Title: Hemodynamic Stability and Analgesia with Different Doses of Intrathecal Fentanyl Added to Hyperbaric Bupivacaine in Patients Undergoing TURP – A Comparative Study
Authors: Elizabeth Joseph, Susan T Cheeran
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.165
Abstract
Background: Transurethral resection of prostate (TURP) is one of the most common procedures performed in elderly men for benign prostatic hypertrophy. Subarachnoid block is considered the technique of choice, as it is the fastest, most predictable and reliable form of regional anaesthesia. Several adjuvants have been added to hyperbaric bupivacaine to improve the quality of the block. Here we have evaluated the effects of two different doses of intrathecally administered fentanyl (12.5microgram and 25 micro gram) along with hyperbaric bupivacaine, in patients undergoing transurethral resection of prostate.
Methods and findings: This prospective randomised double blind study was carried out in 75 ASA 1-11 adults aged 50 to 80 years of age who were scheduled to undergo TURP under sub arachnoid block. Patients were divided in to 3 groups. Group1 received 0.5%bupivacaine heavy 1.5ml made to 2 ml with normal saline intrathecally. Group 2 received 0.5% bupivacaine heavy1.5 ml +25 microgram fentanyl .Group 3 received 1.5ml bupivacaine+12.5 microgram fentanyl made to 2ml with normal saline . Onset of adequate sensory blockade, cardiovascular stability, duration of post op analgesia and incidence of complications were assessed and compared.
Results: Onset time for adequate block (T10) was significantly less for fentanyl groups when compared to bupivacaine alone group .Duration of analgesia was more for fentanyl groups when compared to bupivacaine alone group (p<0.05). But among fentanyl groups, the duration of analgesia was comparable (P>0.05) All three groups had comparable haemodynamic stability and there was no statistically significant difference in the occurance of major side effects.
Conclusion: Addition of 12.5 microgram of fentanyl to 1.5cc of hyperbaric bupivacaine 0.5% is an effective and safe method to provide good intra operative anaesthesia and prolonged post operative analgesia for elderly patients undergoing TURP.
Keywords: TURP, Subarachnoid block, bupivacaine, fentanyl.
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