medigraphic.com
ISSN 2078-7170 (Electronic)

2023, Number 1

<< Back Next >>

CorSalud 2023; 15 (1)

Intrathecal meperidine in the emergency surgery of a patient with ischemic heart disease

Borló SD, Hernández OR, Sánchez HY, Cleger CM, Fernández DD, Hernández MEM

Language: Spanish
References: 18
Page: 75-79
PDF size: 415.19 Kb.


ABSTRACT

Intrathecal meperidine has been used in a wide variety of surgical procedures for both anesthetic and analgesic purposes. To demonstrate its utility as an anesthetic agent via this route of administration in patients with ischemic heart disease, we present the case of a 71-year-old woman with a history of vasospastic angina and left bundle branch block. She was obese, had difficult intubation, and was being treated with diltiazem but was decompensated at the time of surgery, scheduled urgently for the surgical treatment of bladder bleeding. A regional technique was performed with intrathecal meperidine at 1 mg/kg. It was concluded that the use of meperidine promotes hemodynamic stability, provides adequate trans and postoperative analgesia, and results in minimal motor block. This allows for a prompt anesthetic recovery with the least ischemic complications.


REFERENCES

  1. Pirie K, Traer E, Finniss D, Myles PS, Riedel B. Current approaches to acute postoperative pain management after major abdominal surgery: a narrative review and future directions. Br J Anaesth. 2022;129(3):378-93. DOI: https://doi.org/10.1016/j.bja.2022.05.029

  2. Sivevski AG, Karadjova D, Ivanov E, Kartalov A. Neuraxial Anesthesia in the Geriatric Patient. Front Med (Lausanne) [Internet]. 2018 [citado 14 Ene 2022];5:254. Disponible en: https://doi.org/10.3389/fmed.2018.00254

  3. Brull R, Macfarlane AJ, Chan VW. Anestesia intradural, epidural y caudal. En: Miller RD, Cohen NH, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Young WL, eds. Miller Anestesia. 8Ş ed. Barcelona: Elsevier; 2016. pp. 1684-720.

  4. Cosgrave D, Shanahan E, Conlon N. Opiodes intratecales. World Federation of Societies of Anesthesiologists [Internet]. 2017 [citado 14 Ene 2022]. Disponible en: https://resources.wfsahq.org/atotw/opiodes-intratecales/

  5. Krishna Prasad GV, Khanna S, Jaishree SV. Review of adjuvants to local anesthetics in peripheral nerve blocks: Current and future trends. Saudi J Anaesth. 2020;14(1):77-84. DOI: https://doi.org/10.4103/sja.sja_423_19

  6. Pineda González AR, Aparicio Morales AI. Anestesia espinal con meperidina en paciente con hipersensibilidad a anestésicos locales. Rev Cuba Anestesiol Reanim [Internet]. 2020 [citado 14 Ene 2022];19(2). Disponible en: https://revanestesia.sld.cu/index.php/anestRean/article/view/587

  7. Sharma S, Arora L. Anesthesia for the Morbidly Obese Patient. Anesthesiol Clin. 2020;38(1):197-212. DOI: https://doi.org/10.1016/j.anclin.2019.10.008

  8. 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. J Clin Anesth. 2018;46:3-7. DOI: https://doi.org/10.1016/j.jclinane.2018.01.004

  9. Mugabure Bujedo B, González Santos S, Uría Azpiazu A, Torán García L. Actualizaciones en el manejo clínico de los opioides espinales en el dolor agudo postoperatorio. Rev Soc Esp Dolor. 2012;19(2):72-94. Enlace: https://www.resed.es/Documentos/ArticulosNew/05revisionmbe.pdf

  10. Patel D, Janardhan Y, Merai B, Robalino J, Shevde K. Comparison of intrathecal meperidine and lidocaine in endoscopic urological procedures. Can J Anaesth. 1990;37(5):567-70. DOI: https://doi.org/10.1007/bf03006327

  11. Soriano Hernández IL, Alvarado Ramos JG, Villareal Guzmán RA, Morales Gaytán J. Manejo anestésico con meperidina intratecal en operación cesárea. Rev Sanid Mil. 1999;53(4):238-40. Enlace: https://www.imbiomed.com.mx/articulo.php?id=9873

  12. Booth JV, Lindsay DR, Olufolabi AJ, El-Moalem HE, Penning DH, Reynolds JD. Subarachnoid meperidine (Pethidine) causes significant nausea and vomiting during labor. The Duke Women's Anesthesia Research Group. Anesthesiology. 2000;93(2):418-21. DOI: https://doi.org/10.1097/00000542-200008000-00020

  13. Sinatra RS, Ayoub CM. Postoperative analgesia: Epidural and spinal techniques. En: Chestnut DH, ed. Obstetric Anesthesia: Principles and Practice. 2Ş ed. St. Louis: Mosby; 1999. pp. 521‐55.

  14. Di Leo E, Delle Donne P, Calogiuri GF, Macchia L, Nettis E. Focus on the agents most frequently responsible for perioperative anaphylaxis. Clin Mol Allergy [Internet]. 2018 [citado 17 Ene 2022];16:16. Disponible en: https://doi.org/10.1186/s12948-018-0094-7

  15. Soreingam K, Singh TH, Thokchom RS, Singh YA, Meitei AJ, Singh SS. Comparative study of intravenous ondansetron and intrathecal fentanyl for prevention of perioperative nausea and vomiting during caesarean delivery under spinal anaesthesia with hyperbaric bupivacaine. IOSR J Dent Med Sci. 2017;16(4):22-6. DOI: https://doi.org/10.9790/0853-1604022226

  16. Semiz A, Akpak YK, Yılanlıoğlu NC, Babacan A, Gönen G, Çam Gönen C, et al. Prediction of intraoperative nausea and vomiting in caesarean delivery under regional anaesthesia. J Int Med Res. 2017;45(1):332-9. DOI: https://doi.org/10.1177/0300060516680547

  17. Jelting Y, Klein C, Harlander T, Eberhart L, Roewer N, Kranke P. Preventing nausea and vomiting in women undergoing regional anesthesia for cesarean section: challenges and solutions. Local Reg Anesth. 2017;10:83-90. DOI: https://doi.org/10.2147/lra.s111459

  18. Chooi C, Cox JJ, Lumb RS, Middleton P, Chemali M, Emmett RS, et al. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database Syst Rev [Internet]. 2017 [citado 20 Ene 2022];8(8):CD002251. Disponible en: https://doi.org/10.1002/14651858.cd002251.pub3




2020     |     www.medigraphic.com