Effectiveness Comparison: Saddle Block vs. Low Dose Spinal Anesthesia in Cervical Cancer Brachytherapy

Andy Hafiz Dimas Hariyanto

Abstract

Background: Brachytherapy plays a role in the management of cervical cancer by delivering radiation to large tumors at the end or in conjunction with chemoradiotherapy. Regional anesthesia is the dominant technique used for brachytherapy. Low Dose Spinal Anesthesia involves injecting local anesthetic into the subarachnoid space. Saddle block anesthesia is a type of low spinal block that provides anesthesia to the saddle area. Low Dose Spinal Anesthesia has the disadvantage of longer motor recovery in the extremities compared to saddle block. This study aims to compare the sensory and motor effectiveness between saddle block anesthesia and Low Dose Spinal Anesthesia in cervical cancer patients undergoing intracavitary brachytherapy.

Methods: A non-paired double-blind consecutive clinical trial with cervical cancer patients undergoing elective brachytherapy at Dr. Kariadi Hospital, Semarang. Patients were divided into two groups: Saddle block anesthesia and Low dose spinal anesthesia. Vital signs, NRS pain scale, Bromage motor activity score, side effects including hemodynamics, patient satisfaction level (EVAN-LR), and operator satisfaction level were recorded. The collected data were analyzed using independent t-tests and Mann-Whitney tests, with results considered significant if p < 0.05.

Results: Bromage scores at 30 minutes and 60 minutes in the saddle block anesthesia group were significantly higher than those in the low dose spinal group (p=0.000). The numerical rating scale during applicator placement, after moving rooms, and after removing the indicator in the saddle block anesthesia group was better than the low dose spinal group but not significant (p=0.054).

Conclusion: Sensory and motor effectiveness in patients using Saddle Block Anesthesia is better compared to Low Dose Spinal Anesthesia.

Keywords

Brachytherapy, Bromage Score, Cervical Cancer, Low Dose Spinal Anesthesia, NRS, Saddle Block

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DOI: https://doi.org/10.20961/soja.v6i1.91749

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