| Summary: | 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 SC
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