European Journal of Cardiovascular Medicine

Background: TURP has long been considered the gold standard for the surgical treatment of BPH. Spinal anesthesia is considered the anesthetic technique of choice when traditional M-TURP is performed [1]. Spinal anesthesia provides adequate anesthesia for the patient with relaxation of the pelvic floor and perineum for the sur¬geon. In this study the efficacy of intrathecal 0.5% hyperbaric Bupivacaine (12.5mg) and intrathecal 0.5%hyperbaric Bupivacaine (10mg) with 25 μg of Fentanyl were compared. Materials and methods: This study comprised of 70 male patients, of ASA grades II– III, between the age group 50 and 80 years, planned for elective Transurethral Resection of Prostate (TURP) who were randomly divided into group B (n=35) & group F(n=35). Group B – received 2.5ml of 0.5%hyperbaric Bupivacaine (12.5mg) intrathecally. Group F – received 2ml of 0.5% hyperbaric Bupivacaine(10mg) + 25μg Fentanyl intrathecally. Intra–operative hemodynamic parameters, onset of sensory and motor block, total duration of sensory and motor blockade, time for two segment regression, total duration of perioperative analgesia were recorded. Patients were observed for 72 hours post-operatively to look for any complications. Result: Time for onset of sensory (Group B 3.4±1.2 mins vs Group F 2.5±1.1 mins) & motor blockade (Group B 8.4±1.7 mins vs Group F 6.5±1.5 mins) was faster in group F compared to group B. Two segment sensory block regression time (Group B 65±8.4 mins vs Group F 75±10.9 mins) was relatively longer in group F. Duration of sensory (Group B 186±15 mins vs Group F 210±22 mins) & motor blockade (Group B 155±9.7 mins vs Group F 165±7.5 mins) was longer in group F. Duration of perioperative analgesia (Group B 210±18.5 mins vs Group F 235±25.6 mins) was longer in group F. Hemodynamic parameters between both the groups were comparable. Conclusion: Fentanyl as an adjuvant to bupivacaine when used in spinal anesthesia had showed early onset of sensory & motor blockade, prolonged perioperative analgesia, and showed good hemodynamic stability without significant adverse effects. Use of 25µg of Fentanyl as an adjuvant to low dose Bupivacaine (10mg) showed enhanced efficacy in spinal anaesthesia for TURP procedures.