Sameridine is safe and effective for spinal anesthesia: A comparative dose-ranging study with lidocaine for inguinal hernia repair

Sameridine is a new compound with local anesthetic and analgesic properties when injected intrathecally. We studied the anesthetic and analgesic effic acy of three doses of isobaric sameridine (15, 20, and 23 mg) compared with 100 mg of hyperbaric lidocaine for spinal anesthesia in 140 healthy male p atients undergoing inguinal hernia repair. Patients received spinal anesthe sia with 4 mL of the study drug injected at the L2-3 or L3-4 interspace in the lateral decubitus position. All three doses of sameridine provided spin al anesthesia similar to lidocaine, with a slightly longer time to reach pe ak block height. The failure rate was highest in the 15-mg sameridine group , and accrual was discontinued in that group after 35 patients. The duratio n of blockade was shorter with lidocaine, but the time to voiding and ambul ation was similar in all groups. Patients receiving sameridine were less li kely to request morphine for postoperative analgesia and were less likely t o request any analgesia in the first 4 h after injection of the drug. Use o f oral analgesics (hydrocodone and acetaminophen) was similar in all groups after the first 4 h of the 24-h observation. We conclude that, in the thre e doses studied, sameridine provided spinal anesthesia similar to lidocaine , but with residual analgesia after drug injection that reduced the need fo r systemic analgesics in the first 4 h postoperatively. Implications: Ln th is clinical trial, we show the potential efficacy of a class of drugs that can produce both spinal anesthesia and postoperative analgesia when used fo r hernia repair.