Intrathecal sufentanil or fentanyl as adjuvants to low dose bupivacaine in endoscopic urological procedures

• Main Authors: Shikha Gupta (Author), Supriya Sampley (Author), Suneet Kathuria (Author), Sunil Katyal (Author)
• Format: Book
• Published: Wolters Kluwer Medknow Publications, 2013-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 0970-9185; 10.4103/0970-9185.119158
• Keywords: Adjuvants; bupivacaine; fentanyl; intrathecal; low dose spinal; sufentanil; Anesthesiology; RD78.3-87.3; Pharmacy and materia medica; RS1-441
• Source: Journal of Anaesthesiology Clinical Pharmacology, Vol 29, Iss 4, Pp 509-515 (2013)

Context: Opioids are being increasingly used these days as adjuvants to local anesthetics in spinal anesthesia. Aim: The aim of this study is to compare the effects of adding sufentanil or fentanyl to low dose bupivacaine in spinal anesthesia for endoscopic urological procedures. Settings and Design: Prospective, randomized, double-blind study. Materials and Methods: A total of 90 elective endoscopic urological surgery patients, 40-80 years old, received spinal anesthesia with 7.5 mg hyperbaric bupivacaine 0.5% (Group A) or by adding sufentanil 10 g (Group B) or fentanyl 25 g (Group C) to 5 mg hyperbaric bupivacaine 0.5%. These groups were compared in terms of the quality of spinal anesthesia as well as analgesia. Statistical analysis used: Analysis of variance and Chi-square test. Results: The onset of sensory and motor blockade was significantly rapid in Group A as compared with Groups B and C. The maximum upper level of sensory block was higher in Group A patients than Groups B and C patients. Quality of analgesia was significantly better and prolonged in sufentanil group as compared with other two groups. Motor block was more intense and prolonged in Group A as compared with Groups B and C patients. Request for post-operative analgesic was significantly delayed in Group B patients. Conclusions: Spinal anesthesia for endoscopic urological procedures in elderly patients using low dose bupivacaine (5 mg) combined with 10 μg sufentanil is associated with a lower incidence of hemodynamic instability, better quality and prolonged duration as compared to that by adding 25 μg fentanyl.