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Comparison of intrathecal fentanyl and sufentanil in low-dose dilute bupivacaine spinal anaesthesia for transurethral prostatectomy

 S. Y. Kim  ;  J. E. Cho  ;  J. Y. Hong  ;  B. N. Koo  ;  J. M. Kim  ;  H. K. Kil 
 BRITISH JOURNAL OF ANAESTHESIA, Vol.103(5) : 750-754, 2009 
Journal Title
Issue Date
Adjuvants, Anesthesia/administration & dosage* ; Aged ; Aged, 80 and over ; Anesthesia, Spinal/methods* ; Anesthetics, Local/administration & dosage ; Bupivacaine/administration & dosage ; Double-Blind Method ; Fentanyl/administration & dosage* ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia/surgery ; Sufentanil/administration & dosage* ; Transurethral Resection of Prostate*
anaesthetic techniques ; subarachnoid ; anaesthetics local ; bupivacaine ; analgesics opioid ; fentanyl ; analgesics opioid ; sufentanil ; surgery ; urological
BACKGROUND: The administration of low-dose bupivacaine can limit the distribution of spinal block to reduce adverse haemodynamic effects. Intrathecal opioids can enhance analgesia in combination with subtherapeutic doses of local anaesthetics. We aimed at comparing the efficacy of intrathecal fentanyl and sufentanil with low-dose diluted bupivacaine for transurethral prostatectomy (TURP) in elderly patients.

METHODS: Seventy patients undergoing TURP were randomly allocated into two groups. Group F (n=35) received fentanyl 25 microg+bupivacaine 0.5% (0.8 ml)+normal saline 0.3 ml and Group S (n=35) received sufentanil 5 microg+bupivacaine 0.5% (0.8 ml)+normal saline 0.7 ml--in total, bupivacaine 0.25% (1.6 ml) intrathecally. Onset and duration of the sensory block, the degree of the motor block, side-effects, and the perioperative analgesic requirements were assessed.

RESULTS: The median peak level of the sensory block was significantly higher in Group S than in Group F (P=0.049). Group S required fewer perioperative analgesics than Group F (P=0.008). The time to the first analgesic request was longer in Group S (P=0.025). There were no differences between the groups for the onset and recovery time of the sensory block, degree of the motor block, quality of anaesthesia, or adverse effects.

CONCLUSIONS: Low-dose diluted bupivacaine with fentanyl 25 microg or sufentanil 5 microg can provide adequate anaesthesia without haemodynamic instability for TURP in elderly patients. However, sufentanil was superior to fentanyl in the quality of the spinal block produced
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Bon-Nyeo(구본녀) ORCID logo https://orcid.org/0000-0002-3189-1673
Kil, Hae Keum(길혜금)
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Kim, Jeongmin(김정민) ORCID logo https://orcid.org/0000-0002-0468-8012
Cho, Jang Eun(조장은)
Hong, Jeong Yeon(홍정연)
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