Kuusniemi et al. Anesth Analg 2000;91:1452-6

Reviewed by: R. Prasad, MD

Summary:

Group	SAB
I	Bup 10mg
II	Bup 10mg + Fent 25mcg
III	Bup 7.5mg + Fent 25mcg
IV	Bup 5mg + Fent 25mcg

• 80 men, 20/group. Sitting SAB. Bup 0.5% soln used, final volumes=2.5ml.
• Surgery times usually <1hr; shortest in IV (22 +/- 10min)
• Variety of urologic procedures (cysto, TURP, TURBT, other)
• Avg age >60y
• Findings:
• Sensory block similar in all groups
• median upper level of sensory block T7 in all groups
• similar progression of fall in block level in I, II, III
• IV: no motor block at end of surgery, so ready for discharge from PACU. Fall in level not presented or compared to other 3 groups.
• Blocks adequate for procedure in all groups
• Adding fentanyl increased intensity and duration of motor block

• Don't need much bupiv for short procedures, when fentanyl added
• Potentially important if you believe lidocaine causes TNS
• How does hyperbaric bupiv compare to isobaric?