• Kaushik Rao Seetharam and Gayathri Bhat.
• Department of Anaesthesia, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
• Anesth Essays Res. 2015 May 1;9(2):173-7.

BackgroundThe addition of fentanyl to ropivacaine has shown to improve the quality of analgesia without compromising its benefits such as early mobilization and early voiding.AimThe aim of the study was to evaluate the effects of the isobaric ropivacaine in combination with fentanyl and compare it with the isobaric ropivacaine alone in spinal anesthesia for lower abdominal and lower limb surgeries.Settings And DesignDouble-blinded randomized controlled trial.Subjects And MethodsHundred patients belonging to American Society of Anesthesiologists physical status I and II scheduled for either lower abdominal or lower limb surgery under spinal anesthesia were included. The study was a prospective double-blinded randomized controlled trial where patients were randomly allocated into two groups to receive either 2.5 ml of 0.75% (18.75 mg) isobaric ropivacaine with 25 μg fentanyl (Group RF) or 2.5 ml of 0.75% (18.75 mg) isobaric ropivacaine with 0.5 ml of 0.9% saline (Group R) intrathecally.Statistical AnalysisData analysis was done by Student's unpaired t-test. SPSS version 16 was used. P < 0.05 was considered as statistically significant.ResultsWe found no significant difference in hemodynamics, onset of sensory and motor block, peak level of block, recovery from motor block, return of micturition and incidence of side effects with the addition of fentanyl to ropivacaine. First request for analgesia was required earlier in the control group. There was also a significant prolongation of the duration of sensory block (mean - 341.6 min) and postoperative analgesia in Group RF (mean - 442.2 min) (P < 0.001).ConclusionThe addition of fentanyl to ropivacaine significantly prolongs the duration of postoperative analgesia with clinically insignificant influence on hemodynamics and motor blockade with minimal side effects.

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