SPINAL anesthesia is commonly used for cesarean section, and it has become a popular practice
to add opioids to spinal solutions to enhance and prolong intraoperative and postoperative
analgesia. high incidence of side effects was noted. is there any alternative?
Pain after transurethral resection of prostate is considered mild to moderate severity from
detrusor muscle spasm and traction from urinary catheter. Numerous pain relieve methods have
been studied including spinal opioids, spinal anesthesia with local anesthetic and
dexmedetomidine, periprostatic nerve blockade with bupivacaine and mixing of prilocaine with
distilled water irrigation while undergoing a procedure. Most of patients having this
procedure are in elderly period, thus many anesthetists avoided spinal morphine which may
cause respiratory depressant effect postoperatively. Although previous studies showed
effectiveness of spinal morphine 25-200 mcg, some patients suffered from neuraxial opioid
side effects.
The aim of this study is to demonstrate efficacy of local anesthetic with intrathecal
morphine 50 mcg providing pain relieve after transurethral resection of prostate compare to
spinal anesthesia with sole local anesthetic.
Currently, opioids are widely used for pain relief, but they often provide sub-optimal
analgesia with occasional serious side effects. Preservative-free ketamine hydrochloride was
introduced as a spinal anesthetic more than twenty years ago and found to have advantages
over local anesthetics. Intrathecal dexmedetomidine provides an analgesic effect in
postoperative pain without severe sedation. The objectives of this study were to compare the
efficacy and safety of intrathecally administered dexmedetomidine, ketamine, or their
combination when added to bupivacaine for postoperative analgesia in major abdominal cancer
surgery.