Effect of addition of various doses of fentanyl intrathecally on perioperative analgesia and subarachnoid block characteristics in inguinal hernia repair surgery / 中国医师进修杂志

ABSTRACT

ObjectiveTo study the effect of adding various doses fentanyl to 0.75％ bupivacaine for spinal anesthetic in the population undergoing inguinal hernia repair surgery. MethodsThe population of 100 patients belonging to ASA class Ⅰ and Ⅱ ,scheduled for elective inguinal hernia repair, were randomized to receive a spinal anesthetic with 2 ml 0.75％ bupivacaine and 1.0 ml saline (group B),or 50 μg/ml fentanyl 0.1,0.2,0.4,0.6 ml(group BF5, group BF10, group BF20,group BF30),each group with 20 cases.Subarachnoid block was established in the left lateral position in L2-3 space by use of a midline approach. The volume of injected drug was kept constant at 3 ml. The time to the highest level of sensory block, the time for regression until T12 level, the time for complete motor recovery, the maintenance duration of the analgesia,the anesthesia effect of the groups, duration of surgery, drug-related side effects were assessed and recorded.ResultsThe time of the highest level of sensory block in group BF30 was shorter than that in group B,group BF5, group BF 1 0, group BF20 (P ＜ 0.05 ), but group B and group BF5 was longer than group BF10,group BF20, group BF30(P ＜ 0.05 ). The time of regression to T12 level in group BF20 was longer than that in group B, group BF5, group BF10, group BF30 (P＜0.05),but group B and group BF5 was shorter than group BF10, group BF20, group BF30(P＜ 0.05 ). The time for complete motor recovery and the maintenance duration of the analgesia in group B and group BF5 was shorter than that in group BFI0,group BF20, group BF30 (P ＜ 0.05 ). The occurrence of pruritus in group B (0) was lower than that in group B F5 (8 cases),group BF10 (3 cases), group BF20 (6 cases), group BF30 (6 cases)(P＜0.05). There were no cases of respiratory depression in five groups. ConclusionsIt suggests that in the population receiving spinal anesthetic for hernia repair surgery, addition of 10 μ g fentanyl to 0.75％ bupivacaine significantly improves the quality and duration of analgesia. No further advantage occurs if the dose of fentanyl is increased among 30 μg.