Subarachnoid anesthesia with variable doses of bupivacaine with fentanyl in the trans-urethral resection of the prostate

Abstract

Introduction: currently, several models of spinal anesthesia with bupivacaine in different doses, associated or not to fentanyl, have been described providing a safe and efficacious anesthesia, reducing the intensity of the postsurgical pain, preserving the cognitive function, and reducing the complications attributed to hyperbaric lidocaine due to its neurotoxicity.
Objective: to assess the effect of low doses of bupivacaine with fentanyl as subarachnoid anesthesia in patients undergoing a prostate trans-urethral resection.
Materials and methods: a prospective, longitudinal, quantitative, descriptive study was carried out in 200 patients programmed for that kind of surgery and with the indication of subarachnoid anesthesia through bupivacaine; they were randomly distributed in four groups.
Results: both, the sensory block and the motor one were faster in the patients of the Group B (3.0; 11.2) and (7.1; 8.3), Group C (5.0; 9.4) and (6.2; 9.4) and Group D (6.1; 8.3) and (4.7; 10.9); while in the patients of the Group A they were (6.0; 8.5) y (9.9; 11.7) respectively. It was observed a good quality anesthesia in all the patients of the Groups C and D.
Conclusions: the intrathecal administration of 7.5 mg of bupivacaine with 25 µg of fentanyl produced a satisfactory anesthesia, reduced the latency period, kept a better hemodynamic stability up, extended the post-surgery analgesia and was associated to fewer incidences of perioperative.