelitian...................................................... 5
1.5.3 Manfaat dalam bidang pelayanan masyarakat.................................. 6
BAB 2 TINJAUAN PUSTAKA......................................................................... 7

2.1 Anestesi Regional……………………………………………………… 7

2.2 Spinal Anestesi........................................................................................
2.2.1 Indikasi Spinal Anestesi ........................................................... 8
2.2.2 Kontra Indikasi Absolut .. ........................................................ 8
2.2.3 Kontra Indikasi Relatif ............................................................. 9
2.2.4 Anatomi…………………......................................................... 9
2.2.5 Teknik Spinal Anestesi……...................................................... 10
2.3 PAS (Post Anesthetic Shivering)..................................................... 10
2.3.1 Fisiologi..……........................................................................... 11
2.3.2 Patofisiologi…........................................................................... 13
2.3.3 Etiologi …………...................................................................... 14
2.3.4 Derajat Menggigil...................................................................... 15

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 2.3.5 Cara-cara Mengurangi Menggigil...................................................15
2.4 Ondansetron............................................................................................20
2.4.1 Struktur Kimia.................................................................................20
2.4.2 Farmakokinetik...............................................................................20
2.4.3 Mekanisme Kerja............................................................................21
2.4.4 Efek pada Berbagai Organ..............................................................21
2.4.5 Efek pada Kejadian Menggigil.......................................................22
2.5 Tramadol....................................................................................................22
2.5.1 Struktur Kimia.................................................................................22
2.5.2 Farmakokinetik...............................................................................24
2.5.3 Farmakodinamik.............................................................................24
2.5.4 Efek Samping Obat.........................................................................25
2.5.5 Interaksi Obat..................................................................................25
2.5.6 Tramadol Sebagai Anti Menggigil..................................................25
2.6 KerangkaTeori........................................................................................26
2.7 KerangkaKonsep.....................................................................................27

BAB 3 METODE PENELITIAN.............................................................................28

3.1 Desain Penelitian....................................................................................28
3.2 Tempat dan Waktu Penelitian..............................................................28
3.2.1 Tempat.........................................................................................28
3.2.2 Waktu...........................................................................................28
3.3 Populasidan Sampel Penelitian.............................................................28
3.3.1 Populasi.......................................................................................28
3.3.2 Subjek Penelitian.........................................................................28
3.4 Kriteria Inklusidan Eksklusi.................................................................29
3.4.1 Kriteria Inklusi...............................................................................29
3.4.2 Kriteria Eksklusi............................................................................29
3.4.3 Kriteria PutusUji (Drop Out).........................................................29
3.5 Besar Sampel..........................................................................................29
3.6 Informed Consent....................................................................................30
3.7 Alat, obat,an Cara Kerja........................................................................30

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 3.7.1 Alat..................................................................................................30
3.7.2 Obat.................................................................................................31
3.7.3Cara Kerja........................................................................................31
3.8 Identifikasi Variabel...............................................................................33
3.8.1 Variabel Bebas................................................................................33
3.8.2 VariabelTergantung........................................................................33
3.9 Rencana Manajemen dan Analisis Data.............................................33
3.10 Defenisi Operasional.............................................................................34
3.11 Masalah Etika........................................................................................35
3.12 Alur Penelitian.......................................................................................36

DAFTAR PUSTAKA................................................................................................37
LAMPIRAN...............................................................................................................42

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 Daftar Gambar

Gambar 2.1 Anatomi Vertebra.....................................................................................................9

Gambar 2.3 Fisiologi Termoregulasi..........................................................................................13

Gambar 2.4 Struktur Kimia Ondansetron...................................................................................13

Gambar 2.5 Struktur Molekul Tramadol....................................................................................23

Gambar 2.6 Kerangka Teori.......................................................................................................28

Gambar 2.7. Kerangka Konsep...................................................................................................29

Gambar 3.1. Alur Penelitian.......................................................................................................39

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 DAFTAR
SINGKATAN

BB : Berat Badan
BVM : Bag Valve Mask
CMRO2 : Cerebral Metabolic Rate Oxygen
CSF : Cerebro Spinal Fluid
EKG : Elektrokardiogram
FJ : Frekuensi Denyut Jantung
G : Gauge
GABA : Gamma Amino Butyric Acid
i.m : intra muscular
i.v : intra vena
Kg : kilogram
KgBB : Kilogram Berat Badan
L : Liter
MAO : Mono aminoksidase
Mg : milligram
Mg : milligram
Ml : milliliter
mmHg : millimeter air raksa
NaCl : Natrium Chlorida
NMDA : N-Methyl-D-Aspartate
PAS : Post Anesthetic Shivering
PONV : Post Operastive Nausea and Vomitting
PS ASA : Physical Status American Society of Anesthesiologist
PSH : Post Spinal Headache
TDD : Tekanan Darah Diastolik
TDS : Tekanan Darah Sistolik
Th : Thorakal