title: Subarachnoid bupivacaine and pethidine for caesarean section: assessment of quality of perioperative analgesia and side effects.
abstract: OBJECTIVE
  This study determined the quality of perioperative analgesia and side effect profile of spinal bupivacaine plus pethidine for caesarean section.
  
  
  METHODS
  Patients were randomised to receive 2.0mL of bupivacaine + pethidine 7.5mg or 2.0mL bupivacaine + saline of equal volume. Spinal anaesthesia was instituted at L2/3, L3/4 or L4/5 using a 25G pencil point spinal needle. Heart rate, blood pressure and oxygen saturation were monitored. Timelines such as time of injection of study medication, skin incision, delivery time, termination of surgery and time to first request for analgesia as well as complications were noted. Demographic characteristics were also recorded.
  
  
  RESULTS
  50 patients were studied in 2 groups and the demographic characteristics were similar. Addition of pethidine resulted in block height greater than T6 and longer duration of analgesia (256.9 ± 112.2 min.) compared with the saline group (160.5 ± 65.0 min; p = 0.0005). Maternal hypotension occurred more in the pethidine group (10/25 vs 2/25; p = 0.01). Peritoneal irritation and inadequate anaesthesia were more frequent in the saline group. Nausea and vomiting and drowsiness were mild and occurred only in the pethidine group. In the Post Anaesthetic Care Unit (PACU), more patients reported pain in the saline group (p = 0.002).
  
  
  CONCLUSIONS
  Bupivacaine with pethidine 7.5mg resulted in better quality of anaesthesia, longer postoperative analgesia with acceptable side effect profile. This will be of value in the management of post-caesarean section pain particularly in the resource poor setting.
authors: Department of Anaesthesiology, University of Benin Teaching Hospital, PMB 1111, Benin City. Nigeria. esemama@yahoo.co.uk
authors: C O
authors: CO
authors: Imarengiaye
authors: F D
authors: FD
authors: Asudo
authors: D D
authors: DD
authors: Akpoguado
authors: I I
authors: II
authors: Akhideno
authors: C E
authors: CE
authors: Omoifo
authors: A T
authors: AT
authors: Ogunsakin
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D000775:Anesthesia, Spinal / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D002585:Cesarean Section; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007268:Injections, Epidural; D007275:Injections, Intravenous; D008297:Male; D008614:Meperidine / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D059035:Perioperative Period; D011247:Pregnancy
chemical_list: D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D008614:Meperidine; D002045:Bupivacaine