• Fauzia A Khan and Gauhar A Hamdani.
• Department of Anaesthesiology, Aga Khan University, Karachi.
• J Pak Med Assoc. 2006 Jun 1;56(6):277-81.

ObjectiveTo evaluate and compare the characteristics of spinal block, its postoperative analgesic effects and side effects using intrathecal bupivacaine and its combination with fentanyl or buprenorphine in elderly patients undergoing urological surgery.MethodsSixty patients aged sixty and above scheduled for elective transurethral resection of prostate (TURP) randomly received hyperbaric bupivacaine 0.75% 2 ml (group L control, n = 20), buprenorphine 30 micrograms [DOSAGE ERROR CORRECTED] with hyperbaric bupivacaine 0.75% 2 ml (group B, n = 20) or fentanyl 10 micrograms [DOSAGE ERROR CORRECTED] with hyperbaric bupivacaine 0.75% 2 ml(group F, n = 20). Characteristics of spinal block, haemodynamic stability, postoperative analgesia and incidence of adverse effects were compared. All patients were followed for twenty four hours.ResultsThe patients' blood pressures remained within 20% of baseline values. The mean time for the sensory block to reach T10 dermatomal level was 3.2 +/- 2 minutes in fentanyl-bupivacaine group versus 4.3 +/- 1 in buprenorphine-bupivacaine and 4.5 +/- 2 bupivacaine alone group. The duration of sensory block was significantly longer in buprenorphine-bupivacaine group. Median block levels reached T8 in all groups. All patients required postoperative analgesia in group L and F except 6 in buprenorphine group.ConclusionBuprenorphine 30g in combination with bupivacaine 0.75% 2 ml provided analgesia of comparable clinical onset and longer duration but was associated with a clinically increased incidence of nausea and vomiting in elderly patients.

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