Features of adjuvants using in spinal anesthesia: local analysis of intrathecal fentanyl effectiveness
- 1Dnipro State Medical University, Volodymyra Vernadskoho str., 9, Dnipro, 49044
- 2Dnipro State Medical University,Volodymyra Vernadskoho str.,9,Dnipro,49044
Abstract
The study is devoted to evaluating the clinical feasibility of intrathecal fentanyl administration as an adjuvant to bupivacaine during spinal anesthesia. The clinical part of the study was conducted at the State Institution “Ukrainian State Research Institute of Medical and Social Problems of Disability” of the Ministry of Health of Ukraine. The relevance of the topic is conditioned by the need to prolong early postoperative analgesia without excessive intensification of motor block, hemodynamic instability, or respiratory risks. The aim of the study was to compare the analgesic efficacy and safety profile of bupivacaine without an adjuvant and bupivacaine with fentanyl at a dose of 25 μg based on local clinical data. A single-center comparative retrospective cohort study was conducted involving two groups of 20 patients each (control group – bupivacaine; fentanyl group – bupivacaine + fentanyl 25 μg). The analysis included de-identified medical records of adult patients with an ASA physical status of I-II who underwent elective procedures on the lower extremities and in areas below the umbilicus. Systolic and diastolic blood pressure, heart rate, peripheral oxygen saturation (SpO2), pain intensity assessed using the Visual Analog Scale (VAS) in 1, 2, 4, 6, and 12 hours, time to the first requirement for additional analgesia, and the incidence of nausea, vomiting, and pruritus were evaluated. It was established that the addition of fentanyl increased the median time to the first requirement for analgesia from 230.0 [225.0; 240.0] min to 310.0 [305.0; 318.0] min (p<0.001), representing a 34.2% increase in the duration of analgesia. VAS scores in 6 and 12 hours were significantly lower in the Fent group (Me=2.5 [2.0; 3.0] and 5.0 [4.0; 5.5], respectively) than in the control group (3.5 [3.0; 4.0] and 6.0 [5.0; 7.0], respectively; p<0.02). The addition of fentanyl was not associated with impaired oxygenation (SpO2 Me=99.0 [98.0; 99.0]%). The main adverse effects were pruritus and nausea, which require appropriate prophylactic management.
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BibTeX
@article{linnyk2026features,
title = {{Features of adjuvants using in spinal anesthesia: local analysis of intrathecal fentanyl effectiveness}},
author = {V.M. Linnyk and A.G. Tiutiunnyk and Yu.Yu. Kobeliatskyi},
journal = {Medičnì Perspektivi},
year = {2026},
month = sep,
doi = {10.26641/2307-0404.2026.3.376684},
url = {https://doi.org/10.26641/2307-0404.2026.3.376684},
note = {CC BY},
}
RIS
TY - JOUR
TI - Features of adjuvants using in spinal anesthesia: local analysis of intrathecal fentanyl effectiveness
AU - V.M. Linnyk
AU - A.G. Tiutiunnyk
AU - Yu.Yu. Kobeliatskyi
PY - 2026
DA - 2026/09/01
JO - Medičnì Perspektivi
DO - 10.26641/2307-0404.2026.3.376684
UR - https://doi.org/10.26641/2307-0404.2026.3.376684
AB - The study is devoted to evaluating the clinical feasibility of intrathecal fentanyl administration as an adjuvant to bupivacaine during spinal anesthesia. The clinical part of the study was conducted at the State Institution “Ukrainian State Research Institute of Medical and Social Problems of Disability” of the Ministry of Health of Ukraine. The relevance of the topic is conditioned by the need to prolong early postoperative analgesia without excessive intensification of motor block, hemodynamic instability, or respiratory risks. The aim of the study was to compare the analgesic efficacy and safety profile of bupivacaine without an adjuvant and bupivacaine with fentanyl at a dose of 25 μg based on local clinical data. A single-center comparative retrospective cohort study was conducted involving two groups of 20 patients each (control group – bupivacaine; fentanyl group – bupivacaine + fentanyl 25 μg). The analysis included de-identified medical records of adult patients with an ASA physical status of I-II who underwent elective procedures on the lower extremities and in areas below the umbilicus. Systolic and diastolic blood pressure, heart rate, peripheral oxygen saturation (SpO2), pain intensity assessed using the Visual Analog Scale (VAS) in 1, 2, 4, 6, and 12 hours, time to the first requirement for additional analgesia, and the incidence of nausea, vomiting, and pruritus were evaluated. It was established that the addition of fentanyl increased the median time to the first requirement for analgesia from 230.0 [225.0; 240.0] min to 310.0 [305.0; 318.0] min (p<0.001), representing a 34.2% increase in the duration of analgesia. VAS scores in 6 and 12 hours were significantly lower in the Fent group (Me=2.5 [2.0; 3.0] and 5.0 [4.0; 5.5], respectively) than in the control group (3.5 [3.0; 4.0] and 6.0 [5.0; 7.0], respectively; p<0.02). The addition of fentanyl was not associated with impaired oxygenation (SpO2 Me=99.0 [98.0; 99.0]%). The main adverse effects were pruritus and nausea, which require appropriate prophylactic management.
SN - 2307-0404
SN - 2786-4804
ER -