Background: Spinal anaesthesia is a regional technique that blocks the spinal nerves in the subarachnoid space. The anaesthetic agents that are deposited subarachnoid space act on the spinal nerve roots. It is extensively used for genitourinary surgeries like transurethral resection of prostate, transurethral resection of bladder tumours, cystoscopy, gynaecological and obsteteric procedures, abdominal surgeries, orthopaedic procedures etc. This study is designed to evaluate the block characteristics of intrathecal hyperbaric bupivacaine with and without fentanyl as adjuvant in patients undergoing TURP.

Objective: To study the block characteristics of intrathecal hyperbaric bupivacaine with and without fentanyl as adjuvant in patients undergoing TURP, as assessed by time to 2 segment regression of sensory blockade ,time to regression of sensory block level to L1, time to first rescue analgesic, duration of motor blockade,and the maximum motor block produced, in patients undergoing TURP.

Methodology: 40 Patients undergoing transurethral resection of prostate (TURP) belonging to American Society of Anaesthesiologists Physical Status (ASA) grade 1 and 2 were enrolled in this study after getting informed consent and institutional ethical board clearance and randomly allocated into two groups. Group ‘1’ received 7.5mg 0.5% heavy Bupivacaine (1.5ml) with 25µg Fentanyl(0.5ml)- total of 2ml, while group ‘2’ received 7.5mg 0.5% heavy Bupivacaine (1.5ml) with 0.5ml sterile water (total 2ml) .

Results: It was found from this study that Group ‘1’ prolongs the duration of sensory block (91.8±5.3 min) compared to Group ‘2’(75.7±4.9 min),provides longer duration of postoperative analgesia,227.5±24min in Group’1’compared to 183.2±8.6min in Group ‘2’ and causes a delay in the attainment of peak sensory levels 7.4±1.0 min in Group ‘1’ compared to 6.3±0.7 min in Group’2’, without affecting the peak sensory block, maximum motor block or duration of motor block.

Keywords: Intrathecal fentanyl, block characteristics, TURP, postoperative analgesia.

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Dr Harikrishnan.S

Associate Professor

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