The use of bupivacaine and fentanyl for spinal anesthesia for urologic surgery

• Published in: Anesthesia and analgesia Vol. 91; no. 6; pp. 1452 - 1456
• Main Authors: KUUSNIEMI, Kristiina S, PIHLAJAMÄKI, Kalevi K, PITKÄNEN, Mikko T, HELENIUS, Hans Y, KIRVELÄ, Olli A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01.12.2000
• Subjects: Abdominal surgery. Urology. Gynecology. Obstetrics; Aged; Analgesics, Opioid; Anesthesia; Anesthesia depending on type of surgery; Anesthesia, Spinal; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Local; Biological and medical sciences; Bupivacaine; Double-Blind Method; Electroencephalography; Female; Fentanyl; Humans; Male; Medical sciences; Middle Aged; Nerve Block; Prospective Studies; Urologic Surgical Procedures, Male; Human; Drug combination; Urinary system disease; Fentanyl; Opiates; Narcotic analgesic; Intrathecal administration; Local anesthetic; Regional anesthesia; Bupivacaine; Surgery; Organic amide; Anilide
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1097/00000539-200012000-00029

We evaluated the effect of 25 microg of fentanyl added to bupivacaine on sensory and motor block. By using a double-blinded study design, 80 men undergoing urologic surgery were randomized into the following four groups: Group I, bupivacaine 10 mg; Group II, bupivacaine 10 mg + fentanyl 25 microg; Group III, bupivacaine 7.5 mg + fentanyl 25 microg; Group IV, bupivacaine 5 mg + fentanyl 25 microg. The final volume of intrathecal injectate was adjusted to 2. 5 mL with sterile distilled water. Spinal anesthesia was administered with the 27-gauge Whitacre needle at the L2-3 interspace with the patient in the sitting position. Neural block was assessed by using pinprick and a modified Bromage scale. The degree of motor block was more profound in Group II compared with Group I at the end of operation. In Group IV, there was no motor block at the end of operation in any of the patients. The median level of the upper limit of the sensory block was higher than T(7) in all groups before the start of surgery. The addition of 25 microg of fentanyl to 5 mg of bupivacaine resulted in short-acting motor block. When 25 microg of fentanyl was added to 10 mg of bupivacaine, it increased the intensity and duration of motor block. Only 5 (6. 3%) of the patients needed supplemental analgesia during the operation. ¿abs¿