Anesthesia & Analgesia. 80(4):730-734, APRIL 1995
PMID: 7893026
Issn Print: 0003-2999
Publication Date: April 1995
Fentanyl Prolongs Lidocaine Spinal Anesthesia Without Prolonging Recovery
Spencer Liu;Andrew A. Chiu;Randall L. Carpenter;Michael F. Mulroy;Hugh W. Allen;Joseph M. Neal;Julia E. Pollock;
+ Author Information
Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington.Accepted for publication November 23, 1994.Address correspondence to Spencer Liu, MD, Department of Anesthesiology, Virginia Mason Medical Center, 1100 Ninth Ave., PO Box 900, Seattle, WA 98111.
Abstract
Lidocaine spinal anesthesia is a popular anesthetic for short procedures due to its brief duration.The addition of fentanyl may improve the quality and duration of lidocaine spinal anesthesia. Eight volunteers received plain lidocaine 5% in dextrose (50 mg) both with and without 20 micro gram of fentanyl in a randomized, double-blind, cross-over fashion. Sensory analgesia was assessed with pinprick, cold, touch, transcutaneous electrical stimulation equivalent to surgical incision, and duration of tolerance of pneumatic thigh tourniquet. Motor block was assessed with isometric force dynamometry. Regression of pinprick, touch, and cold was prolonged with fentanyl. Duration of tolerance of electrical stimulation at the umbilicus, hip, knee, and ankle was increased with fentanyl (181% increase from plain lidocaine on average; P < 0.01). Duration of tolerance of tourniquet-induced pain was increased by an average of 48% with addition of fentanyl (P = 0.02). Neither motor block nor time to void was prolonged with fentanyl. Pruritus occurred in all subjects receiving fentanyl but was treated easily and were well tolerated. We recommend the addition of 20 micro gram of fentanyl to lidocaine spinal anesthesia as a means to improve duration of sensory anesthesia without prolonging recovery of motor function or time to micturition.(Anesth Analg 1995;80:730-4)
