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Intrathecal fentanyl does not modify the duration of spinal procaine block

From the Département d'anesthésie-réanimation, Hôpital Maisonneuve-Rosemont and Université de Montréal, Montréal, Québec, Canada.

Address correspondence to: Dr. Michel Girard, Département d'anesthésie-réanimation, Hôpital Maisonneuve- Rosemont, 5415 boul. l'Assomption, Montréal, Québec, H1T 2M4, Canada. Phone: 514-252-3426; Fax: 514-252-3542; E-mail: girardmi{at}videotron.ca

Purpose: To document the clinical characteristics of spinal procaine with or without the addition of fentanyl in light of the failure rate observed previously with procaine 10%.

Methods: In a randomized, prospective, double-blind study, 52 patients received spinal anesthesia with 100 mg procaine and either saline 0.9% (0.4 ml) (CONTROL group) or 20 µg fentanyl (0.4 ml) (FENTANYL group). Sensory anesthesia to needle prick was evaluated each minute for ten minutes, every three minutes for 33 minutes and every five minutes until regression to T10. Motor block was assessed with the Bromage scale. Patients were questioned by telephone for pain suggesting transient radicular irritation (TRI) 48 hr later.

Results: Mean time to reach highest sensory level, maximum number of segments blocked and mean time for regression of the sensory level to T10 showed no difference. Time to recuperate to full flexion of knees and feet (Bromage 4) showed no difference. Nine patients had nausea (five in CONTROL group and four in FENTANYL group) and nine had pruritus (three in CONTROL group and six in FENTANYL group). No patient reported pain suggesting TRI.

Conclusion: Spinal procaine is appropriate for short-duration surgery. Fentanyl does not change the characteristics of the block or the incidence of side effects associated with spinal procaine.

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