The Effects of Low Dose Levobupivacaine with or without Sufentanil Intrathecally in Transurethral Resection of Prostate

Hale Borazan,Işıl Davarcı,Şeref Otelcioğlu,Ahmet Keçecioğlu

doi:10.29333/ejgm/82714

Abstract

Aim: We aimed to compare the clinical efficacy of levobupivacaine alone and levobupivacaine/sufentanil combination in spinal anesthesia for transurethral resection of the prostate (TURP) in elderly patients. Method: Ninety patients were randomly assigned into two groups to receive either levobupivacaine 10 mg (Group L) or levobupivacaine 7.5 mg combined with 2.5 μg sufentanil (Group LS) for spinal anesthesia. The dermatome level and upper level of sensory blockade, time to develop a sensory block to T10, duration of sensory and motor blockade, Bromage score at the end of surgery, two- segment sensory regression time, and side effects were recorded. The quality of anesthesia was evaluated and rated after the surgery. Result: There were no significant differences between groups in demographic data or hemodynamic variables in terms of sensory blockade, onset time of sensory blockade to T10 dermatome, and two-segment regression. Bromage score at the end of surgery was significantly higher in Group L (p<0.05). The number of patients with maximum motor block was significantly higher in Group L (p<0.05). Complete motor block resolution time was longer in Group L (p<0.05). There were no significant differences in side effects between groups except for pruritus (p<0.05). There were no significant differences between groups in quality of anesthesia. Conclusion: It was shown that 10 mg levobupivacaine and 7.5 mg levobupivacaine combined with 2.5 μg sufentanil were considered to be convenient for clinical use in TURP surgery with spinal anesthesia; both treatments provided adequate anesthesia with hemodynamic stability in elderly patients.

Highlights

Subarachnoid block is a widely used technique for transurethral resection of the prostate (TURP) surgery in the elderly, especially in those with respiratory and cardiac problems
It was shown that 10 mg levobupivacaine and 7.5 mg levobupivacaine combined with 2.5 μg sufentanil were considered to be convenient for clinical use in TURP surgery with spinal anesthesia; both treatments provided adequate anesthesia with hemodynamic stability in elderly patients
There were no significant differences between groups in hemodynamic data, including systolic blood pressure (SBP) values, diastolic blood pressure (DBP) values, mean arterial pressure (MAP) values (Figure 1) and heart rate (HR) (Figure 2)

Summary

Introduction

Subarachnoid block is a widely used technique for transurethral resection of the prostate (TURP) surgery in the elderly, especially in those with respiratory and cardiac problems. This procedure usually lasts less than one hour, and early recovery and discharge are desirable [1,2]. Lipophilic opioids added to local anesthetics (LA) can adapt the spinal anesthetic to a specific type and duration of surgery. By using the synergistic analgesic effect of an opioid, it is possible to create adequate spinal anesthesia for surgery with normally subtherapeutic doses of LA. IT administration of such a combination improves anesthesia quality, prolongs sensory blockade without prolonged motor block and reduces LA requirements [6]

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