Comparison of Analgesia With and Without Addition of Sufentanil to Bupivacaine in Spinal Anesthesia for Orthopedic Surgery of the Lower Limbs Fracture

Background and objective: Analgesia is of the main goals of anesthesiology. For this purpose, various medications and methods are used. One of these drugs is bupivacaine. Opioids such as sufentanil are used in spinal anesthesia in order to increase the duration of analgesia, reduce the complications, and improve the quality of anesthesia. The present study aimed to compare analgesia with or without addition of sufentanil to bupivacaine in spinal anesthesia for orthopedic surgery of the lower limbs fracture. Methodology: A clinical trial was carried out on 86 patients aged 15-65 with anesthesia class of 1 and 2 undergoing lower limb orthopedic surgery in Peymaniyeh Hospital of Jahrom. The subjects were equally dividied into two groups of 43; the experimental group which had spinal anesthesia with 15 mg of bupivacaine and 3 micrograms of sufentanil and the control that was treated with only 15 mg of bupivacaine. The onset of anesthesia, duration of analgesia, pain intensity and complications of spinal anesthesia such as nausea, vomiting, and pruritus, arterial blood pressure; respiratory rate, and heart rate were measured and recorded at different times. The obtained data were analyzed using t-test and chi-square test in SPSS software. Level of significance was determined to be p<0.05. Findings: Two studied groups showed no significant difference in terms of underlying variables. Mean analgesia duration in the experimental group and the control was 4.91±150.80 minutes and 7.25±117.27 minutes, respectively (p=0.000). The anesthesia effect started sooner in the experimental group than the control (p=0.001). Pain intensity 120 minutes after spinal anesthesia was less in patients of the experimental group (p=0.000). Conclusion: The results of the present study showed that adding 3 mcg sufentanil to bupivacaine in spinal anesthesia leads to prolonged duration of analgesia, faster onset of spinal anesthesia effect, pain reduction, and reduction in arterial blood pressure. In addition, this substance does not exacerbate the complications of spinal anesthesia such as nausea, vomiting, and pruritus, compared to the method of using bupivacaine alone. Therefore, in cases where it is required that analgesia lasts more than 130 minutes, sufentanil can be used in spinal anesthesia.