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Scholars Journal of Applied Medical Sciences | Volume-8 | Issue-03
Comparison of Subarachnoid Block with Low Dose Bupivacaine –Fentanyl and Conventional Dose of Bupivacaine for Transurethral Resection of Prostrate
Dr. Felin Paul P, Dr. Mahilamani PP, Dr. Paramasivan A
Published: March 30, 2020 | 44 54
Background: Sub Arachnoid block is the anaesthetic technique of choice for Transurethral Resection of Prostrate (TURP) because the complications of the surgery can be detected early as the patient remains awake. But the side effects of sympathetic blockade in elderly are more with the conventional dose of Bupivacaine (7.5mg). We aimed to evaluate the effects of adding 25 mcg of Fentanyl to low dose Bupivacaine in Subarachnoid block for elderly patients undergoing TURP. Methods: 40 elderly patients of ASA 1 to 3 electively scheduled for TURP under lumbar subarachnoid block was enrolled and randomly grouped into group B and group F. Group B received 7.5 mg of 0.5% hyperbaric bupivacaine (1.5ml) and group F received 5mg of 0.5% Bupivacaine with 25 mcg of Fentanyl (total of 1.5ml) intrathecally. Level of peak sensory block, time to attain peak sensory block, maximum motor block,time to two segment regression, time to S2 segment regression, duration of motor block, haemodynamic stability and incidence of complications were compared. Results: The sensory block was adequate in both the groups. There was statistically significant difference in the maximum motor block and duration of motor block between the groups. Maximum motor block and duration of block were less in group F(p<0.001). Hypotension and shivering were more in group B. Addition of 25 mcg Fentanyl with low dose hyperbaric Bupivacaine provides adequate anaesthesia for TURP with better haemodynamic stability, early recovery from motor block and lower incidence of side effects in elderly patients when compared to the conventional dose of hyperbaric Bupivacaine.