SummaryWe evaluated the effect of low-dose bupivacaine plus fentanyl administered intrathecally in elderly patients undergoing transurethral prostatectomy. Patients were randomly assigned to one of two groups. Group F received plain bupivacaine 4 mg with 25 lg of fentanyl and sterile water to a total of 1.5 ml, and Group B received only 0.5% plain bupivacaine 7.5 mg for spinal anaesthesia. Sensory block was adequate for surgery in all patients. The mean level of motor block was higher and the duration of motor block was longer in Group B (p < 0.0001). Hypotension and shivering were significantly more common in Group B (p < 0.05). The addition of fentanyl 25 lg to plain bupivacaine 4 mg provides adequate analgesia for transurethral prostatectomy with fewer side-effects in elderly patients when compared with the conventional dose of bupivacaine.
Renal nociception conducted multisegmentally by both the spinal nerves (T10 to L1) and the vagus nerve cannot be blocked by epidural analgesia alone. We demonstrated that IV ketamine had an improved analgesic or opioid-sparing effect when it was combined with epidural bupivacaine and morphine after renal surgery.
The development of hypotension after spinal block in subjects undergoing cesarean section was not prevented despite low-dose (4 mg) bupivacaine plus 25 microg fentanyl, but the severity of maternal hypotension, and the number of ephedrine treatments and the total dose of ephedrine were decreased.
The present study found that pretreatment with lidocaine 20 mg with or without venous occlusion significantly reduced the incidence and the severity of pain during the injection of propofol when compared with the group with no venous occlusion administered saline. In addition, pretreatment with lidocaine 20 mg plus venous occlusion for 60 seconds significantly reduced the incidence of propofol-induced pain compared with lidocaine without venous occlusion.
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