Analgesic effects of intrathecally administered fentanyl in spinal anaesthesia for lower limb surgery
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Date
2013
Authors
Akanmu, O.N.
Soyannwo, O.A
Sotunmbi, P.T
Lawal-Osunde, A.S.
Desalu, I
Adekola, O.O
Oridota, E.S.
Journal Title
Journal ISSN
Volume Title
Publisher
Macedonian Journal of Medical Sciences
Abstract
Background: Intrathecal opioids as adjuvants to local anaesthetics during spinal anaesthesia have
been used to augment the analgesia produced by local anaesthetic agents. The aim of this study is
to determine the duration of analgesia following addition of fentanyl to 0.5% hyperbaric bupivacaine
during open reduction of lower limb fractures.
Material and Methods: This prospective randomized study is comparing the effect of addition of
25µg of fentanyl to 10 mg of 0.5% hyperbaric bupivacaine intrathecally on sixty consecutive ASA I
and II patients scheduled to undergo elective open reduction and internal fixation of lower limb
fractures (ORIF) at the UCH, Ibadan. The patients were randomized into their either bupivacaine
saline (SB n=30) 10 mg (2 ml) 0.5% hyperbaric bupivacaine or bupivacaine-fentanyl combination
(FB n= 30) through a 25-guage Whitacre spinal needle. Quality and duration of analgesia as well as
any sequelae were recorded.
Result: Socio-demographic as well as operating data were comparable between the two groups.
Fentanyl provided significantly longer duration of complete (239.97 ± 28.58 vs 129.17 ± 11.61),
p<0.001 and effective (276.23 ± 26.21 vs 150.80 ± 10.33) analgesia than bupivacaine alone
(p<0.001). The pain intensity (visual analog scale [VAS]) at the time to first post-operative analgesic
dose in the Fentanyl-Bupivacaine (FB) groups was significantly lower than in the group BS
(p<0.001). Eight of the patients in the control group BS (26.67%) group had hypotension whereas
six patients (20%) in FB groups had hypotension that required rapid infusion of crystalloid. There
was no statistical difference in the level of shivering in the two groups. No patient in either group
developed respiratory insufficiency.
Conclusion: Addition of 25 µg of fentanyl to 10 mg of 0.5% hyperbaric bupivacaine intrathecally for
open reduction and internal fixation of lower limb fractures significantly prolonged the duration of
complete analgesia as well as effective analgesia thereby reducing the need for early postoperative
analgesic use without increase in severe adverse effect.
Description
Scholarly article
Keywords
intrathecal , Subarachnoid block , Analgesia , Fentanyl , Complications , Research Subject Categories::MEDICINE
Citation
Akanmu ON, Soyannwo OA, Sotunmbi PT, Lawani-Osunde AS, Desalu I, Adekola OO, Oridota SE. Analgesic Effects of Intrathecally Administered Fentanyl in Spinal Anaesthesia for Lower Limb Surgery. Maced J Med Sci. 2013 Sep 15; 6(3):255-260. http://dx.doi.org/10.3889/MJMS.1857-5773.2013.0302