Spinal Anesthesia Using Lidocaine / Meperidine Mixture for Cesarean Section

Kim, Ae Ra; Park, Jung Goo; Cheun, Jae Kyu

Abstract

Recently several reports have described the usefullness of meperidine as a sole agent for spinal anesthesia. In this study, 50 mg meperidine mixed with l5-25 mg lidocaine(group 1, n= 11), 25 mg meperidine mixed with 40~50 mg lidocaine(group 2, n= l0) and 65~75 mg lidocaine only (group 3, n=9) were respectively injected into the subarachnoid space for elective cesarean section. The results were as follows: 1) Hypotension over 20% decrease in systolic blood pressure was found in 7 out of 11 cases in group 1,5 out of 10 cases in group 2 and S out of 9 cases in group 3. The dosage of ephedrine used for hypotension was not signifieantly different amoung the three groups. 2) The time from subarachnoid injection to Bromage scale 0 of group l was 77.3+/-20.7 minutes which was significantly shorter than 125.0+21.5 minutes of group 3(p<0.05). 3) The duration from the administration of the drug until the development of severe pain postoperatively was checked as 483.6+/-157.9 minutes in group 1, 424.0+/-109.4 minutes in group 2 which were significantly longer than 55.5+/-25 minutes in group 3(p<0.05). 4) Nausea/vomiting were occured 5/0 out of l1 cases in group 1, 4/1 out of 10 cases but none in group 3. 5) Complaints about pain during the operation occured in 5 out of 9 cases in group 3, but none in group 2 and 3. 6) The Apgar score and umbilical cord blood gas analyses were not significantly different amoung the three groups. The results of this study clear1y indicate that combining meperidine with hyperbaric spinal lidocaine for cesarean section is a safe and effective method of improving intraoperative pain relief. Furthermore, it provides adquate prolonged postoperative analgesia.