Comparing the Duration of Spinal Anesthesia Induced With Bupivacaine and a Bupivacaince-Lidocaine Combination in Trans-Urethral Resection of the Prostate (TURP)

Background: Spinal anesthesia is a safe anesthetic mode for transurethral prostate resection (TUPR). There are several studies assessing the effect of bupivacaine, lonely or accompanied by other drugs, on short duration operations. However, there is controversy regarding the exact combination. Objectives: The aim of the study was to compare the effects of spinal anesthesia with bupivacaine and low dose lidocaine with bupivacaine alone on postoperative pain in those undergoing transurethral resection of prostate (TURP). Materials and Methods: This was a randomized clinical trial performed in Shiraz university of medical sciences during one year. Eighty men scheduled for TURP were randomly assigned to receive spinal anesthesia with 1.5 mL bupivacaine 0.6% and 0.6 mL Lidocaine 1% or spinal anesthesia with 1.5 mL bupivacaine 0.5% in combination with 0.6 mL normal saline. The primary endpoint was the time lag between induction of spinal anesthesia and reaching the highest spinal block level. We also recorded the duration of spinal block declining to L1 level, operation duration and the admission duration. Results: Both study groups were comparable regarding the baseline characteristics. We did not find any difference between the two study groups regarding the duration of anesthetic block reaching the maximum level (P = 0.433) and duration of decreasing it to L1 (P = 0.189). The course of postoperative recovery and duration of hospital admission were also comparable between the groups (P = 0.661). Conclusions: Lidocaine does not have additive effects on duration and quality of spinal anesthesia with bupivacaine in those undergoing TURP.