A COMPARATIVE STUDY BETWEEN USE OF LOW DOSE BUPIVACAINE AND BUPIVACAINE PLUS FENTANYL IN SPINAL ANAESTHESIA IN TRANSURETHRAL RESECTION OF PROSTATE

Spinal anaesthesia is most frequently used for transurethral prostatectomy (TURP), because it permits early recognition of TURP syndrome. However, many elderly patients can have coexisting cardiac or pulmonary disease so, it is important to limit the distribution of spinal block in such patients. Aim and Objectives: To evaluate the efficacy and effect of addition of fentanyl 25 μg (0.5 ml) intrathecally to bupivacaine 5mg (0.5%) (1ml) and low dose bupivacaine 7.5mg (0.5%) (1.5 ml) alone for TURP. Methodology: It was a comparative prospective study under which 60 subjects were enrolled and divided into 2 groups of 30 patients each. Group A will receive Low dose bupivacaine 7.5mg (0.5%) (1.5 ml) Group B will receive bupivacaine 5mg (0.5%) (1ml) and fentanyl 25 μg (0.5). Results: Sensory block duration is higher in group B patients while time of onset of sensory block is low in Group B patients (1.18 + 0.31) in compare to Group A (1.59 + 0.34), similar findings were observed for motor block. In Group A complications of Hypotension (in 3 patients), Shivering (in 3 patients), Bradycardia (in 1 patient) and Vomiting (in 1 patient) were reported, while in Group B only pruritus (in 3 patients) was noted which is peculiar of fentanyl. Conclusion: Addition of intrathecal Fentanyl to Bupivacaine leads to early motor recovery with good haemodynamic stability. It also reduces the need for post-operative analgesics without any significant adverse effects.