Pethidine as a regional intravenous anaesthetic agent

ABSTRACT

Pethidine hydrochloride [100 mg diluted in 30-40 ml saline] was compared with lidocaine hydrochloride [0.5 mg/kg in 5% solution 30-40 ml] for intravenous regional anaesthesia [IVRA] for upper limb surgery. The onset, degree of analgesia need for supplementary analgesia, cardiovascular respiratory changes and motorparalysis during and after release of the tourniquet, the need for post-operative analgesia and any complications due to its use for this procedure were determined. Pethidine hydrochloride provided excellent analgesia in 75.7% of cases comparable to 70% in case of lidocaine hydrochloride. The onset of analgesia was prolonged but of longer duration after release of tourniquet, no cardiovascular or respiratory complications were noticed with the two studied drugs. Poor analgesia was noticed in 9.1% of wrist and fingers operations, which Suggested that the mechanism of analgesia is due to blockage of small nerves or possibly sensory nerve endings and not major nerve trunks at the elbow as has been suggested previously for local anaesthetic. No motor paralysis was noticed. It also has the advantage of prolonged postoperative analgesia. So it could be used safely for the procedure of IVRA