title: Combination of ultra-low dose bupivacaine and fentanyl for spinal anaesthesia in out-patient anorectal surgery.
abstract: This study investigated whether the addition of 25 microg fentanyl to an ultra-low (sub-anaesthetic) dose of intrathecal bupivacaine provides adequate anaesthesia for out-patient anorectal surgery, without increasing side-effects or delaying hospital discharge. Patients were randomly allocated to receive 2.5 mg 0.5% bupivacaine plus 25 microg fentanyl (group BF, n = 18) or 5 mg 0.5% bupivacaine alone (group B, n = 17). There were no significant differences in intra-operative outcomes, but mean recovery and discharge times were significantly shorter in group BF. There were no between-group differences in hypotension, bradycardia or respiratory depression and post-operative complications were comparable, apart from pruritus which was significantly more frequent in group BF. Fewer patients requested analgesic medication in the early post-operative period in group BF than in group B. In conclusion, 25 microg intrathecal fentanyl added to ultra-low dose (2.5 mg) bupivacaine provided good-quality spinal anaesthesia and reduced post-operative analgesic requirement in patients undergoing ambulatory anorectal surgery.
authors.affiliation: Department of Anaesthesiology and Reanimation, Faculty of Medicine, Uludag University, Bursa, Turkey. agurbet@uludag.edu.tr
authors.forename: A
authors.initials: A
authors.lastname: Gurbet
authors.forename: G
authors.initials: G
authors.lastname: Turker
authors.forename: N K
authors.initials: NK
authors.lastname: Girgin
authors.forename: H
authors.initials: H
authors.lastname: Aksu
authors.forename: N H
authors.initials: NH
authors.lastname: Bahtiyar
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D001003:Anal Canal / Q000601:surgery*; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine