Intrathecal Isobaric Bupivacaine Fentanyl Mixture versus Hyperbaric Bupivacaine Fentanyl Mixture in Urological Procedures

Intrathecal adjuvants in urological procedures

Abstract

Background: To compare of intrathecal isobaric bupivacaine fentanyl mixture and hyperbaric bupivacaine fentanyl mixture in urological procedures. Subjects and Methods: One hundred thirty patients undergoing urological procedures were divided into 2 equal groups (65). Group I patients received 3 ml of 0.5% isobaric bupivacaine with 25 g fentanyl and group II received 3 ml of 0.5% hyperbaric bupivacaine with 25 g fentanyl. Parameters such as systolic & diastolic blood pressure, onset and duration of motor and sensory blockade and side effects was recorded. Results: Group I comprised of 30 males and 35 females and group II had 32 males and 33 females. The mean onset of sensory block was 4.6 minutes in group I and 1.3 minutes in group II. The mean duration of motor block was 5.3 minutes in group I and 1.2 minutes in group II. The mean duration of sensory block was 2.2 minutes in group I and 3.4 minutes in group II.  The mean duration of motor block was 2.7 minutes in group 1 and 3.9 minutes in group II. The mean systolic blood pressure (mm Hg) at 5 minutes was 138.2 in group I and 130.0 in group II, at 10 minutes was 132.6 and 112.2, at 20 minutes was 129.2 and 110.4, at 30 minutes was 126.0 and 118.2 and at 40 minutes was 122.8 and 116.8 respectively. A significant difference in both groups was observed (P< 0.05). The mean diastolic blood pressure (mm Hg) at 5 minutes was 78.2 in group I and 80.4 in group II, at 10 minutes was 77.4 and 78.0, at 20 minutes was 75.3 and 76.2, at 30 minutes was 77.1 and 72.2 and at 40 minutes was 77.0 and 74.2 respectively. A significant difference in both groups was observed (P< 0.05). Common adverse events recorded were nausea and vomiting seen in 1 patient in group I and 3 patients in group II, bradycardia 2 in group I and 4 in group II, hypotension 2 in group I and 5 in group II, post spinal headache was seen in 2 in group I and 3 in group II, post- operative shivering was seen in 3 in group I and 5 in group II. A significant difference was observed (P< 0.05). Conclusion: A shorter duration of both the sensory and motor blockade and greater haemodynamic stability were linked to intrathecal isobaric bupivacaine fentanyl combination.