Shaukat Raza, Hasan Raza, Humayun Munir Tarar.
Spinal anaesthesia; effects of adding pethidine with bupivacaine.
Professional Med J Jan ;13(4):651-6.

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 : 15th June 2002 to 15th October 2002. Material 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.

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