Intrathecal Anesthesia for Elderly Patients Undergoing Short Transurethral Procedures: A Dose-Finding Study

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Abstract

One hundred elderly men (≥65 yr) undergoing transurethral procedures (<45 min) received bupivacaine 7.5 mg, or bupivacaine 5 mg + fentanyl 20 μg, or bupivacaine 4 mg + fentanyl 20 μg, or bupivacaine 3 mg + fentanyl 20 μg, intrathecally. Intraoperative “rescue” fentanyl requirements were higher (P < 0.03) in group bupivacaine 3 mg + fentanyl. Times (min) to ambulation eligibility were decreased in a dose-dependant manner (157 ± 50 vs 147 ± 37 vs 128 ± 40 vs 116 ± 29, respectively). Of the techniques studied, intrathecal bupivacaine 4 mg + fentanyl 20 μg provided adequate analgesia and was associated with hemodynamic stability and a favorable recovery profile.

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