Hypobaric bupivacaine spinal anesthesia for cystoscopic intervention: the impact of adding fentanyl.
OBJECTIVE
Addition of fentanyl to hyperbaric bupivacaine spinal anesthesia prolonged the duration of sensory block. This study seeks to test the hypothesis that adding fentanyl to small dose hypobaric spinal anesthesia will improve intraoperative patients and surgeon satisfaction without delay in recovery.


METHODS
Patients (n = 80) subjected to minor cystoscopic surgery were randomly assigned to have spinal anesthesia with either 5 mg bupivacaine 0.1% or 5 mg bupivacaine 0.1% mixed with 20 micrograms fentanyl. The main outcome measures included intraoperative patient and endoscopist satisfaction, sedative/analgesic supplementation, postoperative side effects and time to ambulation.


RESULTS
Patients in the bupivacaine group needed more analgesic supplementation. Analgesia was more adequate in the bupivacaine-fentanyl group. Pruritus was the main side effect in the bupivacaine fentanyl group. Ambulation and discharge of patients were nearly the same in both groups.


CONCLUSIONS
Spinal anesthesia with small dose (5 mg) hypobaric (0.1%) bupivacaine mixed with fentanyl (20 micrograms) produced adequate anesthesia for short cystoscopic procedures with minimal side effects and without delay in ambulation.
Atallah
Mohamed M
MM
Urology and Nephrology Center, University of Mansoura, Mansoura, Egypt. daliaat@hotmail.com
Helal
Mostafa A
MA
Shorrab
Ahmed A
AA
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D000775:Anesthesia, Spinal / Q000379:methods*; D019162:Anesthetics, Combined / Q000009:adverse effects / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use; D002045:Bupivacaine / Q000009:adverse effects / Q000627:therapeutic use*; D003558:Cystoscopy; D004305:Dose-Response Relationship, Drug; D004357:Drug Synergism; D005283:Fentanyl / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000187:drug effects; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010865:Pilot Projects; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine