Background:  Benign prostatic hypertrophy is a common problem in elderly patients leading to urinary retention, for which they undergo transurethral resection of prostate(TURP). TURP is preferably done under neuraxial anaesthesia as elderly patients having associated systemic illnesses are at increased risk of hemodynamic fluctuations caused by general anaesthesia. The current study was done to compare the efficacy and safety of 0.5% bupivacaine and 0.75% ropivacaine with fentanyl for epidural anaesthesia in high risk elderly patients undergoing transurethral resection of prostate.

Materials and Method: 70 elderly consented male patients of ASA grade II and III,60–85 yrs, height 150–170cms,undergoing elective TURP for BPH were randomized into 2 groups of 35 patients each. Patients in  group BF(n=35) received 15ml 0.5% bupivacaine with 50mcg fentanyl and group RF(n=35) received 15ml 0.75% ropivacaine  with 50 mcg fentanyl through epidural route. The onset and duration of sensory and motor block, duration of analgesia and hemodynamic parameters were recorded for the comparison. Any side effect eg. Hypotension, bradycardia, nausea, pruritis etc were recorded.

Results: The demographic profile and duration of surgery were comparable in both the groups. The mean time to onset of sensory block to T₁₀ dermatome and onset of motor block was significantly earlier in group BF (p value <0.05). The duration of sensory and motor block was significantly longer in group BF(p value <0.05). Fluctuation in hemodynamic parameters were minimal in group RF, whereas significant hypotension was observed in patients in group BF. None of the patients in both the groups developed nausea, vomiting, respiratory depression and pruritis.

Conclusion: 0.75% Ropivacaine with fentanyl showed better clinical profile and shorter duration of sensory and  motor block than 0.5% bupivacaine with fentanyl.