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Revista Cubana de Anestesiología y Reanimación

2020, Number 2

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Revista Cubana de Anestesiología y Reanimación 2020; 19 (2)

Spinal cord anesthesia with meperidine in a patient with hypersensitivity to local anesthesia

Pineda GAR, Aparicio MAI

Language: Spanish
References: 14
Page: 1-9
PDF size: 254.25 Kb.


ABSTRACT

Introduction: Meperidine (or pethidine) is a synthetic opioid with well-known local anesthetic properties. It has been safely used intrathecally in general, urological and obstetric surgery. This can be used in spinal anesthesia in patients with hypersensitivity to local anesthetics.
Objective: To describe anesthetic management of a patient with hypersensitivity to local anesthetics with the use of intrathecal meperidine.
Case presentation: The case is presented of a 54-year-old female patient with a previous history of hypersensitivity to local anesthetics, scheduled for anterior colporrhaphy, who is performed regional technique, administering intrathecal meperidine. For post-operative analgesia, diclofenac sodium was administered intravenously in a single dose of 75 mg before the incision.
Conclusions: The described technique allowed to achieve adequate sensory and motor block, stability of intraoperative vital signs, and optimal recovery in the immediate postoperative period. It is another alternative in the management of patients with hypersensitivity to local anesthetics.


REFERENCES

  1. Bujedo BM. Current Evidence for Spinal Opioid Selection in Postoperative Pain. The Korean Journal of Pain. 2014[acceso: 10/03/2019];27(3):200-9. Disponible en: http://dx.doi.org/10.3344/kjp.2014.27.3.200

  2. Brull R, Macfarlane A, Chan VW. Anestesia intradural, epidural y caudal. En: Miller RD, Cohen NH, Eriksson L, Fleisher L, Kronish JW, Young W. Miller Anestesia. 8th ed. New York: Elsevier; 2016. p. 1684-1720.

  3. Norris MC. Neuraxial anesthesia. En: Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, Ortega R, et al. Clinical Anesthesia. 8 ed: Wolters Kluwer; 2017. p. 2273-2343.

  4. Chun DH, Kil HK, Kim HJ, Park C, Chung KH. Intrathecal meperidine reduces intraoperative shivering during transurethral prostatectomy in elderly patients. Korean Journal of Anesthesiology. 2010[acceso: 10/03/2019];59:389-93. Disponible en: http://refhub.elsevier.com/S2255-4963(14)00034-8/sbref0020

  5. Khan ZH, Zanjani AP, Makarem J, Samadi S. Antishivering effects of two different doses of intrathecal meperidine in caesarean section: a prospective randomised blinded study. European Journal of Anesthesiology. 2011[acceso: 10/03/2019];28:[202-6]. Disponible en: http://refhub.elsevier.com/S2255-4963(14)00034-8/sbref0025

  6. Pardo MC, Miller RD. Basics of Anesthesia. 7 ed: Elsevier; 2018. 869 p.

  7. Rodríguez M, Meana Báez Z, Delgado Ramos G, Delgado Ramos A. Meperidina intratecal en cirugía anorrectal. Rev Cubana de Anestesiol y Rean. 2004;3(1):12-21.

  8. Hernández Ortega R, González Alfonso O, Hidalgo Menéndez PA. Analgesia subaracnoidea con meperidina en la cirugía ginecológica de pacientes con hipertensión arterial. Rev. CorSalud. 2011;3(4):216-23.

  9. Bujedo BM. Recommendations for spinal opioids clinical practice in the management of postoperative pain. Journal of Anesthesiology & Clinical Science. 2013[acceso: 10/03/2019];2(28). Disponible en: http://www.hoajonline.com/journals/pdf/2049-9752-2-28.pdf

  10. Kee WDN. Epidural pethidine: pharmacology and clinical experience. Anaesth Intensive Care. 1998[acceso: 22/02/2018];26:247-55. Disponible en: http://www.ncbi.nlm.nih.gov/ pubmed/9619217?dopt=Citation

  11. Deer TR, Leong MS, Buvanendran A, Kim PS, Panchal SJ. Treatment of Chronic Pain by Interventional Approaches. Textbook on Patient Management: Springer; 2015. 554 p.

  12. Leo ED, Donne PD, Calogiuri GF, Macchia L, Nettis E. Focus on the agents most frequently responsible for perioperative anaphylaxis. Clinical and Molecular Allergy. 2018[acceso: 10/03/2019];16(16):1-6. Disponible en: https://doi.org/10.1186/s12948-018-0094-7

  13. Valencia MIB. Perioperative anaphylaxis. Revista Brasileira de Anestesiologia 2015[acceso: 10/03/2019];65(4):292-7. Disponible en: http://dx.doi.org/10.1016/ j.bjane.2014.09.002

  14. Finsterwald M, Muster M, Farshad M, Saporito A, Brada M, Aguirre JA. Spinal versus general anesthesia for lumbar spine surgery in high risk patients: Perioperative hemodynamic stability, complications and costs. Journal of Clinical Anesthesia. 2018[acceso: 22/03/2019];46:3-7. Disponible en: https://doi.org/10.1016/j.jclinane. 2018.01.004




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