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Intrathecal sufentanil versus fentanyl for lower limb surgeries - a randomized controlled trial
Poonam Motiani1, Sujata Chaudhary, Nitin Bahl
1Assistant Professor, Department of Anaesthesiology and Critical Care, Delhi State Cancer Institute, Dilshad Garden, Delhi - 110095.
Journal of Anaesthesiology, Clinical Pharmacology
|August 2, 2011
Summary
Adding intrathecal sufentanil or fentanyl to hyperbaric bupivacaine significantly improves sensory block onset and duration for lower limb surgeries. Both adjuvants offer prolonged effective analgesia compared to bupivacaine alone.
Area of Science:
- Anesthesiology
- Pharmacology
- Orthopaedic Surgery
Background:
- Major orthopaedic lower limb surgeries require effective anesthesia and post-operative pain management.
- Intrathecal adjuvants are used to enhance the effects of local anesthetics like hyperbaric bupivacaine.
- Sufentanil and fentanyl are commonly used opioid adjuvants in spinal anesthesia.
Purpose of the Study:
- To compare the efficacy and safety of intrathecal sufentanil versus fentanyl as adjuvants to hyperbaric bupivacaine.
- To evaluate the impact on sensory and motor block characteristics.
- To assess post-operative pain relief and identify potential side effects.
Main Methods:
- A prospective, randomized, double-blind study involving 90 patients undergoing major orthopaedic lower limb surgery.
- Patients received intrathecal hyperbaric bupivacaine with either sufentanil (5 μg), fentanyl (25 μg), or normal saline.
- Onset and duration of sensory/motor block, pain scores, analgesia duration, and side effects were recorded.
Main Results:
- Demographic, hemodynamic, and respiratory parameters were comparable across all groups.
- Intrathecal sufentanil and fentanyl significantly accelerated sensory block onset and prolonged its duration.
- Effective analgesia duration was significantly extended in the sufentanil and fentanyl groups compared to the control group.
Conclusions:
- Intrathecal sufentanil (5 μg) and fentanyl (25 μg) effectively enhance hyperbaric bupivacaine for lower limb orthopaedic surgery.
- These adjuvants provide a faster onset and longer duration of sensory block and analgesia.
- The addition of sufentanil or fentanyl to hyperbaric bupivacaine offers superior post-operative pain relief compared to bupivacaine alone.
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