title: A prospective randomized controlled study comparing intrathecal bupivacaine combined with fentanyl and sufentanil in abdominal and lower limb surgeries.
abstract: BACKGROUND
  Hyperbaric bupivacaine along with either fentanyl or sufentanil as additive, has been widely used in spinal anesthesia. In the present study, we compared the analgesic effects of intrathecal fentanyl versus sufentanil combined with bupivacaine for surgical procedures over the abdomen and lower limbs.
  
  
  METHODS
  This was randomized controlled study conducted in a tertiary care hospital attached to a medical school.
  
  
  METHODS
  Sixty American Society of Anesthesiologists I and II patients were randomized into three groups by sealed envelope technique. Group 1 was to receive bupivacaine with fentanyl; group 2 to receive bupivacaine with sufentanil and group 3 to receive bupivacaine with saline (control), intrathecally. The parameters checked were hemodynamic changes, onset and duration of sensory block, duration of analgesia and maximal sensory level achieved.
  
  
  METHODS
  The data collected were analyzed using χ2 test and paired Student's t-test.
  
  
  RESULTS
  The time taken for the onset of analgesia was longest in the control group followed by fentanyl group. The earliest onset of action of 9.35 ± 1.92 min was recorded in sufentanil group. Duration of sensory blockade and analgesia was longest for fentanyl group than the other groups. Adverse effects noted were more for sufentanil group but were self-limiting.
  
  
  CONCLUSIONS
  Fentanyl with bupivacaine produced prolonged analgesia and delayed two-segment regression and demonstrated reduced incidence of complications as compared with intrathecal sufentanil. As the quality of analgesia was complete and comparable, fentanyl emerges as a better option for analgesia and it is much economical too when compared to sufentanil.
authors.affiliation: Department of Anesthesiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: S
authors.initials: S
authors.lastname: Neeta
authors.affiliation: Department of Anesthesiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: Madhusudan
authors.initials: M
authors.lastname: Upadya
authors.affiliation: Department of Anesthesiology, Fortis Hospital, Mohali, Punjab, India.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Gosain
authors.affiliation: Department of Anesthesiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: Jesni Joseph
authors.initials: JJ
authors.lastname: Manissery
keywords: Bupivacaine; fentanyl; sufentanil