Abstract

Background: Ropivacaine has a clinical profile similar to bupivacaine with less toxic effects on the central nervous system and the cardiovascular system. Moreover, Ropivacaine may have a shorter time to recover motor function compared with bupivacaine. Therefore, Ropivacaine may be an appropriate option in spinal anesthesia for transurethral resection of the prostate.

Objectives: This paper compared the anesthetic efficacy and the adverse effects of intrathecal ropivacaine plus fentanyl with bupivacaine plus fentanyl.

Patients and methods: One hundred and sixty patients of ASA I – III, 55–80 years scheduled for transurethral resection of prostate under spinal anesthesia. A single-blinded, randomized clinical trial. Patients were randomized into two equal groups, RF group: Ropivacaine 0.5% 7.5 mg plus fentanyl 20 mcg and BF group: bupivacaine 0.5% 5 mg plus fentanyl 20 mcg.

Results: the onset time of sensory block at T10 and motor block were comparable. The RF group had a shorter duration of sensory block at T10 of 108.1±19.9 min and 120.3±17.1 min for the BF group (p<0.0001). The highest sensory level achieved was comparable from T10 to T6 dermatome. The duration of the motor block in the RF group (59.5±14.9 min) was shorter than that in the BF group (76.9±18.3 min) (p<0.0001). Motor Bromage scale 0 in the RF group was more significant than in the BF group (58.7% versus 41.3%). The effective rate of spinal anesthesia in the RF group and BF group was 96.2% and 97.5%. No statistical difference was found regard to adverse effects between the groups.

Conclusion: In spinal anesthesia for transurethral resection of the prostate, the RF group provided similar anesthetic efficacy and adverse effects but less motor block than the BF group.

Keywords: Intrathecal, transurethral resection of the prostate, Ropivacaine