Spinal hyperbaric ropivacaine-fentanyl for day-surgery

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Optimizing intraoperative analgesia and patient mobilization is crucial in surgical procedures.
• Investigating the use of fentanyl in combination with hyperbaric ropivacaine may offer improved outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of combining fentanyl with hyperbaric ropivacaine for spinal anesthesia.
• To compare the effects of a fentanyl-ropivacaine combination versus higher-dose ropivacaine alone on sensory and motor block characteristics and patient recovery.

Main Methods:

• A randomized study involving 60 patients undergoing spinal anesthesia.
• Patients received either hyperbaric ropivacaine 10 mg with fentanyl 20 microg (group FR10) or hyperbaric ropivacaine 15 mg (group R15).
• Sensory and motor block levels were assessed using pinprick and the Bromage scale, respectively, at regular intervals until full recovery.

Main Results:

• Both groups demonstrated comparable success rates and onset times for sensory block.
• The fentanyl-ropivacaine group (FR10) showed significantly faster recovery of motor function (full recovery in 1 hour vs. 1.5 hours) and ambulation (2.5 hours vs. 3 hours).
• Pruritus was more common in the FR10 group (60%), but generally mild; hemodynamic stability was similar between groups.

Conclusions:

• Intrathecal hyperbaric ropivacaine 10 mg plus fentanyl 20 microg facilitates faster patient mobilization and motor recovery compared to hyperbaric ropivacaine 15 mg alone.
• This combination achieves comparable onset and duration of analgesia while potentially improving early functional recovery.
• The findings support the judicious use of fentanyl in spinal anesthesia to enhance post-operative outcomes.