Addition of fentanyl prolongs the duration of bupivacaine spinal anaesthesia in orthopedic surgery

Marinela Valerica Haţegan¹, Iurie Acalovschi²

1) Secţia ATI, Spitalul Judeţean Deva
2) Clinica A.T.I., Spitalul Clinic de Urgenţă „Prof.dr.Octavian Fodor”, Cluj-Napoca

Abstract

The aim of the study was to evaluate the efficacy of addition of fentanyl to bupivacaine for improvement of spinal anaesthesia in orthopedic surgery.

Material and mehod. A number of 30 patients ASA II/III programmed for orthopedic surgery on lower limbs were randomly allocated in two equal groups: group B which received spinal anaesthesia with 0.2 mg/kg bupivacaine 0.5% and group BF in which 0.5 g/kg fentanyl were added to 0.15 mg/kg bupivacaine 0.5%. After intrathecal injection of the drugs, the quality of sensory and motor block, duration of postoperative analgesia, the intraanaesthetic hypotension and the administered amount of fluids and ephedrine, as well as the incidence of side-effects were recorded.

Results. Addition of fentanyl to 0.5% bupivacaine reduced the onset time and increased the extension and duration of sensory block. The motor block was prolongued and the duration of postoperative analgesia was increased (235.4 ± 124.3 min in group B vs 380 ± 99.4 min in group BF). The intraanaesthetic hypotension occurred more freguently and needed larger amounts of fluids and ephedrine for compensation in group B vs group BF. In group BF, one patient developped postoperative nausea and vomiting and two patients, pruritus.

Conclusions. Addition of small dose of fentanyl to 0.5 % bupivacaine for spinal anaesthesia in orthopedic surgery, improved the quality of sensory and motor block, maintained haemodynamic stability and prolongued the postoperative analgesia.

Key words: spinal anaesthesia, bupivacaine, fentanyl, orthopedic surgery

Asocierea fentanylului prelungeşte durata anesteziei subarahnoidiene cu bupivacaină în chirurgia ortopedică

Jurnalul Român de Anestezie Terapie intensivă 2007 Vol.14 Nr.1, 38-42