STUDI KASUS SHIVERING POST SPINAL ANESTHESIA PADA PASIEN POST SECTIO SECARIA

Abstract

ABSTRACT

Background: Shivering is a thermoregulatory response that may occur after spinal anesthesia and requires systematic clinical assessment and monitoring. Objective: This study aimed to describe the onset, severity, clinical condition, management, and progression of shivering in a patient after sectio caesarea under spinal anesthesia. Methods: A descriptive case study was conducted involving one 32-year-old woman who developed shivering after sectio caesarea under spinal anesthesia at Ajibarang Regional Hospital. Data were obtained from clinical observation, nursing documentation, and medical records. Shivering severity was assessed using the Wrench Shivering Scale, while body temperature, blood pressure, pulse rate, and respiratory rate were monitored at onset, 10 minutes, and 20 minutes after management. Results: Shivering was identified approximately 15 minutes after spinal anesthesia with a severity grade of 4. Management included administration of 500 mL of warmed intravenous fluid, use of a warming blanket, and adjustment of room temperature. During observation, the shivering grade changed from 4 to 2 at 10 minutes and to 0 at 20 minutes, accompanied by an increase in body temperature from 35.2°C to 36.5°C and changes in vital signs. Conclusion: This case describes the clinical progression of shivering after spinal anesthesia and highlights the importance of systematic assessment, management, and clinical monitoring.

ABSTRAK

Background: Shivering merupakan respons termoregulasi yang dapat muncul pada pasien setelah anestesi spinal dan memerlukan pengkajian serta pemantauan kondisi klinis secara sistematis. Objective: Studi ini bertujuan mendeskripsikan onset, tingkat keparahan, kondisi klinis, penatalaksanaan, dan perkembangan shivering pada pasien pasca sectio caesarea dengan anestesi spinal. Methods: Penelitian menggunakan studi kasus deskriptif pada satu pasien perempuan berusia 32 tahun yang mengalami shivering setelah tindakan sectio caesarea dengan anestesi spinal di RSUD Ajibarang. Data diperoleh melalui observasi klinis, dokumentasi keperawatan, dan rekam medis. Derajat shivering dinilai menggunakan Wrench Shivering Scale, sedangkan suhu tubuh, tekanan darah, frekuensi nadi, dan frekuensi napas dipantau pada saat onset, 10 menit, dan 20 menit setelah penatalaksanaan. Results: Shivering teridentifikasi sekitar 15 menit setelah anestesi spinal dengan derajat 4. Penatalaksanaan berupa pemberian cairan intravena hangat 500 mL, penggunaan selimut penghangat, dan penyesuaian suhu ruangan. Selama observasi, derajat shivering berubah dari 4 menjadi 2 pada menit ke-10 dan menjadi 0 pada menit ke-20, disertai peningkatan suhu tubuh dari 35,2°C menjadi 36,5°C serta perubahan tanda vital. Conclusion: Kasus ini menggambarkan perkembangan klinis shivering setelah anestesi spinal dan pentingnya pengkajian, penatalaksanaan, serta pemantauan secara sistematis.