ANESTHESIA AND ADVERSE-EFFECTS AFTER INTRATHECAL PETHIDINE HYDROCHLORIDE FOR UROLOGICAL SURGERY

Anaesthesia, postoperative analgesia and the incidence of adverse effe cts after intrathecal pethidine hydrochlorine 0.50 mg.kg(-1) and 0.75 mg.kg(-1) were assessed and compared with a conventional technique usi ng isobaric bupivacaine 13.75 mg in patients undergoing transurethral resection of the prostate gland. Sensory and motor block were signific antly shorter with both pethidine regimens than with bupivacaine Gn < 0.001). Although sensory and motor block were shorter after pethidine 0.50 mg.kg(-1) than after pethidine 0.75 mg.kg(-1) the difference in d uration was clinically insignificant. The incidence of incomplete moto r block was significantly greater with pethidine 0.50 mg.kg(-1) than w ith bupivacaine 13.75 mg.kg(-1) P < 0.01). Visual analogue pain scores recorded after the operation were low and were similar in the pethidi ne groups to those obtained with bupivacaine alone. Mean arterial bloo d pressure was significantly lower in both pethidine groups compared w ith the bupivacaine group between 30 and 240 min after intrathecal inj ection (p < 0.001). However, the within-group reductions in blood pres sure were within clinically acceptable limits. The incidences of nause a and emesis were low and emesis occurred in patients in the bupivacai ne group only (p < 0.03). Pruritus was seen only in patients receiving pethidine. Intra-operative sedation occurred more often in patients r eceiving both pethidine 0.50 mg.kg(-1) and 0.75 mg.kg(-1) compared wit h patients receiving bupivacaine (p < 0.04). Both pethidine regimens p rovided acceptable anaesthesia and there were no significant differenc es between the two regimens in quality of intra-operative anaesthesia, incidence of adverse events or postoperative analgesia.