Intrathecal pethidine as a sole agent for spinal anesthesia and analgesia - a comparison with 5% lignocaine

Parmar, Mahendra; Patel, Hemangini; Kantharia, Bansari

doi:10.5455/ijmsph.2017.19072016601

Cited by 3 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The dose of pethidine in the present study was based on data from Parmar et al's study (2017) (15). It was reported that pethidine provided better postoperative patient comfort and decreased postoperative systemic analgesic (21).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

bupivacaine , pethidine and sole pethidine on the hemodynamic status and duration of sensory and motor block: A randomized clinical trial in iran

MojaverAghili

Halakou

Talebi

et al. 2022

Preprint

View full text Add to dashboard Cite

BackgroundManagement of analgesia and hemodynamic status is essential for orthopedic surgery patients. This study aimed to determine the effect of intrathecal (bupivacaine + magnesium sulfate) versus (pethidine + magnesium sulfate) and sole pethidine on the hemodynamic status and onset and duration of sensory/motor block in patients with lower limb fractures.MethodsThis double-blind randomized clinical trial was done between October 2020 and August 2021 in the Gorgan 5thAzar, Hospital, northeastern Iran and included 120 patients undergoing orthopedic surgery with spinal anesthesia and divided them in four groups of A: bupivacaine (10 mg), B: (pethidine 1 mg / kg), C: (bupivacaine 10 mg + magnesium sulfate 100 mg), and D: (pethidine 1 ‌mg / kg + magnesium sulfate 100 mg). The recorded parameters were hemodynamic parameters, time of onset, and duration of sensory/motor block.ResultsThere were no clinically significant differences in hemodynamic parameters between the groups. The onset of sensory block (P = 0.235), the onset of motor block (P = 0.097), and the duration of motor block (P = 0.135) were not statistically different between the groups; however, there was a significant difference in the duration of sensory block between the groups (P = 0.035). Magnesium sulfate increased the duration of motor block in the pethidine group C (80.93 ± 30.28) and decreased it in the bupivacaine group D (75.23 ± 38.56).ConclusionsThe intrathecal drugs used in the study did not cause any specific side effects. Therefore, these drugs can be used interchangeably. Magnesium sulfate, in combination with bupivacaine reduced the duration of sensory/motor block. While in the pethidine group, it acted as suitable analgesia by increasing the duration of sensory block. Therefore, magnesium can be considered a suitable additive for intrathecal pethidine.Trial registration: Iran clinical trial register: (IRCT20170413033408N3) Registration date: 2020-06-11

show abstract

Section: Discussionmentioning

confidence: 99%

“…Patients received druges inthertecally in group A: bupivacaine (10 mg), group B (bupivacaine: 10 mg + magnesium sulfate: 100 mg) (14), group C: (pethidine: 1 mg / kg + magnesium sulfate: 100 mg) (15,16), and group D: pethidine: 1 mg / kg (15,16).…”

Section: Data Collectionmentioning

confidence: 99%

bupivacaine , pethidine and sole pethidine on the hemodynamic status and duration of sensory and motor block: A randomized clinical trial in iran

MojaverAghili

Halakou

Talebi

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Pethidine subarachnoid block has been shown to be comparable to 5% lignocaine with fewer side effects, additionally, there is less requirement for postoperative analgesia and prevention of postoperative shivering. 24,25 With these advantages, pethidine subarachnoid block is suitable for day care surgery where early ambulation, street fitness, adequate analgesia without postoperative nausea and vomiting are desirable to prevent unplanned admission.…”

Section: Discussionmentioning

confidence: 99%

Pethidine and bupivacaine spinal anaesthesia: a comparative evaluation of postoperative complications and recovery profile

2017

View full text Add to dashboard Cite

Background: Bupivacaine is commonly used as a sole agent for spinal anaesthesia unlike Pethidine. This study compares the immediate postoperative complications and recovery profile following spinal anaesthesia with pethidine and bupivacaine.Methods: Fifty-two patients who required short duration surgical procedures below the umbilicus were randomized to receive spinal anaesthesia with pethidine 1mg/Kg and 2.5 mL 0.5% bupivacaine. Time to recovery of pin prick sensation at S2, plantar flexion, proprioception of the big toe, and full motor recovery were compared for the two agents. Complications of pain, sedation, nausea and vomiting, pruritus and urinary retention in the immediate postoperative period were also compared.Results: Comparing Pethidine and Bupivacaine, time to return of pinprick sensation at S2 was 94.62±20.25 and 205.96±31.05 minutes respectively; return of plantar flexion was 92.88±12.01 and 193.85±39.56 minutes respectively; recovery of proprioception of the big toe was 31.15±9.41 and 172.50±42.70 minutes respectively; complete motor recovery was 47.89±14.08 and 221.73±44.72 minutes respectively. All the differences in recovery times were statistically significant (p<0.0001). There was no statistically significant difference in the incidence of pain and sedation. Only 4 (15.38%) patients in the Bupivacaine group experienced mild pain. There was no incident of nausea and vomiting. However, pethidine group experienced pruritus (19.22%) and bupivacaine group none. Bupivacaine group also had urinary retention (11.54%), while pethidine group had none. These differences were statistically significant (p=0.01).Conclusions: Pethidine exhibited a shorter recovery profile than Bupivacaine and also caused no significant complication in the immediate postoperative period.

show abstract

“…Neuraxial anesthesia (NA) is a commonly used type of regional anesthesia employing the injection of local anesthetics along with other additives into fat tissue surrounding the nerve roots (epidural anesthesia [EA]) or into the intrathecal space containing the cerebrospinal fluid (CSF) surrounding the spinal cord (spinal anesthesia [SA]). [ 1 – 3 ] NA is described as a safe, efficient, and cost-effective technique that provides appropriate perioperative analgesia and is frequently used in surgical procedures performed in the lower abdominal and pelvic region, lower extremities (LE), and cesarean section. [ 2 , 3 ] NA has been linked to the reduction of cardiopulmonary complications, postoperative mortality, and deep vein thrombosis prophylaxis.…”

Section: Introductionmentioning

confidence: 99%

“…[ 1 – 3 ] NA is described as a safe, efficient, and cost-effective technique that provides appropriate perioperative analgesia and is frequently used in surgical procedures performed in the lower abdominal and pelvic region, lower extremities (LE), and cesarean section. [ 2 , 3 ] NA has been linked to the reduction of cardiopulmonary complications, postoperative mortality, and deep vein thrombosis prophylaxis. [ 4 ] The occurrence of neurologic complications after NA is very rare—between 1–1000/1–100,000 [ 4 ] ; nevertheless, anesthesia care providers should be always aware of its possible postoperative neurologic complications.…”

Section: Introductionmentioning

confidence: 99%

Cauda equina syndrome following an uneventful spinal anesthesia in a patient undergoing drainage of the Bartholin abscess

et al. 2018

View full text Add to dashboard Cite

Rationale:Neuraxial anesthesia is a commonly used type of regional anesthesia. Cauda equina syndrome is an unusual and severe complication of neuraxial anesthesia, and is caused by damage to the sacral roots of the neural canal. We present a case of cauda equina syndrome following spinal anesthesia in a patient who underwent Bartholin abscess drainage.Patient concerns:A 23-year old female scheduled to undergo surgical drainage of Bartholin abscess. Spinal anesthesia was performed with bupivacaine and fentanyl. There were no perioperative adverse events reported. On postoperative day 1, the patient went to the emergency department describing bilateral weakness and pain of the lower extremities (LE).Diagnoses:Lumbar magnetic resonance imaging showed increased gadolinium accumulation in the neural sheath at the level of the cauda equina tracts, consistent with the diagnosis of arachnoiditis and the diagnosis of cauda equina was established.Interventions:The patient received the following emergent treatment: 75 mg pregabalin (oral) every 12 hours, 20 mg (8 drops) tramadol (oral) every 8 hours, and 4 mg dexamethasone (intravenous) every 6 hours. On postoperative day 4, the patient still experienced bilateral flaccid paraparesis (accentuated in the left side), neuropathic pain in low extremities, and left brachial monoparesis. Hence, dexamethasone was instantly replaced with 1 g methylprednisolone (intravenous) for 5 days.Outcomes:After completing 5 days of methylprednisolone, on postoperative day 9, the patient experienced less pain in left extremities, osteotendinous reflexes were slightly diminished, and she was able to walk with difficulty for 3 to 5 minutes. Greater mobility was evidenced, with right proximal and distal low extremities Medical Research Council Scale grades of 2 and 3 and left proximal and distal low extremities Medical Research Council Scale grades 1 and 2, respectively. Oral prednisone was restarted. Consequently, she was discharged home in stable conditions on postoperative day 25 with a prescription for sertraline, clonazepam, pregabalin, paracetamol, and prednisone.Lesson:The early detection and treatment of complications after neuraxial anesthesia is essential to minimize the risk of permanent damage.

show abstract

Intrathecal pethidine as a sole agent for spinal anesthesia and analgesia - a comparison with 5% lignocaine

Cited by 3 publications

References 0 publications

bupivacaine , pethidine and sole pethidine on the hemodynamic status and duration of sensory and motor block: A randomized clinical trial in iran

bupivacaine , pethidine and sole pethidine on the hemodynamic status and duration of sensory and motor block: A randomized clinical trial in iran

Pethidine and bupivacaine spinal anaesthesia: a comparative evaluation of postoperative complications and recovery profile

Cauda equina syndrome following an uneventful spinal anesthesia in a patient undergoing drainage of the Bartholin abscess

Contact Info

Product

Resources

About