Erfan Efendi
Department of Biochemistry, Faculty of Medicine, University of Jember, Jember, Indonesia

Muhamad Hasan
Departement of Anatomy, Faculty of Medicine, University of Jember, Jember, Indonesia

DOI: https://doi.org/10.19184/ams.v10i2.45478

Abstract

Enhanced recovery after cesarean surgery (ERACS) is a surgical method supporting the mother's recovery process more quickly. In the ERACS method, multidrug anesthesia is used, namely bupivacaine at a low dose (<10 mg) combined with fentanyl and morphine to maintain the quality of anesthesia so that the mother can mobilize more quickly with minimal pain and reduce the duration of hospitalization. This study used an observational analytical design with a cross-sectional approach which was conducted in September-November 2023 at the Bina Sehat Jember Hospital. The research sample was determined using a purposive sampling technique. Data obtained from 100 medical records were analyzed using the Mann-Whitney test with a confidence level of 95%. The average post-operative mobilization ability for the ERACS method was 10.10 hours, while for the conventional method 14.76 hours and the duration of postoperative hospitalization for the ERACS method was 2.22 days, while for the conventional method 2.98 days. The statistical test results showed a significance value for both variables of 0.000 (p<0.05), which meant there was a significant difference between the speed of walking mobilization and the duration of hospitalization between the ERACS and conventional methods. In conclusion, the ERACS method accelerates mobilization and duration of hospitalization after surgery compared to conventional method.

Keyword: ERACS, cesarean section, mobilization, hospitalization.

REFERENCE

1. Amiman, R. C., Tumboimbela, M. J., & Kembuan, M. A. H. N. (2016). Gambaran length of stay pada pasien stroke rawat inap di RSUP Prof. Dr. R. D. Kandou Manado periode Juli 2015-Juni 2016. E-CliniC, 4(2). https://doi.org/10.35790/ecl.4.2.2016.14500

2. Cunningham, F., Leveno K. J., Bloom, S. L., Dhase, J. S., Hoffman, B. L., Casey, B. M, & Spong C. Y. (2018). William Obstetrics. 25th edition. Texas: McGraw-Hill Education, 2513–2522. https://snhrp.unipasby.ac.id/prosiding/index.php/snhrp/article/view/833

3. Dinkes. (2018). Profil Kesehatan Jawa Timur Tahun 2017. Dinas Kesehatan Provinsi Jawa Timur, 100. https://dinkes.jatimprov.go.id/userfile/dokumen/PROFIL KESEHATAN JATIM 2022.pdf 

4. Fajriyah, S., Farida, U., Agustina, S., Astuti, L. W., & Widyaningrum, E. A. (2023). The Use of Prophylactic Antibiotics for Cesarean Section Delivery and The Incident of Surgical Site Infection. Indonesian Journal of Pharmaceutical Education, 3(2), 247–255. https://doi.org/10.37311/ijpe.v3i2.19864

5. Ferrarezi, W. P. P., Braga, Angelica, Ferreira, V. B., Mendes, S. Q., Brandão, M. J. N., Braga, Sarmento, F. & Carvalho, V. H. (2021). Spinal anesthesia for elective cesarean section. Bupivacaine associated with different doses of fentanyl: randomized clinical trial. Brazilian Journal of Anesthesiology (English Edition), 71(6), 642–648. https://doi.org/10.1016/j.bjane.2021.03.030

6. Fonseca, N. M., Guimarães, G. M. N., Pontes, J. P. J., Torres, L. M., & Ricardo. (2023). Safety and effectiveness of adding fentanyl or sufentanil to spinal anesthesia: systematic review and meta-analysis of randomized controlled trials. Brazilian Journal of Anesthesiology (English Edition), 73(2), 198–216. https://doi.org/10.1016/j.bjane.2021.10.010 

7. Hartono, R., & Husodo, D. P. (2018). Anestesi Spinal Dosis Rendah Untuk Pasien Operasi Sesar dengan Stenosis Mitral Berat Low Dose Spinal Anesthesia For Caessarian Section Delivery in Patient with Severe Mitral Stenosis. Jurnal Anestesiologi Indonesia, 10(3), 163–174.