Résumé
Background: Patients who are candidates for TURP are elderly with cardiovascular and respiratory diseases with anticipated problems during spinal anesthesia. Aim: To compare three different doses (5mg, 7.5mg and 10mg) of Bupivacaine after adding 25 mcg of fentanyl during spinal anesthesia in transurethral resection of prostate surgeries. Methods: Single blinded Randomized clinical study conducted in 75 patients. The subjects were allocated in to three groups. Group A - received Inj. 0.5% Bupivacaine 5 mg, Group B- received Inj. 0.5% Bupivacaine 7.5 mg, Group C - received Inj.0.5% Bupivacaine 10 mg added with 25 mcg of Fentanyl. Baseline and intraoperative vital parameters, time to sensory block at t10, maximum sensory height, time to two segment sensory regression, total duration of sensory blockade, grading of motor blockade and total duration of motor blockade were recorded. Results: Maximum sensory level achieved in Group A was T9, Group B T7 and in Group C it was T5. Time to T10 level in Group A was 7.88 ±0.80 minutes, Group B 5.41 ±0.50 minutes and Group C 3.33 ±0.65 minutes. Two segment sensory regression times in Group A was 56.8±13.61 minutes, Group B 79.58 ±25.32 minutes, and Group C was 116.25 ±9.35 minutes. Total duration of pain free interval in Group A was 84.6 ±20.41 minutes, Group B 104.12 ±45.89 minutes. Group C was 194.20 ±41.53 minutes. Conclusion: Low dose of Bupivacaine (5mg) with addition of Fentanyl 25μg can be used for painless TURP surgeries when compared to higher doses (7.5mg and 10 mg) without any major side effects and facilitates early discharge.