Title: A Comparative Study of Low Dose Bupivacaine- Fentanyl with Plain Bupivacaine in Spinal Anaesthesia for Transurethral Prostatectomy
Authors: Dr Alladi Srikanth, Dr V.Vamsi Krishna Reddy, Dr M H Nagrale
DOI: https://dx.doi.org/10.18535/jmscr/v5i10.148
Abstract
Introduction: The patients undergoing transurethral prostatectomy are elderly with co- existing cardiac and respiratory diseases with compromised reserves. Spinal anaesthesia is the mostly used technique for this procedure due to the advantageous of earlier recognition of signs and symptoms of water intoxication, fluid overload, perforation and also elderly patients tolerate regional anaesthesia better. In this study the efficacy of 0.5% hyperbaric Bupivacaine (7.5mg) and 0.5% hyperbaric Bupivacaine (5mg) with 25 µg of Fentanyl given intrathecally were compared.
Materials and Methods: The patients were randomly allocated into 2 groups, each having 50 patients. Group A: receiving 1.5ml of 0.5% hyperbaric bupivacaine (7.5mg) Group B:receiving 1ml of 0.5% hyperbaric bupivacaine+25 μg fentanyl. Standard subarachanoid block was performed with 27G Quinckie type spinal needle in sitting position in L3-L4 space after infiltrating the space with 2cc of 2%lignocaine and drugs were injected after checking the free flow of csf under strict aseptic conditions. observations were recorded and the results were analysed statistically.
Results: Addition of Fentanyl 25µg to Bupivacaine resulted in significant faster onset of sensory block(mean time 2.35 minutes as compared to 3.51minutes in group1) and motor block ( mean time of 5.26 minutes as compared to 6.39minutesin group1). The time taken to reach T10 dermatomal level was also faster in group II, though the maximum height of sensory block achieved was comparable in both groups. Time for two segment regression was faster in group II and was significant. Duration of analgesia was significantly prolonged in group II (mean duration 0f 714.7minutes as compared to 177.28minutees in group1).
Conclusion: It is concluded that intrathecal Fentanyl 25µg with 5mg of hyperbaric Bupivacaine provides adequate and satisfactory anaesthesia for TURP.
Keywords: Spinal anaestheia, TURP, Fentanyl.
