Addition of meperidine to bupivacaine for spinal anaesthesia for Caesarean section.
BACKGROUND
In a prospective, randomized, double-blind, placebo-controlled trial, we investigated the effect of adding meperidine 10 mg to intrathecal bupivacaine on the duration of early postoperative analgesia in 40 patients having elective Caesarean section under spinal anaesthesia.


METHODS
Patients received intrathecal injection of 0.5% hyperbaric bupivacaine 2.0 ml plus either normal saline 0.2 ml (saline group) or 5% meperidine 0.2 ml (meperidine group). After operation, all patients were given i.v. patient-controlled analgesia using morphine.


RESULTS
The duration of effective analgesia, defined as the time from intrathecal injection to first patient-controlled analgesia demand, was greater in the meperidine group (mean 234 min, 95% confidence interval 200-269 min) compared with the saline group (mean 125 min, 95% confidence interval 111-138 min; P<0.001). The 24 h morphine requirement was similar in the two groups. The meperidine group had a greater incidence of intraoperative nausea or vomiting compared with the saline group (11 vs 3; P=0.02).


CONCLUSIONS
Addition of meperidine 10 mg to intrathecal bupivacaine for Caesarean section is associated with prolonged postoperative analgesia but with greater intraoperative nausea and vomiting.
Yu
S C
SC
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong SAR, People's Republic of China.
Ngan Kee
W D
WD
Kwan
A S K
AS
D000759:Adjuvants, Anesthesia / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D002045:Bupivacaine; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000139:chemically induced; D008614:Meperidine / Q000009:adverse effects; D010149:Postoperative Pain / Q000517:prevention & control; D011247:Pregnancy
D000759:Adjuvants, Anesthesia; D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D008614:Meperidine; D002045:Bupivacaine