This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Khaw, K.S. Articles by Critchley, L.A.H. Search for Related Content PubMed PubMed Citation Articles by Khaw, K.S. Articles by Critchley, L.A.H. Related Collections Obstetrical and Pediatric Anesthesia

Epidural meperidine does not cause hemodynamic changes in the term parturient

From the Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, Peoples Republic of China.

Dr K.S. Khaw. Phone: +852-2632-2735; Fax: +852-2637-2422; E-mail: kimkhaw{at}cuhk.edu.hk

Purpose: Meperidine has local anesthetic properties and, therefore, when given epidurally it has the potential to cause hemodynamic changes. Our objective was to study the hemodynamic effects of an analgesic dose of epidural meperidine (50 mg) in 34 ASA 1-2 term parturients scheduled for elective Cesarean section under epidural anesthesia.

Methods: A lumbar epidural catheter was inserted and patients lay in the supine left wedge position. Intravenous fluid preload was withheld, and hemodynamic measurements comprising of mean arterial pressure, cardiac output and heart rate were made using automatic oscillotonometry (Dinamap 1486SX) and transthoracic electrical bioimpedance (Bomed NCCOM3). Following baseline measurements, the hemodynamic effects of sequential epidural injection of first, 10 ml saline, and 20 min thereafter, 50 mg meperidine diluted to 10 ml with saline, were recorded. Sensory blockade was assessed following each injection using loss of temperature discrimination to ice. Paired Student t tests were used to compare changes in hemodynamic variables.

Results: Epidural meperidine produced a small increase from the saline values in the mean (SD) cardiac output of 5.81 ±1.44 to 6.04 ± 1.54 Lmin^–1 (P < 0.05), and mean arterial pressure of 77.1 ± 8.8 to 79.3 ± 9.9 mmHg (P < 0.05). Sensory changes, the upper level of which ranged from L1 to T1, were detected in 94% of patients given epidural meperidine. Epidural saline injection had no such hemodynamic effects, but produced a detectable sensory level in two patients.

Conclusion: Epidural meperidine, 50 mg, caused minimal hemodynamic changes in term parturients.

This article has been cited by other articles:

				C. Connolly, D. M. Coventry, and J. A. W. Wildsmith Double-blind comparison of ropivacaine 7.5 mg ml-1 with bupivacaine 5 mg ml-1 for sciatic nerve block Br. J. Anaesth., May 1, 2001; 86(5): 674 - 677. [Abstract] [Full Text] [PDF]