Bupivacaine-Sufentanil Versus Bupivacaine-Fentanyl in Spinal Anesthesia of Patients Undergoing Lower Extremity Surgery (original) (raw)
Related papers
The Internet Journal of Anesthesiology, 2009
This study was conducted to compare sufentanil & fentanyl in combination with bupivacaine for infra-umbilical surgeries. Sixty ASA I and II patients for elective intra-umbilical surgeries under spinal anaesthesia were divided into three groups to receive 15 mg bupivacaine alone, 10 g sufentanil & 25 g fentanyl in combination with 15mg bupivacaine. Onset time of sensory blockade, Duration of side effects, surgical conditions, and quality of the anaesthesia was assessed. The duration of effective analgesia of bupivacaine alone was prolonged with the addition of sufentanil and fentanyl by 179% and 141% respectively. No patient is the sufentanil and fentanyl groups required additional intra-operative analgesics compared with 17.6% of patients in the bupivacaine alone group. There was an increase in incidence of desaturation in the sufentanil group (45%) and fentanyl group (5.6%) compared with the bupivacaine only group (0%). The incidence of pruritus was 35% with sufentanil, 27.8% with fentanyl against 0% with bupivacaine alone. The addition of 10 g of sufentanil and 25 g of fentanyl to improved intraoperative analgesia. However, the incidence of pruritus and episodes of desaturation were increased more with 10 g sufentanil than with 25 g fentanyl.
National Journal of Medical Research, 2013
Objectives: We designed a prospective, randomized, single blind study to compare the postoperative analgesic efficacy and common adverse effects of fentanyl and sufentanil along with hyperbaric bupivacaine by intrathecal route. Methodology: Sixty patients undergoing lower abdominal, gynecological, plastic surgery and orthopedic surgery were randomly divided in two groups. Group I (n=30) received 2.5 ml bupivacaine heavy (0.5%) and 0.5 ml (25 micrograms) fentanyl where as group II (n=30) received 2.5 ml bupivacaine heavy (0.5%) and 0.2 ml (6 micrograms) sufentanil with 0.3 ml normal saline intrathecally. Intraoperative and postoperative vitals, onset of spinal anesthesia and duration of sensory and motor blockade and occurrence of any side effects were assessed at specific time intervals. Analgesic efficacy in terms of duration of analgesia postoperatively was assessed by using the Pain Intensity Score (PIS) for 24 hours. Results: Mean duration of pain free period in group I was 145+/-84.08 minutes (mean+/-SD) as compared to 266.5+/-114.5 minutes (mean+/-SD) in group II which was highly significant. Cardiovascular and respiratory stability was maintained with no significant incidence of side effects in either group. Conclusion: We conclude that intrathecal fentanyl(25 microgram) and sufentanil (6 microgram) with bupivacaine heavy prolong postoperative analgesia without respiratory depression or other serious adverse effects .This prolonged analgesia is more marked with sufentanil than fentanyl.
Introduction: Intrathecal anesthesia and epidural anesthesia (EA) are the most popular regional anesthesia techniques used for surgeries below umbilicus. EA is more versatile in providing anesthesia, analgesia and treatment of chronic disease syndromes. It provides better postoperative pain control and more rapid recovery from surgery. It also provides effective prolonged surgical anesthesia, prolonged postoperative analgesia, reduces the incidence of hemodynamic changes and reduces the incidence of PDPH as the dura is not pierced. Aims And Objectives: To Compare with the efficacy of lumbar epidural block with 0.5% bupivacaine 10ml with Fentanyl 50µg and 0.5%bupivacaine 10ml with butorphanol 1mg in lower limb surgeries focusing on Onset and duration of analgesia, Cardio respiratory effects, Sedation, Adverse effects Summary: The study was conducted to compare the effect in lower limb surgeries. 100 patients belonging to ASA grade I&II were selected. Bupivacaine (0.5%) 10ml with fentanyl (50µg) was given in Group I, and Bupivacaine (0.5%)10ml with butorphanol (1mg) was given in Group II. The patients studied across the group did not vary much with respect to age, sex or height. The onset of sensory blockade was delayed by about 20 seconds in groupII and the onset of motor blockade was delayed by about 20-25 seconds in group-II compared to group-I. Duration of sensory blockade in Group II is longer compared to group I , thus prolonging the duration of analgesia. Duration of motor blockade in group II is prolonged than in Group I. The time of first request of analgesics by the patients in group-II is longer (360 minutes) compared to group-l (206 minutes) thus prolonging the duration of analgesia. Visual analogue scores were significantly lower in group-II compared to group-l thus reducing the requirement of supplemental postoperative analgesics. The adverse effects observed in the study were minimal. Conclusion: Addition of the opioids, i.e., Butorphanol and Fentanyl significantly quickens the onset and prolongs analgesia Onset is fast with Bupivacaine with Fentanyl combination compared with Bupivacaine with Butorphanol combination. Bupivacaine with Butorphanol provide more effective and longer duration of analgesia as compared with Bupivacaine with Fentanyl.
Advances in Orthopedics
Introduction. This study aimed to compare the effect of intrathecal bupivacaine plus dextrose 5% and fentanyl with bupivacaine alone on the onset and duration of analgesia in patients undergoing lower-limb orthopedic surgery. Materials and Methods. A total of 40 patients eligible for lower-limb surgery were divided into two groups by simple randomization: the control group which received only bupivacaine and the intervention group which received bupivacaine plus dextrose 5% and fentanyl. Anesthesia was induced by the spinal method. The visual analog scale (VAS) was used to assess the patients’ pain; hemodynamic status (systolic and diastolic blood pressure and the heart rate) and oxygen saturation were also monitored. Results. There was a significant difference between groups in the type of lower-limb movement at the L1 anesthesia level, the sensory block level at time zero after surgery, the type of backward movement at time zero after surgery, and the analgesic dose received ( p &...
Brazilian Journal of Anesthesiology (English Edition), 2016
Objective: The primary outcome of this study was to evaluate the effect of adding sufentanil to hyperbaric bupivacaine on duration of sensory blockade of spinal anesthesia in chronic opioid users in comparison with non-addicts. Methods: Sixty patients scheduled for orthopedic surgery under spinal anesthesia were allocated into four groups: group 1 (no history of opium use who received intrathecal hyperbaric bupivacaine along with 1 mL saline as placebo); group 2 (no history of opium use who received intrathecal bupivacaine along with 1 mL sufentanil [5 g]); group 3 (positive history of opium use who received intrathecal bupivacaine along with 1 mL saline as placebo) and group 4 (positive history of opium use who received intrathecal bupivacaine along with 1 mL sufentanil [5 g]). The onset time and duration of sensory and motor blockade were measured. Results: The duration of sensory blockade in group 3 was 120 ± 23.1 min which was significantly less than other groups (G1 = 148 ± 28.7, G2 = 144 ± 26.4, G4 = 139 ± 24.7, p = 0.007). The duration of motor blockade in group 3 was 145 ± 30.0 min which was significantly less than other groups (G1 = 164 ± 36.0, G2 = 174 ± 26.8, G4 = 174 ± 24.9, p = 0.03). Conclusions: Addition of 5 g intrathecal sufentanil to hyperbaric bupivacaine in chronic opioid users lengthened the sensory and motor duration of blockade to be equivalent to blockade measured in non-addicts.
International Journal of Research in Pharmaceutical Sciences, 2020
Opioids are added to local anesthetics to extend theduration of spinal analgesia/anaesthesia.The present study was undertaken to compare the analgesic efficacy of subarachnoid hyperbaric bupivacaine 0.5% alone as a control,bupivacaine 0.5% with fentanyl and bupivacaine 0.5% with nalbuphine. Total 150 patients of either sex, ASA grade I and II, between 18 to 60 years and height 150 to 170 cm, posted for elective lower abdominal and lower limb surgeries were enrolled. They were divided into three equal groups. Group B: received 15mg hyperbaric bupivacaine 0.5%(3ml) + 0.5ml normal saline, Group BF: received 15mg hyperbaric bupivacaine 0.5% (3ml) + Inj. Fentanyl25µg(0.5ml) and Group BN: received 15mg hyperbaric bupivacaine 0.5%(3ml) + Inj. Nalbuphine 500µg(0.5ml). The sensorimotor blockade was significantly faster and prolonged in group BF and BN than group B. Quality of analgesia during the procedure was excellent in 90%, 94% and 94% in group B, BF and BN respectively. The duration of ...
Journal of Evolution of Medical and Dental Sciences, 2020
BACKGROUND Epidural analgesia is an important component of the multimodal approach to pain management. It is used effectively for postoperative pain management following joint replacement surgeries. In this study, we aimed to evaluate the post-operative analgesic efficacy of epidural Ropivacaine (0.2%)-Fentanyl (2 µg/mL) and epidural Bupivacaine (0.125%)-Fentanyl (2 µg/mL) on patients undergoing joint replacement surgeries. METHODS 60 adult patients of ASAPS grade I or II between ages 25-65 years of either sex undergoing elective joint replacement surgeries were randomly allocated to two groups: Group A (ropivacaine group) receiving ropivacaine 0.2% (40 mL) + fentanyl (2 µg/mL) and Group B (bupivacaine group) receiving bupivacaine 0.125% (40 mL) + fentanyl (2 µg/mL). RESULTS The immediate post-operative VAS scores for pain at rest and on touch of patients in the two groups were close to no-pain status. Mean VAS scores at rest showed an incremental trend with passage of time. At 24 hour postoperative interval, mean VAS score at rest was 3.13 ± 0.43 in group A and 3.10 ± 0.40 in group B while mean VAS score on touch was 3.20 ± 0.55 in group A and 3.40 ± 0.68 in group B. Statistically, there was no significant difference between the two groups at any of the follow-up intervals. Thus, as far as analgesic effect of the two drugs was concerned, both the drugs have comparable efficacy in terms of mean VAS scores. In the present study, median VAS scores peaked at 6-hour postoperative interval and remained at same level till the end of study. CONCLUSIONS In our study, both ropivacaine (0.2%) and bupivacaine (0.125%) with fentanyl (2 µg/mL) combinations showed similar efficacy in postoperative pain management with almost stable hemodynamic profile. Moreover, the ropivacaine group gives better motor blockade and lower overall rescue analgesic needs.
Journal of clinical and diagnostic research : JCDR, 2015
Continuous epidural infusion of Bupivacaine and Ropivacaine with or without the addition of Fentanyl has been evaluated by various researchers for effective postoperative pain relief. Studies however, depict significant variability in their results with regard to analgesic efficacy and adverse effects like hypotension, motor blockade etc. To comparatively evaluate postoperative analgesic efficacy, motor sparing effect, postoperative haemodynamic variations and total postoperative analgesic consumption in first 24 hours. A randomised double blind study was conducted on 100 adult, ASA grade I and II patients, of either sex who had undergone elective lower limb surgery under spinal anaesthesia. According to the group allocated, patients were started on epidural infusion after completion of surgery. Group I (0.2% Ropivacaine), Group II (0.1% Ropivacaine + 2μg/ml Fentanyl), Group III (0.2% Bupivacaine), Group IV (0.1% Bupivacaine + 2μg/ml Fentanyl) at the rate of 6 ml/hour. VAS scores, e...