Abstract

Spinal anaesthesia for transurethral resection of prostate (TURP) and transurethral resection of bladder tumor (TURBT) has been frequently used. Levobupivacaine 0.5% has been found to be equally effective as bupivacaine 0.5% in spinal anaesthesia. Aims & Objectives: To compare safety and efficacy of levobupivacaine 0.5% 2 ml (10 mg) with 25 µg fentanyl and levobupivacaine 0.5% 2 ml (10 mg) when given intrathecally in patients of transurethral resection of prostate/bladder tumor surgery. Methodology: Sixty patients in the age group of 45 to 70 years, ASA grade I and II undergoing TURP and TURBT under spinal anesthesia at Govt. Medical college, Rajindra Hospital Patiala were randomized into groups of 30 patients each. Group A received subarachnoid block with drug containing 2ml (10 mg) of 0.5% levobupivacaine and 25 mcgs of injection fentanyl and Group B received block with drug containing 2ml (10 mg) of 0.5% levobupivacaine plain. The changes in intra- operative haemodynamics (SBP, DBP, MBP, HR, SPO2, RR and PR), onset of sensory and motor block, level of sedation, duration of analgesia and occurrence of complications was recorded for both the groups. Data was tabulated and subjected to statistical analysis. Results: The results showed statistically non-significant difference in haemodynamics, occurence of complications, postoperative vitals, level of sedation and postoperative pain which were comparable in both the groups (p>0.05). The mean onset of sensory blockade was earlier and action was prolonged in group with 0.5% levobupivacaine with fentanyl. Onset of motor blockage was slightly delayed in levobupivacaine with fentanyl as compared to levobupivacaine plain, however it was statistically non-significant. Conclusion: Levobupivacaine with fentanyl showed better haemodynamic stability, prolonged duration of action, good patient and surgeon satisfaction as compared to levobupivacaine plain in the elderly patients undergoing a urological intervention under spinal anaesthesia.

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