• C O Imarengiaye, F D Asudo, D D Akpoguado, I I Akhideno, C E Omoifo, and A T Ogunsakin.
• Department of Anaesthesiology, University of Benin Teaching Hospital, PMB 1111, Benin City. Nigeria. esemama@yahoo.co.uk
• Niger Postgrad Med J. 2011 Sep 1;18(3):200-4.

Aims And ObjectivesThis study determined the quality of perioperative analgesia and side effect profile of spinal bupivacaine plus pethidine for caesarean section.Patients And MethodsPatients were randomised to receive 2.0mL of bupivacaine + pethidine 7.5mg or 2.0mL bupivacaine + saline of equal volume. Spinal anaesthesia was instituted at L2/3, L3/4 or L4/5 using a 25G pencil point spinal needle. Heart rate, blood pressure and oxygen saturation were monitored. Timelines such as time of injection of study medication, skin incision, delivery time, termination of surgery and time to first request for analgesia as well as complications were noted. Demographic characteristics were also recorded.Results50 patients were studied in 2 groups and the demographic characteristics were similar. Addition of pethidine resulted in block height greater than T6 and longer duration of analgesia (256.9 ± 112.2 min.) compared with the saline group (160.5 ± 65.0 min; p = 0.0005). Maternal hypotension occurred more in the pethidine group (10/25 vs 2/25; p = 0.01). Peritoneal irritation and inadequate anaesthesia were more frequent in the saline group. Nausea and vomiting and drowsiness were mild and occurred only in the pethidine group. In the Post Anaesthetic Care Unit (PACU), more patients reported pain in the saline group (p = 0.002).ConclusionBupivacaine with pethidine 7.5mg resulted in better quality of anaesthesia, longer postoperative analgesia with acceptable side effect profile. This will be of value in the management of post-caesarean section pain particularly in the resource poor setting.

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