Background: The low-dose ropivacaine provides differential spinal block to reduce adverse hemodynamic effects in elderly patients. Addition of Intrathecal fentanyl with ropivacaine enhance analgesia and early postoperative mobility..

Methods: Sixty male patients aged >50 years of ASA I-III scheduled for elective transurethral resection were included in a prospective, randomized, double-blinded study and they were divided in two groups of 30 each. Group A (n=30) received intrathecal injection of ropivacaine 2ml (0.75%) and Group B (n=30) ropivacaine 1.8ml (0.75%) with fentanyl 10µg. The characteristics of onset and regression of sensory and motor blockade, hemodynamic stability and side effects were observed. Student’s t test (for parametric data) and Mann-Whitney U test (for non-parametric data) were used for statistical analyses.

Results: There were no significant differences between the two groups for patient demographic data, intraoperative hemodynamic parameters, side effects and satisfaction to patients and surgeon. The highest level of sensory block was at T10 in the group A and T9 in the group B (p = 0.001). Duration of motor block was longer in group B 210.51±61.25 min than in group A 286.25 ± 55.65 min (p < 0.001).

Conclusion: The addition of fentanyl to ropivacaine may offer the advantage of shorter duration of complete motor block, long duration of post-operative analgesia and short discharged time, hemodynamic stability and without major side-effects.

Key Words: Ropivacaine; Fentanyl, Analgesics, Low Spinal Anesthesia, Ambulatory surgery