Key result
Intrathecal bupivacaine 4 mg plus fentanyl 20 μg provided adequate analgesia and a favorable time to ambulation (128 mins) without the higher rescue analgesic needs seen with the 3 mg dose (P<0.03).
Why the study?
Does intrathecal bupivacaine plus fentanyl improve recovery and provide adequate analgesia compared to bupivacaine alone in elderly men undergoing short transurethral procedures?
RCT (n=100)
Does intrathecal bupivacaine plus fentanyl improve recovery and provide adequate analgesia compared to bupivacaine alone in elderly men undergoing short transurethral procedures?
p-value: p=<0.03
Intrathecal bupivacaine 4 mg plus fentanyl 20 μg provides adequate analgesia, hemodynamic stability, and favorable recovery for elderly men undergoing short transurethral procedures.
Supports 4 mg intrathecal bupivacaine plus fentanyl for short transurethral procedures in elderly men; extends dose-optimization data for spinal anesthesia recovery.
In Brief One hundred elderly men (≥65 yr) undergoing transurethral procedures (<45 min) received bupivacaine 7.5 mg, or bupivacaine 5 mg + fentanyl 20 μg, or bupivacaine 4 mg + fentanyl 20 μg, or bupivacaine 3 mg + fentanyl 20 μg, intrathecally. Intraoperative “rescue” fentanyl requirements were higher (P < 0.03) in group bupivacaine 3 mg + fentanyl. Times (min) to ambulation eligibility were decreased in a dose-dependant manner (157 ± 50 vs 147 ± 37 vs 128 ± 40 vs 116 ± 29, respectively). Of the techniques studied, intrathecal bupivacaine 4 mg + fentanyl 20 μg provided adequate analgesia and was associated with hemodynamic stability and a favorable recovery profile. IMPLICATIONS: Four intrathecal anesthetic techniques were compared among elderly people (≥65 yr) undergoing short transurethral procedures. Of the doses investigated, bupivacaine 4 mg plus fentanyl 20 μg, was associated with adequate analgesia, hemodynamic stability and favorable recovery.
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Zohar et al. (2007) conducted an RCT in Short transurethral procedures (n=100). Intrathecal bupivacaine and fentanyl vs. Active comparators (different doses) was evaluated on Intraoperative rescue fentanyl requirements and time to ambulation eligibility (p=<0.03). Intrathecal bupivacaine 4 mg plus fentanyl 20 μg provided adequate analgesia and a favorable time to ambulation (128 mins) without the higher rescue analgesic needs seen with the 3 mg dose (P<0.03).
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