A Comparison of Effects of lidocaine 5%، lidocaine 5% plus pethidine 5% and pethidine 5% in spinal anesthesia for cesarean section.

Spinal anesthesia for elective cesarean section using drugs such as lidocaine has long been used with reports of various complications. To reduce these complications, many methods such as administration of sympathetic stimulating drugs like ephedrine, and using other drugs including pethidine have been recommended. The present study was aimed to evaluate comparatively the effects of separate and combined administration of pethidine and lidocaine on spinal anesthesia in candidates for cesarean surgery. In this double blind clinical trial study, 150 cases with ASA I – II and full term neonatal, candidate for elective cesarean surgery from Zahedan Ghods Hospital and Ali-Ebene-Abitaleb Hospital, were subjected to the study during 2001-2004. They were randomly divided into three groups of 50, for using 5% lidocaine, 5% lidocaine plus 5% pethidine and 5% pethidine, respectively. A number of variables, including duration of postoperative analgesia, variation of homodynamic, heart rate, hypotension, nausea and vomiting were assessed. Statistical descriptive methods, one way ANOVA and X2 were used for the data analysis. Breath depression was not seen in the neonates. The Apgar score was ≥8. Duration of post operating analgesia was 453 minutes in pethidine group, 344.3 minutes in lidocaine plus pethidine group and 141.4 minutes in lidocaine group with significant differences (P<0.05). Differences of nausea and vomiting between groups were not significant. The longest duration of analgesia was seen with pethidine usage. The combination of pethidine and lidocaine was intermediately effective and seems to be suitable choice in anesthesia comparing to lidocaine alone.