Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery

Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal...
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Autor*in:	Jović Marija [verfasserIn] Janković Radmilo [verfasserIn] Videnović Nebojša [verfasserIn] Stošić Marija [verfasserIn] Veselinović Ines [verfasserIn] Stošić Biljana [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch ; srp

Erschienen:	2021

Schlagwörter:	spinal anesthesia bupivacaine fentanyl postoperative analgesia

Übergeordnetes Werk:	In: Srpski Arhiv za Celokupno Lekarstvo - Serbian Medical Society, 2010, 149(2021), 5-6, Seite 301-305
Übergeordnetes Werk:	volume:149 ; year:2021 ; number:5-6 ; pages:301-305

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.2298/SARH200729010J

Katalog-ID:	DOAJ001522159

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245	1	0	\|a Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery
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520			\|a Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods. This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1–2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 μg (Group I), or 25 μg (Group II) or 30 μg fentanyl intrathecally (Group III). Results. Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shevering were not recorded among the groups. The first time an analgetic was needed postoperatively was the longest in the Group III. Conclusion. The dose of 10 mg of bupivacaine combined with 25 μg fentanyl was the optimal option to achieve hemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response and incidence of the opioids side effects such as vomiting, nausea, pruritus etc.
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allfields	10.2298/SARH200729010J doi (DE-627)DOAJ001522159 (DE-599)DOAJ4b9307d4dbaf48e5ada29330447dbd69 DE-627 ger DE-627 rakwb eng srp Jović Marija verfasserin aut Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods. This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1–2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 μg (Group I), or 25 μg (Group II) or 30 μg fentanyl intrathecally (Group III). Results. Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shevering were not recorded among the groups. The first time an analgetic was needed postoperatively was the longest in the Group III. Conclusion. The dose of 10 mg of bupivacaine combined with 25 μg fentanyl was the optimal option to achieve hemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response and incidence of the opioids side effects such as vomiting, nausea, pruritus etc. spinal anesthesia bupivacaine fentanyl postoperative analgesia Medicine R Janković Radmilo verfasserin aut Videnović Nebojša verfasserin aut Stošić Marija verfasserin aut Veselinović Ines verfasserin aut Stošić Biljana verfasserin aut In Srpski Arhiv za Celokupno Lekarstvo Serbian Medical Society, 2010 149(2021), 5-6, Seite 301-305 (DE-627)637421205 (DE-600)2577665-4 24060895 nnns volume:149 year:2021 number:5-6 pages:301-305 https://doi.org/10.2298/SARH200729010J kostenfrei https://doaj.org/article/4b9307d4dbaf48e5ada29330447dbd69 kostenfrei http://www.doiserbia.nb.rs/img/doi/0370-8179/2021/0370-81792100010J.pdf kostenfrei https://doaj.org/toc/0370-8179 Journal toc kostenfrei https://doaj.org/toc/2406-0895 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 149 2021 5-6 301-305
spelling	10.2298/SARH200729010J doi (DE-627)DOAJ001522159 (DE-599)DOAJ4b9307d4dbaf48e5ada29330447dbd69 DE-627 ger DE-627 rakwb eng srp Jović Marija verfasserin aut Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods. This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1–2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 μg (Group I), or 25 μg (Group II) or 30 μg fentanyl intrathecally (Group III). Results. Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shevering were not recorded among the groups. The first time an analgetic was needed postoperatively was the longest in the Group III. Conclusion. The dose of 10 mg of bupivacaine combined with 25 μg fentanyl was the optimal option to achieve hemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response and incidence of the opioids side effects such as vomiting, nausea, pruritus etc. spinal anesthesia bupivacaine fentanyl postoperative analgesia Medicine R Janković Radmilo verfasserin aut Videnović Nebojša verfasserin aut Stošić Marija verfasserin aut Veselinović Ines verfasserin aut Stošić Biljana verfasserin aut In Srpski Arhiv za Celokupno Lekarstvo Serbian Medical Society, 2010 149(2021), 5-6, Seite 301-305 (DE-627)637421205 (DE-600)2577665-4 24060895 nnns volume:149 year:2021 number:5-6 pages:301-305 https://doi.org/10.2298/SARH200729010J kostenfrei https://doaj.org/article/4b9307d4dbaf48e5ada29330447dbd69 kostenfrei http://www.doiserbia.nb.rs/img/doi/0370-8179/2021/0370-81792100010J.pdf kostenfrei https://doaj.org/toc/0370-8179 Journal toc kostenfrei https://doaj.org/toc/2406-0895 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 149 2021 5-6 301-305
allfields_unstemmed	10.2298/SARH200729010J doi (DE-627)DOAJ001522159 (DE-599)DOAJ4b9307d4dbaf48e5ada29330447dbd69 DE-627 ger DE-627 rakwb eng srp Jović Marija verfasserin aut Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods. This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1–2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 μg (Group I), or 25 μg (Group II) or 30 μg fentanyl intrathecally (Group III). Results. Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shevering were not recorded among the groups. The first time an analgetic was needed postoperatively was the longest in the Group III. Conclusion. The dose of 10 mg of bupivacaine combined with 25 μg fentanyl was the optimal option to achieve hemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response and incidence of the opioids side effects such as vomiting, nausea, pruritus etc. spinal anesthesia bupivacaine fentanyl postoperative analgesia Medicine R Janković Radmilo verfasserin aut Videnović Nebojša verfasserin aut Stošić Marija verfasserin aut Veselinović Ines verfasserin aut Stošić Biljana verfasserin aut In Srpski Arhiv za Celokupno Lekarstvo Serbian Medical Society, 2010 149(2021), 5-6, Seite 301-305 (DE-627)637421205 (DE-600)2577665-4 24060895 nnns volume:149 year:2021 number:5-6 pages:301-305 https://doi.org/10.2298/SARH200729010J kostenfrei https://doaj.org/article/4b9307d4dbaf48e5ada29330447dbd69 kostenfrei http://www.doiserbia.nb.rs/img/doi/0370-8179/2021/0370-81792100010J.pdf kostenfrei https://doaj.org/toc/0370-8179 Journal toc kostenfrei https://doaj.org/toc/2406-0895 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 149 2021 5-6 301-305
allfieldsGer	10.2298/SARH200729010J doi (DE-627)DOAJ001522159 (DE-599)DOAJ4b9307d4dbaf48e5ada29330447dbd69 DE-627 ger DE-627 rakwb eng srp Jović Marija verfasserin aut Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods. This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1–2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 μg (Group I), or 25 μg (Group II) or 30 μg fentanyl intrathecally (Group III). Results. Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shevering were not recorded among the groups. The first time an analgetic was needed postoperatively was the longest in the Group III. Conclusion. The dose of 10 mg of bupivacaine combined with 25 μg fentanyl was the optimal option to achieve hemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response and incidence of the opioids side effects such as vomiting, nausea, pruritus etc. spinal anesthesia bupivacaine fentanyl postoperative analgesia Medicine R Janković Radmilo verfasserin aut Videnović Nebojša verfasserin aut Stošić Marija verfasserin aut Veselinović Ines verfasserin aut Stošić Biljana verfasserin aut In Srpski Arhiv za Celokupno Lekarstvo Serbian Medical Society, 2010 149(2021), 5-6, Seite 301-305 (DE-627)637421205 (DE-600)2577665-4 24060895 nnns volume:149 year:2021 number:5-6 pages:301-305 https://doi.org/10.2298/SARH200729010J kostenfrei https://doaj.org/article/4b9307d4dbaf48e5ada29330447dbd69 kostenfrei http://www.doiserbia.nb.rs/img/doi/0370-8179/2021/0370-81792100010J.pdf kostenfrei https://doaj.org/toc/0370-8179 Journal toc kostenfrei https://doaj.org/toc/2406-0895 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 149 2021 5-6 301-305
allfieldsSound	10.2298/SARH200729010J doi (DE-627)DOAJ001522159 (DE-599)DOAJ4b9307d4dbaf48e5ada29330447dbd69 DE-627 ger DE-627 rakwb eng srp Jović Marija verfasserin aut Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods. This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1–2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 μg (Group I), or 25 μg (Group II) or 30 μg fentanyl intrathecally (Group III). Results. Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shevering were not recorded among the groups. The first time an analgetic was needed postoperatively was the longest in the Group III. Conclusion. The dose of 10 mg of bupivacaine combined with 25 μg fentanyl was the optimal option to achieve hemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response and incidence of the opioids side effects such as vomiting, nausea, pruritus etc. spinal anesthesia bupivacaine fentanyl postoperative analgesia Medicine R Janković Radmilo verfasserin aut Videnović Nebojša verfasserin aut Stošić Marija verfasserin aut Veselinović Ines verfasserin aut Stošić Biljana verfasserin aut In Srpski Arhiv za Celokupno Lekarstvo Serbian Medical Society, 2010 149(2021), 5-6, Seite 301-305 (DE-627)637421205 (DE-600)2577665-4 24060895 nnns volume:149 year:2021 number:5-6 pages:301-305 https://doi.org/10.2298/SARH200729010J kostenfrei https://doaj.org/article/4b9307d4dbaf48e5ada29330447dbd69 kostenfrei http://www.doiserbia.nb.rs/img/doi/0370-8179/2021/0370-81792100010J.pdf kostenfrei https://doaj.org/toc/0370-8179 Journal toc kostenfrei https://doaj.org/toc/2406-0895 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 149 2021 5-6 301-305
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spellingShingle	Jović Marija misc spinal anesthesia misc bupivacaine misc fentanyl misc postoperative analgesia misc Medicine misc R Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery
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topic_title	Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery spinal anesthesia bupivacaine fentanyl postoperative analgesia
topic	misc spinal anesthesia misc bupivacaine misc fentanyl misc postoperative analgesia misc Medicine misc R
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title	Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery
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title_full	Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery
author_sort	Jović Marija
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title_sort	comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery
title_auth	Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery
abstract	Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods. This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1–2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 μg (Group I), or 25 μg (Group II) or 30 μg fentanyl intrathecally (Group III). Results. Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shevering were not recorded among the groups. The first time an analgetic was needed postoperatively was the longest in the Group III. Conclusion. The dose of 10 mg of bupivacaine combined with 25 μg fentanyl was the optimal option to achieve hemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response and incidence of the opioids side effects such as vomiting, nausea, pruritus etc.
abstractGer	Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods. This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1–2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 μg (Group I), or 25 μg (Group II) or 30 μg fentanyl intrathecally (Group III). Results. Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shevering were not recorded among the groups. The first time an analgetic was needed postoperatively was the longest in the Group III. Conclusion. The dose of 10 mg of bupivacaine combined with 25 μg fentanyl was the optimal option to achieve hemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response and incidence of the opioids side effects such as vomiting, nausea, pruritus etc.
abstract_unstemmed	Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods. This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1–2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 μg (Group I), or 25 μg (Group II) or 30 μg fentanyl intrathecally (Group III). Results. Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shevering were not recorded among the groups. The first time an analgetic was needed postoperatively was the longest in the Group III. Conclusion. The dose of 10 mg of bupivacaine combined with 25 μg fentanyl was the optimal option to achieve hemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response and incidence of the opioids side effects such as vomiting, nausea, pruritus etc.
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title_short	Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery
url	https://doi.org/10.2298/SARH200729010J https://doaj.org/article/4b9307d4dbaf48e5ada29330447dbd69 http://www.doiserbia.nb.rs/img/doi/0370-8179/2021/0370-81792100010J.pdf https://doaj.org/toc/0370-8179 https://doaj.org/toc/2406-0895
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Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shevering were not recorded among the groups. The first time an analgetic was needed postoperatively was the longest in the Group III. Conclusion. 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Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery

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