Efficacy of the use of intrathecal meperidine for spinal anesthesia
Keywords:
ANESTHESIA, SPINAL, MEPERIDINE, INTRATHECAL ROUTE, OPIOID, PATIENT.Abstract
Introduction: spinal anesthesia is one of the fundamental tools in anesthesiological practice. There is little evidence of the results of intrathecal use of meperidine.
Objective: to describe the efficacy of spinal anesthesia with intrathecal meperidine.
Methods: observational, descriptive and transversal study at the Martín Chang Puga General Teaching Hospital, Nuevitas municipality, Camagüey province, between January and December 2021. The sample consisted of 60 patients who underwent spinal anesthesia with meperidine.
Results: the sample was predominantly female (58,3 %) and aged between 30 and 39 years (38,3 %). Most of the patients had an ASA II classification (58,3 %), and the most frequent operative diagnosis was salpinguectomy partial bilateral (28,3 %). The mean latency time was 5,4 minutes, while the mean muscle tone recovery time was 101,7 minutes. Most patients had high block intensity, while the most frequent complication was pruritus (45,0 %).
Conclusions: latency and muscle tone recovery times were relatively short, while the intensity of the block was high in all cases. Most patients presented mild complications, pain was absent in most cases, and there was a high degree of satisfaction with the treatment, so it can be affirmed that intrathecal meperidine spinal anesthesia is highly effective.
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1. De La Cuadra JC, Altermatt F, Kychenthal C, Irarrázaval MJ, Lacassie H. Anestesia espinal: Parte I. Historia. Rev Chil Anest [Internet]. 2021 [citado 10/10/2022]; 50(2): 393-97. Disponible en: http://doi.org/10.25237/revchilanestv50n02-16
2. Tornero Tornero C, Fernández Rodríguez LE, Orduña Valls J. Analgesia multimodal y anestesia regional. Revista Española de Anestesiología y Reanimación [Internet]. 2017 [citado 10/10/2022]; 64(7):401-05. Disponible en: https://doi.org/10.1016/j.redar.2017.01.008
3. Bermúdez-Guerrero FJ, Gómez-Camargo D, Palomino-Romero R, Llamas-Bustos W, Ramos-Clason E. Comparación de 3 pautas de sedación para pacientes sometidos a anestesia subaracnoidea. Ensayo clínico aleatorizado, simple ciego. Rev Colomb Anestesiol [Internet]. 2015 [citado 10/10/2022]; 43(2): 122-28. Disponible en: https://doi.org/10.1016/j.rca.2014.12.002
4. Recart A, González A. La Cirugía Mayor Ambulatoria: Rol de la Anestesia Regional. Rev Chil Anest [Internet]. 2020 [citado 11/10/2022]; 50(2):398-407. Disponible en: https://doi.org/10.25237/carsach2020.03
5. Zetlaoui PJ. Anestesia y analgesia locorregional en la práctica médica. EMC-Tratado de Medicina [Internet]. 2018 [citado 11/10/2022]; 22(2): 1-10. Disponible en: https://doi.org/10.1016/S1636-5410(18)89305-9
6. Ausset S. Epidemiología de la mortalidad y de la morbilidad en anestesia. EMC-Anestesia-Reanimación [Internet]. 2017 [citado 11/10/2022]; 43(4): 1-13. Disponible en: https://doi.org/10.1016/S1280-4703(17)86783-9
7. Bujedo BM. Current Evidence for Spinal Opioid Selection in Postoperative Pain. The Korean J Pain [Internet]. 2014 [citado 11/10/2022]; 27(3): 200-9. Disponible en: http://dx.doi.org/10.3344/kjp.2014.27.3.200
8. Pineda González AR, Aparicio Morales AI. Anestesia espinal con meperidina en paciente con hipersensibilidad a anestésicos locales. Rev Cubana Anestesiología y Reanimación [Internet]. 2019 [citado 12/10/2022]; 19(2): 1-8. Disponible en: http://www.revanestesia.sld.cu/index.php/anestRean/article/view/587
9. Brull R, Macfarlane A, Chan VW. Anestesia intradural, epidural y caudal. En: Miller RD, Cohen NH, Eriksson L, Fleisher L, Kronish JW, Young W. Miller Anestesia. 8th ed. New York: Elsevier; 2016. p. 1684-1720.
10. Alegre Andrade P. Eficacia de ketamina y meperidina para prevención de temblores en pacientes sometidas a cesárea bajo anestesia regional. Rev Cient Cienc Méd [Internet]. 2020 [citado 12/10/2022]; 23(1): 38-43. Disponible en: http://www.scielo.org.bo/scielo.php?pid=S1817-74332020000100006&script=sci_arttext
11. Zhou C, Zhu Y, Liu Z, Ruan L. 5-HT3 receptor antagonists for the prevention of postoperative shivering: a meta-analysis. J IntMed Res [Internet]. 2016 [citado 12/10/2022]; 44(6): 1174–81. Disponible en: https://doi.org/10.1177/0300060516668776
12. Arroyo-Fernández FJ, Seoane JC, Morera LT. Estrategias de tratamiento analgésico tras cesárea. Estado actual y nuevas alternativas. Revista Española de Anestesiología y Reanimación [Internet]. 2020 [citado 12/10/2022]; 67(3): 167-175. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0034935619302142
13. Peñuela Saldaña IS. Analgesia epidural y sus implicaciones en la salud materna en una comunidad de baja paridad. [Tesis]. España: Universidad de Valladolid; 2019 [citado 14/10/2022]. Disponible en: https://uvadoc.uva.es/bitstream/handle/10324/40120/Tesis1665-200113.pdf?sequence=1
14. Cruz Crespo M, Sánchez Tamayo M, Ortega Valdés ME, Sánchez Martín ML, García Real E. Analgesia subaracnoidea en el trabajo de parto: bupivacaína/fentanilo vs. petidina. Rev Cuba Anestesiol y Reanim[Internet]. 2019 [citado 14/10/2022]; 18(3): 1-8 Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1726-67182019000300007
15. Mugabure Bujedo B. Current Evidence for Spinal Opioid Selection in Postoperative Pain. Journal of Pain [Internet]. 2014 [citado 14/10/2022]; 27(3): 200-09. Disponible en: https://synapse.koreamed.org/articles/1159529
16. Mekki YMH, Hamouda MAM, Zaki MSM, El Hennawy AMES. Comparative Randomized Controlled Blind Study of the Anti-Shivering Effect of Hydrocortisone, Granisetron and Meperidine in Post-Spinal Anesthesia in Patients Undergoing Cesarean Section. The Egyptian Journal of Hospital Medicine [Internet]. 2018 [citado 14/10/2022]; 71(3): 2759-764. Disponible en: https://journals.ekb.eg/article_8691.html
17. Khezri MB, Mosallaei MAS, Ebtehaj M, Mohammadi N. Comparison of preemptive effect of intravenous ketorolac versus meperidine on postoperative shivering and pain in patients undergoing cesarean section under spinal anesthesia: A prospective, randomized, double-blind study. Caspian J of intern med [Internet]. 2018 [citado 14/10/2022]; 9(2): 151-157. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5912223/
18. Gozzani JL, Bussolotti RM, Vasconcellos ACM. Associação de meperidina e bupivacaína por via peridural em cesarianas. Rev Bras Anesthesiol [Internet]. 1996 [citado 14/10/2022]; 46(2): 114-21. Disponible en: https://www.bjan-sba.org/article/5e498be70aec5119028b485a/pdf/rba-46-2-114.pdf
19. Hong GW, Lee JK, Lee JH, Bong JH, Choi SH, Cho H, et al. Comparison of fentanyl versus meperidine in combination with midazolam for sedative colonoscopy in Korea. Clin Endosc [Internet]. 2020 [citado 14/10/2022]; 53(5): 562-67. Disponible en: https://synapse.koreamed.org/articles/1151137
20. Bayar F, Cesur M, Aksoy M, Dostbil A, Ince I, Doymus O, et al. What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study. AGRI [Internet]. 2021 [citado 14/10/2022]; 33(1): 28–35. Disponible en: https://acikerisim.sakarya.edu.tr/handle/20.500.12619/95483
21. Girma T, Alemu W, Assen S. Effect of Prophylactic Intrathecal Pethidine on the Incidence of Shivering on Mothers Undergoing Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial. Front Med [Internet]. 2022 [citado 14/10/2022]; 9: 887724. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365984/
22. Gholinataj A, Baradari AG, Najafi S, Kiabi FH. Comparison of Intravenous Ketamine with Intrathecal Meperidine in Prevention of Post-anesthetic Shivering after Spinal Anesthesia for Lower Limb Orthopedic Surgeries: A Double-blind Randomized Clinical Trial. Ethiop J Health Sci [Internet]. 2021 [citado 14/10/2022]; 31(6). Disponible en: https://www.ajol.info/index.php/ejhs/article/view/219271
23. Raushan D, Prakash A. Intrathecal dexmedetomidine or meperidine for post-spinal shivering. European Journal of Molecular & Clinical Medicine [Internet]. 2022 [citado 14/10/2022]; 9(4): 2173-2177. Disponible en: https://ejmcm.com/pdf_19024_bc2b3bc73b6146cb071f9fc38208595d.html
24. Shen L, Wang W, L, S, Qin J, Huang Y. NMDA receptor antagonists attenuate intrathecal morphine-induced pruritus through ERK phosphorylation. Molecular Brain [Internet]. 2018 [citado 14/10/2022]; 11(35):1-10. Disponible en: https://molecularbrain.biomedcentral.com/articles/10.1186/s13041-018-0379-2
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