Comparison of Hemodynamic Stability in Patients with Intrathecal 0.75% Hyperbaric Bupivacaine Alone and with Pethidine

Abstract

Objective: To find out better hemodynamic stability in patients with intrathecal 0.75% hyperbaric bupivacaine
alone and with pethidine.
Study Design: Quasi experimental
Place and Duration: This study was conducted in department of Anesthesiology. Combined Military Hospital
Multan from 2-3-23 to 2-12-23 total duration of the study was 6 months.
Methodology: Pregnant women numbering 80 with gravidity 2 undergoing elective lower segment cesarean
section surgery meeting the inclusion criteria were selected. They were divided in two equal groups A and B,
n-40 each. Group A received 10mg of 0.75% bupivacaine whereas group B were injected with 7.5mg of 0.75%
bupivacaine plus 25mg of pethidine. Comparative decrease in blood pressure in terms of ‘mean arterial pressure’, incidence of hypotension, bradycardia, nausea and post spinal shivering were noted.
Results: Mean Arterial Pressure (MAP) decreased in both groups at 2.5-minute post intrathecal injection but
this decline was more prominent in group A 70±2 versus 80±3 for group B respectively (p 0.001). At I0 minute
the decline in MAP was lesser but the difference between the two groups remained significant statistically. Similarly, frequency of bradycardia and post-op shivering remained on the lower side in group B. The major difference was seen in the frequency of hypotension in both the groups.
Conclusion: Addition of pethidine to bupivacaine for intrathecal use keeps the hemodynamic profile of the patients
relatively more stable and thus avoids the feto-maternal adverse events.