Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 27;8(8):e71116.
doi: 10.1002/hsr2.71116. eCollection 2025 Aug.

Analgesia Quality and Duration of Fentanyl and Sufentanil Added to Bupivacaine in Spinal Anesthesia in Inguinal Hernia Surgery: A Double-Blind Parallel Randomized Controlled Trial

Haniyeh Soleimany  1 , Hamed Tavan  1   2 , Ebrahim Khalighi  3 , Reza Pakzad  1   4   5
Affiliations

Analgesia Quality and Duration of Fentanyl and Sufentanil Added to Bupivacaine in Spinal Anesthesia in Inguinal Hernia Surgery: A Double-Blind Parallel Randomized Controlled Trial

Haniyeh Soleimany et al. Health Sci Rep. .

Abstract

Background and aims: To compare the quality and duration of analgesia provided by Fentanyl and Sufentanil when added to 12-15 mg Bupivacaine 0.5% in spinal anesthesia for inguinal hernia surgery.

Methods: In the present double-blind parallel Randomized Controlled Trial (RCT), 180 patients who were candidates for elective inguinal hernia surgery were divided into three groups using balanced-block randomization. The first group received 2.5 cc Bupivacaine with 0.5 cc (25 mg) Fentanyl, the second group received 0.5 cc (2.5 micrograms) of Sufentanil with 2.5 cc Bupivacaine, and the third group received 2.5 cc Bupivacaine with 0.5 cc normal saline. The pain score was evaluated by VAS (visual analog scale) at recovery and arrival in PACU, 2, 4, 6, and 12 h after the surgery.

Results: A total of 60 subjects were allocated to each group. The mean (standard deviation) of pain score 2 h after surgery in Bupivacaine, Bupivacaine-Fentanyl, and Bupivacaine-Sufentanil were 1.73 (0.49), 1.10 (1.10), and 1.22 (1.25), respectively. These values 12 h after surgery were 2.76 (0.36), 2.97 (0.61), and 2.92 (0.56), respectively. The within-group comparison showed a significant increase in the pain score over time (p < 0.001). Also, the between-group comparison revealed significant differences between the three groups regarding pain scores (p = 0.030), so that the mean and standard deviation of pain score in Bupivacaine (1.67 ± 0.05) was higher than Bupivacaine-Fentanyl (1.51 ± 0.09) (p < 0.001) and Bupivacaine-Sufentanil (1.52 ± 0.08) (p < 0.001), but Bupivacaine-Fentanyl was not different from Bupivacaine-Sufentanil (p = 0.437). Results showed a significant interaction between time and intervention for pain score (p < 0.001).

Conclusions: The pain-reducing effects of Sufentanil and Fentanyl, when combined with Bupivacaine, were significantly greater than those of Bupivacaine alone. However, this effect lasts only for up to 4 h after surgery, after which their efficacy diminishes.

Keywords: Bupivacaine; Fentanyl; Sufentanil; inguinal hernia surgery; pain; randomized clinical trial.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of study design.
Figure 2
Figure 2
The mean of pain score between the three study groups at six time points was adjusted for the timing of the first morphine injection and the total morphine dosage administered.
Figure 3
Figure 3
Pairwise comparison of secondary outcomes between the three study groups.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Yildirim D., Hut A., Uzman S., et al., “Spinal Anesthesia Is Safe in Laparoscopic Total Extraperitoneal Inguinal Hernia Repair. A Retrospective Clinical Trial,” Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and Other Miniinvasive Techniques 12, no. 4 (2017): 417–427. - PMC - PubMed
    1. “International Guidelines for Groin Hernia Management,” Hernia 22 (2018): 1–165. - PMC - PubMed
    1. Meco B. C., Bermede O., Vural C., Cakmak A., Alanoglu Z., and Alkis N., “A Comparison of Two Different Doses of Morphine Added to Spinal Bupivacaine for Inguinal Hernia Repair,” Brazilian Journal of Anesthesiology (Elsevier) 66 (2016): 140–144. - PubMed
    1. Palumbo P., Usai S., Amatucci C., et al., “Tailored Surgery in Inguinal Hernia Repair. The Role of Subarachnoid Anesthesia: A Retrospective Study,” Open Medicine (Warsaw, Poland) 14, no. 1 (2019): 639–646. - PMC - PubMed
    1. Bhattacharya P., Mandal M. C., Mukhopadhyay S., Das S., Pal P. P., and Basu S. R., “Unilateral Paravertebral Block: An Alternative to Conventional Spinal Anaesthesia for Inguinal Hernia Repair,” Acta Anaesthesiologica Scandinavica 54, no. 2 (2010): 246–251. - PubMed

LinkOut - more resources