Spinal Anesthesia for Transurethral Resection of Prostate: Levobupivacaine with or without Fentanyl

Background: The aim of the present study was to compare the characteristics of spinal blocks produced by low dose levobupivacaine (0.5%) and compare it when combined with fentanyl in transurethral resection of prostate. Methods: With Institutional ethical committee clearance a prospective, randomized, double-blinded study conducted. After obtaining informed written consent a total of 140 patients scheduled for elective TURP were randomly allocated into one of the two groups of 70 patients each. Following a spinal tap, patients in Levobupivacaine Group(L) received 1.5 ml of 0.5% isobaric levobupivacaine and in Levobupivacaine - Fentanyl Group (LF) received 1 ml of 0.5% isobaric levobupivacaine with fentanyl 25 μg (0.5 ml) intrathecally. The characteristics of sensory and motor block, hemodynamic data, side effects, patient and surgeon satisfaction were recorded. Results: There were no significant differences between the two groups for patient demographic, intraoperative hemodynamic parameters, side effects and satisfaction. The highest level of sensory block was T9 in the Group L, and T8 in the Group LF (p = 0.001). Duration of motor block was shorter in Group LF than in Group L (154.76 ± 16.39 minutes in Group L; 136.23 ± 9.06 minutes in Group LF) (p = 0.001). Conclusion: Both regimes are effective, and the addition of fentanyl to levobupivacaine may offers prolong duration of sensory block and postoperative analgesia and the advantage of shorter duration of motor block, thus it may be used as an alternative to pure levobupivacaine solution in spinal anaesthesia, for transurethral resections.