Low dose Intrathecal sufentanil versus mrophine and Isobaric bupivacaine in laparoscopic surgery: Effect on postoperative pain relief

ABSTRACT

This study was designed to evaluate the perioperative analgesic effect of intrathecal anaesthesia with a low dose intrathecal sufentanil combined with low dose isobaric bupivacaine and to compare it with a low dose intrathecal morphine combined with low dose isobaric bupivacaine in laparoscopic surgery. 45 female patients of ASA I and II were scheduled for laparoscopic adhesolysis for infertility as diagnosed by hysterosalpingiography with or without diagnostic laparoscopy. Patients were randomly allocated into one of three equal groups Group [I] Patients in this group received 20 micro gm intrathecal sufentanil in 1ml saline and 1ml isobaric bupivacaine 0.5%; Group [II] Patients of this group received 10 micro gm intrathecal sufentanil in 1ml saline and 1ml isobaric bupivacaine 0.5%; and Group [III] Patients of this group received 100 micro gm intrathecal morphine in 1ml saline and 1ml isobaric bupivacaine 0.5%. The main finding of this study was that 100 micro gm of intrathecal morphine prolonged postoperative pain relief as measured with VAS [9 +/- 1.813] where intrathecal sufentanil was less effective for prolonged analgesic effect [3.47 +/- 0.51 for 20 micro gm group and 3.40 +/- 0.52 for 10 micro gm group], with p value 0.000 which is extremely significant. This dose resulted in excellent pain relief and a low dem and for systemic analgesics postoperatively. On the other h and, intrathecal sufentanil in dose of 20 micro gm has the same duration of action of 10 micro gm with denser block but with higher incidence of side effects. We conclude that intrathecal morphine 0.1 mg provided good analgesic effect in laparoscopic adhesolysis that lasted for longer duration [mean 9 hours] than intrathecal sufentanil with fewer side effects