Intrathecal pethidine as a sole agent for spinal anesthesia and analgesia – a comparison with 5% lignocaine
Journal Title: International Journal of Medical Science and Public Health - Year 2017, Vol 6, Issue 2
Abstract
Background: Spinal anesthesia is very safe, effective, and economical technique in anesthesia for a regional block. Various drugs are used for spinal anesthesia from which lignocaine is very popular since several decades. The discovery of opioid receptors in the central nervous system especially in spinal cord initiated interest in using them as intrathecal and extradural uses. Objective: To evaluate the efficacy of intrathecal pethidine as a sole anesthetic agent and as a postoperative analgesia in the surgical procedure below the umbilicus. It was compared with commonly used drug like lignocaine. Materials and Methods: The present study was carried out in patients of either sex belonging to American Society of Anesthesiology (ASA) grade I or II, in the age group of 16–70 years. Patients were undergoing elective lower abdominal, genitourinary or lower extremity surgery under spinal anesthesia at our hospital. Patients were divided into 2 groups of 50 patients each. Patients in group 1 (study group) were given 1 mg/kg preservative-free injection pethidine hydrochloride (5%) diluted up to 2cc with 0.9% normal saline intrathecal. Patients in group 2 (control group) were given 2 ml injection lignocaine (5%) in 7.5% dextrose intrathecal. Anesthesia was given in subarachnoid space in lateral or sitting position between L3–L4 interspace by using 25 gauge needles with all aseptic precautions. Sensory block was tested by using pin prick method. Time to onset of motor blockage was determined by modified Bromage scales of grade II. The degree of postoperative analgesia was carried out by visual analog scale. Result: There was no incidence of sensory block failure in either group. Time of onset of sensory block was significantly (p < 0.01) faster in the case of lignocaine group (group 2). The difference between the time to regress sensory block by two segments was significant between 2 groups (p < 0.01). Duration of analgesia at L1 level was significantly different between both groups (p < 0.05). The difference between the total duration of sensory block was not significantly different between both groups (p > 0.05). The onset of motor block at knee joint was significantly prolonged in group 1 as compared to group 2 (p < 0.01). The mean duration of motor block was shorter in group 1 as compared to group 2 (p < 0.01). In group 1, 4 out of 50 patients developed incomplete motor block. In this study mean duration of analgesia was 14 hours in group 1 and 2 hours in group 2. This showed a significant difference (p < 0.01). The patients in group 1 required analgesia once in 24 hours postoperatively while in group 2 patients required analgesia two to three times in 24 hours postoperatively. Conclusion: This study showed that intrathecal pethidine in the dose of 1 mg/kg produced comparable effects produced by subarachnoid administration of local anesthetics such as lignocaine including sensory, motor, and sympathetic block. It also showed fewer side effects than lignocaine. It also showed lesser requirements of analgesics postoperatively and early ambulation.
Authors and Affiliations
Mahendra Parmar, Hemangini Patel, Bansari Kantharia
Keywords
Related Articles
- EP ID EP299380
- DOI 10.5455/ijmsph.2017.19072016601
- Views 97
- Downloads 0
A genderwise study on the morphometry of infraorbital foramen and its laterally in dry adult skulls of South Indian population
Background: The infraorbital foramen is situated in the maxilla and it conveys infraorbital nerve and vessel, the knowledge of its morphometry and variations is therefore mandatory to do therapeutic infraorbital n...
Study of acute acalculous cholecystitis as an atypical manifestation in dengue fever
Background: Dengue is a rapidly emerging global health problem. It is an arboviral disease caused by four antigenically distinct dengue viruses. Dengue epidemic occurs annually with major outbreaks in various part...
A cross-sectional study of anemia among women of reproductive age group (15-49 years) in a rural population of Tamil Nadu
Background: Iron deficiency is the most common nutritional disorder in the world, affecting particularly the women of reproductive age group in tropical and subtropical zones. In India, 20-40% of maternal deaths are due...
Association of vitamin D and insulin resistance in individuals with metabolic syndrome
Background: Metabolic syndrome (MetS), a lifestyle disease related with many biochemical alterations which prompt a person to type 2 diabetes and cardio vascular diseases (CVD). Widespread studies conceded right t...
Epidemiological determinants of pregnancy outcome in urban slums of Jammu city-a prospective study
Background: In the backdrop of continuing high child and maternal mortality, eight millennium development goals (MDGs) were spelt out by United Nations in 1990 setting targets for reduction in child mortality (MDG-4) by...