title: Low-dose levobupivacaine plus fentanyl combination for spinal anesthesia in anorectal surgery.
abstract: BACKGROUND
  the aim of this study was to investigate the effects of spinal anesthesia using two different doses of fentanyl combined with low-dose levobupivacaine in anorectal surgery.
  
  
  METHODS
  in this prospective, double-blind study, 52 American Society of Anaesthesiologists I-II patients scheduled for elective anorectal surgery were randomized into two groups. The patients in group I received intrathecal 2.5mg hyperbaric levobupivacaine plus 12.5 μg fentanyl and in group II received intrathecal 2.5mg hyperbaric levobupivacaine plus 25 μg fentanyl. All the patients remained in the seated position for 5 min after completion of the spinal anesthesia. Sensory block was evaluated with pin-prick test and motor block was evaluated with a modified Bromage scale.
  
  
  RESULTS
  motor block was not observed in both of the groups. The sensory block was limited to the S2 level in group I, and S1 level in group II. None of the patients required additional analgesics during the operation. Time to two-segment regression was shorter in group I compared with group II (p<0.01). One patient in group I and 5 patients in group II had pruritus. Hemodynamic parameters were stable during the operation in both of the groups.
  
  
  CONCLUSIONS
  spinal saddle block using hyperbaric levobupivacaine with both 12.5 μg and 25 μg fentanyl provided good quality of anesthesia without motor block for anorectal surgery in the prone position.
authors.affiliation: Department of Anesthesiology and Reanimation, Kecioren Training and Research Hospital, Ankara, Turkey. Electronic address: mehtaphonca@hotmail.com.
authors.forename: Mehtap
authors.initials: M
authors.lastname: Honca
authors.affiliation: Department of Anesthesiology and Reanimation, Kecioren Training and Research Hospital, Ankara, Turkey.
authors.forename: Necla
authors.initials: N
authors.lastname: Dereli
authors.affiliation: Department of Anesthesiology and Reanimation, Istanbul Medipol University, Medipol Mega Hospital, Istanbul, Turkey.
authors.forename: Emine Arzu
authors.initials: EA
authors.lastname: Kose
authors.affiliation: Department of Medical Biochemistry, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Tevfik
authors.initials: T
authors.lastname: Honca
authors.affiliation: Department of Anesthesiology and Reanimation, Kecioren Training and Research Hospital, Ankara, Turkey.
authors.forename: Selcen
authors.initials: S
authors.lastname: Kutuk
authors.affiliation: Department of Anesthesiology and Reanimation, Kecioren Training and Research Hospital, Ankara, Turkey.
authors.forename: Selma Savas
authors.initials: SS
authors.lastname: Unal
authors.affiliation: Department of Anesthesiology and Reanimation, Kecioren Training and Research Hospital, Ankara, Turkey.
authors.forename: Eyup
authors.initials: E
authors.lastname: Horasanli
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D000775:Anesthesia, Spinal / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*
chemical_list: D000077554:Levobupivacaine; D005283:Fentanyl; D002045:Bupivacaine
keywords: Anorectal surgery; Cirurgia colorretal; Fentanil; Fentanyl; Hyperbaric levobupivacaine; Levobupivacaína; Raquianestesia; Spinal