Korean J Anesthesiol.  2000 Jan;38(1):49-57. 10.4097/kjae.2000.38.1.49.

Comparison of Intrathecal Meperidine, Fentanyl, or Placebo Added to 0.5% Hyperbaric Bupivacaine for Cesarean Section

• Choi JH
• Kong MH
• Lim SH
• Lee MK

• KMID: 2091488
• DOI: http://doi.org/10.4097/kjae.2000.38.1.49

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.

Keyword

Analgesics, opioid: fentanyl; meperidine; Anesthetics, local: bupivacaine; Anesthetic techniques: spinal; Surgery, obstetrics: cesarean section

MeSH Terms

Analgesia
Analgesics, Opioid
Anesthesia
Anesthesia, Spinal
Bupivacaine*
Cesarean Section*
Female
Fentanyl*
Humans
Incidence
Infant, Newborn
Meperidine*
Mothers
Nausea
Postoperative Period
Pregnancy
Vomiting
Analgesics, Opioid
Bupivacaine
Fentanyl
Meperidine