ABSTRACT
The effect and suitability of lower doses of bupivacaine spinal anesthesia supplemented with intrathecal fentanyl in patients undergoing transurethral resection of prostate [TURP] were evaluated. double blind randomized clinical trial. 45 elderly men undergoing TURP under spinal anesthesia were randomized into the following 3 groups; Group I received 10mg bupivacaine, group II received 7.5mg bupivacaine plus 20 micro g fentanyl and group III received 5 mg bupivacaine plus 20 micro g fentanyl. Neural block was assessed by using pin prick and modified Bromage scale. Both sensory and motor blocks were longer in group I >II >III, motor block was also more dense. Hypotension occurred in significantly more patients and was more persistent in group I compared with groups II and III and significantly more ephedrine was administered to patients in group I whereas significantly more patients in group III required IV fentanyl supplementation to treat intraoperative discomfort. More patients complained of postoperative nausea and vomiting [PONV] and pruritis in groups II and III while more patients complained of shivering in group I. Anesthetic management was well rated by both surgeons and patients in group I and II. Anesthetic management was adequate and satisfactory in both groups I and II, but group II had the additional advantage of lower incidence of hypotension