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Spinal anesthesia is one of the regional anesthesia methods that is often chosen in various surgical procedures, especially in the area of the lower extremities, pelvis, and lower abdomen. The most common complication encountered in this technique is the occurrence of hypotension, which can affect tissue perfusion and hemodynamic stability of the patient. This study aims to examine the incidence of hypotension in spinal anesthesia, including mechanisms, risk factors, and management. The method used in this study is literature review with a scientific source search process conducted through various databases PUBMED, Sciencedirect, Researchgate, and Google Scholar with a publication year range of 2016 to 2026. The results showed that hypotension arises as a consequence of an obstacle in the sympathetic nervous system, which provokes dilation of blood vessels as well as reduced venous return. Risk factors include age, body mass index, patient position, block height, duration of surgery, fluid status, Injection Point, and type of anesthetic drug used. Management is carried out by administering fluids, vasopressors, as well as strict hemodynamic monitoring. A good understanding of the risk factors and mechanisms of hypotension is expected to improve patient safety during spinal anesthesia..

Hypothermia is a common complication following spinal anesthesia, which can lead to more severe consequences if not detected and treated early. Early detection of hypothermia is essential for preventing additional complications, such as cardiovascular instability, delayed recovery, or prolonged hospitalization. This study aims to analyze the effectiveness of providing health education in improving the early detection of hypothermia among patients after spinal anesthesia at Gemolong Regional Hospital. The research utilized a quantitative approach, applying a pre-experimental one-group pre-test and post-test design to measure the impact of the intervention. A total of 15 patients who underwent spinal anesthesia were selected as respondents and were provided with health education on recognizing the signs, risks, prevention, and treatment of hypothermia. Health education sessions were conducted through interactive presentations and written materials, emphasizing practical knowledge that could be directly applied by healthcare staff and patients. The primary data collection tool involved pre-test and post-test assessments to measure the participants' understanding of hypothermia and its management. The results indicated a significant improvement in the patients' understanding of hypothermia after receiving the health education. The average score of the post-test was noticeably higher than the pre-test, suggesting that the education effectively increased awareness and preparedness for early detection of hypothermia. This finding emphasizes the importance of integrating health education programs into clinical practice, especially for patients undergoing spinal anesthesia, to enhance early detection and reduce the risks of complications related to hypothermia.

Hydronephrosis is a condition widening of one or second kidneys because of enhancement of the pressure kidney. Pressure increase consequence exists in blockage like the presence of stones in the ureters (ureterolithiasis). Treatment of stones in the ducts can done with surgery so that needs procedure anesthesia. One of the indications of spinal anesthesia is surgery urology. The patient a 45-year-old male, based on history, examination, and supporting patient was diagnosed with hydronephrosis dextra and during the ureteroscopy (URS) process a stone was found in the ureter of the dextra. Therefore, that done lithotripsy to break up stones. In this patient, it was Spinal anesthesia with Bupivacaine 0.5% 15 mg injected using spinal needle no. 25 G in the L3 - L4 region. During the operation, vital signs in the form of pressure are also monitored for blood, pulse, and oxygen saturation every 5 minutes efficiently and continuously, and administration of intravenous fluids in the form of Ringer's lactate. During the operation the patient's condition was stable. After the operation is complete, observation continues in the recovery room, where vital signs are monitored and assessed bromage scale.