Effects of mepivacaine articaine and pethidine on hemodynamics and total analgesia period in saddle block Saddle blokta mepivakain ve artikain ile petidinin hemodinami ve total analjezi suresi uzerine etkileri
Turk Anesteziyoloji ve Reanimasyon, vol.28, no.2, pp.83-87, 2000 (Scopus)
- Publication Type: Article / Article
- Volume: 28 Issue: 2
- Publication Date: 2000
- Journal Name: Turk Anesteziyoloji ve Reanimasyon
- Journal Indexes: Scopus
- Page Numbers: pp.83-87
- Keywords: Local anaesthesia, Opioid, Postoperative analgesia, Saddle block
- Gazi University Affiliated: Yes
Abstract
In this study, we aimed to compare the effects of pethidine with hyperbaric mepivacaine and articaine on hemodynamics, onset of anaesthesia and duration of total analgesia period in saddle block. Patients (n:60) who would undergo anal and perineal region operations were separated randomly into three equal (n:20) groups. Spinal anaesthesia was performed with 0.5 mg/kg 5 % pethidine for the patients in the first group, 1 mL 4 % mepivacaine for the second and 1 mL 5 % articaine for the third group. Measurements of hemodynamic parameters were made before and 5, 10, 20, 30, 40, 50, 60 minutes after the spinal anaesthesia, tests of the time to initial onset of sensory blockade and anal relaxation (motor blockade) were made every 1 min after the patients were laid on the operation table. While no significant changes were observed between the groups regarding hemodynamic parameters; mean arterial pressure significantly decreased from the twentieth min to throughout the study in the group in which pethidine was used (max 8.2 %) (p<0.05, p<0.01) and significantly increased in fifth min (p<0.01), but no significant decrease from the tenth min to throughout the study in the group in which mepivacaine was used (max 2.6%) and no significant decrease throughout the study in the group in which articaine was administered (max 6.6%) were observed when compared with control values. A significant decease in heart rate from the twentieth min to throughout the study in mepivacaine group (p<0.05) and a mild, but insignificant decrease in articaine group were observed, the mean values of heart rate did not change in pethidine group. The time to initial onset of sensorial block and anal relaxation was significantly longer (p<0.05) in the group in which pethidine was administered (5.5 and 8.7 min) than the group in which mepivacaine (3.3 and 5.1 min) and the group in which articaine (2.9 and 3.9 min) was administered. Total analgesia period was significantly longer (p<0,001) in the group in which pethidine was used (mean 580 min) when compared with the other groups (mepivacaine 195 and articaine 144 min). We have concluded that cases who will undergo anal and perineal region operations, especially the ones associated with cardiac disease and in whom long analgesia period is required, it seems to be more suitable to apply saddle block with pethidine in a dose of 0.5 mg/kg.