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

Abstract

<p class="abstract"><strong>Background:</strong> Fentanyl is 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 local anaesthetics in an attempt to decrease the local anaesthetic dose enabling faster recovery.</p><p class="abstract"><strong>Methods:</strong> 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 inguinal region surgeries under low dose spinal anaesthesia. Patients received 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.</p><p class="abstract"><strong>Results:</strong> Prolonged postoperative analgesia was observed in group F (216.7 min) 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.</p><p><strong>Conclusions: </strong>When compared to intrathecal bupivacaine-fentanyl combination; intrathecal bupivacaine-sufentanil combination provided prolonged postoperative analgesia with a lesser duration of motor blockade thus allowing early post operative ambulation.</p>

Dexmedetomidine versus sufentanil as adjuvants to bupivacaine for brachial plexus block during upper extremity surgery: a randomized clinical trial

“… 30 A similar result showing prolonged analgesia with sufentanil is reported in a study by Antonucci. 16 Since sufentanil is an analgesic 5 to 15 times more potent than fentanyl, 17 , 18 the discrepancy of the results between our study and the mentioned studies on dexmedetomidine and fentanyl is possibly due to this considerable difference in drugs... potency. The difference in the dosage of the drugs between the current and the previously mentioned studies is yet another possible factor.…”

“…Sufentanil, a semi-synthetic fentanyl analog, is believed to be 5 to 15 times more potent than fentanyl and has been used in various types of anesthesia, including as an adjuvant to local anesthetics. 11 , 16 , 17 , 18 Sufentanil has been shown to prolong the duration of local analgesia when used as an adjuvant, 10 , 11 however, some studies suggest otherwise. 19 Since a limited number of studies have been done a head-to-head comparison of dexmedetomidine and sufentanil as adjuvants for local anesthetic during BPB, we compared these two drugs in our study.…”