Article Type

Original Study


Introduction: Intrathecal fentanyl is routinely mixed with hyperbaric bupivacaineduring spinal block, but this may alter the baricity of both drugs andhenceaffect their spread and action.Aim:This study aimed to compare the sequential administration of intrathecalfentanyl and bupivacaine to the routine mixing of the two drugs as regardthe block characteristics, the postoperative analgesia duration, and theadverseeffects.Methods:Current prospective, controlled, randomized trial was carried outon100 adult participants subjected to lower limb orthopedic surgeries underspinalanesthesia. Subjects were allocated randomly into two equal groups(50each). Group P: received premixed solution of hyperbaric bupivacaine(HB)0.5 % (12.5 mg) plus 25 µgof fentanyl in the same syringe and group < br />S:received 25 µgof fentanyl followed by 12.5 mg of HB in sequential manner.Block characteristics, time to the first rescue pethidine request, numberofparticipants who requested for pethidine within the first 6 postoperativehours,and adverse effects were assessed.Results:Group S patients had statistically significantly faster onset of bothsensory(4.58 ±1.5 vs 5. 40 ±1.8 min, p = 0.02) and motor block (5.79 ±1.5min versus 6.64 ±1.9 min, p = 0.01), shorter time to achieve the highestsensorylevel (6.12 ±1.96 min vs 8.77 ±2.5min, p = 0.00), and a longertimetill the first postoperative rescue analgesic need (252.26 ±39.3 minversus234.70 ±40.2 min, p = 0.03) . Group P patients achieved statisticallysignificantlyhigher level of sensory blockade and showed longer sensoryblockduration (216.30 ±30.8vs 199.44±23.8, p = 0.003). Adverse effectswerecomparable in both groups.Conclusions:The sequential administration of fentanyl and hyperbaric bupivacaineimproves the spinal block characters in patients subjected to lowerlimb orthopedic surgeries with comparable adverse effects profile in comparisonto mixing both drugs.

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Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.