Researches

A comparison of the efficiency of intrathecal bupivacaine, levobupivacaine and levobupivacaine with fentanyl in transurethal prostate resection

  • Güray Demir
  • Zafer Çukurova
  • Gülay Eren
  • Oya Hergünsel
  • Ali İhsan Taşçı

Received Date: 11.11.2008 Accepted Date: 24.03.2009 Med J Bakirkoy 2009;5(4):143-148

Objective:

Spinal anesthesia is a preferential method of anesthesia in transurethal prostate resection (TUR-P) patients. In this study, we aimed to compare the sensorial and motor block efficiency of isobaric bupivacaine, isobaric levobupivacaine and levobupivacaine added fentanyl.

Material and Methods:

60 patients with ASA physical status I or III were randomly divided in three groups. Spinal anesthesia was achieved through L4- 5 interspace with 3 mL (15 mg) of bupivacaine 0.5% in Group BPV, with 3 ml (15 mg) of levobupivacaine 0.5% in Group LVB, with 0.5 ml (25 μg) fentanyl added to 2.5 ml (12.5 mg) of levobupivacaine 0.5% in Group LVB+FNT. Sensorial block increment time of T10, maximum level of sensorial block, total sensorial block time, maximum level of motor block and its formation time, total motor block time, pain degree with VAS, complications and side effects were recorded and tested.

Results:

Demographic data were similar between the groups (p>0.005). Maximum level of sensorial block was T8 per three groups. Sensorial block increment time of T10 was lower in Group BPV than Group LVB and Group LVB+FNT (p=0.004, p=0.017). Maximum level of motor block was higher and its formation time was lower in Group BPV than Group LVB and Group LVB+FNT (p=0.003, p=0.001). Total sensorial block time was similar in Group BPV and Group LVB+FNT and lower than Group LVB (p>0.005, p=0.001). Total motor block time was higher in Group BPV than other groups (p=0.001, p=0.002). Pain degree before surgery, complications and side effects were similar between groups (p>0.005).

Conclusion:

Bupivacaine, levobupivacaine and fentanyl added to levobupivacaine provided effective anesthesia for TUR-P. The formation time of sensorial and motor block were lower and level of motor block was higher with bupivacaine. Fentanyl addition to levobupivacaine increased sensorial block time. In TUR-P, motor block isn’t a requirement. For then fentanyl addition to levobupivacaine is a proper choise for TUR-P. Also its supplies a benefit for postoperative analgesia.

Keywords: Bupivacaine, levobupivacaine, spinal anesthesia, transurethal prostate resection