Abstract
Objective. To investigate the efficacy of preoperative intravenous flurbiprofen axetil and tramadol on spinal anesthesia for transurethral resection of the prostate (TURP). Methodology. In this prospective clinical study, we enrolled 60 patients undergoing TURP under spinal anesthesia with small-dose bupivacaine and sufentanil. Patients were randomly divided in two: group flurbiprofen axetil and tramadol (Group FT) intravenously received 1 mg/kg flurbiprofen axetil and 1 mg/kg tramadol 20 min prior to the surgical procedures and group control (Group C) was given normal saline. The characteristics of spinal anesthesia, blood pressure, heart rate, analgesic requirement, visual analogue scale (VAS), and overall satisfaction degree were collected. Results. Time to the first analgesic requirement was significantly longer in Group FT. Patients who needed postoperative analgesics were fewer in Group FT. VAS scores were lower in Group FT at postoperative time points of 1, 2, 6, and 12 h. The patients in Group FT were more satisfied than in Group C. Conclusions. Preoperative flurbiprofen axetil and tramadol can reduce and delay postoperative pain and then decrease analgesic consumption for TURP under spinal anesthesia without an increase of side effects.
Highlights
Intrathecal anesthesia is widely used for endoscopic urological surgery because it is easy for us to detect early symptom of transurethral resection syndrome (TURS) [1]
Fifty-seven patients successfully underwent TURP under spinal anesthesia, and three patients were excluded from this study because of a failure of spinal puncture, one in Group FT, two in group control (Group C)
Mean blood pressure (MBP) and heart rate (HR) at various time points were showed in Figures 1 and 2
Summary
Intrathecal anesthesia is widely used for endoscopic urological surgery because it is easy for us to detect early symptom of transurethral resection syndrome (TURS) [1]. Hyperbaric 4 mg bupivacaine and 5 μg sufentanil can provide an adequate spinal anesthetic condition for transurethral resection of the prostate (TURP) and limit the spread of block level but maybe cannot yield an adequate postoperative analgesia [2, 3]. Previous studies have reported that preoperative administration of flurbiprofen axetil or tramadol can reinforce the effect of general anesthesia [4, 5]. There are no reports on whether the combination of preoperative flurbiprofen axetil and tramadol which have different analgesic mechanisms can enhance spinal anesthesia and reduce postoperative pain.
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