Incidence of hypotension between Intrathecal Hyperbaric Bupivacaine with and without Fentanyl in Geriatric Patients Undergoing Urological Surgeries

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Thavat Chanchayanon Mareeya Chearong Piyaporn Vasinanukorn Natsana Withayanuphakorn Tidarat Sangkaew


Objective: We aimed to assess the efficacy, the incidence of hypotension and adverse consequences of using intrathecal hyperbaric bupivacaine in comparison to a combination of low dose hyperbaric bupivacaine and fentanyl, in geriatric patients undergoing urological surgeries.
Material and Methods: Our study was a prospective, triple-blinded and randomized controlled. One hundred and fortyeight geriatric participants scheduled for urological surgeries were randomly assigned into two groups: Group B (n=74) received intrathecal injection with 0.5% hyperbaric bupivacaine 1.5 milliliters (ml) alone (7.5 milligrams; mg), while Group F (n=74) received 0.5% hyperbaric bupivacaine 1 ml (5 mg) plus 0.5 ml of fentanyl (25 micrograms; mcg) making up to a total volume of 1.5 ml.
Results: One hundred and forty-eight patients were included however, six patients were excluded from statistical analysis, due to an inadequate level of anesthesia; hence, 142 patients were analyzed. The incidence of hypotension in group B was: 9.7%, and in group F the percentage was 12.9%, respectively (p-value=0.74). There was no significant difference in regards to the highest sensory level in both groups. The anesthesia level in group B was Thoracic level 11 (T10-T12), and in group F it was 11 (T10-T12) (p-value=0.68), while the analgesia level in group B was Thoracic level 7 (T6-T8) with group F being a Thoracic level 6 (T6-T8) (p-value=0.16). The occurrence of bradycardia, and respiratory depression did not differ between the 2 groups.
Conclusion: Intrathecal administration of 5 mg of 0.5% hyperbaric bupivacaine, plus 25 mcg of fentanyl provided an adequate level of sensory blockade, but did not decrease the frequency of hypotension.


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Chanchayanon T, Chearong M, Vasinanukorn P, Withayanuphakorn N, Sangkaew T. Incidence of hypotension between Intrathecal Hyperbaric Bupivacaine with and without Fentanyl in Geriatric Patients Undergoing Urological Surgeries. Journal of Health Science and Medical Research [Internet]. 14Mar.2019 [cited 17Aug.2019];37(2):93-9. Available from:
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