Assessment of subarachnoid block and saddle block anaesthesia using hyperbaric bupivacaine and fentanyl for transurethral resection of the prostate (TURP) surgeries
Hyperbaric bupivacaine and fentanyl for transurethral resection of the prostate
Abstract
Aim: To compare subarachnoid block and saddle block anaesthesia using hyperbaric bupivacaine and fentanyl for transurethral resection of the prostate (TURP) surgeries.
Methodology: Patients were randomly divided into 2 groups of 31 each. Group A Subarachnoid block with 2.2 ml of drug [ 1.7ml of 0.5% hyperbaric bupivacaine with 0.5ml (25 mcg) fentanyl] in L4-L5 intervertebral space in sitting position and patient was made to lie supine immediately after the intrathecal injection. Group B Saddle block with 2.2ml of drug [1.7ml of 0.5% hyperbaric bupivacaine with 0.5ml (25 mcg) fentanyl] in L4-L5 intervertebral space in the sitting position and patient was kept in sitting position for 10 minutes after the intrathecal injection and then made supine. Investigations performed were Hb, BT, CT, urine complete examination, FBS, blood urea, serum creatinine, L.F.T and ECG. Assessment of vitals, SPO2 and complications was done.
Results: The mean age of group A patients was 56.76.2 years and group B patients was 58.48.6 years. The mean onset of sensory block was 2.5 minutes in group A and 5.6 minutes in group B, duration of sensory block was 126.1 minutes in group A and 123.8 minutes in group B and mean modified bromage score was 2.6 in group A and 1.3 in group B. Vasopressor requirement was seen in 18 in group A and 2 in group B. Complications observed were headache in 1 and 2, respiratory depression in 4 and 3, hypotension in 1 and 2, bradycardia in 4 and 2, pruritis in 2 and 3 and urinary retention in 1 and 2 patients in group A and B respectively.
Conclusion: Saddle block is a safer technique as it provides adequate anaesthesia and stable haemodynamics with less complications in comparison to subarachnoid block using hyperbaric bupivacaine and fentanyl for transurethral resection of the prostate (TURP) surgeries.
