Comparison Of Variations Of Low Dosage Spinal Anesthesia On Mobilization Speed After Caesarea Sectio Eracs Method At Hermina General Hospital Purwokerto

Zazza Syahira, Refni Riyanto, Susiyadi Susiyadi, Muhammad Saifulhaq Maududi



Enhanced Recovery After Caesarian Surgery (ERACS) is the development of sectio caesarean delivery techniques that offer preoperative, intraoperative, and postoperative care to hasten patient recovery. The ERACS technique is related to using low-dose spinal anesthesia, which is using a bupivacaine dose of 3.75–12 mg. The use of low doses in sectio caesarean can help the speed of patient mobilization, which can be measured by achieving a Bromage score. The study aims to compare the effectiveness of giving low-dose spinal anesthesia type bupivacaine 6 mg compared to bupivacaine 7.5 mg on the post-sectio caesarea mobilization speed of the ERACS (Enhanced Recovery After Caesarian Surgery) method at Hermina General Hospital Purwokerto. This type of research is observational and analytical with a cross-sectional study approach. The sampling technique used was consecutive sampling, so a study sample of 58 respondents was obtained, which was divided into two groups, namely the bupivacaine dose group of 6 mg and the bupivacaine dose group of 7.5 mg. Results were analyzed using the Mann-Whitney test. The results of statistical tests showed that the bupivacaine group at a dose of 6 mg and the bupivacaine group at a dose of 7.5 mg (p = 0.534) did not have a significant difference in effectiveness against the onset of post-sectio caesarean mobilization speed of the ERACS method (P > 0.05). This study concludes that there is no difference between the comparison of the effectiveness of administering low-dose spinal anesthesia type bupivacaine 6 mg compared to bupivacaine 7.5 mg on the speed of mobilization after caesarean section using the ERACS (Enhanced Recovery After Caesarian Surgery) method at Hermina General Hospital Purwokerto. The maximum time achieved for the onset of mobilization after ERACS to achieve a bromage score is in the range of 1 – 2 hours (60 – 120 minutes) with the level of mobilization after caesarean section being a score of 1 and a score of 0. 



Low-dose spinal anesthesia; ERACS caesarean section; Mobilization onset; Bromage score.


  1. Białowolska, K., Horosz, B., Sękowska, A., Malec-Milewska, M., 2020. Fixed dose versus height-adjusted conventional dose of intrathecal hyperbaric bupivacaine for caesarean delivery: A prospective, double-blinded randomized trial. J. Clin. Med. 9, 1–10.
  2. Bizuayew, H., Abebe, H., Mullu, G., Bewuket, L., Tsega, D., Alemye, T., 2021. Post-cesarean section surgical site infection and associated factors in East Gojjam zone primary hospitals, Amhara region, North West Ethiopia, 2020. PLoS One 16, 1–15.
  3. Depkes RI. 2016. Peraturan Menteri Kesehatan Nomor 25 tahun 2016 tentang Rencana Aksi Nasional Kesehatan Lanjut Usia Tahun 2016-2019. Jakarta : Kementrian Kesehatan RI.
  4. Ferrarezi, W.P.P., Braga, A. de F. de A., Ferreira, V.B., Mendes, S.Q., Brandão, M.J.N., Braga, F.S. da S., Carvalho, V.H., 2021. Spinal anesthesia for elective cesarean section. Bupivacaine associated with different doses of fentanyl: randomized clinical trial. Brazilian J. Anesthesiol. (English Ed. 71, 642–648.
  5. Fitria, W.E., Fatonah, S., Purwati, P., 2019. Faktor Yang Berhubungan Dengan Bromage Score Pada Pasien Spinal Anastesi Di Ruang Pemulihan. J. Ilm. Keperawatan Sai Betik 14, 182.
  6. Huang, Q., Wen, G., Hai, C., Zheng, Z., Li, Y., Huang, Z., Huang, B., 2022. A Height-Based Dosing Algorithm of Bupivacaine in Spinal Anesthesia for Decreasing Maternal Hypotension in Cesarean Section Without Prophylactic Fluid Preloading and Vasopressors: A Randomized-Controlled Non-Inferiority Trial. Front. Med. 9, 1–10.
  7. Indradata, F., Dwi Purnomo, H., Thamrin, M.H., Budi Santoso, S., Tri Arianto, A., Supraptomo, R., 2021. Perbandingan Efektivitas Anestesi Spinal dengan Bupivacain 12,5 Mg dan Bupivacain 5 Mg yang ditambah Fentanyl 50 Mcg pada Seksio Sesarea. J. Anestesi Obstet. Indones. 4, 11–7.
  8. Kayir, S., Kisa, A., 2021. The evolution of the regional anesthesia: A holistic investigation of global outputs with bibliometric analysis between 1980-2019. Korean J. Pain 34, 82–93.
  9. Nadiya, S., Mutiara, C., 2018. Hubungan Mobilisasi Dini Post Sectio Caesarea (SC) dengan Penyembuhan Luka Operasi di Ruang Kebidanan RSUD dr. Fauziah Kecamatan Kota Juang Kabupaten Bireuen. J. Healthc. Technol. Med. 4, 187.
  10. Ningsih, N.J. setia, Rahmadhani, W., 2022. the Role of Early Mobilization on Wound Healing After Sectio Caesarea. J. Sex. Reprod. Heal. Sci. 1, 7.
  11. Ratnasari, F., 2022. Pengaruh Sectio Caesarea Metode Eracs Terhadap Percepatan Mobilisasi pada Ibu Bersalin di RS Hermina Daan Mogot Tahun 2022 2, 821–829.
  12. Razan, A., Wijianto, W., 2021. The effectiveness of mobilization in improving mother’s functional status after caesarean section delivery. Acad. Physiother. Conf. Proceeding 542–546.
  13. Sulistyawan, V., Isngadi, I., Laksono, R.M., 2020. Perbandingan Outcome Teknik Spinal Anestesi Dosis Rendah Dibandingkan Dosis Biasa pada Sectio Caesarea Darurat di Rumah Sakit dr. Saiful Anwar. J. Anaesth. Pain 1, 37–44.
  14. Supriyatin, T., Siwi, A. sekar, Rahmawati, A.N., 2022. Pencapaian Bromage dan Aldrete Score pada Tindakan Anestesi di Instalasi Bedah Sentral (IBS) RSUD Ajibarang.
  15. Tika, T.T., Sidharti, L., Himayani, R., Rahmayani, F., 2022. Metode ERACS Sebagai Program Perioperatif Pasien Operasi Caesar. J. Med. Hutama 03, 2386–2391.
  16. Wang, H.Z., Chen, H.W., Fan, Y.T., Jing, Y.L., Song, X.R., She, Y.J., 2018. Relationship between body mass index and spread of spinal anesthesia in pregnant women: A randomized controlled trial. Med. Sci. Monit. 24, 6144–6150.

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DOI: 10.30595/hmj.v6i2.19276


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