INTRATHECAL SUFENTANIL ALONG WITH BUPIVACAINE PROLONGS POSTOPERATIVE ANALGESIA AS COMPARED TO FENTANYL WITH BUPIVACAINE: A RANDOMIZED TRIAL

Abstract

Objectives: We designed a prospective, randomized, single blind study to compare the postoperative analgesic efficacy and common adverse effects of fentanyl and sufentanil along with hyperbaric bupivacaine by intrathecal route.

Methodology: Sixty patients undergoing lower abdominal, gynecological, plastic surgery and orthopedic surgery were randomly divided in two groups. Group I (n=30) received 2.5 ml bupivacaine heavy (0.5%) and 0.5 ml (25 micrograms) fentanyl where as group II (n=30) received 2.5 ml bupivacaine heavy (0.5%) and 0.2 ml (6 micrograms) sufentanil  with 0.3 ml normal saline intrathecally. Intraoperative and postoperative vitals, onset of spinal anesthesia and duration of sensory and motor blockade and occurrence of any side effects were assessed at specific time intervals. Analgesic efficacy in terms of duration of analgesia postoperatively was assessed by using the Pain Intensity Score (PIS) for 24 hours.

Results:  Mean duration of pain free period in group I was 145+/-84.08 minutes (mean+/-SD) as compared to 266.5+/-114.5 minutes (mean+/-SD) in group II which was highly significant. Cardiovascular and respiratory stability was maintained with no significant incidence of side effects in either group.

Conclusion: We conclude that intrathecal fentanyl(25 microgram) and sufentanil (6 microgram) with bupivacaine heavy prolong postoperative analgesia without respiratory depression or other serious adverse effects .This prolonged analgesia is more marked with sufentanil than fentanyl.