SPINAL ANAESTHESIA

Objectives: To investigate the effects of adding pethidine with intrathecalbupivacaine, in patients having elective Caesarian section under spinal anaesthesia. Design: A prospectiverandomized double blind study. Setting: Department of Anaesthesiology in Combined Military Hospital, RawalpindiPeriod : 15 June 2002 to 15 October 2002. Material th th and Methods: One hundred patients received intrathecalinjection of 0.5 % bupivacaine 2.0 ml plus either normal saline 0.2 ml (control group) or 0.2 ml 5% pethidine equivalentto 10mg of the drug (pethidine group). Duration of effective analgesia (defined as the time duration from the intrathecalinjection to first patient demand of analgesia) was recorded. Other variables recorded were Hypotension (defined aswhen 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 thepethidine group (mean 238.70 minutes) compared with control group (mean 120.88 minutes), this difference wasstatistically significant with p<0.05. Hypotension was more common in the pethidine group 70% compared to 52% inthe control group (P=0.06), while pruritis occurred in 20 % patients of Pethidine group compared to only 6% of controlgroup (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 postoperativeanalgesia but at a cost of higher rate of side effects.