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Fattahi-Saravi Z, Naderi-Boldaji V, Azizollahi A, Azemati S, Asmarian N, Khosravi MB. Adequate Anesthesia and More Effective Analgesia by Adjusted Doses of Bupivacaine during Cesarean Section: A Randomized Double-blind Clinical Trial. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:393-400. [PMID: 37456203 PMCID: PMC10349160 DOI: 10.30476/ijms.2022.95205.2653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/11/2022] [Accepted: 07/30/2022] [Indexed: 07/18/2023]
Abstract
Background Several adjuvants, added to local anesthetics, were suggested to induce an ideal regional block with high-quality analgesia. The purpose of this study was to evaluate the particular blocking properties of low-dose bupivacaine in combination with meperidine and fentanyl in spinal anesthesia during Cesarean sections. Methods A randomized, double-blind clinical trial was conducted at Hafez Hospital affiliated with Shiraz University of Medical Sciences (Shiraz, Iran) from February 2015 to February 2016. A total of 120 pregnant women, who underwent spinal anesthesia during elective Cesarean section were enrolled in the study. Based on block-wise randomization, the patients were randomly assigned to three groups, namely "B" group received 2 mL bupivacaine 0.5% (10 mg), "BM" group received 8 mg bupivacaine and 10 mg meperidine, and "BF" group received 8 mg bupivacaine and 15 µg fentanyl intrathecally. The block onset, the duration of analgesia, and the time of discharge from the post-anesthesia care unit (PACU) were all assessed. Data were analyzed using SPSS software version 21, and P<0.05 were considered statistically significant. Results The mean duration of motor blocks in the B group (150 min) were significantly higher than the BM (102 min) and BF (105 min) groups (P<0.0001). In both the BM and BF groups, the duration of sensory and motor blocks was the same. The length of stay in the PACU was significantly longer in the B group (P<0.001) than the BM and BF groups. When meperidine or fentanyl was added to bupivacaine, the duration of the analgesia lengthened (P<0.001). Conclusion Intrathecal low-dose spinal anesthesia induced by bupivacaine (8 mg) in combination with meperidine and/or fentanyl for Cesarean section increased maternal hemodynamic stability, while ensuring effective anesthetic conditions, extending effective analgesia, and reducing the length of stay in PACU.Trial Registration Number: IRCT2015013119470N14.
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Affiliation(s)
| | - Vida Naderi-Boldaji
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azadeh Azizollahi
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Simin Azemati
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naeimehossadat Asmarian
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad-Bagher Khosravi
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Kanawati S, Barada MA, Naja Z, Rajab O, Sinno L, El Hasan J. Comparison of clinical effects of meperidine and sufentanil added to 0.5% hyperbaric bupivacaine for spinal anesthesia in patients undergoing cesarean delivery: a randomized controlled trial. J Anesth 2022; 36:201-209. [DOI: 10.1007/s00540-021-03031-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/03/2021] [Indexed: 11/24/2022]
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Lin YC, Chen CY, Liao YM, Liao AHW, Lin PC, Chang CC. Preventing shivering with adjuvant low dose intrathecal meperidine: A meta-analysis of randomized controlled trials with trial sequential analysis. Sci Rep 2017; 7:15323. [PMID: 29127294 PMCID: PMC5681692 DOI: 10.1038/s41598-017-14917-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 10/18/2017] [Indexed: 01/07/2023] Open
Abstract
The aim of this systematic review and meta-analysis is to evaluate the pros and cons of adjuvant low dose intrathecal meperidine for spinal anaesthesia. We searched electronic databases for randomized controlled trials using trial sequential analysis (TSA) to evaluate the incidence of reduced rescue analgesics, shivering, pruritus, nausea and vomiting when applying adjuvant intrathecal meperidine. Twenty-eight trials with 2216 patients were included. Adjuvant intrathecal meperidine, 0.05-0.5 mg kg-1, significantly reduced incidence of shivering (relative risk, RR, 0.31, 95% confidence interval, CI, 0.24 to 0.40; TSA-adjusted RR, 0.32, 95% CI, 0.25 to 0.41). Intrathecal meperidine also effectively reduced need for intraoperative rescue analgesics (RR, 0.27, 95% CI, 0.12 to 0.64; TSA-adjusted RR, 0.27, 95% CI, 0.08 to 0.91) and the incidence of pruritus was unaffected (RR, 2.31, 95% CI, 0.94 to 5.70; TSA-adjusted RR, 1.42, 95% CI, 0.87 to 2.34). However, nausea and vomiting increased (RR, 1.84, 95% CI, 1.29 to 2.64; TSA-adjusted RR, 1.72, 95% CI, 1.33 to 2.23; RR, 2.23, 95% CI, 1.23 to 4.02; TSA-adjusted RR,1.96, 95% CI, 1.20 to 3.21). Under TSA, these results provided a sufficient level of evidence. In conclusion, adjuvant low dose intrathecal meperidine effectively attenuates spinal anaesthesia-associated shivering and reduces rescue analgesics with residual concerns for the nausea and vomiting.
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Affiliation(s)
- Yu-Cih Lin
- Department of Anaesthesiology, Taipei Medical University Hospital, Taipei, 110, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, 110, Taiwan
| | - Chien-Yu Chen
- Department of Anaesthesiology, Taipei Medical University Hospital, Taipei, 110, Taiwan
- Department of Anaesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 110, Taiwan
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, 110, Taiwan
| | - Yuan-Mei Liao
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, 110, Taiwan
- Institute of Clinical Nursing, School of Nursing, National Yang-Ming University, Taipei, 112, Taiwan
| | - Alan Hsi-Wen Liao
- Department of Anaesthesiology, Taipei Medical University Hospital, Taipei, 110, Taiwan
| | - Pi-Chu Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, 110, Taiwan
- Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, 110, Taiwan
| | - Chuen-Chau Chang
- Department of Anaesthesiology, Taipei Medical University Hospital, Taipei, 110, Taiwan.
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, 110, Taiwan.
- Department of Anaesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 110, Taiwan.
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Zinboonyahgoon N, Srinivasan S, Narang S. Harlequin Syndrome Following Implantation of Intrathecal Pumps: A Case Series. Neuromodulation 2015; 18:772-5. [DOI: 10.1111/ner.12343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 05/26/2015] [Accepted: 06/25/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Nantthasorn Zinboonyahgoon
- Department of Anesthesiology, Perioperative and Pain Medicine; Brigham and Women's Hospital; Boston MA USA
| | - Suresh Srinivasan
- Department of General Surgery; Creighton University Medical Center; Omaha NE USA
| | - Sanjeet Narang
- Department of Anesthesiology, Perioperative and Pain Medicine; Brigham and Women's Hospital; Boston MA USA
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Pöpping DM, Elia N, Wenk M, Tramèr MR. Combination of a reduced dose of an intrathecal local anesthetic with a small dose of an opioid: A meta-analysis of randomized trials. Pain 2013; 154:1383-90. [DOI: 10.1016/j.pain.2013.04.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 03/29/2013] [Accepted: 04/11/2013] [Indexed: 11/16/2022]
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Abstract
Pethidine (meperidine) is a unique member of the opioid family. In addition to its analgesic activity, it also has significant local anaesthetic activity. This property enables it to be used as the sole agent for spinal anaesthesia. We describe the successful use of intrathecal pethidine 1 mg/kg for an elective lower segment caesarean section in a patient presumed to be allergic to amide local anaesthetics. There were no significant adverse effects in either the mother or the newborn.
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Affiliation(s)
- R M Vassiliadis
- Department of Anaesthesia, Gosford District Hospital, Gosford, New South Wales, Australia.
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Atalay C, Aksoy M, Aksoy AN, Dogan N, Kürsad H. Combining Intrathecal Bupivacaine and Meperidine during Caesarean Section to Prevent Spinal Anaesthesia-Induced Hypotension and other Side-Effects. J Int Med Res 2010; 38:1626-36. [DOI: 10.1177/147323001003800507] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study compared intrathecal hyperbaric bupivacaine with low-dose intrathecal plain bupivacaine plus different doses of meperidine (pethidine), administered sequentially, with regard to blood pressure stability, post-operative analgesia and incidence of side-effects in 80 parturients undergoing caesarean section. Patients were randomly assigned to one of four groups ( n = 20 each group): the HB group received 10 mg hyperbaric bupivacaine intrathecally; the BM35, BM30 and BM25 groups received 5 mg plain bupivacaine plus 35, 30 or 25 mg of meperidine intrathecally, respectively. The incidence of hypotension in the BM25 group was significantly lower than in the HB group. Nausea and vomiting were less prevalent in the BM25 group than in the HB and BM35 groups. In conclusion, sequential administration of 5 mg plain bupivacaine and 25 mg meperidine intrathecally provided better blood pressure stability and a lower incidence of side-effects than bupivacaine alone, without affecting quality of anaesthesia or surgical and patient satisfaction.
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Affiliation(s)
- C Atalay
- Department of Anaesthesia and Reanimation, Medical Faculty, Atatürk University, Erzurum, Turkey
| | - M Aksoy
- Department of Anaesthesia and Reanimation, Medical Faculty, Atatürk University, Erzurum, Turkey
| | - AN Aksoy
- Department of Obstetrics and Gynaecology, Nenehatun Hospital, Erzurum, Turkey
| | - N Dogan
- Department of Anaesthesia and Reanimation, Medical Faculty, Atatürk University, Erzurum, Turkey
| | - H Kürsad
- Department of Anaesthesia and Reanimation, Medical Faculty, Atatürk University, Erzurum, Turkey
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Shimizu M, Inai K, Nakazawa M. The use of pethidine as pre-medication to prevent anoxic spells in patients with tetralogy of Fallot. Pediatr Int 2005; 47:388-91. [PMID: 16091074 DOI: 10.1111/j.1442-200x.2005.02077.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether morphine-HCl or pethidine-HCl differ as pre-medication to prevent anoxic spell in patients with tetralogy of Fallot (TOF) at catheterization. METHODS A 3 year retrospective case notes review study of 46 consecutive patients who underwent cardiac catheterization from 1998 to 2001 was conducted. In a prospective 1 year randomized control study, 10 patients diagnosed as TOF and admitted to Tokyo Women's Medical University, The Heart Institute of Japan, Tokyo, in 2002 were randomized to receive morphine or pethidine as pre-medication for cardiac catheterization. The incidence of anoxic spell before and after cardiac catheterization was investigated in both studies. RESULTS In the case notes review, a total of 10 out of the 46 patients showed anoxic spell study: eight out of 24 patients in the morphine group and two out of 22 in the pethidine group. The difference in the incidence was statistically significant (P < 0.05, Fisher's exact test). Four patients in the prospective study showed anoxic spell: three out of six in the morphine group and one out of four in the pethidine group (odds ratio = 3.0). Overall, 14 out of 56 patients had anoxic spell: 11 out of 30 in the morphine group and three out of 26 in the pethidine group (P = 0.03). CONCLUSION The incidence of hypoxic spells in patients with TOF undergoing cardiac catheterization is reduced by the use of pethidine-HCl as pre-medication compared to morphine. This has important clinical implications.
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Affiliation(s)
- Mikiko Shimizu
- Pediatric Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan.
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Souter KJ, Davies JM, Loeser JD, Fitzgibbon DR. Continuous Intrathecal Meperidine for Severe Refractory Cancer Pain. Clin J Pain 2005; 21:193-6. [PMID: 15722815 DOI: 10.1097/00002508-200503000-00013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The control of severe cancer pain may be problematic despite advances in pain management. Patients with severe intractable pain and/or intractable side effects may require aggressive interventional pain management strategies including the administration of medications by the continuous intrathecal route and/or neurosurgical procedures. Various medications, including opioids, local anesthetics, and alpha-2 agonists may be used intrathecally for the control of cancer pain. Failure of the intrathecal route may require the additional use of neurosurgical procedures such as cordotomy for pain control. We describe a case of severe cancer pain refractory to conventional intrathecal medications and cordotomy that was successfully managed by the addition of meperidine to the intrathecal regimen.
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Affiliation(s)
- Karen J Souter
- Pain Service and Department of Anesthesiology, University of Washington School of Medicine, Seattle, WA 98195, USA.
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Khaw KS, Ngan Kee WD, Critchley LA. Epidural meperidine does not cause hemodynamic changes in the term parturient. Can J Anaesth 2000; 47:155-9. [PMID: 10674510 DOI: 10.1007/bf03018852] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Meperidine has local anesthetic properties and, therefore, when given epidurally it has the potential to cause hemodynamic changes. Our objective was to study the hemodynamic effects of an analgesic dose of epidural meperidine (50 mg) in 34 ASA 1-2 term parturients scheduled for elective Cesarean section under epidural anesthesia. METHODS A lumbar epidural catheter was inserted and patients lay in the supine left wedge position. Intravenous fluid preload was withheld, and hemodynamic measurements comprising of mean arterial pressure, cardiac output and heart rate were made using automatic oscillotonometry (Dinamap 1486SX) and transthoracic electrical bioimpedance (Bomed NCCOM3). Following baseline measurements, the hemodynamic effects of sequential epidural injection of first, 10 ml saline, and 20 min thereafter, 50 mg meperidine diluted to 10 ml with saline, were recorded. Sensory blockade was assessed following each injection using loss of temperature discrimination to ice. Paired Student t tests were used to compare changes in hemodynamic variables. RESULTS Epidural meperidine produced a small increase from the saline values in the mean (SD) cardiac output of 5.81 +/-1.44 to 6.04+/-1.54 L x min(-1) (P<0.05), and mean arterial pressure of 77.1+/-8.8 to 79.3+/-9.9 mm Hg (P<0.05). Sensory changes, the upper level of which ranged from L1 to T1, were detected in 94% of patients given epidural meperidine. Epidural saline injection had no such hemodynamic effects, but produced a detectable sensory level in two patients. CONCLUSION Epidural meperidine, 50 mg, caused minimal hemodynamic changes in term parturients.
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Affiliation(s)
- K S Khaw
- Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Peoples Republic of China.
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Critchley LA, Morley AP, Derrick J. The influence of baricity on the haemodynamic effects of intrathecal bupivacaine 0.5%. Anaesthesia 1999; 54:469-74. [PMID: 10995146 DOI: 10.1046/j.1365-2044.1999.00841.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study compared the haemodynamic effects of subarachnoid block with plain bupivacaine 0.5% (dextrose-free), heavy bupivacaine 0.5% (in dextrose 8%) and a mixture of these two solutions, i.e. bupivacaine 0.5% in dextrose 4%. Thirty-six male patients, aged 55-89 years, undergoing transurethral surgery were recruited. Invasive systolic arterial and central venous pressures were recorded at 5-s intervals after the block was initiated using a computerised data-collection system. The height of sensory blockade was recorded at 5-min intervals. No preload was given and episodes of hypotension were treated with colloid (8 ml x kg(-1)) and, if this was ineffective, a metaraminol infusion. Systolic arterial and central venous pressures decreased in all three groups following block (p < 0.05). These decreases were more rapid in onset in the heavy bupivacaine group compared with plain bupivacaine group (p < 0.005). Patients in the heavy bupivacaine group also had a greater requirement for early treatment of hypotension (< 10 min) and treatment with metaraminol (p < 0.05). The onset of sensory blockade was more rapid in the heavy group compared with the mixed group, although final sensory levels were similar. The onset of haemodynamic and sensory changes are more rapid when using heavy bupivacaine intrathecally. This leads to a higher and earlier incidence of hypotension and requirement for treatment.
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Affiliation(s)
- L A Critchley
- Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories
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Hansen D, Hansen S. The effects of three graded doses of meperidine for spinal anesthesia in African men. Anesth Analg 1999; 88:827-30. [PMID: 10195532 DOI: 10.1097/00000539-199904000-00027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
UNLABELLED The intrathecal injection of 0.7-1 mg/kg meperidine provides spinal anesthesia of only short duration. In this study, we investigated the effects of three different doses of meperidine for spinal anesthesia on the duration and level of sensory block and the incidence of side effects. Forty-five African men were randomly allocated to receive one of three doses of intrathecal meperidine: Group A = 1.2 mg/kg, Group B = 1.5 mg/kg, and Group C = 1.8 mg/kg. The duration of sensory block was significantly longer after 1.5 mg/kg compared with 1.2 mg/kg meperidine (112 +/- 19 vs 79 +/- 27 min; P = 0.001). Increasing the dose to 1.8 mg/kg did not further increase the duration of block. The level and the onset of the block were not affected by the dose. Common side effects were fatigue (27%), pruritus (20%), and nausea (7%). Seven patients had respiratory depression and seven had a decrease of systolic arterial blood pressure (SAP) >30% from baseline. There was no difference in the incidence of any side effect among groups. Respiratory depression and decreases in SAP were observed 5-50 min after meperidine injection. Twenty-two patients had no pain after the sensory block had terminated. We conclude that increasing the dose of meperidine from 1.2 to 1.5 mg/kg increased the duration, but not the level, of sensory block without an increase in side effects. IMPLICATIONS Intrathecal meperidine 1 mg/kg provides surgical anesthesia for only 40-90 min. We investigated the effects of three larger doses of meperidine in 45 African men. The 1.5 and 1.8 mg/kg doses provide a longer duration of anesthesia compared with 1.2 mg/kg. Nausea, pruritus, and respiratory depression were common in all dose groups. We conclude that increasing the dose of meperidine from 1.2 to 1.5 mg/kg increased the duration, but not the level, of sensory block without an increase in side effects.
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Affiliation(s)
- D Hansen
- Lilongwe Central Hospital, Malawi, Africa
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Hansen D, Hansen S. The Effects of Three Graded Doses of Meperidine for Spinal Anesthesia in African Men. Anesth Analg 1999. [DOI: 10.1213/00000539-199904000-00027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Murto K, Lui AC, Cicutti N. Adding low dose meperidine to spinal lidocaine prolongs postoperative analgesia. Can J Anaesth 1999; 46:327-34. [PMID: 10232715 DOI: 10.1007/bf03013223] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To investigate the effects of the addition of low dose meperidine to spinal lidocaine on the sensory and motor blockade profile, and the quality and duration of postoperative analgesia. METHODS In a randomized double blind prospective dose finding study 40 patients undergoing transurethral prostatectomy with spinal anesthetic were allocated to receive 75 mg lidocaine 5% intrathecally as the sole agent (group A), or co-administered with 0.15 mg x kg(-1) meperidine (group B) or 0.30 mg x kg(-1) meperidine (group C). Sensory and motor blockade profiles were documented. Postoperatively, the amount of analgesics required, time to first analgesic, visual analogue scores and adverse events were recorded. RESULTS Sensory blocks at or above T10 was maintained for 128, 156 and 145 minutes in groups A, B and C respectively. There was no difference in the latency or duration of the motor block among the three groups. Patients in group C had lower visual analogue pain scores (VAPS) over time than did those in groups A and B (P < 0.05). Time to first analgesia was longer (429 +/- 197 minutes) in group C than in group A (254 +/- 157 minutes) (P < 0.05). Fewer patients in group C required parenteral opioid postoperatively than in group A (P < 0.05). The incidence of bradycardia was higher in the groups receiving meperidine. No symptoms of transient radicular irritation (TRI) were reported in the groups receiving meperidine. CONCLUSION The addition of 0.3 mg x kg(-1) of meperidine to spinal lidocaine prolongs postoperative analgesia without delaying discharge from post anesthetic care unit (Table II) and reduces the requirement for parenteral analgesics (Table III).
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MESH Headings
- Adjuvants, Anesthesia/administration & dosage
- Adjuvants, Anesthesia/adverse effects
- Adjuvants, Anesthesia/therapeutic use
- Aged
- Aged, 80 and over
- Analgesia/methods
- Analgesics, Opioid/administration & dosage
- Analgesics, Opioid/adverse effects
- Analgesics, Opioid/therapeutic use
- Analysis of Variance
- Anesthesia, Spinal/methods
- Anesthetics, Local/administration & dosage
- Arrhythmia, Sinus/chemically induced
- Bradycardia/chemically induced
- Double-Blind Method
- Humans
- Hypotension/chemically induced
- Incidence
- Lidocaine/administration & dosage
- Male
- Meperidine/administration & dosage
- Meperidine/adverse effects
- Meperidine/therapeutic use
- Middle Aged
- Motor Neurons/drug effects
- Nerve Block/methods
- Neurons, Afferent/drug effects
- Pain Measurement
- Pain, Postoperative/prevention & control
- Prospective Studies
- Prostatectomy
- Time Factors
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Affiliation(s)
- K Murto
- Department of Anesthesia, Ottawa Hospital, Ontario, Canada
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16
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Abstract
Pethidine is the only member of the opioid family that has clinically important local anaesthetic activity in the dose range normally used for analgesia. Pethidine is unique as the only opioid in current use that is effective as the sole agent for spinal anaesthesia. In lower doses, intrathecal pethidine is also an effective analgesic for treating pain in labour. This paper reviews the pharmacology of intrathecal pethidine and clinical experience reported to date. Articles reviewed include those identified by a Medline search using keywords "intrathecal" or "spinal anaesthesia/ anesthesia" and "pethidine" or "meperidine". Reference lists from identified papers were scrutinized to identify further relevant articles.
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Affiliation(s)
- W D Ngan Kee
- Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital
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17
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CRITCHLEY L, MORLEY A. Complications of intrathecal administration of pethidine. Anaesthesia 1996. [DOI: 10.1111/j.1365-2044.1996.tb04674.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Critchley LA, Morley AP. Complications of intrathecal administration of pethidine. Anaesthesia 1996; 51:711-2. [PMID: 8758180 DOI: 10.1111/j.1365-2044.1996.tb07874.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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