Comparative evaluation of subarachnoid block with low dose bupivacaine and fentanyl versus low dose bupivacaine and sufentanil in patients undergoing inguinal surgeries

ABSTRACT

Background:Fentanylis a phenylpiperidine derivative synthetic opioid agonist. As an analgesic fentanyl is 75-125 times more potent than morphine. Sufentanil is a semisynthetic thienyl analogue fentanyl with analgesic potency 5 to 10 times more than that of fentanyl. Recently there has been an interest in using analgesics and localanaesthetics in an attempt to decrease the local anaestheticdose enabling fasterrecovery.Methods:A double blinded randomised study was carried out with 50 patients of ASA grade I and II aged between 20 and 60 years undergoing elective inguinal and below inguinalregionsurgeriesunder low dose spinal anaesthesia. Patientsreceived 10 mg of 0.5% hyperbaric bupivacaine with 50 μg of fentanyl added to a total volume of 3 ml(group F),and with sufentanil 5 μg [diluted with 5% dextrose] and volume made to 3 ml(group S). Postoperative VAS score for pain, duration of motor block and complications postoperatively is noted.Results:Prolonged postoperative analgesia was observed in group F (216.7min) and group S(264.8)which was statistically significant among the groups (p<0.001) is higher in group S and also duration of motor block in group F(130.6) and group S (90.5) which was statistically significant among the groups (p<0.001) which is higher in group F than group S. Conclusions: When compared to intrathecalbupivacaine-fentanyl combination; intrathecal bupivacaine-sufentanil combination provided prolonged postoperative analgesia with a lesser duration of motor blockade thus allowing early post operative ambulation