Intrathecal Fentanyl in Spinal Anesthesia for Appendectomy
Anchalee Techanivate MD*, Pakorn Urusopone MD*, Predee Kiatgungwanglia MD*, Rungrat Kosawiboonpol MD*
Affiliation : * Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University
Objective : The authors assessed the effectiveness of the administration of fentanyl in spinal anesthesia for
appendectomy.
Materials and Methods : Forty patients randomized double-blind, were recruited to receive either 4 ml of 0.5
% hyperbaric bupivacaine + 20 mg of fentanyl (Group F) or 4 ml of 0.5 % hyperbaric bupivacaine 0.5 % +
0.4 ml normal saline (Group S).
Results : There were no significant differences in the highest analgesic level between the groups. The number
of segments regressed at 60 min in Group F was statistically less than in Group S (0 vs. 2; P 0.002). Group F
showed significantly lower median VNS pain scores than Group S (0 vs. 3; P 0.004). Time to first required
postoperative analgesics in Group F was significantly higher than in Group S (13.6 vs. 6.3 h; P < 0.001). The
incidence of shivering in Group F was significantly lower than Group S (35 % vs. 70 %; P 0.023). There were
no significant differences in the incidence of nausea, vomiting, hypotension and urinary retention. No
patient developed respiratory depression or PDPH. The patients’ satisfaction of spinal anesthesia was 100 %
in Group F and 80 % in Group S.
Conclusion : Intrathecal 20 µg fentanyl significantly improved the quality of analgesia; it prolonged the
duration of bupivacaine in spinal anesthesia and delayed the analgesics requirement in the early
postoperative period. Shivering was less frequently found in the fentanyl group.
Keywords : Intrathecal, Fentanyl, Spinal anesthesia, Appendectomy
