Compare the effects of intrathecal three different doses of bupivacain application combined with opioids in transuretral resection.

In this study, we aimed to compare the effects of three different doses of bupivacain application combined with opioids on postoperative analgesia, motor and sensory blockade and anesthesia quality in patients undergoing transurethral resection of the prostate (TUR-P) under spinal anesthesia .60 patients all above the age of 55 undergoing transurethral resection of the prostate (TUR-P) were randomly divided into 3 groups recieving 5.0 mg (Group I, n=20), 7,5 mg (Group II, n=20), 10 mg (Group III, n=20) of bupivacaine. In each group ,100 µg of morphine was added to application in order to complete the final volume of adminstration to 3 cc. Hemodinamic parameters, motor and sensorial blockade, the time of first postoperative analgesia requirement, intra and postoperative adverse effects of spinal anesthesia were then recorded.Maximum sensorial blockade levels in order of groups revealed to be T10, T8 and T6 respectively. As the sensorial block levels of the groups evaluated during the procedure, a higher level was detected in group III , although it was observed stable in the groups I and II. Changes in hemodinamic parameters were found to be corralated.There was sıgnıfıcant difference in terms of hypotension between the groups. In groups II and III hypotension was detected to be more frequently compared to group I. (p=0,047 and p<0,001). There were no statistically significant differences between groups II and III in hypotension frequency. (p=0,102).Bradycardia was detected in 1 patient in Group I (%5), 4 patients in Group II (%20) and 10 patients in Group III (%50).The time to reach T10 dermatome blockade was shorter in Group II and III than in Group I. Two dermatome regression time of sensory block was shorter in Group I when compared to Groups II and III. Besides, regression time of sensory block for two dermatoms in Group II was shorter than in Group III.There were no statistically significant differencies among the groups regarding demographic charachteristics, sensory and motor block onset times. Patient and surgeon satisfaction revealed to be significantly higher in Group III than Groups II and I.In conclusion, for transurethral prostate surgery of elderly patients with morbid diseases, low dose local anestehetic in addition with intratechal morphine can provide stable hemodynamic profile, patient and surgeon satisfaction and effective sensorial and motor blockade in spinal anaesthesia.