title: Clinical effects of intrathecal fentanyl on shoulder tip pain in laparoscopic total extraperitoneal inguinal hernia repair under spinal anaesthesia: a double-blind, prospective, randomized controlled trial.
abstract: OBJECTIVE
  The study evaluated the clinical intraoperative effects of intrathecal administration of fentanyl on shoulder tip pain in patients undergoing laparoscopic total extraperitoneal inguinal hernia repair (TEP) under spinal anaesthesia.
  
  
  METHODS
  Patients undergoing TEP were allocated in a double-blinded, prospective, randomized manner to two groups. Spinal anaesthesia was induced by intrathecal administration of 2.8 ml of 0.5% hyperbaric bupivacaine (14 mg) in the control group and with 2.6 ml of 0.5% hyperbaric bupivacaine (13 mg) and 10 µg fentanyl (0.2 ml) in the experimental group.
  
  
  RESULTS
  The quality of muscle relaxation, adequacy of operative space and incidence of pneumoperitoneum were similar in the two groups (n = 36 per group). Compared with the control group, the experimental group had significantly fewer cases of hypotension (12 [33.3%]) versus 23 [63.9%]) and shoulder tip pain (nine [25%] versus 18 [50%]). Intraoperative shoulder tip pain was more severe in the control group than in the experimental group.
  
  
  CONCLUSIONS
  Addition of intrathecal fentanyl to local anaesthetic can relieve shoulder tip pain with no change in complications, especially hypotension, during TEP under spinal anaesthesia.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea.
authors.forename: Tae-Yun
authors.initials: TY
authors.lastname: Sung
authors.forename: Min-Su
authors.initials: MS
authors.lastname: Kim
authors.forename: Choon-Kyu
authors.initials: CK
authors.lastname: Cho
authors.forename: Dong-Ho
authors.initials: DH
authors.lastname: Park
authors.forename: Po-Soon
authors.initials: PS
authors.lastname: Kang
authors.forename: Sang-Eok
authors.initials: SE
authors.lastname: Lee
authors.forename: Won-Kyoung
authors.initials: WK
authors.lastname: Kwon
authors.forename: Nam-Sik
authors.initials: NS
authors.lastname: Woo
authors.forename: Seong-Hyop
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000005:Abdomen / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D002045:Bupivacaine / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D006552:Hernia, Inguinal / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007278:Injections, Spinal; D007431:Intraoperative Complications; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020069:Shoulder Pain / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl; D002045:Bupivacaine
keywords: Laparoscopic total extraperitoneal inguinal hernia repair; intrathecal fentanyl; spinal anaesthesia