LOWER ABDOMINAL & PELVIC SURGERY

ADDITION OF PETHIDINE TO BUPIVACAINE FOR SPINAL ANAESTHESIA

Abstract

Objectives: To investigate the effect of adding pethidine to
intrathecal bupivacaine on the duration of postoperative analgesia in patients for lower abdominal and pelvic
surgery under spinal anaesthesia. Design: A randomized placebo controlled observational study. Place and
duration of study: The study was conducted in department of anaesthesiology and intensive care, combined
military hospital Gujranwala Cantonment from September 2000 to March 2002. Subjects & Methods: A total
of 80 patients were included in the study with ASA class II & III. Patients were divided into two equal groups.
40 patients received intrathecal injection of 0.75% hyperbaric bupivacaine 1.8 ml with 0.2 ml of Pethidine.
Where as 40 patients in placebo group received intrathecal injection of 0.75% hyperbaric bupivacaine1.8ml with
0.2ml of saline. Intraoperative adverse effects and effective duration of post operative analgesia was recorded.
Results: The duration of effective analgesia was greater in group II 180-287 minutes(min) (mean 231 min)
compared with group I 100-135 min (mean 121 min). The incidence of nausea and vomiting was greater ingroup
II (35%) as compared to group I (7.5%). Conclusion: Addition of 10 mg pethidine to intrathecal
hyperbaric bupivacaine is associated with prolonged analgesia but with greater intraoperative nausea and vomiting.
Key Words: Pethidine, Intrathecal, Hyperbaric, Bupivacaine, Prostaectomy, Analgesia.