MEPERIDINE, AS AN EFFECTIVE ADJUVANT AGENTIN UNILATERAL SPINAL ANAESTHESIA FOR KNEE ARTHROSCOPY

Abstract

-

Keywords

• -

MEPERIDINE, AS AN EFFECTIVE ADJUVANT AGENTIN UNILATERAL SPINAL ANAESTHESIA FOR KNEE ARTHROSCOPY

Abstract

Aim: Unilateral spinal anaesthesia permits early recovery and short ambulatory stay. Our study aimed to search if meperidine may prolong sensory block time when added to hyperbaric bupivacaine. Methods: This is a prospective, double blinded study: Ambulatory, 46 consenting patients aged 18-60 years, undergoing unilateral knee arthroscopy were randomized in two groups. saline group (n=20): 1.3 ml of hyperbaric bupivacaine and 0.2 ml of serum physiologic was used. Meperidine group (n=20): 1.3 ml of hyperbaric bupivacaine and 0.2 ml of 5% meperidine was used. Sensory block times, duration of spinal anaesthesia, intraoperative adverse effects and patient satisfaction were recorded. Results: Mean duration of sensory block was greater in the meperidine group compared with the saline group. Strict unilateral block and hypotension were comparable among groups. Conclusion: Addition of meperidine to hyperbaric bupivacaine in unilateral spinal anaesthesia prolonged analgesia without effecting total anesthesia time with minimal adverse effects

Keywords

• Unilateral spinal anaesthesia, meperidine, outpatient surgery, knee arthroscopy

References

1. Urmey WF. Spinal anesthesia for outpatient surgery. Best Pract Res Clin Anaesthesiol 2003;17:335–46
2. Liu SS. Optimizing Spinal Anesthesia for Ambulatory Surgery. Reg Anesth 1997;22: 500-10
3. Fanelli G, Borghi B, Casati A, Bertini L, Montebugnoli M, Torri G. Unilateral bupivacaine spinal anesthesia for outpatient knee arthroscopy. Can J Anesth 2000;47: 746-51
4. Fanelli G, Casati A, Aldegheri G, et al. Cardiovascular effects of two different regionel anaesthetic techniques for unilateral leg surgery. Acta Anaesthesiol Scand 1998;42:80-4
5. Kuusniemi K, Pihlajamaki K, Pitkanen MT. A low dose of plain and hyperbaric bupivacaine for unilateral spinal anesthesia. Reg Anesth Pain Med 2000;25:605-10
6. Iselin-Chaves IA, VanGessel EF, Donald FA, Forster A, Gamulin Z. The effects of solution concentration and epinephrine on lateral distribution of hyperbaric tetracaine spinal anesthesia. Anesth Analg 1996;83:755-9
7. Liu S, Chiu A, Carpenter RL, et al. Fentanyl prolongs lidocaine spinal anesthesia without prolonging recovery. Anesth Analg 1995;80: 730-4
8. Tsen LC, Schultz R, Martin R, Data S, Bader AM. Intrathecal low dose bupivacaine versus lidocaine for in vitro fertilization procedures. Reg Anesth Pain Med 2001;26:52-6

9. Yu SC, Ngan Kee WD, Kwan ASK. Addition of meperidine to bupivacaine for spinal anesthesia for Caesarean section. Br J Anaesth 2002;88:379-83
10. Casati A, Fanelli G, Cappelgeri G, Leoni A et al. Does speed of intrathecal injection effect the distribution of % 0.5 hyperbaric bupivacaine? Br J Anaesth 1998;81:355-7
11. Newel R. Pelvic girdle and lower limb. In: Standring S, Editor. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. Madrid: Elsevier Churchill Livingstone, 2005: 1413-4
12. Gerancher JC, Liu SS. Complications of anesthesia. In: Benumof JL, Saidman LJ, Editors. Anesthesia and perioperative complications. St. Louis: Mosby Co, 1999: 50-65
13. Sumi M, Sakura S, Koshizaki M, Saito Y, Kosaka Y. The advantages of the lateral decubitus position after spinal anesthesia with hyperbaric tetracaine. Anesth Analg 1998;87:879-84
14. Gentili ME. Added morphine may spoil unilateral spinal block. Reg Anesth Pain Med 2005;30:596
15. Gentili ME,Mamelle JC, Le Foll G. Combination of low dose bupivacaine and clonidine for unilateral spinal anesthesia in arthroscopic knee surgery. Reg Anesth 1995;20:169-70
16. Casati A, Fanelli G, Cappelleri G, et al. Effects of spinal needle type on lateral distribution of % 0.5 hyperbaric bupivacaine. Anesth Analg 1998;87:355-9
17. Enk D, Prien T, Van Aken H, Metres N, Meyer J, Brüssel T. Success rate of unilateral spinal anesthesia is dependent on injection flow. Reg Anesth Pain Med 2001;26:420-7.
18. Kafle SK. Intrathecal meperidine for Caesarean section: a comparison with lidocaine. Can J Anaesth 1993;40:718-21
19. Roy JD, Girard M, Drolet P. Intrathecal meperidine decreases shivering during cesarean delivery under spinal anesthesia. Anesth Analg 2004;98:230-4