Saddle Block with Pethidine for Perineal Operations

Abstract

Small doses of morphine given intrathecally and extradurally produce long-lasting relief of chronic and postoperative pain in man (Behar et al., 1979; Wang, Nauss and Thomas, 1979). In addition to morphine, the efficacy of pethidine (Cousins et al., 1979), fentanyl (Bailey and Smith, 1980), methadone and hydromorphone (Bromage, Camporesi and Chestnut, 1980) has been studied. Using the extradural route, all the opiates, including pethidine, were able to interrupt pain at a spinal level without affecting motor and autonomic control (Cousins et al., 1979). Recent studies (Mircea et al., 1982; Sandu et al., 1983) showed that pethidine, unlike morphine, when given intrathecally did not produce a selective segmental analgesia, but exhibited all the effects of the subarachnoid administration of local anaesthetics-including motor, sensory and sympathetic blockades. Thus spinal anaesthesia was obtained which was adequate for surgical interventions, particularly in the perineal area. The purpose of this study was to assess the effectiveness of the intrathecal administration of pethidine in obtaining blockade, suitable for surgery on the perineum. PATIENTS AND METHODS Studies were carried out on 111 patients undergoing perineal surgery between March 1983 and December 1984 (table I). The group included 77 men and 34 women, aged between 20 and 72 yr (mean age of 37 yr). Institutional approval and informed patient consent were obtained.

Anesthetic Efficacy of Lidocaine/Meperidine for Inferior Alveolar Nerve Blocks in Patients with Irreversible Pulpitis

“…A number of clinical and experimental studies (10 -22) have shown that meperidine induces spinal anesthesia and blocks action potentials, providing segmental and sensory blocks comparable in effect to lidocaine. In medicine, it has been administered intrathecally (8,10,14,16,18), spinally (13,20), and as a saddle block (11), as well as locally for intravenous regional anesthesia (21), block (15), and infiltration (22) for the effects of analgesia, anesthesia, or both.…”

Anesthetic Efficacy of Lidocaine/Meperidine for Inferior Alveolar Nerve Blocks

“…22 Clinically, meperidine has local anesthetic activity. A number of clinical and experimental studies [24][25][26][27][28][29][30][31][32][33][34][35][36] have shown that meperidine induces spinal anesthesia and blocks action potentials, providing segmental and sensory blocks comparable to those provided by lidocaine. In medicine, it has been administered intrathecally, 22,24,28,30,32 spinally, 27,34 and as a saddle block, 25 as well as locally for intravenous regional anesthesia, 35 block, 29 and infiltration 36 for the effects of analgesia, anesthesia, or both.…”

Pethidine and bupivacaine spinal anaesthesia: a comparative evaluation of postoperative complications and recovery profile

“…[7][8][9] Reported side effects from subarachnoid pethidine have included nausea and vomiting, pruritus, urinary retention, respiratory depression, and hypotension. 13,18 Grace and Fee observed that only subjects in the pethidine group experienced pruritus. 8 Three subjects (11.54%) from bupivacaine group developed urinary retention while none from pethidine group experienced it.…”