Bupicaine plus ephedrine versus bupicaine plus fentanyl for postoperative pain control for hernial repair

Background Inguinal hernias are common and typically necessitate surgical repair. This procedure can cause considerable pain after the procedure and even long-term discomfort in the days following the procedure. Many adjuvant drugs have been used to decrease the postoperative pain and complications. Aim of the work Compare the effect of Ephedrine versus Fentanyl for postoperative pain control for hernial repair as regards the quality of pain control and other associated side effects when added to bupicaine spinal anesthesia. Patients and methods Sixty patients undergoing unilateral hernial repair were randomized to receive hyperbaric bupivacaine plus ephedrine or hyperbaric bupivacaine plus fentanyl during spinal anesthesia. The primary outcome was the quality of anesthesia between the two techniques. The secondary outcomes were duration of sensory block, changes in intraoperative hemodynamics, total amount of rescue analgesia and incidence of complications. Results In the current study, the intraoperative heart rate and mean arterial pressure showed significant decrease in the fentanyl group. The time of first analgesic recall was statistically significantly longer in the ephedrine group ( p <0.001). The total dose of required analgesia was statistically significantly higher in the intrathecal block group. Conclusion The use of ephedrine with spinal anesthesia maintained optimum hemodynamic stability during the spinal anesthesia. Moreover, ephedrine improved analgesic control by prolonging first analgesic recall, decreasing postoperative pain score, and reducing postoperative analgesia.