Subarachnoid sufentanil as sole agent vs standard spinal bupivacaine in transurethral resection of the bladder.
OBJECTIVE
The aim of the study was to determine whether intrathecal sufentanil alone provides an adequate analgesia for patients undergoing transurethral resection of the bladder (TURB) and to compare it to standard spinal bupivacaine anesthesia in terms of motor and sensory blockade, discharge time and side effects.


METHODS
Sixty-two patients were blindly and randomly assigned to receive either intrathecal bupivacaine (10 mg of 0.5% hyperbaric bupivacaine) or intrathecal sufentanil (15 microg). Motor and sensory blockade was evaluated using a modified Bromage scale as well as cold and pinprick tests. Severity of pain was assessed by means of a 10-point verbal analog scale.


RESULTS
We found that the mean duration of sensory blockade was similar for both sufentanil and bupivacaine patients but the quality of analgesia induced by sufentanil alone was poor as compared with spinal bupivacaine anesthesia.


CONCLUSIONS
The subarachnoid administration of sufentanil 15 mg seems to be inadequate for TURB surgery. In addition, the advantage of a faster recovery we observed in sufentanil patients is minimized by the occurrence of a troublesome symptom such as pruritus. On the other hand, spinal bupivacaine produces an undesirable motor blockade exceeding, in our opinion, the requirement for TURB procedure.
Marandola
M
M
Department of Anesthesiology, Critical Care and Pain Medicine, Policlinico Umberto I, La Sapienza University, Rome, Italy. maurizio.marandola@uniroma1.it
Antonucci
A
A
Tellan
G
G
Fegiz
A
A
Fazio
R
R
Scicchitano
S
S
Delogu
G
G
D000368:Aged; D000775:Anesthesia, Spinal; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013346:Subarachnoid Space; D017409:Sufentanil / Q000008:administration & dosage; D014521:Urethra / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery*; D013520:Urologic Surgical Procedures
D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D017409:Sufentanil; D002045:Bupivacaine