Comparison of Intrathecal Meperidine, Fentanyl, or Placebo Added to 0.5% Hyperbaric Bupivacaine for Cesarean Section.
10.4097/kjae.2000.38.1.49
- Author:
Joon Hyeuk CHOI
1
;
Myoung Hoon KONG
;
Sang Ho LIM
;
Mi Kyoung LEE
Author Information
1. Department of Anesthesiology, College of Medicine, Korea University, Seoul, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Analgesics, opioid: fentanyl;
meperidine;
Anesthetics, local: bupivacaine;
Anesthetic techniques: spinal;
Surgery, obstetrics: cesarean section
- MeSH:
Analgesia;
Analgesics, Opioid;
Anesthesia;
Anesthesia, Spinal;
Bupivacaine*;
Cesarean Section*;
Female;
Fentanyl*;
Humans;
Incidence;
Infant, Newborn;
Meperidine*;
Mothers;
Nausea;
Postoperative Period;
Pregnancy;
Vomiting
- From:Korean Journal of Anesthesiology
2000;38(1):49-57
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The addition of various opioids to 0.5% hyperbaric bupivacaine intrathecally seems to potentiate analgesic effects of bupivacaine and to prolong the duration of analgesia. We compared the effect of intrathecal meperidine 0.25 mg/kg and 0.5 mg/kg, fentanyl 0.15 microgram/kg, and placebo when administered together with 0.5% hyperbaric bupivacaine 9 mg for cesarean section. METHODS: Forty-four healthy term parturients were randomly allocated (n = 11 per group) to receive the test solution (1 ml) containing preservative-free normal saline (control group), fentanyl 0.15 microgram/kg, meperidine 0.25 mg/kg, or meperidine 0.5 mg/kg intrathecally, immediately followed by the injection of 0.5% hyperbaric bupivacaine 9 mg. We observed the effective postoperative analgesic duration (time to VAS > or = 4), quality of anesthesia and side effects. RESULTS: The effective postoperative analgesic duration significantly increased in the groups receiving opioid compared with the control group (P < 0.05); control group 101.4 +/- 28.6 min; fentanyl group 192.3 +/- 29.2 min; meperidine 0.25 mg/kg group 208.8 +/- 21.7 min; meperidine 0.5 mg/kg group 289.8 53.6 min (data expressed as mean +/- SD). The quality of anesthesia was excellent in 100% of the meperidine group but in 82% of the fentanyl group and 91% of the control group. The incidence of nausea and vomiting were higher in the meperidine 0.5 mg/kg group (73%) than in the remaining groups (P < 0.05). CONCLUSIONS: The addition of fentanyl 0.15 microgram/kg or meperidine 0.25 mg/kg to 0.5% hyperbaric bupivacaine 9 mg for spinal anesthesia improves intraoperative analgesia and provides analgesia into the immediate postoperative period with no adverse effects on mother or neonate.
