Low-dose levobupivacaine plus fentanyl combination for spinal anesthesia in anorectal surgery

Honca, Mehtap; Dereli, Necla; Kose, Emine Arzu; Honça, Tevfik; Kütük, Selcen; Ünal, Selma; Horasanlı, Eyüp

doi:10.1016/j.bjane.2014.01.007

Cited by 8 publications

(7 citation statements)

References 12 publications

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“…[10] Studies reported that addition of 25 μg fentanyl to LA improves anesthesia quality and prolongs postoperative analgesia without prolonging the time to void. [11] Inspired by the above findings, we selected 10 mg dose of levobupivacaine and compared it with 10 mg levobupivacaine plus 25 μg fentanyl given intrathecally for spinal block characteristics. Ozyilkan et al [12] compared 2.2 ml of levobupivacaine plain with 10 μg fentanyl or 2.5 μg sufentanil as adjuvant in spinal anesthesia for caesarean section.…”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Epidural Levobupivacaine and Levobupivacaine with Fentanyl for Pediatric Abdominal Surgeries

Manoharan¹,

Selvarajan²,

P³

et al. 2017

Ann. Int. Med. Den. Res.

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Background: Levobupivacaine has increasingly been used in the clinical anesthesia practice since last few years because of its safer pharmacological profile. Literary evidence has established the safety of levobupivacaine over bupivacaine when used in regional anesthesia as the incidence of various adverse outcomes is higher with the latter as compared to levobupivacaine. Aim: Comparative evaluation of Epidural Levobupivacaine and levobupivacaine with fentanyl for pediatric abdominal surgeries. Methods: Sample size of 50 patients in pediatric age group between 8 years to 13 years of ASA Grade I coming for abdominal surgeries were included. Patients are randomly selected and allocated into two groups. Group LN [N=25] received 0.25% of levobupivacaine and 0.5ml of normal saline, Group LF [N=25] received 0.25% of levobupivacaine + 1 μg/kg of fentanyl. Results: Levobupivacaine with fentanyl group onset of sensory block was 14.2 ± 1.155. Levobupivacaine with normal saline onset of sensory block was 14.72 ± 1.542. The onset of motor blockade in 0.25% levobupivacaine with normal saline was mean 19.56 ± 1.71. At the same time motor blockade of 0.25% levobupivacaine with fentanyl was mean 18.64 ± 1.72. Level of blockade of both LF and LN groups are comparable but not significant. Duration of Anesthesia for LF was 84.4 ± 17.5, LN group was 79.6 16.7. Duration of Analgesia for LF group was 11.2 ± 0.39 and LN group was 10.94 ±0.37. Conclusion: This study showed that combining lower dose levobupivacaine with fentanyl and sufentanil provides faster onset of sensorial block, lower frequency and shorter duration of motor block, and longer analgesia time in TURP under spinal anesthesia.

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Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Epidural Levobupivacaine and Levobupivacaine with Fentanyl for Pediatric Abdominal Surgeries

Manoharan¹,

Selvarajan²,

P³

et al. 2017

Ann. Int. Med. Den. Res.

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“…[ 10 ] Studies reported that addition of 25 μg fentanyl to LA improves anesthesia quality and prolongs postoperative analgesia without prolonging the time to void. [ 17 ] Inspired by the above findings, we selected 10 mg dose of levobupivacaine and compared it with 10 mg levobupivacaine plus 25 μg fentanyl given intrathecally for spinal block characteristics.…”

Section: Discussionmentioning

confidence: 99%

Comparison of levobupivacaine and levobupivacaine with fentanyl in infraumbilical surgeries under spinal anaesthesia

Attri

Kaur

et al. 2015

Anesth Essays Res

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Background:Intrathecal opioids added to low dose local anesthetics in spinal anaesthesia intensifies sensory block without affecting sympathetic blockade. Aim was to evaluate the safety and efficacy of intrathecal levobupivacaine plain versus levobupivacaine plus fentanyl in infraumbilical surgeries.Materials and Methods:In a prospective randomized double blind study, 100 patients of American Society of Anesthesiologists grades I and II of either sex, 20–65 years of age were included after approval from the Ethics Committee. Informed consent was taken and patients were randomly divided into two groups of 50 each, to receive either 2 ml of 0.5% isobaric levobupivacaine (group L) or 2 ml of 0.5% isobaric levobupivacaine + 25 μg fentanyl (group LF) intrathecally. Patients were monitored for sensory and motor block characteristics, postoperative analgesia, haemodynamics and side effects and complications for 24 h.Results:Onset of sensory block and time to maximum sensory block was rapid in group LF (4.8 ± 1.50 and 8.46 ± 1.87 min) as compared to group L (7.6 ± 1.46 and 15.80 ± 2.43 min) (P < 0.000). Maximum sensory block was T6 in group LF and T8 in group L. Maximum Bromage score was 2 in both groups but was achieved earlier in group LF (P < 0.000). Duration of sensory and motor block was significantly prolonged in group LF (270.98 ± 28.60 and 188.52 ± 9.81 min) as compared to group L (197.58 ± 11.20 and 152.76 ± 9.79 min). Total duration of analgesia was also prolonged in group LF (265.16 ± 26.18 min) as compared to group L (168.16 ± 11.08 min). Patients remained haemodynamically stable and side effects and complications were comparable in both groups. Data was analyzed using “Chi-square test” and “unpaired t-test.”Conclusion:Addition of fentanyl to levobupivacaine leads to early onset and prolonged duration of sensory and motor block as well as postoperative analgesia with stable haemodynamics and minimal side effects.

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“…Postoperative pain is said to be most severe in anorectal surgery and thus, the choice of anesthetic methods in this procedure is crucial to reduce the postoperative pain as well as postoperative complications 3 . Spinal anesthesia for anorectal surgery is a 04 July 2020 popular and commonly used method characterized by rapid onset and offset, easy mobilization and short hospital stay 4 . No matter how skillfully conducted or successful the result, almost all surgical procedures produce tissue trauma and pain.…”

Section: Introductionmentioning

confidence: 99%

Comparison of analgesic efficacy of bupivacaine, bupivacaine with dexmedetomidine, and bupivacaine with fentanyl in local perianal infiltration technique in perianal surgeries: A prospective, randomized controlled study

Haribabu¹

2020

MIJOANS

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Background: Numerous methods have been proposed to alleviate pain after perianal surgeries but the role of addition of Dexmedetomidine or fentanyl to bupivacaine as local infiltration in surgical wound for post-operative analgesic effect is less explored. Hence a study was conducted to compare the efficacy of wound infiltration with bupivacaine, bupivacaine with fentanyl and bupivacaine with Dexmedetomidine for post-operative analgesia following perianal surgeries. Methods: 75 patients with ASA physical status of I and II scheduled for perianal surgeries were recruited for the study. The patients were randomly assigned into 3 groups namely DM, F and C. Group DM received perianal wound infiltration with 0.5% bupivacaine 15ml which included Dexmedetomidine 1.5 µg /kg, Group F received perianal wound infiltration with 0.5% bupivacaine 15 ml which included Fentanyl 2µg/ml and Group C received perianal wound infiltration with 0.5% bupivacaine 15 ml which included 1 ml saline. Post-operative quality of analgesia was assessed by VAS (0-10) for 24 h and rescue analgesic was administered when VAS > 4. Pain score at the time of defecation was also noted. Total dose of analgesic needed in 24 hours and side effects were noted. Results: Group DM had significantly longer duration of postoperative analgesia when compared with Group F and group C. Group F had prolonged postoperative analgesia when compared to Group C. The pain score at first defecation was significantly lower in Group DM when compared to both Group F and Group C. None of the patients developed skin rash, respiratory depression, hypotension, hypoxemia, and there were no significant tachycardia or bradycardia. Conclusions: Perianal wound infiltration with Dexmedetomidine-bupivacaine mixture provides prolonged analgesia, and decreases the total analgesic consumption in patients undergoing perianal surgeries.

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Low-dose levobupivacaine plus fentanyl combination for spinal anesthesia in anorectal surgery

Abstract: spinal saddle block using hyperbaric levobupivacaine with both 12.5 μg and 25 μg fentanyl provided good quality of anesthesia without motor block for anorectal surgery in the prone position.

Cited by 8 publications

References 12 publications

Comparative Evaluation of Epidural Levobupivacaine and Levobupivacaine with Fentanyl for Pediatric Abdominal Surgeries

Comparative Evaluation of Epidural Levobupivacaine and Levobupivacaine with Fentanyl for Pediatric Abdominal Surgeries

Comparison of levobupivacaine and levobupivacaine with fentanyl in infraumbilical surgeries under spinal anaesthesia

Comparison of analgesic efficacy of bupivacaine, bupivacaine with dexmedetomidine, and bupivacaine with fentanyl in local perianal infiltration technique in perianal surgeries: A prospective, randomized controlled study

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