Porównanie znieczulenia podpajęczynówkowego z zastosowaniem czystej bupiwakainy i zredukowanej dawki bupiwakainy z dodatkiem fentanylu do zabiegów przezcewkowej resekcji prostaty

Hanna Misiołek, Hanna Kucia, Jacek Karpe, Małgorzata Werner, Aleksandra Kwosek, Dariusz Budziński, Piotr Knapik

Summary
Background. Spinal anaesthesia is routinely used for transurethral prostatectomy (TURP) and is especially attractive in elderly patients with concomitant diseases. Methods. We have compared spinal anaesthesia using hyperbaric bupivacaine 15-20 mg (group I) and hyperbaric bupivacaine 5-10 mg with fentanyl 100 mcg (group II) in terms of sensory and motor blocks, and haemodynamic function. Results. The sensory block was rated adequate in all patients. Patients in group I experienced a higher level of motor block, greater changes in systolic arterial pressure (p <0.05), and larger fluid (p = 0.01) and ephedrine requirements. Discussion and conclusions. Subarachnoid injection of fentanyl, mixed with a reduced dose of bupivacaine, significantly decreased the frequency of haemodynamic side effects and the need for fluid and ephedrine, providing satisfactory analgesia in patients undergoing transurethral prostatectomy. We therefore recommend the described protocol for elderly, high risk patients.

To jest tylko fragment artykułu. Aby przeczytać całość, przejdź do Czytelni medycznej.