Meperidine as a spinal anesthetic agent: A comparison with lidocaine-glucose

• Main Authors: S. Sangarlangkarn, V. Klaewtanong, P. Jonglerttrakool, V. Khankaew
• Other Authors: Mahidol University
• Format: Article
• Published: 2018
• Subjects: Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/15448

The anesthetic effects of 2 ml of 5% lidocaine in 7.5% glucose (LG) or 5% meperidine in water were evaluated and compared in 40 ASA class 1 or 2 patients. Patients were randomly assigned to one of the two groups (20 patients in each) according to the anesthetic agent, which was injected into the lumbar subarachnoid space in the sitting position. The patients remained sitting for 5 min before being placed in the supine position. Times of onset of sensory and complete motor blockade were significantly more rapid with LG. The extent of maximum cephalad spread of analgesia and the time to maximum height of analgesia in the two groups were not different. Duration of analgesia at the T-7 (48.96 ± 6.64 min with LG, 44.74 ± 6.14 min with meperidine; means ± SEM) and L-1 (94.37 ± 7.42 min with LG, 76.19 ± 5.64 min with meperidine) dermatomes was not different in the two groups but was statistically longer at the T-10 dermatome with LG (66.83 ± 6.72 min) than with meperidine (46.66 ± 6.26 min). The duration of complete motor blockade was also significantly longer with LG (66.44 ± 7.05 min) than with meperidine (42.67 ± 4.47 min). Complications in both groups included decrease in blood pressure and nausea and vomiting intraoperatively, and urinary retention, nausea and vomiting, and mild headache postoperatively. Complications that occurred only in the meperidine group were intraoperative drowsiness, respiratory depression, bronchospasm, and itching. The frequency of complications was greater with meperidine. The number of patients requiring only oral medication for pain relief during the first 24 hr after surgery was significantly greater in the meperidine group but the number of patients who were pain free and required neither oral nor narcotic analgesic did not differ. Meperidine-water as the sole spinal anesthetic agent in this study had no significant advantage over lidocaine-glucose.