Comparison the effect of levobupivacain and fentanyl addition levobupivacain in short urologic surgery in spinal anesthesia

MG LEVOBUPIVACAINE + 25μG FENTANYL IN SPINAL ANESTHESIA IN PATIENT THAT PLANNED SHORT PROCEDURE UROLOGIC SURGERY The aim of this study is the comparison of the effect of low dose levobupivacaine on hemodinamy on surgical comfort in spinal anesthesia in patient that planned short prosedure urologic surgery. This study was planned as prospective, double-blinded. After the Local ethics committee approval and informed consent from patients, 40 patients, 18-65 years old, ASA I-III, that planned short procedure urologic surgery, were divided in to two groups. Spinal anesthesia was performed in lateral decubitis position with 22 G spinal needle with median procedure .1,5 ml 0,5% levobupivacaine (7,5mg) + 0,5 ml saline were given Group L, and 1,2 ml 0,5% levobupivacaine (6mg) +25μg fentanyl+ 0,3 ml saline were given Group LF After spinal anesthesia, systolic, diastolic, mean arteriel blood pressurees, pulse rate, peripheral oxygen saturation recorded at 3., 5., 10., 15., 30., 60., 120., and 360 minutes.Time to first postoperative analgesic requirement and spinal blocks fecture swere also recorded. Patients who were devoloping hypotension during the operation (systolic artriel pressure decreased from basal measurement more than 30%) were given 200 ml saline over 10 minutes .In the absance of improvement 5 mg ephedrine was administered intravenousyl. When devoloped bradycardia (heart rate<45 beat/ min) 0,5 mg atrophyn was administered. Spinal block characteristics were evaluated Pin prick test for sensory block and Bromage scale for motor block. Bromage 0-1: No paralysis, Bromage 2-3: Paralysis Patients went in post operative recovery room. Postoperative pain scalase NRS>4 were analgesics. Postoperative surgical satisfaction was assessed (1-4 1: bad 4: exellant). There were no significantly different in terms of demogrophic data and hemodynamics in comparison of between the groups. At 120. minute in Group LF motor block releases were more than those in GroupL. Time to first postoperative analgesia requirement was longer in the Group LF than Group L . But this time was not statistically significant. As a result, both intratecal 7,5 mg levobupivacaine and 6 mg levobupivacaine +25μg fentanyl provided sufficent anesthesia for short urologic surgery. In opioid added group, recovery was faster than the other group.