Perbandingan Efek Blokade Sensorik dan Motorik antara Kombinasi Bupivakain Fentanyl Morfin dengan Kombinasi Ropivakain Fentanyl Morfin pada Intrathecal Labour Analgesia

Abstract

Background and objective : Ropivacain has less potential for central nervous system and cardiovascular toxicity than bupivacain. We compared two dose of intratechal ropivacain combine with fentanil and morfin with a standard dose of intra techal bupivacain plus fentanil and morfin for labor analgesia using an Intratechal technique. Methods : After getting the approval from the ethic commite with a prospective, randomized, double- blined fashion , 30 patiens requesting labour analgesia received either 3 mg of intrathecal ropivacain plus fentanil 25 ug plus 150 µg morphine(A),and 2,5 mg of intratechal bupivacain plus fentanil 25 ug plus morphine 150 µg . Onset and duration of analgesia and side effect , such as motor block, block height, pruritus, urine retention, nausea and vomiting, hemodynamic changes, and Apgar score, were recorded. All patiens receive equal preloading with 10 ml/ kgBW RL infutions 20 minutes before intrathecal analgesia. Result: Duration of analgesia (mean± sd) was 130,7 ± 39 min for A, 194,8 ± 50,8 min for B, p 0,01 (P= significant ). Onset of analgesia mean ± SD 91,3"± 26,3 for A, and 94,4"±15,3 for B p = 0,10, (P= not significant). No differences in motor block or side effect were detected among the groups . Conclution : We conclude that bupivacain, when combined with fentanil and morphine, is more effective for providing level analgesia and offers advantage over ropivacain in this studied dose. Implications : In this study , both local anestetics provided similar onset level analgesia with equivalent side effect profiles in the doses studied.