Subarachnoid block for transurethral resection of the prostate: a comparison of the block characteristics between 0.5% isobaric bupivacaine with fentanyl and 0.5% isobaric bupivacaine alone

Abstract

Background: Spinal anaesthesia is commonly administered for transurethral resection of prostate (TURP).

Aim: To compare the block characteristics of 0.5% isobaric bupivacaine with fentanyl versus 0.5% isobaric bupivacaine alone in TURP.

Methods: Sixty male patients aged 40 - 90 years, scheduled for elective TURP were recruited into this prospective study, and allocated into two groups. Group A (n = 30) received intrathecal injection of 2.0 ml of 0.5% isobaric bupivacaine with fentanyl 25 µg (0.5 ml), while Group B (n = 30) received 2.0 ml of 0.5% isobaric bupivacaine with 0.9% saline solution 0.5 ml. The block characteristics, quality of analgesia during and after the surgery, haemodynamic data, and side effects were assessed and recorded.

Results: Four patients in Group A and 2 patients in Group B were excluded. Fifty-four   patients participated throughout the study, 26 in Group A and 28  in Group B. The median maximal sensory block height was T4 in Group A and T6 in Group B (p=0.02). The mean duration of motor block was longer in Group A. Postoperative analgesia was requested for more by Group A patients.  The haemodynamic profile  were  lower at 35 min in Group B. Bradycardia and hypotension were more common in Group B.

Conclusion: Isobaric bupivacaine with fentanyl for spinal anaesthesia in TURP patients provides adequate sensory block, and more stable haemodynamic profile.

Keywords: Spinal block characteristics, Bupivacaine, Fentanyl, TURP