Clinical Observation of Intrathecal Meperidine Anesthesia and the Effect of Added Epinephrine

Kim, Seong Bong; Byen, Jin Kwan; Shin, Chi Mann; Park, Joo Yeol

Abstract

Intrathecal meperidine produces a profound analgesia, because meperidine has a high lipid solubility and a structure similar to local anesthetics. This study was undertaken to evaluate the anesthetic effect and complications of intrathecal meperidine anesthesia and the effect of added epinephrine. Two percent meperidine 30 mg (Group I) and 2% meperidine 30 mg with 0.3 mg epinephrine (Group II) in 20% D/W were injected intrathecally in each of 30 cases scheduled for simple and short surgical procedures. The results are as follows: 1) Systolic blood pressure and pulse rate decreased significantly from 10 minutes to 1 hour after intrathecal meperidine injection, compared with the value before anesthetic administration, but did not require special medical treatment. 2) The onset time of block of T, sensory dermatome in the meperidine injection group (Group 1) and the added epinephrine mixed injection group (Group II), were 5.3+/-1.4 minutes and 6.6+/-2.1 minutes, and duration were 58.5+/-10.5 minutes and 74.1+/-16.4 minutes respectively. Therefore, the onset time of motor nerve blok were 5.5+/-2.6 minutes and 8.9+/-1.6 minutes, and then their duration were 65.7+/-11.4 minutes and 79.7+/-13.4 minutes respectively. 3) PaO decreased and PaCO2 increased significantly 1 hour after meperidine injection without any serious problem. 4) Complications, such as nausea, pruritus and urinary retention, were observed in many patients without any serious problem.