Spinal anesthesia for transurethral resection operations: levobupivacaine with or without fentanyl.
BACKGROUND
The objective ofthe present study was double fold; to compare the characteristics of spinal blocks produced by 0.5% levobupivacaine with and without fentanyl in transurethral resection and to test the hypothesis that, fentanyl added to levobupivacaine, may be used as an alternative to pure levobupivacaine solution, in spinal anesthesia.


METHODS
Forty males, aged >60 years, ASA I-III patients scheduled for elective transurethral resection were included in a prospective, randomized, double-blinded study. Following a spinal tap, intrathecal injection in Group L (n=20), 2.5 mL of 0.5% levobupivacaine and in Group LF (n=20), 2.2 mL of 0.5% levobupivacaine with fentanyl 15 microg (0.3 mL) was performed. The characteristics of sensory and motor block, hemodynamic data, side effects, patient and surgeon satisfaction were recorded. Patients were observed until the level of sensory block was S1 and the Bromage score was 0.


RESULTS
There were no significant differences between the two groups forpatient demographic, intraoperative, hemodynamic parameters, side effects and satisfaction. The highest level of sensory block was T9 in the Group L, and T6 in the Group LF (p = 0.001). Duration of motor block was shorter in Group LF than in Group L (291.00 +/- 81.08 min in Group L; 213.75 +/- 59.49 min in Group LF) (p = 0.001).


CONCLUSIONS
Both regimes are effective, and the addition of fentanyl to levobupivacaine may offers the advantage of shorter duration of motor block and may be used as an alternative to pure levobupivacaine solution in spinal anesthesia, for transurethral resections.
Cuvas
Ozgun
O
Department of Anesthesiology and Intensive Care Medicine, Ankara Training and Research Hospital, Ulucanlar, Ankara, Turkey. ozguncuvas@yahoo.com
Basar
Hulya
H
Yeygel
Aydan
A
Turkyilmaz
Esra
E
Sunay
Mehmet Melih
MM
D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods; D017060:Patient Satisfaction; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000601:surgery; D020728:Transurethral Resection of Prostate / Q000379:methods; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000379:methods*
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077554:Levobupivacaine; D005283:Fentanyl; D002045:Bupivacaine