Low‐dose bupivacaine plus fentanyl for spinal anesthesia during ambulatory inguinal herniorrhaphy: a comparison between 6 mg and 7. 5 mg of bupivacaine

Gupta, Anil; Axelsson, Kjell; Thörn, Sven‐Egron; Matthiessen, Peter; Larsson, Lars; Holmström, Björn; Wattwil, Magnus

doi:10.1034/j.1399-6576.2003.470103.x

Cited by 90 publications

(75 citation statements)

References 26 publications

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“…This finding is comparable to the studies done by Singh et al and Ben David et al 9,12 Thus, it is evidenced that intrathecal Fentanyl was not involved in the incidence of bradycardia. Similarly, there was no respiratory depression, excessive sedation or drowsiness observed in both the groups that was in accordance with the studies of Gupta et al, Singh et al, Ben David et al and Belzarena et al 7,12,9,16 In our study, shivering occurred in 36% of group B and only 8% of group BF patients. Similar significant findings were reported by Biswas et al and Techanivate et al 21,22 This is due to added Fentanyl to the Bupivacaine.…”

Section: Discussionsupporting

confidence: 81%

“…Intrathecal Fentanyl has already shown to prolong the duration of local anaesthetic blockade in dose dependent manner. 5,[14][15][16] A combination of Bupivacaine 7.5 mg + Fentanyl 25 µg as a spinal anaesthesia proved to be safe and effective in relieving the intense pain associated with inguinal herniorrhaphy by the studies conducted by Gupta et al, H Singh et al, Song et al 7,9,17 Kuusniemi et al, also evaluated the effect of addition of 25 µg Fentanyl to various doses of Bupivacaine (10, 7.5, 5 mg) in urological surgeries, and found increase in the intensity and duration of sensory block by Fentanyl. 18 In our study, the earlier onset of surgical anaesthesia and peak sensory level in Group B may be because of cephalad spread of spinal blockade.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] To avoid these consequences, a low dose of Bupivacaine with an adjunct intrathecal Fentanyl is used as a reliable combination in spinal anaesthesia for inguinal herniorrhaphy. 7,8 This combination produces synergestic…”

Section: Introductionmentioning

confidence: 99%

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Comparison between high dose hyperbaric Bupivacaine (12.5 mg) alone versus low dose hyperbaric Bupivacaine (7.5 mg) with Fentanyl (25 µg) in spinal anaesthesia for inguinal hernia surgery

et al. 2016

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Background: For performing inguinal hernia surgeries, giving spinal anesthesia is a well known technique as it easy and provides fast onset, effective sensory and motor blockade in an awake patient. Now-a-days Bupivacaine is gaining importance as an effective spinal anaesthetic agent in combination with opioid analgesic Fentanyl to reduce the postoperative pain and side effects associated with surgery. This study aims to compare the effectiveness of intrathecal Bupivacaine alone versus combination of Bupivacaine with Fentanyl.Methods: The study designed was a prospective, randomized, double blinded comparative study. Patients were randomly divided into two groups of 25 each. Group B received hyperbaric intrathecal Bupivacaine 12.5 mg and Group BF received diluted hyperbaric intrathecal Bupivacaine 7.5 mg and Fentanyl 25 µg for spinal anesthesia . Parameters like sensory and motor block were assessed. Side effects produced during perioperative and postoperative period were observed and noted. Satisfactory criteria by the surgeons and patients were considered.Results: The time taken to attain surgical anesthesia and peak sensory levels in minutes was statistically significant in Group B compared to Group BF. Due to higher dose of Bupivacaine, it was observed that degree of motor blockade is also higher in group B when compared to group BF. The incidence of hypotension, nausea, vomiting and hypothermia are significantly higher in group B due to high dose of Bupivacaine. The surgeons and patients satisfaction was good in both the groups. Conclusions: Low dose Bupivacaine in combination with Fentanyl is safe and effective alternative for spinal anesthesia for inguinal herniorrphaphy as compared to conventional high dose Bupivacaine alone.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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Comparison between high dose hyperbaric Bupivacaine (12.5 mg) alone versus low dose hyperbaric Bupivacaine (7.5 mg) with Fentanyl (25 µg) in spinal anaesthesia for inguinal hernia surgery

et al. 2016

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“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] In 41 studies (5,548 patients), urinary retention or PVR with intrathecal anesthesia was assessed (Table 3), 11,13,16,17,20,22, and in 39 studies (4,938 patients), urinary retention or PVR with epidural anesthesia and/or analgesia was assessed (Table 4). 28,33,35,43,[48][49][50]54, An additional five studies involved both intrathecal and epidural techniques.…”

Section: Resultsmentioning

confidence: 99%

“…45,64 In contrast, studies in which either intrathecal fentanyl or sufentanil was utilized reported lower incidence rates ranging from 0 to 25%. 12,16,18,46,48,57,61 Kamphuis et al…”

Section: Resultsmentioning

confidence: 99%

Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review

Choi

Mahon

Awad

2012

Can J Anesth/J Can Anesth

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Purpose Urinary retention requiring catheterization carries the risk of infection. Neuraxial anesthesia causes transient impairment of bladder function ranging from delayed initiation of micturition to frank urinary retention. We undertook a review of the literature to determine the elements of neuraxial anesthesia and analgesia that prolong bladder dysfunction and increase the incidence of urinary retention. Methods We performed a systematic search of the PubMed, MEDLINE, and EMBASE databases (from January 1980 to January 2011) to identify studies where neuraxial anesthesia and/or analgesia were employed and at least one of the following outcomes was reported: urinary retention, time to micturition, or post void residual. We included randomized controlled trials and observational studies published in the English language and we excluded case reports. The randomized trials were graded according to the Jadad score. Principal findings Our search yielded 94 studies, and in 16 of these studies, the authors reported time to micturition after intrathecal anesthesia of varying local anesthetics and doses. Intrathecal injections were performed in 41 of these studies, epidural anesthesia/analgesia was used in 39 studies, and five studies involved both the intrathecal and epidural routes. Meta-analysis was not possible because of the heterogeneity of interventions and reported outcomes. The duration of detrusor dysfunction after intrathecal anesthesia is correlated with local anesthetic dose and potency. The incidence of urinary retention displays a similar trend and is further increased by the presence of neuraxial opioids, particularly long-acting variants. Urinary tract infection secondary to catheterization occurred rarely. Conclusions Neuraxial anesthesia/analgesia results in transient detrusor dysfunction. The duration of dysfunction depends on the potency and dose of medication used; however, it does not appear to result in significant morbidity.

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Anesthesia

Nordin¹

2012

Management of Abdominal Hernias

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Low‐dose bupivacaine plus fentanyl for spinal anesthesia during ambulatory inguinal herniorrhaphy: a comparison between 6 mg and 7. 5 mg of bupivacaine

Abstract: Spinal anesthesia with bupivacaine 7.5 mg and fentanyl offers an alternative to general or local anesthesia for ambulatory inguinal herniorrhaphy. However, the long discharge times and risk for urinary retention restrict its routine use in all patients.

Cited by 90 publications

References 26 publications

Comparison between high dose hyperbaric Bupivacaine (12.5 mg) alone versus low dose hyperbaric Bupivacaine (7.5 mg) with Fentanyl (25 µg) in spinal anaesthesia for inguinal hernia surgery

Comparison between high dose hyperbaric Bupivacaine (12.5 mg) alone versus low dose hyperbaric Bupivacaine (7.5 mg) with Fentanyl (25 µg) in spinal anaesthesia for inguinal hernia surgery

Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review

Anesthesia

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