This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (10) Citing Articles via Google Scholar Google Scholar Articles by Kuusniemi, K. S. Articles by Kirvelä, O. A. Search for Related Content PubMed PubMed Citation Articles by Kuusniemi, K. S. Articles by Kirvelä, O. A.

---

REGIONAL ANESTHESIA AND PAIN MEDICINE

The Use of Bupivacaine and Fentanyl for Spinal Anesthesia for Urologic Surgery

Kristiina S. Kuusniemi, MD^*, Kalevi K. Pihlajamäki, MD, Mikko T. Pitkänen, MD, PhD^§, Hans Y. Helenius, MSc, and Olli A. Kirvelä, MD, PhD^*

Departments of *Anaesthesiology and Biostatistics, University of Turku, Department of Anaesthesiology of Turku City Hospital, Turku, Finland, and §Department of Anaesthesiology, University Central Hospital, Helsinki, Finland

Address correspondence and reprint requests to Kristiina S. Kuusniemi, MD, Department of Anaesthesiology, Kiinamyllynkatu 4-8, 20520 Turku, Finland.

We evaluated the effect of 25 µg of fentanyl added to bupivacaine on sensory and motor block. By using a double-blinded study design, 80 men undergoing urologic surgery were randomized into the following four groups: Group I, bupivacaine 10 mg; Group II, bupivacaine 10 mg + fentanyl 25 µg; Group III, bupivacaine 7.5 mg + fentanyl 25 µg; Group IV, bupivacaine 5 mg + fentanyl 25 µg. The final volume of intrathecal injectate was adjusted to 2.5 mL with sterile distilled water. Spinal anesthesia was administered with the 27-gauge Whitacre needle at the L2-3 interspace with the patient in the sitting position. Neural block was assessed by using pinprick and a modified Bromage scale. The degree of motor block was more profound in Group II compared with Group I at the end of operation. In Group IV, there was no motor block at the end of operation in any of the patients. The median level of the upper limit of the sensory block was higher than T₇ in all groups before the start of surgery. The addition of 25 µg of fentanyl to 5 mg of bupivacaine resulted in short-acting motor block. When 25 µg of fentanyl was added to 10 mg of bupivacaine, it increased the intensity and duration of motor block. Only 5 (6.3%) of the patients needed supplemental analgesia during the operation. {abs}

Implications: Bupivacaine 5 mg with 25 µg of fentanyl for spinal anesthesia resulted in short-acting motor block. On the contrary, the addition of 25 µg of fentanyl to 10 mg of bupivacaine resulted in an increase in the motor block intensity and duration.

This article has been cited by other articles:

				E. Zohar, Y. Noga, U. Rislick, I. Leibovitch, and B. Fredman Intrathecal Anesthesia for Elderly Patients Undergoing Short Transurethral Procedures: A Dose-Finding Study Anesth. Analg., March 1, 2007; 104(3): 552 - 554. [Abstract] [Full Text] [PDF]

				A. C. S. Law, K. K. Lam, and M. G. Irwin The Effect of Right Versus Left Lateral Decubitus Positions on Induction of Spinal Anesthesia for Cesarean Delivery Anesth. Analg., December 1, 2003; 97(6): 1795 - 1799. [Abstract] [Full Text] [PDF]