Case Report

Intrathecal Pethidine as a Sole Anesthetic Agent in Cesarian Section: Case Report for Clinical Education

Abstract

Pethidine was the first synthetic opioid to be used to provide analgesia in humans and was shown also to have local anesthetic activity comparable with that of cocaine. The neonatal Apgar score after birth is an important factors of mortality of the newborn. In this regard, the type of drug used for the cesarean section is very important in the Apgar score of the cesarean section. Pethidine is an intermediate lipid-soluble opioid with both a postoperative analgesic mechanism and a sensory block which is known as the only opioid which can be used alone in the cesarean section under spinal anesthesia. We used pethidine as an alternative to bupivacaine in patients going under cesarean section.

[1] Bilgen S, Köner O, Türe H, Menda F, Fiçicioğlu C, Aykaç B. Effect of three different doses of ketamine prior to general anaesthesia on postoperative pain following Caesarean delivery: a prospective randomized study. Minerva Anestesiol. 2012; 78(4):442-9.
[2] Conde-Agudelo A, Nieto A, Rosas-Bermudez A, Romero R. Misoprostol to reduce intraoperative and postoperative hemorrhage during cesarean delivery: a systematic review and metaanalysis. Am J Obstet Gynecol. 2013; 209(1): 40.e1-40.e17.
[3] Jaafarpour M, Vasigh A, Khajavikhan J, Khani A. Effect of ketofol on pain and complication after Caesarean delivery under spinal anaesthesia: A randomized double-blind clinical trial. J Clin Diagn Res. 2017; 11(3):UC04-07.
[4] Beiranvand S, Noparast M, Eslamizade N, Saeedikia S. The effects of religion and spirituality on postoperative pain, hemodynamic functioning and anxiety after cesarean section. Acta Med Iran. 2014; 52(12):909-15.
[5] Anaraki AN, Mirzaei K. The effect of different intrathecal doses of meperidine on shivering during delivery under spinal anesthesia. Int J Prev Med. 2012; 3(10):706-12.
[6] Rastegarian A, Ghobadifar MA, Kargar H, Mosallanezhad Z. Intrathecal meperidine plus lidocaine for prevention of shivering during cesarean section. Korean J Pain. 2013; 26(4): 379-86.
[7] Shami S, Nasseri K, Shirmohammadi M, Sarshivi F, Ghadami N, Ghaderi E, Pouladi M, Barzanji A. Effect of low dose of intrathecal pethidine on the incidence and intensity of shivering during cesarean section under spinal anesthesia: a randomized, placebo-controlled, double-blind clinical trial. Drug Des Devel Ther. 2016; 10: 3005–3012.
[8] Farzi F, Mirmansouri A, Forghanparast K, Heydarzadeh A, Abdollahzadeh M, Moghadam FJ. Addition of intrathecal fentanyl or meperidine to lidocaine and epinephrine for spinal anesthesia in elective cesarean delivery. Anesth Pain Med. 2014;4(1):e14081.
[9] Çakırtekin V, Yıldırım A, Bakan N, Çelebi N, Bozkurt Ö. Comparison of the effects of thiopental sodium and propofol on haemodynamics, awareness and newborns during caesarean section under general anaesthesia. Turk J Anaesthesiol Reanim. 2015; 43(2):106-12.
[10] Jaafarpour M, Taghizadeh Z, Shafiei E, Vasigh A, Sayehmiri K. The Effect of Intrathecal Meperidine on Maternal and Newborn Outcomes After Cesarean Section: A Systematic Review and Meta-Analysis Study. Anesth Pain Med. 2020;10(2):e100375.
[11] Vassiliadis RM, Taylor PG. Spinal pethidine for elective caesarean section. Anaesth Intensive Care. 2013; 41(1):113-5.
[12] Camann WR, Bader AM. Spinal anesthesia for cesarean delivery with meperidine as the sole agent. Int J Obstet Anesth. 1992; 1(3):156-8.
[13] Bakhsha F, Behnampour N. Saddle block anaesthesia with meperidine for perineal surgery. Journal of Clinical and Diagnostic Research. 2010;4(1).
[14] Pandu Naik R, Chandra Shekar N, Pooja J, Raghuram CG. “Intrathecal Pethidine as a Sole Anesthetic Agent for Lower Limb Surgeries”. Journal of Evidence based Medicine and Healthcare. 2015; 2(39):6291-6299.
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IssueVol 7 No 3 (2021): Summer QRcode
SectionCase Report(s)
Published2021-07-31
DOI https://doi.org/10.18502/aacc.v7i3.6908
Keywords
Opioid Pethidine Cesarean Section Spinal Anesthesia

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How to Cite
1.
Hassannasab S, Mirkatouli A, Jabbari A. Intrathecal Pethidine as a Sole Anesthetic Agent in Cesarian Section: Case Report for Clinical Education. Arch Anesth & Crit Care. 2021;7(3):180-182.