1. Comparison of Spinal, Low-Dose Spinal and Epidural Anesthesia With Ropivacaine Plus Fentanyl for Transurethral Surgical Procedures
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Simay Serin, Baris Ulker, Hülya Sungurtekin, and Riza Hakan Erbay
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Male ,vomiting ,Time Factors ,medicine.medical_treatment ,Blood Pressure ,ephedrine ,Aged ,Amides/administration & dosage/*pharmacology ,Analgesics, Opioid/administration & dosage/pharmacology ,Anesthesia, Epidural/*methods ,Anesthesia, Spinal/*methods ,Anesthetics, Local/administration & dosage/pharmacology ,Blood Pressure/drug effects ,Demography ,Dose-Response Relationship, Drug ,Fentanyl/administration & dosage/*pharmacology ,Heart Rate/drug effects ,Humans ,Intraoperative Care ,Nerve Block ,Postoperative Care ,Postoperative Complications/etiology/physiopathology ,Ropi ,nerve block ,Fentanyl ,low drug dose ,fentanyl citrate ,Postoperative Complications ,Heart Rate ,dermatome ,epidural catheter ,Medicine ,Anesthetics, Local ,epidural anesthesia ,comparative study ,Medicine(all) ,ropivacaine ,lcsh:R5-920 ,Anesthesia complication ,article ,Transurethral Resection of Prostate ,clinical trial ,analgesic agent ,General Medicine ,nausea ,Analgesics, Opioid ,aged ,medicine.anatomical_structure ,Dermatome ,postdural puncture headache ,Anesthesia ,sodium chloride ,Urologic Surgical Procedures ,low-dose spinal anesthesia ,lcsh:Medicine (General) ,prospective study ,medicine.drug ,Anesthesia, Epidural ,medicine.medical_specialty ,Analgesic ,Anesthesia, Spinal ,motor nerve block ,Urethra ,transurethral resection ,controlled study ,human ,anesthesia complication ,spinal anesthesia ,controlled clinical trial ,business.industry ,Ropivacaine ,pruritus ,major clinical study ,Amides ,transurethral surgery ,oxygen saturation ,Blockade ,Surgery ,Anesthesiology and Pain Medicine ,randomized controlled trial ,Anesthetic ,Nerve block ,business - Abstract
The aim of This study was to compare spinal, low-dose spinal, and epidural anesthesia using ropivacaine and fentanyl combinations for transurethral surgical procedures. Sixty patients with American Society of Anesthesiologists scores of I-III were allocated into three groups. After pre- loading with 5 mL/kg normal saline, patients in the spinal anesthesia group (Group S) received 15 mg of hyperbaric ropivacaine plus 25 μg of fentanyl intrathecally; patients in the epidural anesthesia group (Group E) received 112.5 mg of ropivacaine plus 25 μg of fentanyl epidurally via an epidural catheter; and patients in the low-dose spinal anesthesia group (Group L) received 10 mg of hyperbaric ropivacaine plus 25 μg of fentanyl intrathecally. Blood pressure, heart rate, peripheral oxygen saturation, time to onset of thoracic (T)-10 dermatome, two-segment sensorial block regression time, full recovery of sensorial block, maximum motor blockade levels, motor blockade regression time, additional analgesic administration, patient comfort, and complications were recorded. The time to the onset of T10 dermatome level was shortest in Group S and longest in Group E (p < 0.001). The sensorial blockade time and motor blockade regression time were shorted in Group L (p < 0.001). The two-segment sensorial block regression time in Group E exceeded that in the other groups. Additional analgesic administration was not needed in any group. No complications or adverse effects were observed in any patient. We conclude that all three anesthetic techniques may be used safely and are appropriate for transurethral surgical procedures. However, low-dose spinal anesthesia with ropivacaine plus fentanyl may be preferable in transurethral surgery because we reach an adequate sensorial level with less motor blockade. © 2010 Elsevier.
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