Spinal Anesthesia with Low-Dose Bupivacaine-Fentanyl Combination: A Good Alternative for Day Case Transurethral Resection of Prostrate Surgery in Geriatric Patients

Abstract

We evaluated the effectiveness, block duration, postanesthesia care unit stay and adverse effects of using intrathecal low dose bupivacaine and fentanyl combination and compared with conventional dose prilocaine and fentanyl combination for day case transurethral resection of prostate surgery in geriatric patient population. Sixty patients were randomized into two groups with Group B receiving 4 mg bupivacine 0.5%+25 μg fentanyl and Group P receiving 50 mg prilocaine 2%+25 μg fentanyl intrathecal. Block quality and duration, postanesthesia care unit stay and adverse effects were compared. Block durations and postanesthesia care unit stay were shorter in Group B than in Group P (p<0.001 in both). Hypotension and bradycardia were not seen in Group B which was significantly different than in Group P (p=0.024 and p=0.011 respectively). Intrathecal 4 mg bupivacaine + 25 μg fentanyl provided adequate spinal anesthesia with shorter block duration and postanesthesia care unit stay with stable hemodynamic profile than intrathecal 50 mg prilocaine + 25 μg fentanyl for day case transurethral resection of prostate surgery in geriatric patients.