What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study

Objectives: This study was an analysis of the effect of different dosages of intrathecal meperidine (40 mg, 50 mg, 60 mg, and 70 mg) on hemodynamic parameters, the duration of neural blockade, and the incidence of meperidine-related side effects in patients who underwent an open prostatectomy. Methods: Sixty patients who underwent an open prostatectomy with combined spinal-epidural anesthesia were included. The patients were allocated to receive 1 of 4 different dosages of intrathecal meperidine (n=15 for each group): Group I: 40 mg, Group II: 50 mg, Group III: 60 mg, and Group IV: 70 mg. The duration of the block procedure, surgery duration, highest sensory block level, and anesthetic complications were recorded and analyzed. Results: At 20 minutes after the spinal injection, the maximum sensory block level was T6 in Group I and II, and it was T5 in Group III and IV. The mean motor block scores at 20 minutes after the spinal injection were lower in Group I compared with the other groups (p

Açık prostat cerrahisinde intratekal meperidinin optimal dozu nedir? Bir prospektif çift-kör randomize çalışma

Amaç: Bu çalışmada; açık prostatektomi uygulanan hastalarda, farklı dozlarda intratekal meperidinin (40 mg, 50 mg, 60 mg ve 70 mg) hemodinamik parametreler, nöral blokaj süresi ve meperidine bağlı yan etki görülme sıklığı üzerindeki etkisini araştırdık. Gereç ve Yöntem: Kombine spinal epidural anestezi ile açık prostatektomi uygulanan 60 hasta çalışmaya alındı. Hastalar dört doz intratekal meperidinden birini almak üzere (her grup için n=15) sahip olmak üzere ayrıldı: Grup I: 40 mg, Grup II: 50 mg, Grup III: 60 mg, Grup IV: 70 mg. Blok işleminin süresi, ameliyat süresi, en yüksek duyusal blok düzeyi ve anestezik komplikasyonlar kaydedildi. Bulgular: Spinal enjeksiyondan 20 dakika sonra, grup I ve II’de maksimum duyusal blok seviyesi T6 idi ve grup III ve IV’de T5 idi. Spinal enjeksiyondan 20 dakika sonra ortalama motor blok skorları grup I’de diğer gruplara göre daha düşük olarak bulundu (hepsi için p

___

1. Kanonidou Z, Karystianou G. Anesthesia for the elderly. Hippokratia 2007;11(4):175–7.

2. Salonia A, Suardi N, Crescenti A, Colombo R, Rigatti P, Montorsi F. General versus spinal anesthesia with different forms of sedation in patients undergoing radical retropubic prostatectomy: results of a prospective, randomized study. Int J Urol 2006;13(9):1185–90.

3. Naguib M, Famewo CE, Absood A. Pharmacokinetics of meperidine in spinal anaesthesia. Can Anaesth Soc J 1986;33(2):162–6.

4. Davoudi M, Mousavi-Bahar SH, Farhanchi A. Intrathecal meperidine for prevention of shivering during transurethral resection of prostate. Urol J 2007;4(4):212–6.

5. Chun DH, Kil HK, Kim HJ, Park C, Chung KH. Intrathecal meperidine reduces intraoperative shivering during transurethral prostatectomy in elderly patients. Korean J Anesthesiol 2010;59(6):389–93.

6. Hansen D, Hansen S. The effects of three graded doses of meperidine for spinal anesthesia in African men. Anesth Analg 1999;88(4):827–30.

7. Honarmand A, Safavi M, Dadkhah S, Amoushahi M. The effects of different doses of intrathecal meperidine on the incidence and severity of shivering during lower extremity orthopedic surgery under spinal anesthesia: A randomized, placebo-controlled, double blind-clinical trial. Adv Biomed Res 2015;4:3.

8. Roy JD, Girard M, Drolet P. Intrathecal meperidine decreases shivering during cesarean delivery under spinal anesthesia. Anesth Analg 2004;98(1):230–4.

9. Atalay C, Aksoy M, Aksoy AN, Dogan N, Kürsad H. Combining intrathecal bupivacaine and meperidine during caesarean section to prevent spinal anaesthesia-induced hypotension and other side-effects. J Int Med Res 2010;38(5):1626–36.

10. Booth JV, Lindsay DR, Olufolabi AJ, El-Moalem HE, Penning DH, Reynolds JD. Subarachnoid meperidine (Pethidine) causes significant nausea and vomiting during labor. The Duke Women’s Anesthesia Research Group. Anesthesiology 2000;93(2):418–21.

11. Grace D, Fee JP. Anaesthesia and adverse effects after intrathecal pethidine hydrochloride for urological surgery. Anaesthesia 1995;50(12):1036–40.

12. Wantman A, Hancox N, Howell PR. Techniques for identifying the epidural space: a survey of practice amongst anaesthetists in the UK. Anaesthesia 2006;61(4):370–5.

13. Bakhsha F, Behnampour N. Saddle block anaesthesia with meperidine for perineal surgery. J Clin Diagn Res 2010;3:2010–7.

14. Yaksh TL. Spinal opiate analgesia: characteristics and principles of action. Pain 1981;11(3):293–346.

15. Famewo CE, Naguib M. Spinal anaesthesia with meperidine as the sole agent. Can Anaesth Soc J 1985;32(5):533– 7.

16. Ehikhametalor KO, Nelson M. Intrathecal pethidine as sole anaesthetic agent for operative procedures of the lower limb, inguinal area and perineum. West Indian Med J 2001;50(4):313–6.

17. Anaraki AN, Mirzaei K. The Effect of Different Intrathecal Doses of Meperidine on Shivering during Delivery Under Spinal Anesthesia. Int J Prev Med 2012;3(10):706–12.

18. Najafi Anaraki A, Abbasi M, Anvarypour A, Motamed N. The effects of Adding Meperidine to Heavy Intrathecal Lidocaine on Hemodynamic Changes and Blood Loss in Open Prostatectomy: A Randomized Double-Blind Clinical Trial. Iran J Med Sci 2012;37(1):15–22.

19. Heidegger T, Saal D, Nübling M. Patient satisfaction with anaesthesia - Part 1: satisfaction as part of outcome - and what satisfies patients. Anaesthesia 2013;68(11):1165–72.

20. Canakcı E, Tas N, Yagan O, Mutlu T, Benli E, Cırakoglu A. The Effect of Different Intrathecal Doses of Meperidine on Postoperative Pain Relief in Patients Undergoing TURP Surgery. J Anest and Inten Care Med 2017;2(1):555580.
Ağrı-Cover
  • ISSN: 1300-0012
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2018
  • Yayıncı: Ali Cangül
Sayıdaki Diğer Makaleler

Vestibular migraine: A case report and review of the literature

Bahar SAY, Ufuk ERGUN

Vestibuler migren: Olgu sunumu ve literatürün gözden geçirilmesi

Bahar SAY, Ufuk ERGÜN

Trigeminal neuralgia in a patient with multiple sclerosis: Coincidental? An attack? Teriflunomide-induced?

Sevda DIKER

Analysis of two non-pharmacological pain management methods for vaccine injection pain in infants: A randomized controlled trial

Tuğba GÜNGÖR, Özlem ÖZTÜRK ŞAHİN

The use of ultrasound guided combined peripheral nerve blocks in a high-risk patient: A case report

Ali Sait KAVAKLI, Nilgün KAVRUT ÖZTÜRK, Ülkü ARSLAN, Ferhat ENGINAR, Şenay CANIM, Erdinç UZUNAY

Bilgilendirme broşürleri işlem öncesi anksiyete seviyesi ve transforaminal epidural steroid enjeksiyonu sonrası akut ağrı düzeyini etkiler mi? Prospektif randomize kontrollü bir çalışma

Savaş ŞENCAN, Osman Hakan GÜNDÜZ, Serdar KOKAR, Tülay ERÇALIK, Yeliz BAHAR ÖZDEMIR,

Bebeklerde aşı enjeksiyonu ağrısında iki non-farmokolojik ağrı yönetim metodu: Randomize kontrollü bir çalışma

Özlem ÖZTÜRK ŞAHIN, Tuğba GÜNGÖR

Yüksek riskli hastada ultrason rehberliğinde kombine periferik sinir bloğu: Olgu sunumu

Ali Sait KAVAKLI, Nilgün KAVRUT ÖZTÜRK, Ülkü ARSLAN, Ferhat ENGINAR, Şenay CANIM, Erdinç UZUNAY

Do informative leaflets affect pre-procedural anxiety and immediate pain after transforaminal epidural steroid injections? A prospective randomized controlled study

Yeliz BAHAR ÖZDEMIR, Savaş SENCAN, Tülay ERÇALIK, Serdar KOKAR, Osman Hakan GÜNDÜZ

El-el bileği yaralanmalarında kompleks bölgesel ağrı sendromu

Merih ÖZGEN, Merve GEMIKÖZ, Zeliha ATİK, ONUR ARMAĞAN, FEZAN MUTLU