Comparison of intrathecal fentanyl and sufentanil in low-dose dilute bupivacaine spinal anaesthesia for transurethral prostatectomy

Kim, S.Y.; Cho, J.E.; Hong, Jeong Yeon; Koo, Bon‐Nyeo; Kim, J.M.; Kil, Hae Keum

doi:10.1093/bja/aep263

Cited by 58 publications

(91 citation statements)

References 27 publications

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“…Intrathecal opioids or clonidine are frequently co-administered with local anesthetics to improve the anesthetic quality and postoperative analgesia [2][3][4][5][6][7][8] ; the synergistic action of clonidine with local anesthetics is well-established.…”

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confidence: 99%

“…1) Thus, it is important to limit the block level to minimize hemodynamic changes during the spinal anesthesia in such patients. 2,3) Low-dose local anesthetics can limit the block level and induce rapid recovery from anesthesia, but sometimes these low-dose local anesthetics may not provide an adequate anesthetic level for surgery. Intrathecal opioids or clonidine are frequently co-administered with local anesthetics to improve the anesthetic quality and postoperative analgesia [2][3][4][5][6][7][8] ; the synergistic action of clonidine with local anesthetics is well-established.…”

mentioning

confidence: 99%

“…2,3) Low-dose local anesthetics can limit the block level and induce rapid recovery from anesthesia, but sometimes these low-dose local anesthetics may not provide an adequate anesthetic level for surgery. Intrathecal opioids or clonidine are frequently co-administered with local anesthetics to improve the anesthetic quality and postoperative analgesia [2][3][4][5][6][7][8] ; the synergistic action of clonidine with local anesthetics is well-established. [6][7][8] Unlike opioids, intrathecal clonidine does not produce respiratory depression or pruritus, but usual dose of clonidine (15-150 µg) may be associated with bradycardia, hypotension, or sedation.…”

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confidence: 99%

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Effects of Intrathecal Dexmedetomidine on Low-Dose Bupivacaine Spinal Anesthesia in Elderly Patients Undergoing Transurethral Prostatectomy

Kim

Lee

et al. 2013

Biological & Pharmaceutical Bulletin

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Low-dose bupivacaine can limit the spinal block level with minimal hemodynamic effects and yield a rapid recovery, but sometimes it may not provide adequate anesthesia for surgery. Dexmedetomidine, a selective α2-adrenoreceptor agonist, was shown to be a potent antinociceptive agent when given intrathecally in animals and humans. The purpose of this study was to evaluate the adjuvant effects of intrathecal dexmedetomidine in elderly patients undergoing transurethral prostate surgery with low-dose bupivacaine spinal anesthesia. Fifty-four patients undergoing transurethral prostate surgery were randomized into two groups receiving either dexmedetomidine 3 µg (n=27) or normal saline (n=27) intrathecally with 6 mg of 0.5% hyperbaric bupivacaine. The characteristics of the spinal block and postoperative analgesic effects were evaluated. The peak block level was similar for the two groups. However, the dexmedetomidine group demonstrated a faster onset time to the peak block and longer duration of spinal block than the saline group (p<0.01). The motor block scales at the time of peak sensory block and regression of 2-sensory dermatomes were higher in the dexmedetomidine group than in the saline group ( p<0.001). There was less analgesic request and the time to the first analgesic request was longer in the dexmedetomidine group than in the saline group (each 487, 345 min, p<0.05). Dexmedetomidine 3 µg when added to intrathecal bupivacaine 6 mg produced fast onset and a prolonged duration of sensory block and postoperative analgesia in elderly patients for transurethral surgery. However, recovery of motor block could be delayed in dexmedetomidine-added patients.Key words anaesthesia; spinal; dexmedetomidine; transurethral resection of prostate; bupivacaine; elderly patient Spinal block is a common anesthetic technique for patients undergoing transurethral resection of prostate (TURP). Most patients indicated for TURP are elderly and frequently associated with cardiopulmonary, endocrine, or other comorbidities.1) Thus, it is important to limit the block level to minimize hemodynamic changes during the spinal anesthesia in such patients.2,3) Low-dose local anesthetics can limit the block level and induce rapid recovery from anesthesia, but sometimes these low-dose local anesthetics may not provide an adequate anesthetic level for surgery. Intrathecal opioids or clonidine are frequently co-administered with local anesthetics to improve the anesthetic quality and postoperative analgesia [2][3][4][5][6][7][8] ; the synergistic action of clonidine with local anesthetics is well-established.6-8) Unlike opioids, intrathecal clonidine does not produce respiratory depression or pruritus, but usual dose of clonidine (15-150 µg) may be associated with bradycardia, hypotension, or sedation. 6-8)Dexmedetomidine is an S-enantiomer of medetomidine with a higher specificity for α2-adrenoreceptor (α2 : α1, 1620 : 1) compared to clonidine (α2 : α1, 220 : 1). It was first introduced into practical use as intravenous sedative after the appro...

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Effects of Intrathecal Dexmedetomidine on Low-Dose Bupivacaine Spinal Anesthesia in Elderly Patients Undergoing Transurethral Prostatectomy

Kim

Lee

et al. 2013

Biological & Pharmaceutical Bulletin

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“…of Anaesthesiology; Medical College & Hospital, Kolkata, West Bengal, during the period of January 2016 to June 2016. Sample size was calculated based on previous study, [13] Spinal anaesthesia, bupivacaine, adjuvant, dexmedetomidine, fentanyl still the first choice for lower limb surgeries its rapid onset, superior blockade, less failure rates and cost-effectiveness. [1] Various drugs are used along to facilitate the prolongation of spinal block both for long procedures and for [2] alteration.…”

Section: Methodsmentioning

confidence: 99%

A Comparison between Intrathecal Dexmedetomidine and Fentanyl as an Adjuvant to Hyperbaric Bupivacaine in Spinal Anaesthesia for Lower Limb Surgeries - A Double Blind Controlled Study

2017

IJSR

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“…Thus, it is important to limit the block level to minimize hemodynamic changes during the spinal anesthesia in such patients [37,38].…”

Section: Preoperative Considerationsmentioning

confidence: 99%

Anesthesia for Urological Surgery

Tekgül¹,

Horsanalı²,

OzanHorsanali³

2017

Current Topics in Anesthesiology

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Because of the variable techniques and patients' positions used in urological surgery, anesthesia for urologic surgery requires advanced knowledge and special transactions. In this mater, it is important to follow current approaches for anesthesiologists. Diferent surgical procedures and complications due to diferent positions or anesthesia were evaluated separately to be more concise. We have researched recent literature and created this chapter about new technologies in urological surgery and development in anesthesia for urological surgery.Keywords: urological anesthesia, anesthesia management, anesthesia complications, urological surgery complications IntroductionAnesthesia for urological surgery includes unique distinctive diferences, as in all other surgical departments. Therefore, anesthesia for urological surgery requires featured training and experience.To reduce the risk of complications in urological surgery, like all other kinds of surgery, regional anesthesia techniques came to prominence with the help of technological developments. For many urological ventures, only neuraxial blockade application could be enough. This also results in decreased complication risks. In surgeries that must be done with general anesthesia, epidural anesthesia can be used for the maintenance of anesthesia or in the postoperative period. In this way, the rate of intraoperative complications can be reduced and patients' comfort can be increased by providing postoperative pain control and also duration of hospital stay can be reduced [1].© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.During the urological surgery, diferent complications can develop depending on surgical techniques used. For example, most of urological ventures require lots of irrigation luids. In this venture, use of unheated irrigation luid can lead to complications such as hypothermia, delayed recovery from anesthesia and tremor [2].In addition to neuraxial blockade, the use of peripheral blockade has gained importance in urological surgery. For example, obturator blockade application for lateral wall localized bladder cancer could reduce intraoperative complications and increased cancer-free survival [3,4]. Anesthesia for kidney and upper urinary tract surgery Oncological surgery of kidney and upper urinary tract Radical and partial nephrectomyRenal cell carcinoma (RCC) is the ninth common cancer in the USA. According to the SEER database analysis, it is estimated that there will be 62,700 new cases and 14,240 people will die because of this disease. The incidence of kidney and renal pelvis cancer was 15.6 per 100,000 in the USA between 2009 and 2013 [5]. All around the world, radical or partial nephrectomy is accepted curative treatment for kidney tumors. Partial nephrectomy can be performed depending...

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Comparison of intrathecal fentanyl and sufentanil in low-dose dilute bupivacaine spinal anaesthesia for transurethral prostatectomy

Abstract: Low-dose diluted bupivacaine with fentanyl 25 microg or sufentanil 5 microg can provide adequate anaesthesia without haemodynamic instability for TURP in elderly patients. However, sufentanil was superior to fentanyl in the quality of the spinal block produced.

Cited by 58 publications

References 27 publications

Effects of Intrathecal Dexmedetomidine on Low-Dose Bupivacaine Spinal Anesthesia in Elderly Patients Undergoing Transurethral Prostatectomy

Effects of Intrathecal Dexmedetomidine on Low-Dose Bupivacaine Spinal Anesthesia in Elderly Patients Undergoing Transurethral Prostatectomy

A Comparison between Intrathecal Dexmedetomidine and Fentanyl as an Adjuvant to Hyperbaric Bupivacaine in Spinal Anaesthesia for Lower Limb Surgeries - A Double Blind Controlled Study

Anesthesia for Urological Surgery

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