Comparison of two different doses of hyperbaric bupivacaine with fentanyl for spinal anaesthesia in elderly patients undergoing routine endoscopic urological surgery: A randomized controlled study
Atwal, N., Pathania, J., Sharma, A. (2024). Comparison of two different doses of hyperbaric bupivacaine with fentanyl for spinal anaesthesia in elderly patients undergoing routine endoscopic urological surgery: A randomized controlled study. EKB Journal Management System, 16(1), 1-9. doi: 10.21608/asja.2024.250910.1020
Neha Atwal; Jyoti Pathania; Aparna Sharma. "Comparison of two different doses of hyperbaric bupivacaine with fentanyl for spinal anaesthesia in elderly patients undergoing routine endoscopic urological surgery: A randomized controlled study". EKB Journal Management System, 16, 1, 2024, 1-9. doi: 10.21608/asja.2024.250910.1020
Atwal, N., Pathania, J., Sharma, A. (2024). 'Comparison of two different doses of hyperbaric bupivacaine with fentanyl for spinal anaesthesia in elderly patients undergoing routine endoscopic urological surgery: A randomized controlled study', EKB Journal Management System, 16(1), pp. 1-9. doi: 10.21608/asja.2024.250910.1020
Atwal, N., Pathania, J., Sharma, A. Comparison of two different doses of hyperbaric bupivacaine with fentanyl for spinal anaesthesia in elderly patients undergoing routine endoscopic urological surgery: A randomized controlled study. EKB Journal Management System, 2024; 16(1): 1-9. doi: 10.21608/asja.2024.250910.1020

Comparison of two different doses of hyperbaric bupivacaine with fentanyl for spinal anaesthesia in elderly patients undergoing routine endoscopic urological surgery: A randomized controlled study

Ain-Shams Journal of Anesthesiology
Volume 16, Issue 1, 2024, Page 1-9  XML PDF (372.77 K)
Document Type: Original Article
DOI: 10.21608/asja.2024.250910.1020
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Authors
Neha Atwalorcid 1; Jyoti Pathaniaorcid 2; Aparna Sharma email orcid 2
1Anaesthetist Civil Hospital Nadaun, Himachal Pradesh, India.
2Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
Abstract
The major drawback of spinal anesthesia in elderly patients is the per operative hypotension and its sequel . We compared two doses (7.5 mg or 10 mg) of hyperbaric bupivacaine 0.5% with 25µg fentanyl in 150 elderly patients undergoing routine urological surgery with respect to hemodynamic profile .
Results: The time to onset of sensory block (min) was comparable amongst the two groups ( 2.41±0.86 and 2.25±0.79) in group A and B respectively .The mean time to regression of block to S2 level was at 3.56±0.53 hrs. in group A and 4.01±0.71 hrs in group B(p<0.0001). The maximum mean height of sensory block was at T8 level in 73.3% patients and T10 level in 18.6% patients of group A .In group B patients 58.6% had the sensory level at T6 level , in 33% patients it was at T8 and in 8% it was at T4 level .(p<0.0001). Onset of motor block was earlier in group B and was at 3.89±0.8 min over 4.23±1.01in group A. (p=0.026).The time to regression of motor block was earlier in group A ( 4.07±o.54 hrs over 4.69±0.58 hrs in group B).(p<0.0001) The decrease in MAP from baseline values was more in group B over group A (0% vs. 4.7%;p<0.05)) but the incidence of hypotension and bradycardia were statistically comparable amongst the groups .(p>0.05)
Conclusion :The use of 7.5mg bupivacaine with 25 µg fentanyl intrathecally results in adequate anaesthesia and analgesia coupled with stable hemodynamic as required for transurethral surgery of around 2 hrs.duration .
Keywords
Anaesthesia; hypotension; transurethral resection of prostate (TURP)
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