M C Norris1, J E Honet, B L Leighton, V A Arkoosh. 1. Department of Anesthesiology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Abstract
BACKGROUND AND OBJECTIVES: This study compares the anesthetic potency, duration, and side effects of subarachnoid meperidine and lidocaine for postpartum tubal ligation. METHOD: Twenty healthy, unpremedicated postpartum women gave written informed consent to participate in this randomized double-blind study. After intravenous infusion of 200 mL physiologic salt solution, patients received subarachnoid injections from either lidocaine 70 mg in 7.5% glucose or meperidine 60 mg in saline while lying in the right lateral position. Heart rate, blood pressure, sensory and motor block, pain, nausea, and pruritus were recorded at intervals for up to 12 hours after injection. The time to first postoperative analgesic was also recorded. RESULTS: There were no differences between the groups in demographics, heart rate, or blood pressure at any time. Sensory or motor block developed slightly faster in the lidocaine group. One patient in each group required general anesthesia owing to inadequate sensory block. Beginning at 60 minutes, meperidine patients experienced more pruritus (P < .05). Lidocaine patients had more postoperative pain (P < .01) and required supplemental analgesia 83.3 +/- 32.7 minutes after induction versus 447.6 +/- 184.0 minutes in the meperidine group. No patient's oxygen saturation fell below 95%. Patients expressed equal satisfaction with both agents. CONCLUSION:Subarachnoid meperidine and lidocaine both provide adequate anesthesia for postpartum tubal ligation. Meperidine provided longer postoperative analgesia.
RCT Entities:
BACKGROUND AND OBJECTIVES: This study compares the anesthetic potency, duration, and side effects of subarachnoid meperidine and lidocaine for postpartum tubal ligation. METHOD: Twenty healthy, unpremedicated postpartum women gave written informed consent to participate in this randomized double-blind study. After intravenous infusion of 200 mL physiologic salt solution, patients received subarachnoid injections from either lidocaine 70 mg in 7.5% glucose or meperidine 60 mg in saline while lying in the right lateral position. Heart rate, blood pressure, sensory and motor block, pain, nausea, and pruritus were recorded at intervals for up to 12 hours after injection. The time to first postoperative analgesic was also recorded. RESULTS: There were no differences between the groups in demographics, heart rate, or blood pressure at any time. Sensory or motor block developed slightly faster in the lidocaine group. One patient in each group required general anesthesia owing to inadequate sensory block. Beginning at 60 minutes, meperidinepatients experienced more pruritus (P < .05). Lidocainepatients had more postoperative pain (P < .01) and required supplemental analgesia 83.3 +/- 32.7 minutes after induction versus 447.6 +/- 184.0 minutes in the meperidine group. No patient's oxygen saturation fell below 95%. Patients expressed equal satisfaction with both agents. CONCLUSION:Subarachnoid meperidine and lidocaine both provide adequate anesthesia for postpartum tubal ligation. Meperidine provided longer postoperative analgesia.