Why the study?
Bupivacaine use alone is limited by blockade duration and depth, prompting the addition of adjuvants, but comparisons of epinephrine versus fentanyl as intrathecal adjuvants in orthopedic surgeries were needed.
Does intrathecal bupivacaine with epinephrine compared to bupivacaine with fentanyl affect the duration of anesthesia, complications, and hemodynamics in patients undergoing lower limb orthopedic surgeries?
Population
100 patients undergoing femur and tibia surgeries under spinal anesthesia at a tertiary hospital in Iran
Comparison
Intrathecal bupivacaine with epinephrine vs bupivacaine with fentanyl
Design
Quasi-experimental randomized study
Authors
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Bupivacaine-fentanyl may improve analgesia and hemodynamic stability versus epinephrine addition; leaves open need for RCTs before changing spinal anesthesia practice.
Does intrathecal bupivacaine with epinephrine compared to bupivacaine with fentanyl affect the duration of anesthesia, complications, and hemodynamics in patients undergoing lower limb orthopedic surgeries?
Bupivacaine with fentanyl offers superior postoperative analgesia and a more favorable hemodynamic safety profile compared to bupivacaine with epinephrine for spinal anesthesia in lower limb surgery.
Hammod et al. (2025) studied this question.
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