Perbandingan Onset, Durasi Kerja dan Efek Samping Antara Levobupivacaine Isobarik 0.5% 15 Mg dengan Bupivacaine Hiperbarik 0.5 % 15 Mg untuk Anestesi Spinal pada Operasi Transurethral Resection Of Prostate

Abstract

Background: Various anesthetic techniques have been developed to facilitate surgery. Recently, the use of regional anesthesia has become more and more widespread. The advantages of this technique include a relatively cheaper cost, relatively small systemic effect, adequate analgesia, and the ability to prevent a more perfect stress response. Transurethral prostate resection (TURP) is the most common surgical intervention for patients with benign prostatic hyperplasia. Spinal anesthesia is the technique of choice in TURP. Levobupivacaine, is one of the newest long-acting local anesthetic drugs. It is the pure S(-) enasiomer of Bupivacaine. It has an onset of action of 4-8 minutes and an anesthetic duration of action of 135-170 minutes. Also exerts a sensory and motor block effect similar to that of bupivacaine, but the sensory block of levobupivacaine tends to be longer than that of bupivacaine. Methods: This study used a double-blind randomized control trial design, to assess the comparison of the onset and duration of action of isobaric levobupivacaine 0.5% 15 mg with hyperbaric bupivacaine 0.5% 15 mg for spinal anesthesia for transurethral resection of prostate surgery. Results: In this study a total of 5 patients with PS ASA 1 scores (10%) with 2 people in the levoBupivacaine group (4%) and 3 people in the Bupivacaine group (6%). Patients with PS ASA 2 scores were 17 (34%) with 7 patients in the levo-Bupivacaine group (14%) and 10 in the Bupivacaine group (20%). Patients with PS ASA 3 scores were 28 people (56%) with 16 people in the levo-Bupivacaine group (32%) and 12 people in the Bupivacaine group (24%). it was found that there was no significant difference in sensory onset between groups (p=0.703). It was found that there was no significant difference in otoric onset between groups (p=0.683). It was found that there was a significant difference in the duration of sensory block between groups (p=0.046). It was found that there was a significant difference in the duration of motor block between groups (p=0.002). It is known that there is a significant difference in the number of side effects between groups (p=0.019). However, there was no significant difference in the duration of the 2-segment regression between groups (p=0.559). Conclusion: There is a significant difference in side effects, namely hypotension and chills in levobupivacaine and bupivacaine.