Effect of Fentanyl in Spinal Anesthesia With Bupivacaine in Opium Abusers


1 Department of Anesthesiology, Cardiac Anesthesia Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran

2 Student Research Committee, School of medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran


Background: Spinal anesthesia is a common procedure in the anesthesia. In some studies it has been shown that chronic use of opioids  is associated with shorter duration of spinal anesthesia when local anesthetics are applied.
Objectives: This trial was conducted in order to determine effect of fentanyl on the duration of spinal block by bupivacaine in chronic  opium abusers who undergo spinal anesthesia and have lower thresholds for pain.
Patients and Methods: This study was a randomized clinical trial in which 50 opium abusers (25 patients in each group) undergoing  lower extremity orthopedic surgeries with spinal anesthesia were selected. The patients were randomly divided into two groups. The study  group received 15 mg hyperbaric bupivacaine 0.5% plus 25 µg fentanyl, while the control group received 15mg hyperbaric bupivacaine 0.5% 
plus 0.25 mL normal saline.
Results: All randomly selected cases were male (44.7 ± 13.6 year). The mean duration of sensory block was much longer in the study  group (87.8 ± 7.22 minutes) in comparison with the control group (70.47 ± 5.45 minutes) (P < 0.001). There was no statistically significant 
difference between the two groups regarding their age and duration of surgery. Conclusions: Bupivacaine administration in spinal anesthesia for spinal block has a shortened duration in comparison to the combination  of bupivacaine and fentanyl in chronic opium abusers.