Abstract
The purpose of this study was to determine if a small dose of intrathecal meperidine would achieve adequate spinal anaesthesia while minimizing complications and to compare its effectiveness with lidocaine. The spinal anaesthetic effects of five per cent lidocaine 0.5 mg · kg−1 in 7.5 percent glucose (n = 20) or five per cent meperidine 0.5 mg · kg−1 (n = 22) were evaluated in 42 ASA physical status II or III patients. Intrathecal injection of the anaesthetic agent was given with the patient in the sitting position in which he remained for ten minutes before being placed in the lithotomy position. The onset time for sensory blockade was seven minutes in the lidocaine group and ten minutes in the meperidine group. Final sensory levels were identical in both groups. Mean arterial blood pressure decreased significantly in the lidocaine group but not in the meperidine group. Motor block was absent in ten patients in the meperidine group but was present in all the patients in the lidocaine group. Duration of postoperative analgesia was 968 min in the meperidine group and 681 min in the lidocaine group (NS). Complications such as nausea, vomiting, itching, drowsiness and respiratory depression were similar in the two groups. It is concluded that low-dose meperidine, 0.5 mg · kg−1, is effective as a spinal anaestheic agent and has few complications.
Résumé
Nous avons évalué la mépéridine intrathécale en tant qu’anesthésique, et l’avons comparé à la lidocaine. En position assise, on fit une injection sousarachnoidienne de 0,5 mg-kg−1 de lidocaine cinq pour cent dans du dextrose 7,5 pour cent (n = 20) ou de 0,5 mg · kg−1 de mépéridine cinq pour cent (n = 22) à 42 patients de classe ASA II ou III. Dix minutes plus tard le patient etait place en lithotomie. Le bloc sensitif apparaissait au bout de sept minutes avec la lidocaine et de dix minutes avec la mépéridine et atleignait un niveau final semblable avec les deux agents. Une baisse de la pression artérielle moyenne et un bloc moteur survenaient avec la lidocaine mais pas avec la meperidine. L’analgésie postopératoire durait en moyenne 968 min avec la mépéridine et 681 min avec la lidocaine (NS). La prévalence de nausee, de vomissement, de prurit et de dépression respiratoire était semblable entre les deux groupes. Il semble done qu ’ à dose de 0,5 mg · kg−1, la mépéridine intrathécale soit un anesthésique efficace amenant peu de complications.
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Patel, D., Janardhan, Y., Merai, B. et al. Comparison of intrathecal meperidine and lidocaine in endoscopic urological procedures. Can J Anaesth 37, 567–570 (1990). https://doi.org/10.1007/BF03006327
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DOI: https://doi.org/10.1007/BF03006327