The Effect of Adding Fentanyl or Sufentanil to Intrathecal Marcaine on Sensory and Motor Block, Iintraoperative Hemodynamic Status and Pain Reduction after Lumbar Disc Surgery

Document Type : Original Article (s)

Authors

1 Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, Student Research Committee AND School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: This study aimed to investigate the properties of adding fentanyl or sufentanil to intrathecal Marcaine on sensory and motor block, intraoperative hemodynamic status and reducing of pain in patients after lumbar disc surgery and compare it with the control group.Methods: In a clinical-trial study, 96 patients undergoing lumbar disc surgery with spinal anesthesia were distributed in three groups of 32 people. Fentanyl and sufentanile were added to Marcaine in the first and second group, respectively, and in the third group, only Marcaine was injected. The severity of postoperative pain, the analgesic requirement and time of first receiving the drug and drug intake in the three groups were determined and compared during 24 hours after the surgery.Findings: During the stay of fentanyl, sufentanil and control groups in recovery, 40.6, 6.3 and 59.4 percent of the patients had pain in the groups, respectively, and there were significant differences among the three groups (P < 0.001). The severity of postoperative pain from 2 to 12 hours after the surgery was significant between the three groups (P = 0.010).Conclusion: The results of this study showed that using fentanyl or sufentanil with Marcaine led to reduced incidence and severity of postoperative pain after lumbar disc surgery and thus reduction in opioid usage.

Keywords

References

  1. Hurley RW, Wu CL. Acute postoperative pain. In: Miller RD, Editor. Miller's anesthesia. 7th ed. London, UK: Churchill Livingstone/Elsevier; 2010. p. 2757-82.
  2. White PF, Kehlet H. Improving postoperative pain management: What are the unresolved issues? Anesthesiology 2010; 112(1): 220-5.
  3. Vadivelu N, Mitra S, Narayan D. Recent advances in postoperative pain management. Yale J Biol Med 2010; 83(1): 11-25.
  4. Ferrante FM, VadeBoncouer TR. Postoperative pain management. London, UK: Churchill Livingstone; 1993. p. 145.
  5. Gourlay GK, Cousins MJ. Strong analgesics in severe pain. Drugs 1984; 28(1): 79-91.
  6. Jellish WS, Shea JF. Spinal anaesthesia for spinal surgery. Best Pract Res Clin Anaesthesiol 2003; 17(3): 323-34.
  7. Attari MA, Mirhosseini SA, Honarmand A, Safavi MR. Spinal anesthesia versus general anesthesia for elective lumbar spine surgery: A randomized clinical trial. J Res Med Sci 2011; 16(4): 524-9.
  8. Campbell DC, Camann WR, Datta S. The addition of bupivacaine to intrathecal sufentanil for labor analgesia. Anesth Analg 1995; 81(2): 305-9.
  9. Kumar S, Bajwa SJ. Neuraxial opioids in geriatrics: A dose reduction study of local anesthetic with addition of sufentanil in lower limb surgery for elderly patients. Saudi J Anaesth 2011; 5(2): 142-9.
  10. Aydin F, Akan B, Susleyen C, Albayrak D, Erdem D, Gogus N. Comparison of bupivacaine alone and in combination with sufentanil in patients undergoing arthroscopic knee surgery. Knee Surg Sports Traumatol Arthrosc 2011; 19(11): 1915-9.
  11. Olofsson C, Nygards EB, Bjersten AB, Hessling A. Low-dose bupivacaine with sufentanil prevents hypotension after spinal anesthesia for hip repair in elderly patients. Acta Anaesthesiol Scand 2004; 48(10): 1240-4.
  12. Lo WK, Chong JL, Chen LH. Combined spinal epidural for labour analgesia-duration, efficacy and side effects of adding sufentanil or fentanyl to bupivacaine intrathecally vs plain bupivacaine. Singapore Med J 1999; 40(10): 639-43.
  13. Soni AK, Miller CG, Pratt SD, Hess PE, Oriol NE, Sarna MC. Low dose intrathecal ropivacaine with or without sufentanil provides effective analgesia and does not impair motor strength during labour: a pilot study. Can J Anaesth 2001; 48(7): 677-80.
  14. Dahlgren G, Hultstrand C, Jakobsson J, Norman M, Eriksson EW, Martin H. Intrathecal sufentanil, fentanyl, or placebo added to bupivacaine for cesarean section. Anesth Analg 1997; 85(6): 1288-93.
  15. Braga Ade F, Braga FS, Poterio GM, Pereira RI, Reis E, Cremonesi E. Sufentanil added to hyperbaric bupivacaine for subarachnoid block in Caesarean section. Eur J Anaesthesiol 2003; 20(8): 631-5.
  16. Gupta S, Sampley S, Kathuria S, Katyal S. Intrathecal sufentanil or fentanyl as adjuvants to low dose bupivacaine in endoscopic urological procedures. J Anaesthesiol Clin Pharmacol 2013; 29(4): 509-15.
  17. Wang YC, Guo QL, Wang E, Zou WY. Spinal anesthesia with low dose sufentanil-bupivacaine in transurethral resection of the prostate. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2006; 31(6): 925-8.
Journal of Isfahan Medical School
Volume 34, Issue 391 - Serial Number 391
May and June 2016
Pages 841-847

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History

  • Receive Date: 14 May 2016
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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