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ORIGINAL ARTICLE
Year : 2017  |  Volume : 45  |  Issue : 2  |  Page : 57-63

Different low doses of levobupivacaine 0.5% with nalbuphine in spinal anesthesia for transurethral resection of prostate surgery


Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt

Correspondence Address:
Osama M Rehab
Reyad Ghoraba Street, Tanta, El-Gharbia, 31511
Egypt
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DOI: 10.4103/tmj.tmj_9_17

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Background Subarachnoid block is a widely used technique for transurethral resection of the prostate (TURP) surgery in elderly, especially in those with respiratory and cardiac problems. Aim The aim of this study was to evaluate the efficacy of different low doses of levobupivacaine 0.5% when they are combined with nalbuphine in spinal anesthesia for TURP surgery, their efficiency for postoperative analgesia, and its side effects. Patients and methods A total of 90 patients older than 60 years of age and American Society of Anesthesiologists physical status I–III who underwent TURP under spinal anesthesia were enrolled. Patients were randomly divided into two groups: group I received intrathecal injection of 5 mg levobupivacaine 0.5% and 1 mg nalbuphine in 1 ml normal saline as total volume of 3 ml and group II received intrathecal injection of 7.5 mg levobupivacaine 0.5% and 1 mg nalbuphine in 0.5 ml normal saline as total volume of 3 ml. Patients were assessed for sensory and motor block characteristics, postoperative visual analog pain scale, and side effects. Results Patients in group II had earlier onset of sensory block at T10, longer duration of sensory and motor block and two-segment regression times, higher level of maximum sensory block, higher Bromage score at the end of surgery, and lower visual analog pain scale in the early postoperative period. Conclusion Levobupivacaine 0.5% of 5 and 7.5 mg with the addition of 1 mg nalbuphine are considered to be convenient for clinical use in TURP surgery with spinal anesthesia. Levobupivacaine of 7.5 mg had a better sensory block quality and prolonged early postoperative analgesia with similar hemodynamic stability without increasing complications.


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