Muhammad Aslam, Arslan Sharif Malik.
Lower abdominal & pelvic surgery; addition of Pethidine to Bupivacaine for Spinal Anesthesia.
Professional Med J Jan ;11(1):79-82.

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 anesthesia. Design: A randomized placebo controlled observational study. Place and duration of study: The study was conducted in department of anesthesiology 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 bupivacaine 1.8 ml 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 IT 180-287 minutes (min) (mean 231 min) compared with group 1100-135 min (mean 121 min). The incidence of nausea and vomiting was greater in-group 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.

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