Intrathecal meperidine with isobaric lidocaine versus intrathecal hyperbaric bupivacaine for transurethral resection of the prostant [TURP]

ABSTRACT

We administered subarachnoid block, at L 2-3 or L 3-4 interspace in two groups of patients, 20 patients each according to the analgesic used. Group A received 15 mg 0.5% hyperbaric bupivacaine and group B received 60 mg 2% lidocaine with 20 mg meperidine. Patients were observed until anaesthesia descended to less than sacral [S1], criteria of spinal anaesthesia as well as haemodynamic changes have been evaluated. There was significant difference between bupivacaine [group A] and lidocaine meperidine [group B] in all criteria of induction and recovery of spinal block. Time to T10 block was 6.1 ["2.2] min. in group A, versus 3.2 ["1.1] min. in group B, Time of full motor block was 14.2 ["4.1] min. in group A, versus 9.2["2.7] min. in group B, duration of motor block was 182["29.1] min. in group A versus 122["23.3] in group B, and duration of sensory block to S1 was 320["30.3] min. in group A, versus 195["22.3] min. in group B. Regarding haemodynamic changes heart rate showed significant decrease during recovery in group A patients. Pruritis and respiratory depression were recorded only in group B, but they were very mild and need no treatment. We concluded that, the use of lidocaine in moderate dose with 20 mg meperidine intrathecally represented an excellent alternative to intrathecal hyperbaric bupivacaine for TURP Surgery in elderly patients