Abstract PR492

Abstract

Background & Objectives: Spinal anaesthesia is a cheaper alternative to general anaesthesia for surgical procedures below the umbilicus. Bupivacaine is commonly used for spinal anaesthesia following the withdrawal of hyperbaric lidocaine. Pethidine, a lipophilic opioid with local anaesthetic activity is used for spinal. This study seeks to compare the immediate postoperative complications and recovery profile following spinal anaesthesia with pethidine and bupivacaine as sole agents. Materials & Methods: Fifty two ASA I and II patients, aged between 18 and 60 years, were randomized to receive spinal anaesthesia for short surgical procedures of the lower body. The patients were either given preservative-free pethidine 1mg/Kg (n=26) or 2.5mL isobaric 0.5% bupivacaine (n=26), and the time to recovery of pinprick sensation at S2, plantar flexion, proprioception of the big toe, and full motor recovery (Bromage score 0), were compared. Complications of pain, sedation, nausea and vomiting, pruritus and urinary retention in the immediate postoperative period were compared. Results: The time to return of pinprick sensation at S2 was 94.62±20.25 minutes and 205.96±31.05 minutes for pethidine and bupivacaine respectively. The time to return of plantar flexion between pethidine and bupivacaine was 92.88±12.01 minutes and 193.85± 39.56 minutes respectively. The mean time to recovery of proprioception of the big toe between pethidine and bupivacaine 31.15±9.41 minutes and 172.50±42.70 minutes respectively. The time it took for complete motor recovery (Bromage score 0), between pethidine and Bupivacaine, was 47.89±14.08 minutes and 221.73±44.72 minutes respectively. All the differences in recovery times were significant (p<0.0001). There was no significant difference in the incidence of pain and sedation. Four patients (15.38%) in the Bupivacaine group experienced mild and tolerable pain. There was no incidence of nausea and vomiting in either group. However, five patients (19.22%) in the pethidine group experienced pruritus, while bupivacaine group recorded none. Three patients (11.54%) in the Bupivacaine group also had urinary retention, while pethidine group had none. Conclusion: Pethidine exhibited a shorter recovery profile than bupivacaine and also caused no significant complications in the immediate postoperative period. Regional anaesthesia with pethidine should therefore be considered for short duration and ambulatory surgery as an alternative to lignocaine. Disclosure of Interest: None declared