SPINAL ANAESTHESIA

EFFECTS OF ADDING PETHIDINE WITH BUPIVACAINE

Abstract

Objectives: To investigate the effects of adding pethidine with intrathecal
bupivacaine, in patients having elective Caesarian section under spinal anaesthesia. Design: A prospective
randomized double blind study. Setting: Department of Anaesthesiology in Combined Military Hospital, Rawalpindi
Period : 15 June 2002 to 15 October 2002. Material th th and Methods: One hundred patients received intrathecal
injection of 0.5 % bupivacaine 2.0 ml plus either normal saline 0.2 ml (control group) or 0.2 ml 5% pethidine equivalent
to 10mg of the drug (pethidine group). Duration of effective analgesia (defined as the time duration from the intrathecal
injection to first patient demand of analgesia) was recorded. Other variables recorded were Hypotension (defined as
when systolic blood pressure drops to less than 90 mm of Hg or a decrease of 25% from base line blood pressure),
pruritis and occurrence of nausea and vomiting. Results: The duration of effective analgesia was greater in the
pethidine group (mean 238.70 minutes) compared with control group (mean 120.88 minutes), this difference was
statistically significant with p<0.05. Hypotension was more common in the pethidine group 70% compared to 52% in
the control group (P=0.06), while pruritis occurred in 20 % patients of Pethidine group compared to only 6% of control
group (p=0.038). Nausea and vomiting were also common in pethidine group (52% vs. 10%) with a p value of 0.001.
Conclusion: Addition of 10 mg of pethidine to 2 ml of 0.5% bupivacaine results in significant rise in early postoperative
analgesia but at a cost of higher rate of side effects.