Intrathecal fentanyl added to hyperbaric ropivacaine for transurethral resection of the prostate.
BACKGROUND
Our purpose was to evaluate the effect of intrathecal fentanyl 25 microg added to 18 mg of 6 mg ml(-1) hyperbaric ropivacaine on the characteristics of subarachnoid block and postoperative pain relief in patients undergoing TURP surgery.


METHODS
The patients were randomly assigned into two groups: Group S (saline group, n=16) received 3 ml of 18 mg hyperbaric ropivacaine + 0.5 ml saline--in total, a 3.5-ml volume intrathecally; and Group F (fentanyl group, n=15) received 3 ml of 18 mg hyperbaric ropivacaine + 0.5 ml of 25 microg fentanyl--in total, a 3.5-ml volume intrathecally. In both groups the onset and recovery times of the sensory block, degree and recovery times of the motor block and side-effects were recorded and statistically compared.


RESULTS
There was no significant difference between the groups in achieving the highest level of sensory block, and in the times taken to reach the peak level. Regression to L1 was significantly prolonged in the fentanyl group compared with the saline group (P=0.004). Times to the first feeling of pain and the first analgesic requirement were significantly prolonged in the fentanyl group compared with the saline group (P=0.011 and P=0.016, respectively). The frequency of pruritus was significantly higher in the fentanyl group compared with the saline group (P=0.022).


CONCLUSIONS
Addition of fentanyl 25 microg to hyperbaric ropivacaine 18 mg for spinal anesthesia in patients undergoing TURP may significantly improve the quality and prolong the duration of analgesia, without causing a substantial increase in the frequency of major side-effects.
Yegin
A
A
Department of Anesthesiology, Akdeniz University Medical Faculty, 07070 Antalya, Turkey. ayegin@akdeniz.edu.tr
Sanli
S
S
Hadimioglu
N
N
Akbas
M
M
Karsli
B
B
D000577:Amides / Q000627:therapeutic use*; D000775:Anesthesia, Spinal / Q000379:methods; D019162:Anesthetics, Combined / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D004311:Double-Blind Method; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007278:Injections, Spinal / Q000379:methods; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control; D000077212:Ropivacaine; D012965:Sodium Chloride / Q000008:administration & dosage; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome
D000577:Amides; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D012965:Sodium Chloride; D000077212:Ropivacaine; D005283:Fentanyl