Low‐dose bupivacaine‐fentanyl spinal anaesthesia for transurethral prostatectomy

Abstract

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.

Clinical effects of intrathecal fentanyl on shoulder tip pain in laparoscopic total extraperitoneal inguinal hernia repair under spinal anaesthesia: A double-blind, prospective, randomized controlled trial

“…22,23 This concurs with the results obtained in the present study, in which the incidence of hypotension in the experimental group was significantly lower than that in the control group (P ¼ 0.009). However, hypotension was easily corrected, without complications, by intravenous administration of ephedrine and phenylephrine in both groups.…”

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

“…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.…”

“…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.…”

“…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.…”

Raquianestesia com dose baixa da combinação de bupivacaína e fentanil: uma boa alternativa para a cirurgia de ressecção transuretral de próstata em pacientes idosos em regime ambulatorial

“…Spinal anesthesia (SA) is the most commonly used anesthetic technique for transurethral resection of prostate (TURP) surgery in geriatric patient population 1 , which is reported to preserve cerebral function 2 . SA for TURP provides both analgesia and muscular relaxation, rapid onset of action, allows earlier determination of hyponatremia due to absorption of bladder irrigation fluids and also suitable for day case surgery 3 .…”