Intrathecal fentanyl in spinal anesthesia for appendectomy.
OBJECTIVE
The authors assessed the effectiveness of the administration of fentanyl in spinal anesthesia for appendectomy.


METHODS
Forty patients randomized double-blind, were recruited to receive either 4 ml of 0.5% hyperbaric bupivacaine + 20 mg of fentanyl (Group F) or 4 ml of 0.5% hyperbaric bupivacaine 0.5% + 0.4 ml normal saline (Group S).


RESULTS
There were no significant differences in the highest analgesic level between the groups. The number of segments regressed at 60 min in Group F was statistically less than in Group S (0 vs. 2; P 0.002). Group F showed significantly lower median VNS pain scores than Group S (0 vs. 3; P 0.004). Time to first required postoperative analgesics in Group F was significantly higher than in Group S (13.6 vs. 6.3 h, P < 0.001). The incidence of shivering in Group F was significantly lower than Group S (35% vs. 70%; P 0.023). There were no significant differences in the incidence of nausea, vomiting, hypotension and urinary retention. No patient developed respiratory depression or PDPH. The patients' satisfaction of spinal anesthesia was 100% in Group F and 80% in Group S.


CONCLUSIONS
Intrathecal 20 microg fentanyl significantly improved the quality of analgesia, it prolonged the duration of bupivacaine in spinal anesthesia and delayed the analgesics requirement in the early postoperative period. Shivering was less frequently found in the fentanyl group.
Techanivate
Anchalee
A
Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Urusopone
Pakorn
P
Kiatgungwanglia
Predee
P
Kosawiboonpol
Rungrat
R
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000328:Adult; D000775:Anesthesia, Spinal; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D001062:Appendectomy; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007278:Injections, Spinal; D011446:Prospective Studies
D000759:Adjuvants, Anesthesia; D018685:Anesthetics, Inhalation; D005283:Fentanyl; D002045:Bupivacaine