Document Detail


A comparison between lidocaine alone and lidocaine with meperidine for continuous spinal anesthesia.
MedLine Citation:
PMID:  8268117     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Experimental investigations have demonstrated a synergistic interaction between opioids and local anesthetics. This study aims to assess the effective benefit-risk ratio of continuous spinal anesthesia (CSA) induced with either 1.6% lidocaine alone or in combination with 1% meperidine. METHODS: Thirty-four elderly patients (80.7 +/- 7.3 years) operated on for fracture of the neck of the femur were randomly allocated to two groups. In the first group (n = 15), CSA was induced with lidocaine 1.6% plain, whereas in the second group (n = 19) 1% meperidine was added. Reinjections were performed in both groups using lidocaine 1.6% alone. RESULTS: In the lidocaine group, 43 +/- 13 mg was used for induction whereas in the other group the addition of 18 +/- 5 mg of meperidine significantly reduced the dose of lidocaine required to 28 +/- 8 mg (p < 0.001). Delay between two reinjections was increased to 51 +/- 7 minutes in the lidocaine plus meperidine group, compared to 35 +/- 6 minutes in the lidocaine group (p < 0.001). Ephedrine was required for 9 out of the 19 patients in the lidocaine plus meperidine group, whereas it was required for only two patients in the other group (p = 0.05). Mean plasma concentrations of meperidine 1 hour and 3 hours after induction was 45.5 +/- 12 ng/ml and 59 +/- 22 ng/ml, respectively, and drowsiness was observed in 95% of the patients in the second group. Delay before requirement for pain medication was 2.2 +/- 2 hours in the lidocaine group and 14.1 +/- 8 hours in the lidocaine plus meperidine group (p < 0.001). CONCLUSIONS: The association of 1% meperidine with 1.6% lidocaine during the induction of CSA decreases the initial induction dose, prolongs analgesia, produces initial drowsiness, and provides long-lasting pain relief. However, such benefits are offset by some impairment of hemodynamic stability that is likely to make this combination of drugs unacceptable as an enhanced analgesic technique.
Authors:
P Maurette; G Bonada; V Djiane; P Erny
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Regional anesthesia     Volume:  18     ISSN:  0146-521X     ISO Abbreviation:  Reg Anesth     Publication Date:    1993 Sep-Oct
Date Detail:
Created Date:  1994-01-31     Completed Date:  1994-01-31     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  7707549     Medline TA:  Reg Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  290-5     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Centre Hospitalier Universitaire de Bordeaux, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anesthesia, Spinal*
Double-Blind Method
Drug Therapy, Combination
Femoral Neck Fractures / surgery
Humans
Lidocaine*
Meperidine* / blood
Risk Factors
Chemical
Reg. No./Substance:
137-58-6/Lidocaine; 57-42-1/Meperidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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