The Difference Duration between Analgesia Bupivacaine Hyperbaric Morphine and Bupivacaine Hyperbaric Epinephrine Intrathecal toward Post Surgery of Sectio Caesaria Patient in Bhayangkara Mataram Hospital

Keywords: Spinal anesthesia, bupivacaine, duration of analgesia, morphine, epinephrine


Background and Objectives: The most used of regional anesthesia technic is spinal anesthesia. Spinal anesthesia is an easier technic to get the depth and speed of nerve blockade. Some medicine can be used as an adjuvant of local anesthesia to increase the effect of analgesia bupivacaine. This research is aimed to compare the effectiveness of administration of 0.1 mg intrathecal morphine and 0.1 mg intrathecal epinephrine to prolong 0.5% 12.5 mg hyperbaric analgesia bupivacaine toward caesarean section postoperative period.
Method: This research is an experimental clinical trial randomized double-blind phase II. Subject of this study is the elective surgery patients (ASA I and II) with spinal anesthesia who are 18–40 years old and having weight around 50–70 kgs. There are 48 patients that is divided into 2 groups; 24 patients of group M (morphine 0.1 mg) and 24 patients of group E (epinephrine 0.1 mg).
Result: The result of this study revealed the duration of analgesia is longer in group M (morphine 0.1 mg) than group T (tramadol 25 mg) (309.08±5.55 vs 221.66±6.43).
Conclusion: adjuvant of 0.1 mg morphine and 0.5% 12.5 mg intrathecal hyperbaric bupivacaine can make the work period of analgesia longer while post caesaria section surgery rather than 0.5% 12.5 mg bupivacaine and 0.1 intrathecal epinephrine.


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Ciani SD, Rossi M, Casati A, Cocco C, Fanelli G. 2008. Spinal Anasthesia: an everygreen technique. Acta Biomed. 9:9–17

Duke J. 2006. Spinal Anasthesia. Anasthesia Secrets. Edisi ke 3. Philadelphia: Mosby-Elsevier

Bauman J. 2005. Pain Management. Dipiro, et al. Pharmacotherapy: A Pathophysiology Approach, 6th ed. McGraw Hill: New York, pp. 1089–95.

Masaaki, M., Yasutsugu, Y., Tetsuro, H., et al. 2010. Postoperative pain relief of lower extremity fractures: efficacy of intrathecal morphine administration. Nagoya J. Med Sci; 72:145–150

Gehling, M and Tryba, M. 2009. Risks and Side Effects of Intratechal Morphine Combined with Spinal Anaesthesia: A Meta-Analysis.

Rattan. 2014. The Decline of a Once-Important Non-Timber Forest Product in Indonesia. Research Gate.

Gewirtz, David A. 1999. A Critical Evaluation of The Mechanisms of Action Proposed for The Antitumor Effects of The Anthracycline Antibiotics Adriamycin and Daunorubicin. Elsevier.

Rostami, Zeinab et. al. 2012. Dose Interest Predicts Academic Burnout? Interdisciplinary Journal of Contemporary Research Business.

Toru Goyagi, MD, and Toshiaki Nishikawa, MD. 1995. The Addition of Epinephrine Enhaces Postoperatif Analgesia by Intrathecal Morphine.

Bisri, T et. al. 1997. Edisi 2. Bandung Bagian Anestesi dan Perawatan Intensif FK Unpad.

Katzung BG. Basic & Clinical Pharmakology. Terjemahan: Sjabana D, Isbandiati E, Basori A.Ed 8. Jakarta: Penerbit Salemba Medika; 2002: 170–1.

Molnar, Rowan. Spinal, Epidural and Caudal Anaesthesia. In: Clinical Anaesthesia Procedures of The Massachusetts General Hospital. 4th ed. Boston: Little Brown & Co. 1999: 206–25

Rushman GB, Davies NJH, Cashman JN. Lee’s synopsis of anaesthesia. 12th ed. Oxford: Butterworth-Heinemann. 1999: 547 – 49

Tuominen M. Bupivacaine spinal anesthesia. Acta anaesthesiology Scand 2005. 35: 1–10

Jeffery et. al. 2013. Roux-en-Y Bypass Vs Intensive Medical Management for the Control of Type 2 Diabetes, Hypertension, and Hyperlipidemia: The Diabetes Surgery Study. Scholar.

Mansjoer A, Suprohaita, Wardahani WI, Setiowulan W. Anestesi spinal. Dalam: Kapita selekta kedokteran. Ed 3. Jakarta: Penerbit Media Aesculapius Fakultas Kedokteran Universitas Indonesia. 2000: 261–6

Morgan GE, Mikhail MS. Regional Anasthesia & Pain Management. In: Clinical Anasthesiolgy. 2nd ed. New york: Pretince Hall International Inc. 2002. 266–7.

Shelvey, M., 2005. Cultural Healing. University of Manitoba, Faculty of Architecture.

DepKes, R.I., 1979. Farmakope Indonesia. Edisi, 3(7), p.265.

Ian Tanu. 2009. Farmakologi dan Terapi. Edisi 5. Jakarta: Balai Penerbit FKUI

L. F. R. Falcao, M. V. Perez, I. de Castro, A. M. Yamashita, M. A. Tardelli and J. L. G. Amaral. 2012. Minimum effective volume of 0.5% bupivacaine with epinephrine in ultrasound-guided interscalene brachial plexus block.

R. Fournier, E. Van Gessel, A. Weber and Z. Gamulin. 2002. Epinephrine and clonidine do not improve intrathecal sufentanil analgesia after total hip replacement.

Sherwood, Lauralee. 2011. Fisiologi Manusia dari Sel ke Sistem. Edisi 2. Jakarta: EGC

Guyton Arthur, Hall John. 2008. Buku Ajar Patofisiologi Kedokteran. Edisi 11. EGC: Jakarta.

Setyohadi, B., Mulansari, N.A. and Sukmana, N., 2009. Reduced bone mineral density and serum C-telopeptide concentration in HIV-infected patients in Cipto Mangunkusumo Hospital. Age, 21(25), p.5.

Turk, D. C. & Flor, H. (1999). Chronic pain: A biobehavioral perspective. In R. J. Gatchel & D. C. Turk (Ed.). Psychosocial factors in pain (pp. 18- 34). New York: The Guilford Press

Ardinata D. 2007. Multidimensional Nyeri. JurnalKeperawatan Rufaidah Sumatera Utara, Volume 2, Nomor 2. Universitas Sumatera Utara: Medan, Hal. 77–78

Price, SA, Wilson, LM. Patofisiologi: Konsep Klinis Proses-Proses Penyakit. Volume 2 Ed/6. Hartanto H, Susi N, Wulansari P, Mahanani DA, editor. Jakarta: EGC; 2005. BAB 53, Penyakit Serebrovaskular; hal. 1106–1129.

IASP, 1997.

Boulton, A., et. al. 2012. Corpus Informed Research and Learning in ESP: Issues and Applications. Amsterdam: John Benjamins.

Talkington, William J. 2012. Auditory Object Salience: Human Cortical Processing of Non-Biological Action Sounds and Their Acoustic Signal Attributes. Research Gate.

The Difference Duration between Analgesia Bupivacaine Hyperbaric Morphine and Bupivacaine Hyperbaric Epinephrine Intrathecal toward Post Surgery of Sectio Caesaria Patient in Bhayangkara Mataram Hospital
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Kresnoadi E. The Difference Duration between Analgesia Bupivacaine Hyperbaric Morphine and Bupivacaine Hyperbaric Epinephrine Intrathecal toward Post Surgery of Sectio Caesaria Patient in Bhayangkara Mataram Hospital. PMJUA [Internet]. 2019Apr.29 [cited 2019Jun.26];4(1):5-14. Available from:
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