What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study

ÖZMEN, Özgür; AKSOY, Mehmet; doymuş, ömer; Cesur, Mehmet; Ince, Ilker; Dostbil, Aysenur; bayar, fikret

doi:10.14744/agri.2020.90377

What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study

Fikret BAYAR, (Sakarya Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Sakarya, Türkiye)

Mehmet CESUR, (Gaziantep Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Gaziantep, Türkiye)

Mehmet AKSOY, (Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Erzurum, Türkiye)

Aysenur DOSTBIL, (Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Erzurum, Türkiye)

Ilker INCE, (Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Erzurum, Türkiye)

Ömer DOYMUŞ, (Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Erzurum, Türkiye)

Özgür ÖZMEN (Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Erzurum, Türkiye)

Ağrı

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Yıl: 2021 Cilt: 33 Sayı: 1 Sayfa Aralığı: 28 - 35 Metin Dili: İngilizce DOI: 10.14744/agri.2020.90377 İndeks Tarihi: 03-05-2021

What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study

Öz:

Objectives: This study was an analysis of the effect of different dosages of intrathecal meperidine (40 mg, 50 mg, 60 mg, and70 mg) on hemodynamic parameters, the duration of neural blockade, and the incidence of meperidine-related side effects inpatients who underwent an open prostatectomy.Methods: Sixty patients who underwent an open prostatectomy with combined spinal-epidural anesthesia were included.The patients were allocated to receive 1 of 4 different dosages of intrathecal meperidine (n=15 for each group): Group I: 40 mg,Group II: 50 mg, Group III: 60 mg, and Group IV: 70 mg. The duration of the block procedure, surgery duration, highest sensoryblock level, and anesthetic complications were recorded and analyzed.Results: At 20 minutes after the spinal injection, the maximum sensory block level was T6 in Group I and II, and it was T5 inGroup III and IV. The mean motor block scores at 20 minutes after the spinal injection were lower in Group I compared withthe other groups (p<0.001 for all). The motor block duration was significantly shorter in Group I and II than in Group III and IV(p<0.001 for all). Surgeon satisfaction was greater in Group II, III, and IV compared with Group I (p<0.001 for all). Patient satisfaction was better in Group III and IV compared with Groups I and II (p<0.001 for all).Conclusion: Intrathecal meperidine at a dose of 60 mg exerted a sufficient analgesic effect with minimum side effects inpatients undergoing open prostatectomy.

Anahtar Kelime:

Açık prostat cerrahisinde intratekal meperidinin optimal dozu nedir? Bir prospektif çift-kör randomize çalışma

Öz:

Amaç: Bu çalışmada; açık prostatektomi uygulanan hastalarda, farklı dozlarda intratekal meperidinin (40 mg, 50 mg, 60 mg ve 70 mg) hemodinamik parametreler, nöral blokaj süresi ve meperidine bağlı yan etki görülme sıklığı üzerindeki etkisini araştırdık. Gereç ve Yöntem: Kombine spinal epidural anestezi ile açık prostatektomi uygulanan 60 hasta çalışmaya alındı. Hastalar dört doz intratekal meperidinden birini almak üzere (her grup için n=15) sahip olmak üzere ayrıldı: Grup I: 40 mg, Grup II: 50 mg, Grup III: 60 mg, Grup IV: 70 mg. Blok işleminin süresi, ameliyat süresi, en yüksek duyusal blok düzeyi ve anestezik komplikasyonlar kaydedildi. Bulgular: Spinal enjeksiyondan 20 dakika sonra, grup I ve II’de maksimum duyusal blok seviyesi T6 idi ve grup III ve IV’de T5 idi. Spinal enjeksiyondan 20 dakika sonra ortalama motor blok skorları grup I’de diğer gruplara göre daha düşük olarak bulundu (hepsi için p<0.001). Motor blok süresi grup I ve II’de grup III ve IV’e göre anlamlı olarak daha kısaydı (hepsi için p<0.001). Cerrah memnuniyeti grup II, III ve IV’de grup I’e göre daha iyiydi (hepsi için p<0.001). Hasta memnuniyeti, grup I ve II’ye göre grup III ve IV’de daha iyiydi (hepsi için p<0.001). Sonuç: Altmış mg dozda intratekal meperidin açık prostatektomi uygulanan hastalarda minimum yan etki ile yeterli analjezik etki gösterir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Kanonidou Z, Karystianou G. Anesthesia for the elderly. Hippokratia 2007;11(4):175–7.
2. Salonia A, Suardi N, Crescenti A, Colombo R, Rigatti P, Montorsi F. General versus spinal anesthesia with different forms of sedation in patients undergoing radical retropubic prostatectomy: results of a prospective, randomized study. Int J Urol 2006;13(9):1185–90.
3. Naguib M, Famewo CE, Absood A. Pharmacokinetics of meperidine in spinal anaesthesia. Can Anaesth Soc J 1986;33(2):162–6.
4. Davoudi M, Mousavi-Bahar SH, Farhanchi A. Intrathecal meperidine for prevention of shivering during transurethral resection of prostate. Urol J 2007;4(4):212–6.
5. Chun DH, Kil HK, Kim HJ, Park C, Chung KH. Intrathecal meperidine reduces intraoperative shivering during transurethral prostatectomy in elderly patients. Korean J Anesthesiol 2010;59(6):389–93.
6. Hansen D, Hansen S. The effects of three graded doses of meperidine for spinal anesthesia in African men. Anesth Analg 1999;88(4):827–30.
7. Honarmand A, Safavi M, Dadkhah S, Amoushahi M. The effects of different doses of intrathecal meperidine on the incidence and severity of shivering during lower extremity orthopedic surgery under spinal anesthesia: A randomized, placebo-controlled, double blind-clinical trial. Adv Biomed Res 2015;4:3.
8. Roy JD, Girard M, Drolet P. Intrathecal meperidine decreases shivering during cesarean delivery under spinal anesthesia. Anesth Analg 2004;98(1):230–4.
9. Atalay C, Aksoy M, Aksoy AN, Dogan N, Kürsad H. Combining intrathecal bupivacaine and meperidine during caesarean section to prevent spinal anaesthesia-induced hypotension and other side-effects. J Int Med Res 2010;38(5):1626–36.
10. Booth JV, Lindsay DR, Olufolabi AJ, El-Moalem HE, Penning DH, Reynolds JD. Subarachnoid meperidine (Pethidine) causes significant nausea and vomiting during labor. The Duke Women’s Anesthesia Research Group. Anesthesiology 2000;93(2):418–21.
11. Grace D, Fee JP. Anaesthesia and adverse effects after intrathecal pethidine hydrochloride for urological surgery. Anaesthesia 1995;50(12):1036–40.
12. Wantman A, Hancox N, Howell PR. Techniques for identifying the epidural space: a survey of practice amongst anaesthetists in the UK. Anaesthesia 2006;61(4):370–5.
13. Bakhsha F, Behnampour N. Saddle block anaesthesia with meperidine for perineal surgery. J Clin Diagn Res 2010;3:2010–7.
14. Yaksh TL. Spinal opiate analgesia: characteristics and principles of action. Pain 1981;11(3):293–346.
15. Famewo CE, Naguib M. Spinal anaesthesia with meperidine as the sole agent. Can Anaesth Soc J 1985;32(5):533– 7.
16. Ehikhametalor KO, Nelson M. Intrathecal pethidine as sole anaesthetic agent for operative procedures of the lower limb, inguinal area and perineum. West Indian Med J 2001;50(4):313–6.
17. 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.
18. Najafi Anaraki A, Abbasi M, Anvarypour A, Motamed N. The effects of Adding Meperidine to Heavy Intrathecal Lidocaine on Hemodynamic Changes and Blood Loss in Open Prostatectomy: A Randomized Double-Blind Clinical Trial. Iran J Med Sci 2012;37(1):15–22.
19. Heidegger T, Saal D, Nübling M. Patient satisfaction with anaesthesia - Part 1: satisfaction as part of outcome - and what satisfies patients. Anaesthesia 2013;68(11):1165–72.
20. Canakcı E, Tas N, Yagan O, Mutlu T, Benli E, Cırakoglu A. The Effect of Different Intrathecal Doses of Meperidine on Postoperative Pain Relief in Patients Undergoing TURP Surgery. J Anest and Inten Care Med 2017;2(1):555580.

APA	bayar f, Cesur M, AKSOY M, Dostbil A, Ince I, doymuş ö, ÖZMEN Ö (2021). What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study. , 28 - 35. 10.14744/agri.2020.90377
Chicago	bayar fikret,Cesur Mehmet,AKSOY Mehmet,Dostbil Aysenur,Ince Ilker,doymuş ömer,ÖZMEN Özgür What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study. (2021): 28 - 35. 10.14744/agri.2020.90377
MLA	bayar fikret,Cesur Mehmet,AKSOY Mehmet,Dostbil Aysenur,Ince Ilker,doymuş ömer,ÖZMEN Özgür What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study. , 2021, ss.28 - 35. 10.14744/agri.2020.90377
AMA	bayar f,Cesur M,AKSOY M,Dostbil A,Ince I,doymuş ö,ÖZMEN Ö What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study. . 2021; 28 - 35. 10.14744/agri.2020.90377
Vancouver	bayar f,Cesur M,AKSOY M,Dostbil A,Ince I,doymuş ö,ÖZMEN Ö What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study. . 2021; 28 - 35. 10.14744/agri.2020.90377
IEEE	bayar f,Cesur M,AKSOY M,Dostbil A,Ince I,doymuş ö,ÖZMEN Ö "What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study." , ss.28 - 35, 2021. 10.14744/agri.2020.90377
ISNAD	bayar, fikret vd. "What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study". (2021), 28-35. https://doi.org/10.14744/agri.2020.90377

APA	bayar f, Cesur M, AKSOY M, Dostbil A, Ince I, doymuş ö, ÖZMEN Ö (2021). What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study. Ağrı, 33(1), 28 - 35. 10.14744/agri.2020.90377
Chicago	bayar fikret,Cesur Mehmet,AKSOY Mehmet,Dostbil Aysenur,Ince Ilker,doymuş ömer,ÖZMEN Özgür What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study. Ağrı 33, no.1 (2021): 28 - 35. 10.14744/agri.2020.90377
MLA	bayar fikret,Cesur Mehmet,AKSOY Mehmet,Dostbil Aysenur,Ince Ilker,doymuş ömer,ÖZMEN Özgür What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study. Ağrı, vol.33, no.1, 2021, ss.28 - 35. 10.14744/agri.2020.90377
AMA	bayar f,Cesur M,AKSOY M,Dostbil A,Ince I,doymuş ö,ÖZMEN Ö What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study. Ağrı. 2021; 33(1): 28 - 35. 10.14744/agri.2020.90377
Vancouver	bayar f,Cesur M,AKSOY M,Dostbil A,Ince I,doymuş ö,ÖZMEN Ö What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study. Ağrı. 2021; 33(1): 28 - 35. 10.14744/agri.2020.90377
IEEE	bayar f,Cesur M,AKSOY M,Dostbil A,Ince I,doymuş ö,ÖZMEN Ö "What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study." Ağrı, 33, ss.28 - 35, 2021. 10.14744/agri.2020.90377
ISNAD	bayar, fikret vd. "What is the optimal dose of intrathecal meperidine in open prostate surgery? A prospective double-blind randomized study". Ağrı 33/1 (2021), 28-35. https://doi.org/10.14744/agri.2020.90377