The comparison of the intrathecal pethidine with intrathecal bupivacaine in transurethral resection of prostate

Abstract

The aim of this study is to compare the haemo- dynamic effects, and possible complications of intra- thecal pethidine with intrathecal bupivacaine in transurethral resection of prostate (TURP) in benign prostatic hyperplasia. Forty patients in ASA il risk group were allocated randomly to one of two groups; in Group 1 (n=20) patients, spinal anaesthesia was applied by administration of intrathecal 12.5 mg bupivacaine, and in Group il (n::20) patients by 0.75 mg/kg 5 % pethidine. The time for sensorial and motor block was studied. Complications were noted. Duration of sensorial blockade was longer in bupivacaine group than in pethidine group (171 min, and 84. 7 min respectively). The time for completion of regression of block to fıfth lumbar dermatom (353.5 min, and 145.5 min. respectively) and the time for regression of all motor function (348.5 min, and 101.25 min respectively) was longer in bupivacaine group than pethidine group, which was statistically signifıcant (p<0.05). There was no statistically signifıcant difference in heart rate (HR) and mean arterial pressure (MAP) between two groups. There was a decrease in HR and MAP within groups but was not statistically signifıcant. Respiratory depression was not seen in any patient, and oxygen saturation of arterial pulse did not decrease under 95%. Nausea was observed in 3 patients in bupivacaine group, and 5 patients in pethidine group. Ephedrine was needed in 2 patients in pethidine group. Pruritus was not seen in bupivacaine group, but in 3 patients in pethidine group. Midazolam, totally 2 mg. to each patient, was given to 3 patients in bupivacaine group, and 4 in pethidine group,. Atropin was given to 4 patients in bupivacaine group and 5 patients in pethidine group. Drowsiness was seen only in 1 patient in pethidine group. As a result, it is concluded that intrathecal pethidine can be used as bupivacaine in TURP operations, and this cheaper technique can be an alternative in allergic patients to loca! anaesthetics.