UJI BANDING DURASI BLOK SENSORIK & MOTORIK ANTARA BUPIVACAIN 7,5 MG + FENTANYL 15 μG DENGAN BUPIVACAIN 12,5 MG PADA SEKSIO SESAREA DENGAN SPINAL ANESTESI

Background: SAB in SC surgery using 12.5 mg hyperbaric bupivacaine 0.5 % often caused problems such as hypotension, shivering, nausea-vomiting and long recovery of legs paralysis. The methods to eliminate those motoric block was to decrease local anesthesia dose and to add opioid to maintain analgesia quality. Method: The study used double-blind randomized control trial by comparing sensoric and motoric block durations between 7.5 mg hyperbaric bupivacaine 0.5 % + 15 μg fentanyl with 12.5 mg hyperbaric bupivacaine 0.5 %. Thirty six pregnant women of 20- 45 of age with the physica status of ASA I-II, undergoing elective SC and emergency with the operation duration of not more than 120 minutes in The Central Operation Theatre (COT) or Emergency Operation Room of DR. Sardjito Hospital Yogyakarta under regional anesthesia with Subarachnoid Block technique (SAB). The subjects of the study were assigned to two groups of 18 patients. 7.5 mg hyperbaric bupivacaine 0.5 % + 15 μg fentanyl (Group A) with 12.5 mg hyperbaric bupivacaine 0.5 % (Group B). The SAB was conducted on sitting possition with the injection of inter vertebra L2-4 space using spinal needle of 25 G. The hemodinamic status (blood pressure, MAP, and heart rate) and the sensoric and motoric block duration of all of the subjects were measured. Results: The results of the study showed that the motoric block duration of the Group A 102.05±7.91 minutes as compared to the Group B 133.88±15.67 minutes was significant (p=0.000), which was tht time to reach the Bromage Score 0. The sensoric duration reflected with the regression to S2 (A=158,23±10,74 vs B=166,94±10,99 minutes) and it was also statistically different (p= 0.024). From the results of the study also found that the mean of duration of SC was (A=78,52±17,38 and B=82,50±26,74), the kind of operation and the physical status (ASA) did not differ significantly. The maximal analgesia height T4 of Grup A vs B (52,9% vs 38,8%, p=0,348) dan T6 (41,1% vs 61,1%, p=0,286) did not significantly differ. The side effects of hypotension, shivering, nauseavomiting did not significalty differ. Conclusion: 7.5 mg hyperbaric bupivacaine 0.5 % + 15 μg fentanyl had shorter duration of sensoric block than 12.5 mg hyperbaric bupivacaine 0.5 % for SC with spinal anesthesia. 7.5 mg hyperbaric bupivacaine 0.5 % + 15 μg fentanyl had shorter duration of motoric block than 12.5 mg hyperbaric bupivacaine 0.5 % , but it was sufficient for the S